Psychiatrists urged to partner with radiation oncologist in caring for patients
Published:Thursday | October 31, 2024 | 12:12 AMAsha Wilks/Gleaner Writer
A local medical expert has encouraged psychiatrists to work jointly with radiation oncologists in providing patients with the holistic care they need as they wrestle with physical and mental health issues.
Speaking yesterday at the 31st National Science and Technology Conference organised by the Scientific Research Council (SRC) and the International Atomic Energy Agency (IAEA), psychiatrist Dr Geoffrey Walcott stated that patients who undergo radiation therapy often experience some level of anxiety, fear, and depression.
Walcott went on to say that due to this, patients require a certain degree of care, compassion, and empathy when doctors discuss with them diagnoses and treatment plans. This, he said, is because regardless of how well-adjusted a person is, this kind of news will undoubtedly begin to stir up some level of emotion and fear.
One of the panellists at the event was Marta Lamolla-Miret, who has battled cancer for more than three years and who has received radiation and chemotherapy.
Sharing her story through poetic expression, she outlined the various hardships she has had to endure.
“A wound in my soul, it is cancer. Everything started with those words,” she said, adding that the diagnosis felt as though the world was collapsing around her.
Continuing, she stated that “a crack” in her spirit opened up and left behind a wound.
“The cancer journey is very physical; a surgery, a huge scar in my breasts, more tests ... the rip in my spirit, though, seemed to get bigger and bigger, and I felt lost,” she said.
Lamolla-Miret further explained that as she underwent numerous treatments, she soon realised that she needed professional help for “the wounds in her soul” as while dealing with her diagnosis, her mind “couldn’t think clearly”.
Walcott noted that the psychiatric impact on these patients is broken down into two broad categories: the primary and secondary neuropsychiatric symptoms.
Among the most prevalent disorders experienced by patients receiving radiation therapy are anxiety, some phobias, and post-traumatic stress disorder.
“If it’s not handled appropriately, you can actually traumatise the patient by giving them the diagnosis and outlining the management plan, and, therefore, I want to underline again that, in discussions with our patients, we have to exercise high levels of compassion and empathy and understanding, and when in doubt, reach out to your friendly neighbourhood psychiatrist or psychologist for assistance,” Walcott said.
“In some studies, [it] is reported that as much as a third of your patients will have lingering anxiety disorders. Everyone will have an anxiety reaction, but someone will have an anxiety disorder,” Walcott said, noting that the difference is that the anxiety disorder is long lasting and can get worse over time while having a feeling of fear is an appropriate reaction that with discussions held with one’s doctor, usually goes away and does not come back.
He explained that the issue with the disorder is that it can cause recurrences as well as changes in how individuals perceive their situation, making them more anxious and aware of the fact that they are experiencing these attacks. This, in turn, can lead to a vicious cycle in which they worry about having an attack and then actually have one.
The secondary neuropsychiatric symptoms include radiation necrosis and endocrinopathies such as thyroid dysfunction and other hormonal issues.
Walcott shared that radiation necrosis was much like a cancer patient experiencing a recurrence as the agonising symptoms were similar.
He noted that as psychological trauma occurs among patients who have endured the difficult process of dealing with their tumours through radiation therapy and other cancer treatments. At the same time, for those who experience these symptoms again, because of a cancer recurrence, as they will have to go through the process again or deal with thoughts that “this is the end”, Walcott further urged his medical colleagues to stay in touch with their patients.
“One of the risks of all psychiatric illness is mortality (suicide),” he said, pointing out that, as such, they need to be extra careful as a result.
Highlighting how critical early detection of psychological issues faced by patients is and the importance of offering early interventions such as counselling and mental health support that is tailored to the unique emotional needs of these patients, Walcott said that psychiatrists must be familiar with the basic principles of radiation therapy and the neuropsychiatric sequelae and work closely with radiation oncologists because psycho trauma is prominent.
“It is really a holistic approach that we have to take and a very collaborative approach, and we often talk about that, but we recognise that in our different spheres and subdisciplines, we tend to be very isolated and see intrusions as minor irritations,” he said.