Psychosocial and cultural significance of cancer

From Oncology for Medical Students
Ideal oncology curriculum > Psychosocial and cultural significance of cancer

Objective 6.1

At graduation, the student should be able to:

a) discuss cultural and psychosocial factors influencing presentation for screening and diagnosis
b) discuss the psychosocial impact of cancer diagnosis and treatment on the patient and their family, and how they adjust in the short and long term
c) discuss the economic impact of cancer on the patient and family
d) demonstrate an understanding of the impact of cancer on sexuality and fertility
e) be aware of significant cultural and religious differences in the population that frame the challenge of breaking of bad news effectively
f) demonstrate understanding of resources offering appropriate and reliable patient support information
g) demonstrate ability to assess the psychosocial state
h) demonstrate awareness of significant cultural and spiritual (rather than religious) differences within the society.

Prerequisite knowledge

  • Understanding of the doctor-patient relationship
  • Patient-centred communication skills

Representative questions that suggest the required depth of knowledge

1. Why is it important to have a carer present when you convey news about cancer?

Essential in answer:

  • Retention of information is incomplete
  • Communication should involve a number of formats at a number of different times, ideally to the patient as well as a number of different support people

2. Discuss different cultural attitudes to death and dying.

Essential in answer:

  • Knowledge of the “Western” society model v Indigenous v Asian etc.
  • Part of continuum v major event

3. Discuss the importance of body image in breast cancer management.

Essential in answer:

  • Mastectomy v conservation v reconstruction
  • Overall cosmetic outcome
  • Effects on sexuality
  • Effects of premature menopause caused by chemotherapy

4. What are the two major side effects that should be discussed with a man who is about to undergo radical surgery for prostate cancer and how would you discuss their management?

Essential in answer:

  • Impotence and incontinence. In the management of impotence, pharmacological and mechanical treatments can be discussed and counselling for the man and his partner may be necessary