Oncology Health Care Team

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Questions to Ask Your Doctor About Your Cancer
(Free Handout)

Psychiatrists and Psychologists

When patients get a cancer diagnosis, the can experience a wide range of emotions, including fear, anger, sadness, guilt, helplessness, confusion, and anxiety. Psychiatrists and psychologists provide tools for managing these difficult feelings. They can also aid in understanding medical information and in suggesting ways to communicate with medical professionals. Finally, they can help patients successfully learn and practice new behaviors.

Psychiatrists are medical doctors who diagnose and treat mental and emotional illnesses and substance use disorders. Their training focuses on physiological functions and the relationship between emotional and medical illnesses. Psychiatrists can prescribe medications.

The primary concern of psychologists is behavior. They have specialized training in the assessment of behavioral and mental function and can provide both individual and family counseling. They can be especially helpful to patients seeking marital counseling, behavioral interventions, and strategies for coping with stress.

You can find a psychologist or a psychiatrist in the following ways:

• Ask for a referral from a physician or social worker.
• Inquire at your hospital, especially if it has a cancer center or psychiatric department.
• Obtain a list of providers from your insurance carrier or HMO.

Clergy
People affected by cancer often turn to spiritual beliefs as a source of strength, comfort, hope, and understanding. Members of the clergy can help patients, caregivers, family, and friends cope with cancer.

Trying to make sense out of unintelligible medical literature, confusing advice, and conflicting treatment choices can cause feelings of hopelessness and uncertainty. Talking with a member of the clergy can help patients find hope and understanding. Sometimes people who are diagnosed with cancer feel angry, betrayed, or frustrated. They may question their faith. A compassionate clergy member can help them re-examine their beliefs and find renewed meaning in life. During spiritual counseling, patients might reassess priorities and evaluate accomplishments, regrets, and goals. This can help them gain a sense of well being about their life.

Cancer patients might need to talk about death and the afterlife. This is a complicated topic that touches the deepest emotions and beliefs. Many people find that it is difficult to talk about death, particularly with friends and loved ones. Discussions about life and death can prompt periods of intense personal growth. Members of the clergy are well suited to guide people through these issues.

Spiritual counseling combined with community worship can help people connect to a supportive and understanding community. Familiar religious rituals can give a sense of stability and calm fears.

Hospital chaplains are useful resources in the search for community-based clergy, religious organizations, and support groups. Clergy members can also give references to local organizations and agencies that provide support to people affected by cancer.

Nutritional Counseling
Cancer patients have particular nutritional and dietary requirements, and it is recommended that they seek nutritional counseling early in their treatment. Prior to treatment, cancer patients often lose weight, experience a change in the ability to taste and/or smell, lose their appetite; and/or lose interest in food. Treatments for cancer also cause a variety of symptoms that affect food intake and compromise nutritional:

• Constipation
• Depression
• Slow digestion
• Diarrhea
• Dryness in the mouth
• Edema (weight gain in the form of water retention)
• Heartburn
• Impairment of the mouth, throat, and/or stomach
• Lactose intolerance
• Nausea
• Soreness in the mouth and gums, throat, and/or stomach
• Taste blindness (when foods lack their usual flavor and have instead a metallic taste)
• Tooth decay
• Vomiting
• Weight loss

Once treatment has stopped, long-term diet changes may be necessary and the need for good nutrition continues to be important.

In general, cancer patients require a diet that is high in calories, vitamins, and protein. But each patient has unique requirements and a qualified nutritional counselor assesses cases individually and suggests different foods and supplements accordingly.

Qualified dieticians or nutrition counselors do the following:

• Design diets that provide adequate caloric intake, meet vitamin and mineral needs, and provide adequate protein.
• Give advice on increasing appetite.
• Give advice on including a variety of foods and improving flavor.
• Give ideas for food substitutions.
• Help patients and their families implement diets.
• Provide recipes for quick and complete meals.

Most hospitals have a registered dietician on staff. Nutritional services are sometimes covered by insurance, particularly when services are prescribed by a doctor; however it is a good idea to check the with your health plan. If the local hospital does not have a registered dietician who can provide counseling, your physician or another member of your health care team can provide a referral. When selecting a nutritional counselor, it is important to verify their credentials. Most certified nutritional counselors have at least a bachelor's degree and often a master's degree.

The National Cancer Institute is a good starting point for obtaining additional information. Your local hospital or a social worker can provide information about community support programs that can help with nutritional counseling and food preparation. Additionally, there are cookbooks that are written with the cancer patient in mind.

See also: Cancer and Nutrition

Oncology Health Care Team Resources

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