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PAOLI MEMORIAL HOSPITAL ESTABLISHES PSYCHIATRIC/ONCOLOGY LIAISON SERVICE

PAOLI MEMORIAL HOSPITAL ESTABLISHES PSYCHIATRIC/ONCOLOGY LIAISON SERVICE
 PAOLI, Pa., Oct. 8 /PRNewswire/ -- To provide necessary mental support for certain cancer patients and their families when emotional conflicts arise due to the disease, the Department of Psychiatry at Paoli Memorial Hospital (PMH) recently established a Psychiatric/ Oncology Liaison Service.
 Participating psychiatrists who formalized this adjunct to the existing spectrum of cancer services at PMH include: Jeanne A. Hanache, M.D., chairman; Henry E. Clare, M.D.; Dennis W. Donnelly, M.D.; and M. Hossein Etezady, M.D.
 Although any of the PMH staff psychiatrists can be contacted at any time for consultation with a patient, the family or the medical staff, members of the liaison group have committed themselves to an even further outreach.
 Not only are they always on call on a rotation basis for consultation, they also take turns attending meetings, committees and conferences in which psychiatric input may be enlightening to others on the cancer treatment staff. They are committed, as well, to participation in the PMH cancer support group, "I Can Cope."
 "Since we are seeing more patients now because of the opening of the Cancer Center, both outpatient and inpatient, we feel there is a real need for psychiatric services," said Hanache. "The oncologists and surgeons do an excellent job of taking care of the physical needs of the patients, but there are also many emotional needs. Even though a patient can be helped physically, the condition can be sabotaged by emotional problems."
 Not all cancer patients need psychiatric care, she stressed. Many are capable of coping -- some are not.
 "There is a large emotional component to cancer -- so much depression and anxiety associated with it -- the diagnosis of cancer affects people differently in different stages of their lives, and the psychiatrist can help," Hanache added. "Because people have an illness that may be fatal doesn't mean they have to suffer emotionally throughout the whole illness. Also, nowadays, many cancers are curable. Seeking help in dealing with it can make life a little better or help the family through the difficult time."
 Hanache refuted the widely held perception that a patient must be psychotic -- seriously mentally ill -- or in need of medication before feeling the need to consult a psychiatrist. Rather, she pointed out, the psychiatric intervention is viewed as a treatment and support system that when introduced at an early stage may help avoid major crises for both the cancer patient and the family as the illness progresses.
 "There is no more stressful information than the diagnosis of cancer," concurred Stephen C. Fox, M.D., FACP, medical director of The Cancer Center of Paoli Memorial Hospital. "Many have difficulty coping with it, as I think most of us would.
 "Some patients would benefit tremendously from a trained psychiatric perspective to allow them to integrate the news of the diagnosis and to better deal with the implications of cancer -- what the future holds for them. In selected cases, psychiatric intervention is critical."
 As Fox noted, the oncologists, internists and family practitioners are not trained in treating the mental aspects of cancer. "We have experience, but certainly not the expertise of the trained psychiatrist in trying to help people through difficult circumstances -- or -- in determining the exact drug and dosage often necessary for depression, anxiety and fear."
 Among the psychological processes that interplay with the physical condition in certain cancer cases are, for example, defense mechanisms that stop patients and their families from relating and sharing the much needed support they normally offer to each other.
 The family might even begin to push the patient away because of the cancer. The patient may fear dependency or may feel friends will ostracize them because they have a "communicable disease." Their body image may change either because of the loss of hair from chemotherapy or radiation, or from surgery.
 Emotions of resentment, anger, and fear often surface. Along with the onset of depression could come the cessation of eating or discontinuation of beneficial treatment keeping them well. Patients at times become phobic about the treatment itself.
 "We feel the need is there," added Hanache. "And we're available to offer our services to help patients through the crisis of dealing with cancer, help make life a little better, and help them get on with their lives."
 The complete spectrum of treatment modalities offered by the Psychiatric/Oncology Liaison Service at PMH includes: diagnostic evaluation, treatment, and management strategies; individual and family therapies; consultation for physicians and others on the treatment team; evaluation for the use of psychotropic (antidepressant/antianxiety) drugs; crisis intervention; patient/staff education (i.e., programs on stress management and coping strategies); and psychological input into various cancer-related forums.
 While groups similar to the PMH psychiatric/oncology liaison are typically found in cancer hospitals and large teaching universities across the country, it is unusual for a small community hospital to have formulated a program such as this. It will serve as the model for a future rehabilitation/oncology liaison service which will further enhance the cancer-related services currently available at Paoli Memorial Hospital.
 /delval/
 -0- 10/8/92
 /CONTACT: Barbara Johnson of Paoli Memorial Hospital, 215-648-1497/ CO: Paoli Memorial Hospital ST: Pennsylvania IN: HEA SU: PDT


MK-CC -- PH006 -- 7848 10/08/92 12:18 EDT
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Date:Oct 8, 1992
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