Bone mets patients have complex needs beyond the clinical.

5 Important Needs of Bone Mets Patients

Great health care is not just about taking care of the body. “Comprehensive cancer care” is a phrase that has gained wide use. In large part, cancer patients are living longer with their disease than was possible even two or three decades ago. Clinicians now recognize that quality of life is just as important as quantity of life during each patient’s journey with cancer. Nowhere is this more important than in cancer that has spread to the bone (bone metastasis or bone mets).

There are numerous journal articles that help identify important patient and family needs beyond managing the pain and fractures that are associated with bone mets. Not all patients have identical needs, but comprehensive cancer care centers have multidisciplinary teams to respond to a range of situations. In addition to doctors (oncologists, radiologists, etc.) teams may include specially trained professionals such as mental health workers, social workers, nutritionists, physical/massage therapists, pastoral counselors, acupuncturists and more. There is good reason to attend to the emotional, social and spiritual needs of bone mets patients: “Comprehensively addressing the psychosocial needs of patients with bone metastases enhances quality-of-life, improves treatment compliance, reduces distress, decreases unnecessary care, and may reduce time and costs of patient care for providers.”ⁱ

Five important needs are consistently listed by various authors:

1. Limitations on previously normal activities – Patients who are accustomed to an active work, family and social life may find that their disease and treatment regimen contribute to reduced mobility, energy, ability to fulfill responsibilities, visit with friends, etc. Not only is this a depressing loss of daily enjoyment, it also robs a person of a sense of meaning. This is a key area in which a team approach can help analyze what’s problematic, and generate solutions.
2. Family stress – As the patient is able to do less, the burden of caretaking by others increases. This can occur in ways ranging from taking on extra chores and errands to helping the patient with personal care and comfort. Being sensitive to how the patient’s needs are impacting family members is an important part of the cancer team’s support.
3. Adjustment and mood disorders – The demands of coping with pain, clinical interventions and cycles of chemotherapy take a cumulative toll on the patient. While he/she must continually adapt to changes brought by disease and treatment, the ability to be flexible and positive decreases. Cancer care team members who specialize in mental health and emotional issues should periodically monitor the patient and family members in order to identify psychological low points and intervene before a crisis develops.
4. Diversity and underserved populations – Metastatic cancer is completely impartial. It afflicts every demographic group, including marginalized populations. “Diversity is a critical component of psychosocial care and should be thoughtfully considered with regard to race, ethnicity, and culture as well as the needs of lesbian, gay, bisexual, and transgender patients. The needs of these marginalized and underserved populations should be thoughtfully addressed by medical providers in conjunction with mental health providers skilled in recognizing their needs and barriers to care.”ⁱⁱ
5. Community services – A cancer center social worker can help connect bone mets patients with broader services, often by community volunteers. Among the kinds of collateral support for patients and their loved ones are peer support groups, meal deliveries, volunteer drivers, local services for the disabled, etc. Many local governments also offer legal/financial counselors to help those with medical burdens. In this sense, comprehensive cancer care teams can indirectly help patients and families by making links.

It is also important to recognize that many patients do not feel that they want or need extra support, so the offer of assistance should always take this into account without making the patient feel pressured or obligated. The good news is the expanded awareness that bone mets patients potentially have a variety of needs that intertwine with their clinical situation – and the desire to be responsive to them is now there more than ever.

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ⁱ Horyna, A. “Psychosocial Considerations for Patients with Metastatic Bone Disease” in Metastatic Bone Disease. Edited by Randall, R. Lor. (New York: Springer, 2016), 145-54.
ⁱⁱIbid.