[ Music ]
>> Hello. I'm Dr. Lynne Padgett,
and I'm a clinical health psychologist.
I'm here with the Rev. Dr. James Brewer Calvert.
He's a colon cancer survivor.
Cancer survivors are often affected
by mental health problems that for some patients talking
about these challenges is far more difficult than talking
about physical health concerns.
These are not always easy conversations
for providers to start either.
Cultural beliefs, worries about stigma and negative attitudes
about health can all play a role
in how difficult these discussions can be.
James is going to tell us about his experience talking
about mental health issues with his healthcare providers during
and after his cancer diagnosis and treatment.
James, welcome.
>> Hello. How are you, doctor?
>> Good. Thank you.
>> Excellent.
>> We are delighted to hear your story.
>> Thank you.
So in 2005, my father passed away from colon cancer
and he had been diagnosed in 2003 and he was given 20 months
to live which is about as long as he did live after that.
But he used that time to say goodbye
and thank you to everybody.
It was a very gracious opportunity for us to connect
with him even though it was very difficult
and we miss him terribly.
In 2015 exactly 10 years later I was diagnosed with colon cancer.
And so in May 2015, I was given a few days before surgery
and so I went around saying goodbye and thank you to anyone
who moved because I figured this was it.
And it was a very frightening time
for me as well as my family.
I was blessed to have a doctor who cared about me
in a very holistic way.
We connected on a level of faith.
He was Jewish and I was Christian.
He had a wonderful temple.
I had a wonderful church.
And so we were able to share stories about that
and he would ask me how I was doing
and what I was feeling and thinking.
So I felt I had a kinship person in this process.
And then when I came out of surgery and miracle
of miracles I lived, went on to meet with my oncologist
and as I went through six months of chemotherapy, he also dealt
with me on a very holistic level.
He made time to see how I was doing and I was able
to tell him what I was experiencing.
The highs to lows my fears my challenges and I also noticed
that in the waiting rooms, pre-op and also
in the chemo lab I call it the cancer ward--
>> Yeah.
>> -- for lack of better language
that people were very sad and stressed.
There was a lot of grief, loss, a lot of pain, fear, worries,
and going through chemo is an awful experience for everyone.
It's an equal opportunity offender.
You know? It attacks everything that's living in your body.
And so I would walk in and say it's another day of healing.
Try to turn the tables on fear and give people hope
that this was a healing process.
I would hope that doctors
and nurses would use this opportunity to connect
with their patients on a very holistic way just say simply how
are you?
What are you going through?
And that makes all the difference
in the world sometimes.
Let me ask you a question.
So, what issues or concerns do you think
that patients should tell their providers
and what should providers tell their patients when it comes
down to finding out where people are in this process?
>> All right.
We'll James, first of all, I'm really touched
by what a positive experience you had sharing your highs
and lows with your providers
and getting really positive responses from them
and of course that's what we all hope for.
For patients, it's important to know
that the whole person is the target of care
and the whole person is important.
That includes communicating to your doctor physical
and psychological or mental health symptoms.
Those symptoms are all important and all make
up the totality of your care.
One of the ways that we try to elicit that information
from patients is through distress screening.
So it's an opportunity for patients
to check off what symptoms they are experiencing
and those include physical and mental health symptoms.
>> Yes.
>> So things like depression, anxiety, fear,
some of the things that you mentioned.
That's a way to report it.
One thing that's really important for patients
to know is that the symptoms mental health symptoms
that they discuss with their provider are also protected
and confidential information just
like their physical symptoms are.
So that's what I would tell to patients.
For providers, I think it's really important to know
that even sometimes if they do ask and we encourage them to ask
or to discuss the results of screenings.
But that even if they do, patients may have social,
cultural, religious, or personal beliefs that make it difficult
for them to talk about mental health symptoms
versus physical symptoms.
And so it's important for providers to really reach out
and encourage them to talk and to recognize some
of the barriers that may keep them from speaking about it.
>> Do you think that there's a tendency for medical personnel
to think oh, I've got to rush through this process
because there's a long line of patients lining up behind?
And I really don't have time to ask how are you
because that might put me off schedule?
>> I think that that's probably an external pressure
that providers can feel based on scheduling.
I think it's a pressure that patients can feel too
about getting everything covered during the visit
and it may be easy for both providers and patients
to discount those mental health symptoms.
But what we know is that those are important to the totality
of care, and that for good physical
and mental health outcomes you have to address both
of those during the visit.
Providers don't have to solve the problem in the visit.
They just need to be aware of asking, recognizing,
and then referring patients to cancer center resources
or perhaps resources in their local community.
>> I felt very strongly throughout the process
that my doctors and nurses saw me holistically.
That I was being treated body mind and soul.
And I tried to act accordingly with them
but that was a very helpful part of the healing process.
And so I'm grateful for them.
Thank you.
>> Well you certainly had a very positive experience
and that would be our goal for all patients to experience.
>> I hope so.
I hope so.
Doctors and nurses have a real opportunity to reduce the impact
of problems like these and help cancer survivors like me
to live happy, healthier lives.
>> Open communication between healthcare providers
and patients regarding cancer related mental health concerns
is an important part of care.
Healthcare providers can make this communication easier
by assessing patients' cultural, social,
or stigma related beliefs first.
For access to healthcare provider training resources
and information about the topics discussed,
visit cdc.gov/cancer and chronicdisease dot org.