Although cancer treatment aims to improve patients’ physical health, these grueling regimens can sometimes lead to debilitating mental health challenges.
Dartmouth Cancer Center (DCC) offers mental health care to help patients navigate these difficulties, but the demand for these services often exceeds provider availability. Now, with $1 million in Prouty funding, the Cancer Center can hire more providers, expand services, and create more equitable access to this vital care.
Learn how DCC is addressing the mental health care needs of patients in the following conversation with Sivan Rotenberg, PhD, clinical psychologist at DCC and assistant professor of psychiatry at the Geisel School of Medicine at Dartmouth:
Are mental health problems a common experience among cancer patients?
About 20% of patients experience a looming fear of recurrence that impairs their ability to function and to get into a routine that’s not related to cancer. During treatment, the medical team is constantly checking on you. When you shift to maintenance treatment or surveillance [with less frequent medical visits]—that rapid separation from the medical system can create anxiety. Patients can feel alone and scared, which prevents them from living well.
How do the mental health services at Dartmouth Cancer Center help patients?
Our evidence-based psychotherapy services target the psychological processes impacting people’s lives, helping them live rich lives and accept the way things are now, even if they don’t do things the way they used to do pre-treatment. We help patients build skills to navigate their illness, get through treatment, and live well. Some patients benefit from psychiatric medication. We also have neurocognitive testing; when we know the brain is vulnerable, tumors in the brain for example, we’ll get a baseline neurocognitive test and follow patients over time to see how they’re doing.
How do cancer treatments contribute to mental health challenges?
If we use breast cancer as an example, a common treatment is endocrine therapy [hormone suppression therapy]. Our hormones play a huge role in regulating mental health, and inhibitors can raise anxiety and depression. For example, when one of my patients started a hormone inhibitor, her anxiety got much, much worse. She couldn’t work anymore and struggled to leave her home. Working with me and connecting to the psychiatry team and getting medication to “turn down” the anxiety helped her get back to living again.
Why is there a need for more services?
Right now, these services are available only at Dartmouth Cancer Center’s Lebanon, N.H., location. And for some of our services, there’s an incredibly long waiting list. We are able to serve only 5% of eligible patients. Our goal with the $1 million from The Prouty is to get our services to all six Dartmouth Cancer Center sites and increase our impact by helping 15% to 20% of eligible patients.
What will $1 million from The Prouty make possible?
We will be able to hire more providers and a mental health navigator. We can reconceptualize how we deliver care as well as deliver services that don’t exist right now, like screening patients on endocrine therapy who are at high risk of developing mental health issues because of the treatment. The funding will also give us the opportunity to develop group programs, so we can deliver interventions to more people at a time, which will help with access.
