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Assessment of Emotional Issues Vital Part of Cancer Care

Distress should be treated as the sixth vital sign, according to Memorial Sloan-Kettering Cancer Center physician

FRIDAY, June 23 (HealthDay News) -- In addition to pulse, respiratory rate, temperature, blood pressure and pain, there should be another vital sign on the list: distress, said Jimmie C. Holland, M.D., of Memorial Sloan-Kettering Cancer Center, at a June 22 cancer briefing sponsored by the American Medical Association in New York City.

"No patient with distress should be unrecognized or untreated in quality cancer care," said Holland, who holds the Wayne E. Chapman Chair in Psychiatric Oncology. "I don't think you can have quality cancer care that does not integrate this psychological side," she said. "There should be a minimum standard for psychosocial care."

To help get physicians to evaluate a patient's mental condition, Holland and colleagues at the National Comprehensive Cancer Network have developed a questionnaire for patients to complete at routine doctor visits.

Along with the questionnaire, Holland and her colleagues have developed practice guidelines for dealing with patient distress. Holland developed a screening tool that rated a patient's distress on a scale of 0 to 10, what she calls a distress thermometer. "Patients who score 4 or greater, that's the trigger that doctors should note," she said.

Based on this, patients can be referred to psychiatrists, psychologists, social workers or pastoral counseling.

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Physician's Briefing

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