Psycho-Oncology Crash Course: Psychiatric Care of Patients with Cancer for the General C-L Psychiatrist and Psycho-Oncology Specialist (Sponsored by the Psych Onc/Pall Med SIG)

Abstract:‎

Background: ‎
Patients with cancer represent an increasingly large population across the medical ‎system. These patients often require medically complex treatments for management of ‎cancer as well as treatment of associated symptoms including depression, anxiety, ‎existential distress, and a range of neuropsychiatric symptoms1-2. C-L psychiatrists have ‎become increasingly crucial in the holistic management of these patients and the field of ‎psycho-oncology has steadily grown to help manage the mental health and whole-care ‎needs of this population.‎

While many cancer centers support psychosocial oncology services, many patients do not ‎have access to these specialists. Because of this, it is imperative for all C-L psychiatrists ‎to be familiar with core concepts in the psychiatric care of patients living with cancer.‎

Approach:‎
To provide a crash course in the care of patients living with cancer, members of the ‎Palliative Medicine & Psycho-Oncology SIG has developed this skills course, which is ‎targeted for trainees and general C-L psychiatrists as well as providers with expertise in ‎other sub-specialties within C-L psychiatry and psycho-oncologists looking to refresh and ‎improve their clinical skills.‎

Dr. Miran will provide an overview of psychosocial oncology, including a brief review of its ‎history and the role of C-L psychiatrists in oncology care. He will also discuss ‎neuropsychiatric sequelae of cancers including a review of primary brain tumors, ‎metastatic brain tumors, leptomeningeal disease, paraneoplastic syndromes, ‎chemotherapy-related cognitive impairment (so-called “chemobrain”), and similar ‎phenomena.‎

Dr. Ramirez will discuss approaches to providing psychiatric care for cancer patients in the ‎general hospital setting (i.e., outside a cancer center) including ways to liaise with ‎oncology teams.‎

Dr. Levenson will outline current treatment approaches within oncology, including a review ‎of chemotherapies and immunotherapies, with an emphasis on the impact these ‎treatments may have on psychiatric treatments, e.g., medication interactions, ‎neuropsychiatric side effects, etc.‎

Dr. Lahijani will discuss state-of-the-art management of hematologic malignancies ‎including a review of hematopoietic stem cell transplantation and CAR-T cell therapy, as ‎well as common sequelae including graft-versus-host disease, cytokine release syndrome ‎‎(CRS), and immune effector cell-associated neurotoxicity syndrome (ICANS).‎

Dr. Schmitz will discuss ethical considerations in the treatment of the whole patient ‎including approaches to end-of-life care, advanced care planning in patients with ‎advanced cancers, and the benefit in collaborating with palliative care specialists.‎