best when they find some sense
of control, predictability, meaning
and connectedness, notes
Loscalzo, a past president of the
American Psychosocial oncology
Society. Looking at cancer solely
from a medical perspective, he
says, “is the wrong end of the
telescope.”
“Simply coming in and saying,
‘You have a disease and this
is the treatment suggested,’
is only the tip of the iceberg,”
explains social worker Louise
Knight, the director of the Harry
J. Duffey Family Patient and
Family Services Program at the
Sidney Kimmel Comprehensive
Cancer Center at Johns Hopkins
in Baltimore. “Much of our work
CR | Page No. 50 | Winter 2009
Those who care
for the spiritual,
psychological
and socioeconomic
needs of cancer
patients and
their families say
that one of the
most difficult parts
of their jobs is
feeling unable
to help
is helping [patients and families]
sort out the implications of their
choices,” she says. Those choices
can include how to get or pay for
treatment, where to live while
receiving treatment away from
home, or how to cope with any
one of many social ills, like drug
and alcohol abuse, domestic
violence, poverty and untreated
mental illness—problems “that
are present in our culture and
get transferred to our setting.”
Sometimes, Knight says, there are
no clear solutions.
Those who care for the
spiritual, psychological and
socioeconomic needs of cancer
patients and their families say
that one of the most difficult
parts of their jobs is feeling
unable to help. Sometimes the
needed resources aren’t available.
Sometimes people aren’t in a
place where they can accept
assistance. “What’s hardest is
when [patients or families] don’t
want help and you see them
struggling,” says Janis Miller, a
social worker at the Mayo Clinic
Cancer Center in Rochester, Minn.
At times, people struggle to
accept the realities of their illness.
“The thing that is hardest for me
is not the hard, tragic stories,
but watching people so fearful
of death they will ask for chemo
in the casket,” says Jarvis. “Life
becomes about keeping them
alive, not living.” on the other
hand, says Miller, some patients
who have finished successful
treatment can find it difficult “to
step back into life, when they’re
not really the same person
anymore.”
So people grasp for meaning,
for the bigger picture that will
allow them to cope with cancer’s
daily ups and downs, says Lois
M. Ramondetta, a gynecologic
oncologist at the University of
Texas M. D. Anderson Cancer
Center in Houston. Ramondetta,
who recently wrote a book on
spirituality and cancer with a
friend and former patient who
was a professor of religion,
became interested in spirituality
and coping because of the
intimate nature of serving as a
women’s primary physician. “of
course you need to be careful not
to project what gives your life
meaning into what gives their life
meaning,” she says.
Dealing with these deep
needs brought on by cancer
can take a toll on providers.
“Health care professionals get
really used to the things we see,
and sometimes we may grow
callous,” says Mary E. Johnson,
a chaplain at the Mayo Clinic in
Rochester, Minn. “But if we don’t
acknowledge the impact other
people’s suffering has on us, we
can become cynical.” Johnson
copes by splitting wood at her
lake house and swimming every
