Psycho-Oncology Program supports mental health for UAB patients with cancer

Cancer can put a person’s health at risk, but it also poses challenges to physical, social, emotional, and mental well-being. In response, the UAB O’Neal Comprehensive Cancer Center has integrated the UAB Supportive Care Psycho-Oncology Program into patient care, to promote a culture of caring for the emotional impact of cancer.

About one in three patients with a cancer diagnosis will experience mental health issues during treatment, according to one often-cited study. Also, the National Institutes of Health (NIH) says 25% of survivors face persisting mental health challenges after treatment. These challenges may appear at any time – especially during important steps in the cancer journey – and may include depression, scan/appointment anxiety, strained relationships, and body image and self-esteem issues.

Sylvia Huang, Ph.D., clinical psychologist and director of the Psycho-Oncology Program, underscores the importance of mental health care for improved cancer outcomes. The program has grown rapidly since its inception, now encompassing 4,500 visits per year across inpatient and outpatient services and accounting for 40% of all Supportive Care services.

“The dynamic mental health needs of thousands of patients can be met when mental health awareness and responsiveness are integrated into oncology Supportive Care,” Huang said.

Capturing the need

The O’Neal Comprehensive Cancer Center stands out as one of the few such centers that prioritizes mental health screening for cancer patients during intake, integrating it with vital sign checks and other routine care. Huang led development of the Distress Screening and Management Program (DSMP), which has conducted 54,000 distress screenings for UAB Medicine patients with cancer. Patients are asked a series of questions about their mental well-being, and an algorithm is used to identify those who may be at risk, triggering referrals for follow-up care.

To support the DSMP, Huang and colleague Judith Igbinakensua, DNP, AGNP-C, have trained over 200 certified medical assistants, intake nurses, and oncology providers across UAB Medicine. These health care professionals are equipped to provide immediate care using an “emotional first aid kit” for patients who screen positive for distress. They offer guidance and education, and they facilitate connections with Psycho-Oncology Program providers for follow-up care.

“The integration of distress screening into oncology visits, which helps capture care needs early, is key to preventing mental health crises later,” Huang said.

Challenges at each turning point

The Psycho-Oncology Program comprises a team of psychologists, counselors, and residents who serve as a valuable resource for patients throughout their survivorship, extending beyond diagnosis and treatment. Huang said each major turning point in a patient’s cancer journey has the potential to cause unique mental and emotional distress, as described below:

• Diagnosis – A cancer diagnosis often shocks patients, and they may not fully grasp the profound emotional impact during this time. That is why comprehensive, systemwide screening and a robust referral process are crucial.
• During treatment – Side effects of common cancer treatments (chemotherapy, radiation therapy, surgery) can cause fatigue, pain, nausea, loss of appetite or sexual function, and other symptoms. Changes in weight or appearance can trigger body image issues. Addressing these concerns is essential to help promote treatment compliance.
• Between treatments – Patients are likely to feel anxiety and uncertainty, struggling to resume their regular lives. The Psycho-Oncology Program offers ongoing support and care during these challenging times.
• After treatment – Life is never quite the same after cancer. Survivors commonly face sleep disorders, post-traumatic stress symptoms, new medical issues, and anxiety related to tests and routine checkups.
• Social changes, throughout the cancer journey – Patients often form new peer groups during treatment, though the closeness of these relationships also can include an element of grief. “Social networks undergo immediate changes when diagnosed with cancer,” Huang explained. “Patients often need to advocate for themselves and educate their friends and family.”

Approach to care

To meet each patient’s unique goals and care needs, Huang’s team utilizes a combination of research-based treatments such as acceptance and commitment therapy, cognitive behavioral therapy, dialectical behavioral therapy, meaning-centered therapy, mindfulness-based stress reduction, and more.

The Psycho-Oncology Program works closely with Supportive Care and extends mental health care to the patient’s family, including loved ones affected by a cancer diagnosis. Caregivers, who are often silent co-survivors, may also experience distress. Embracing a patient- and family-centered approach, the program offers individual, couple, and family counseling at no additional cost and without insurance involvement. Also, telehealth visits are available to help ensure equitable access to care.

Culture of awareness

Access to effective mental health care is essential for comprehensive cancer care, but a nationwide crisis in access persists due to a shortage of providers. This crisis has become increasingly critical as the population of cancer survivors continues to grow.

To bridge this gap, UAB Medicine has taken the lead in improving regional access and referrals for mental health services. Huang serves as the principal investigator for the Psychosocial Oncology Training Academy (POTA), which offers interactive workshops and virtual training for interprofessional clinicians through continuing education. In close partnership with cancer survivors, POTA has successfully trained more than 400 providers and established the first psycho-oncology provider referral network in the Birmingham area. The goal is to cultivate a culture of awareness and improve access and quality of psychosocial cancer care.

“It is normal to feel stressed and overwhelmed at various points in your cancer journey,” Huang said. “At the O’Neal Comprehensive Cancer Center, you are not alone during those times. Our compassionate team is always just a call away.”

Patients with cancer and their loved ones can contact the UAB Supportive Care Psycho-Oncology Program by clicking here.