Luigi Grassi, MD

The field of psycho-oncology is evolving in important and meaningful ways. Screening for distress in patients with cancer is now a concept that is accepted and expected; how this is achieved, however, may vary. Some countries and cancer centers have a uniform system, whereas other countries and centers—and sometimes even clinics within the same center—allow for autonomy in terms of which scales or instruments are used, frequency of screening, and different protocols for various levels of distress.

The next several years will present challenges and opportunities for psycho-oncology to improve care for our patients. For example, it is important that we determine which evidence-based treatments should be provided to which patients and at which points in their trajectories of care. Similarly, how we provide care is certain to evolve, as it is likely telepsychiatry options will become more prevalent. With COVID-19, we have gained experience with the technology, and insurance companies and governmental payers have become more flexible about how we deliver services to patients. For all fields, and psycho-oncology in particular, this could be a positive aspect to come out of a very difficult time. It will be important for us to study and test various ways to provide needed services in this format.

Likewise, the articles in Part II of this Special Report provide a glimpse into the ways the field is evolving. For instance, Wendy G. Lichtenthal, PhD, and colleagues share insights into meaning-centered psychotherapy; our ability to translate such important work to greater numbers of patients is essential.

Psycho-oncology also has gotten firmly incorporated in fellowship training in consultation-liaison psychiatry. The articles by 

Carey J. Myers, MD, PhD, and Carolina Retamero, MD

, on lessons learned provide opportunities to recognize the importance of framing major psychiatric topics and providing the best care possible.

(WPA) as co-chairs of the WPA Section on Psycho-Oncology and Palliative Care, we recognize that these issues are important for psychiatrists and other mental health clinicians throughout the world. We appreciate that 

 has recognized the importance of bringing these topics to you by leading authors, and we hope this inspires you to learn more. We also thank you, the reader, for your interest in these meaningful clinical topics. And, we thank our patients, who continue to inform and educate us so that we can provide better care.

 is Professor, Department of Psychiatry, and Director, PsychOncology, University of Michigan Rogel Cancer Center, Ann Arbor, MI; she also is Deputy Editor in Chief Emeritus of

 is Professor and Chair of Psychiatry, University of Ferrara, Department of Biomedical and Specialty Surgical Sciences, and Director, University Hospital Psychiatry Unit, S. Anna University Hospital and Health Authorities Ferrara, Italy. They report no conflicts of interest concerning the subject matter of this Special Report.

Articles

The next several years will present challenges and opportunities for psycho-oncology to improve care for patients.

Looking to the Future and Improving Patient Care

We are very appreciative of the opportunity to present some excellent articles on the interface between psychiatry and oncology, which we know will be useful to you in your practice.

Jimmie Holland, MD, a pioneer and one of the founders of the field of psycho-oncology, mentored many of us and advocated all of us to study, understand, teach, research and care about, and provide for the emotional and psychological needs of people with cancer. She lived and breathed a biopsychosocial approach in the screening, evaluation, treatment, and management of distress, a sixth vital sign.

The articles in Part I of this Special Report discuss PTSD in cancer, special issues for patients with schizophrenia and cancer, and distress management.

Thanks to Dr Holland and others, if you are interested in learning more and want to get active in this field, there are major organizations, founded by Dr Holland, such as the International Psycho-Oncology Society, founded in 1984 and the American Psychosocial Oncology Society, founded in 1986. Dr Holland also gave us Psycho-Oncology, one of our premier peer-reviewed journals, for which she served as founder and co-editor in chief. Dr Grassi and I were honored and privileged to take over the reins of the World Psychiatric Association Section on Psycho-Oncology and Palliative Care from Dr Holland.

There is an active and very productive Interest Group on Psycho-Oncology within the Academy of Consultation-Liaison Psychiatry (ACLP) organization, with many wonderful presentations highlighted at the annual meetings of ACLP. With increasing numbers of US psychiatry residents choosing fellowship training in consultation-liaison psychiatry, clinical and research rotations, electives, and core lectures on psycho-oncology are part of the curriculum in Residency Review Committee-accredited consultation liaison fellowship programs. More and more medical students are interested in this field, as well.

Dr Holland was the inaugural chair of the Distress Guidelines of the National Comprehensive Cancer Network (NCCN). She played a key role in the development of the Distress Thermometer, which enables patients and clinicians to talk the same language to discuss anxiety, depression and other issues that can be distressing, on a scale of zero-to-10, similar to the way pain is discussed and measured. I (Riba) was humbled to be asked to take over as chair of the NCCN Distress Guidelines after we lost Dr Holland on Christmas Eve 2017. Her imprint on our field and on our profession will be long lasting and for that, we are so grateful.

We know you will find these articles in Part I, and later in Part II, to be stimulating and useful—we hope that the information will help you in your multi-disciplinary work with patients and families. We also encourage you to check out some of the organizations previously listed should you want to get more involved in the journals, NCCN, and other guidelines that are updated regularly and provide cutting-edge information based on evidence-based findings.

 is Professor, Department of Psychiatry, and Director, PsychOncology, University of Michigan Rogel Cancer Center, Ann Arbor, MI; Dr Grassi is Professor and Chair of Psychiatry, University of Ferrara, Department of Biomedical and Specialty Surgical Sciences, and Director, University Hospital Psychiatry Unit, S. Anna University Hospital and Health Authorities Ferrara, Italy. They report no conflicts of interest concerning the subject matter of this Special Report.

Author | Luigi Grassi, MD

Articles

Looking to the Future and Improving Patient Care

Introduction: The Interface Between Psychiatry and Oncology