You may be asking: what is a psycho-oncologist? We recently chatted with Dr. Bradley Millman, a licensed clinical health psychologist with Banner MD Anderson Cancer Center, who explains the ins and outs of holistic cancer care. He also details the importance of not only looking after the mental health of the patient, but also the caregiver.
How does stress play into advancement of cancer, and what do you do in your role to help alleviate some of that burden that oncology patients and their loved ones face?
Stress is a vital piece of the puzzle when discussing cancer progression and treatment. When an individual is stressed, it affects all parts of the individual: biological, psychological and social. Most people will pay attention to the psychological side of stress because, when we are stressed, our thoughts seem to be the most prevalent disturbance we try to alleviate. However, I often tell patients that our body has ways of talking to us that we may ignore.
With stress, our body may begin to experience wear and tear faster than usual due to an extended release of cortisol, a chemical closely related to stress. With cancer specifically, stress cannot cause cancer. However, recent research has shown that once the disease has metastasized, progression may speed up. This can lead to social isolation, irritability and strain on the patient-caregiver relationship.
As a psychologist at Banner MD Anderson, I work with caregivers and patients to alleviate stress through a variety of evidence-based techniques. I use cognitive-behavioral therapy to help patients and caregivers with those intrusive thoughts that may prove harmful during the treatment process. I also use mindfulness techniques, such as deep breathing, guided imagery and hypnosis, to help patients and caregivers alleviate stress in between sessions.
Tell us why a holistic approach is so beneficial and how you go about treating the person as a whole.
I don’t see any other way to treat a person than from a holistic approach. By treating the entire person, there are multiple doctors who can assess the patient and formulate different opinions on treatment: psychologists, physicians, oncologists, surgeons, dieticians, etc. By fostering this type of approach, patients can feel as though all their needs have been met and concerns addressed.
I believe that this is the future of healthcare and that, at Banner MD Anderson, we are ahead of the curve here as I work in a multidisciplinary setting and participate in a multidisciplinary clinic that practices this holistic approach. Patients have given great feedback about this program, and I look forward to seeing it grow in the future.
What kind of support do you offer to patients for the duration of treatment?
I see patients at all stages of treatment: Diagnosis, treatment, relapse, end of life or any other relevant stage. As a psychologist, a big misconception is that our job is to label people “crazy” or “sane.” That is false. I work to help people from an objective framework with a variety of issues related to their disease: stress, body image concerns as the body changes, how to tell loved ones about their disease and making sure affairs such as advance directives and living wills are completed. I also help screen people for psychological issues that may arise from cancer treatment such as depression, anxiety, insomnia, fatigue and substance abuse. Duration is difficult to identify because everyone is unique; however, I usually meet with patients weekly or bi-weekly throughout treatment and then as needed once cancer treatment is completed.
I also treat patients specifically for tobacco and nicotine addiction through the Tobacco and Nicotine Recovery Program, which began at MD Anderson Cancer Center in Houston, Texas and has begun to be used here at Banner MD Anderson. This program helps people with all varieties and forms of tobacco use who are looking to stop their usage. This program typically last 4 to 6 months with weekly treatment.
What about caregivers? Does Banner MD Anderson offer services catered specifically to this audience?
Caregivers are just as important as the patient themselves when it comes to psychological treatment. People are afraid to speak up when caring for someone with cancer because they are afraid of being a burden or not wanting to divert attention from the patient.
However, caregiver fatigue is very real and can lead to its own set of complications, such as depression, substance abuse or a wide variety of psychological disorders. I meet specifically with caregivers to educate them on their role in their loved ones’ treatment and how to prevent these issues from surfacing for them throughout the duration of treatment.
Let’s talk about bereavement – is it normal to still see a psycho-oncologist even after a loved one has passed?
I love working with individuals in the bereavement stage. I know that might sound odd, but it is because I feel it is stigmatized when it shouldn’t be. Bereavement is just as much a part of the journey as diagnosis or any other stage.
Caregivers always want to know how long they should be thinking about a loved one and grieving before it is abnormal. While this is not cut-and-dry, I like to tell patients a full year of anniversaries, including the date of death, is normal for grieving, as it will be your first Christmas, birthday, etc., without your loved one.
I work with caregivers to find ways to experience closure around their loved one’s death, as well as how keep their relationship with their loved one alive even after they have left this world. This can be as few as one session and as many as once a week for year. It varies based on the individual, and we work as a team to figure out their needs.
If you have questions about services offered at Banner MD Anderson or just want to learn more, visit https://www.bannerhealth.com/banner-md-anderson