An NCI-designated Comprehensive Cancer Center
By Zen Vuong | August 13, 2018
Drs. Pal, Dorff and Loscalzo | City of Hope Solely treating a metastatic renal cell carcinoma patient’s body is not enough, City of Hope researchers say.
Patients with metastatic kidney cancer who have high rates of distress tend to have poorer overall survival compared to those with low distress, according to a new study by City of Hope researchers.
Although more research is needed to better understand this association, the study shows that biological, psychological and social factors – “biopsychosocial” factors – interact with and impact the health of patients with metastatic renal cell carcinoma, said Sumanta Kumar Pal, M.D., co-director of the Kidney Cancer Program at City of Hope and senior author of the study.
“Oftentimes we conceive how well a drug, radiation or surgery impacts patient health, but we don’t think of psychosocial distress,” Pal said. “There is a mind-body connection, and alleviating distress can improve the overall health of kidney cancer patients.”
The study, published in the journal Palliative and Supportive Care on June 18, surveyed 102 City of Hope patients with metastatic kidney cancer about their physical, practical, functional and emotional problems. Concerns ranked as causing high distress include fatigue (48 percent), finances (43 percent), pain (40 percent), sleeping (36 percent) and how family will cope (36 percent).

The importance of early intervention

Unsurprisingly, patients who were newly diagnosed with metastatic kidney cancer had high rates of distress: 21 percent. That’s why it’s important to gauge their biopsychosocial distress level early in the disease treatment, said Cristiane Decat Bergerot, Ph.D., lead author of the study and a postdoctoral fellow at City of Hope.
Knowing what causes distress for metastatic kidney cancer patients allows health professionals to refer them to specialists such as psychologists,” Bergerot said. “Early referrals and early interventions may result in better survival rates.”
Excellent care must include interventions that focus on the informational and psychosocial needs of patients. Behavioral therapy, for example, can reduce the fear of cancer recurrence, symptoms of depression, sleep disorders and pain. On the other hand, if patients feel fatigued, health professionals could recommend exercise programs. Education about finances and alternative modes of transportation can also help some people, Bergerot said.
City of Hope routinely uses tablet devices and a software program developed at City of Hope called SupportScreen to screen patients for treatment-related issues. Some responses will prompt the program to alert the patients’ health care teams to critical issues or risks and funnel patients to support services, including psychiatrists, psychologists, pain specialists, social workers and chaplains.

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