360 Degree Cancer Care
People who are diagnosed with cancer know that they are so much more than just their tumor. You’re an individual with thoughts, feelings, hopes, dreams, and entire ecosystems that rely on you. Why, then, do most cancer treatmentsprimarily focus on removing the tumor?
While this is obviously necessary, it provides a very limiting view that only focuses on one aspect of your life. In life, you have both internal and external experiences. Your internal experiences can be broken up into 4 sections: mood, thoughts, behaviors, and physical. Externally, your relationships, work, school, and social environments, finances, and current events in the world need to be taken into account too, in order to deliver the best care to your whole self.
A more holistic method of cancer care — what we like to call “person in context care” — not only helps support you through the experience but enables you to thrive and tackle anything else in your path.
How do your moods, thoughts, behaviors, and your physical body connect to each other?
Let’s begin by exploring the four internal sections — mood, thoughts, behavior, and physical — and how they are all connected, starting with mood.
Think about when you were in a bad mood — maybe you had a rough day at work or got into an argument with someone you love. Once you recall that mood in your mind, ask yourself these questions:
- What were my thoughts like while I was experiencing that mood?
- What were my behaviors — what I actually did — like??
- How did my body feel when I was experiencing this mood?
Maybe you were thinking about how you wish you had a better boss. Perhaps because of your bad mood you decided not to do an activity that you planned before. You may have even gotten a headache. These are all examples of how your mood can influence your thoughts, behaviors, and physical body.
Now, let’s explore thoughts. Try an experiment with me, will you? I want you to picture a lemon. And I want you to try to conjure that picture in your mind with as much detail as possible, using all of your senses.
- What does the lemon look like? Think about its size, shape, color, and texture on the peel
- What does it feel like? Think about the feel of the texture, its weight, whether it’s firm or squishy.
- See if you can think about what a lemon smells like.
Now, picture taking that lemon, cutting it in half, raising half to your mouth, and taking a bite. What happened?
For many people who do this exercise, they have some kind of physical reaction — their mouth waters, their lips pucker, or they grimace. However, there isn’t a lemon actually present, is there? All of those reactions are conjured up, simply from thoughts. This is a good illustration of exactly how powerful thoughts are — they can influence and elicit behaviors, moods, emotions, and even physical reactions.
Just like your mood and thoughts can influence your behavior, the actions you take can influence all the other aspects of your life. Think about the last time you exercised, whether you went for a walk or did something more intense like weight training.
- Were your thoughts different at the beginning of your workout than they were in the middle or at the end?
- What was your mood like? Did it change during your session?
- How did your body feel at the end of your workout, compared to at the beginning?
As you can see from those examples, behaviors create and/or influence your thoughts, mood/emotions, and of course your physical being.
Lastly, and perhaps most salient in terms of cancer care, is the physical category. Think about the last time you were sick. What was your mood like? Perhaps you felt pretty down, or frustrated. What were your thoughts like? And what did you do? Maybe you curled up in bed with some soup and watched tv? Your body influences your mood, thoughts, and behaviors, whether you’re aware of it or not.
Exercise and participating in enjoyable activities also may help. Recent data suggest that people who maintain some physical exercise during treatment not only cope better but also may live longer.
What all of this shows us is that, when you’re diagnosed with cancer, the illness ends up infiltrating and impacting more than just your physical body — it impacts your thoughts, behavior and mood whether you are aware of it or not. These connections can play to your advantage. While your clinicians are directly targeting the cancerous tumor (the physical piece), we can bolster that by addressing the other aspects as well — helping you to feel better throughout the process and actually get better.
What is person in context care?
Let’s take this one step further. Not only does good cancer care take into account these various aspects in a comprehensive manner that meets the person where they are, it does so proactively. It doesn’t wait for there to be an issue.
Person in context care takes you — and all of the various facets of your being — where you are and proactively shepherds you through what you need, when and how you need it. This form of cancer care is able to smooth the bumps in the road along the way so you can focus on what’s important to you.
Such a model doesn’t exist quite yet but we’ve already seen research that has shown there would be a significant amount of benefits:
- Screening for and addressing issues in these dimensions increases patient satisfaction with care1
- Improves other cancer-related symptoms (for example, pain)2
- Increases ability to tolerate chemotherapy and may prolong survival time3
This research has also repeatedly reinforced the connections we’ve already discussed between the different aspects of a person and their experience with their physical being1.
Many centers are beginning to integrate this perspective — and the necessary services — into their care model but change, while necessary, is slow and often costly. The more patients are aware of this model, adopt it for themselves, and push for providers to see things through a similar lens, the more we can move forward towards an ideal experience for people affected by a life-changing illness.
Robin Care aims to be that catalyst. Using our knowledge and expertise surrounding the cancer experience, our care advocates can leverage technology to guide patients seamlessly through the journey. It is our hope that by being successful with our model of cancer care outside the traditional system we can greater effect change on a more timely scale.
- Loscalzo M, Clark K, Pal S, Pirl WF. Role of Biopsychosocial Screening in Cancer Care. Cancer J 2013; 19:414-420.
- Carlson LE, Waller A, Mitchell AJ. Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol. 2012;30:1160Y1177.
- Gallo JJ, Bogner HR, Morales KH, et al. The effect of a primary care practice-based depression intervention on mortality in older adults: a randomized trial. Ann Intern Med. 2007;146:689Y698.