Advocacy Toolkit #6

The Facts

Fear of death, disruption of life plans, changes in body image and self-esteem, changes in social role and lifestyle, and financial concerns are all realities in the lives of people diagnosed with cancer. In fact, at least a quarter suffer major depression which, unless treated, can impact negatively on their quality of life. [1]

That’s not in question. But a major issue for psychosocial oncology is how we get to a place where we rapidly, and in a standardised way, identify and appropriately care for patients and families in need of specialised psychosocial and rehabilitation services.

The issue of screening for distress is gathering momentum internationally; in 2011 delegates at the meeting in China of the Union for International Cancer Control (UICC) voted to endorse the International Psycho-oncology Standard of Care document, which recognised distress as the 6th Vital Sign. [2]

South Africa needs to urgently rethink its lack of commitment in this area, especially in light of data that shows distress is a risk factor for non-adherence to treatment.

Ultimately it also impacts on patients’ decision-making, which can impact negatively on the oncology team as it manifests in increased visits to doctors and the emergency room, a situation South Africa can ill-afford. [3] Patients – and their families and carers – deserve the best outcomes possible, and this requires the inclusion of systemic psychosocial care in the continuum of cancer care.


  • A general acceptance of the value of psychosocial care for cancer patients. 
  • A strategy to ensure sufficient oncology social workers, trained counsellors and patient navigators throughout the country. 
  • A focus on the problems presented by language barriers. 
  • An acknowledgement that families and carers need significant support.
  • Buy-in from NGOs and communities to help meet the need. 
  • Training in psychotherapy techniques for nurses, clinicians and radiotherapists. 


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