Understanding the Emotional Challenges of Skin Cancer Treatment

Dr. Ariel Ostad sat down with CURE to discuss the often-overlooked emotional and practical challenges that patients face during and after skin cancer treatment. He shared insights on common psychosocial concerns and strategies clinicians can use to support patients beyond the medical aspects of care.

Ostad is a dermatologist, Mohs surgeon, and advocate for The Skin Cancer Foundation. He is also a clinical associate professor in the Ronald O. Perelman Department of Dermatology at NYU Grossman School of Medicine.

Transcript

Patients often face emotional and practical challenges that extend beyond their medical treatment. With that said, what are some of the most common psychosocial concerns that you hear from patients, and how can clinicians help address them throughout their care?

The psychosocial side of cancer often truly as impactful as the clinical treatment side of it. When we name these concerns, plan for them and really communicate that with patients in a very authentic way, patients consistently feel more supported, more comfortable, more in control and grounded.

Some of the most common psychosocial concerns that come up are, obviously, fear — fear of the uncertainty, the fear of whether they are going to be around, the fear of losing control and fear for family members. Are they going to be around for their children or their parents? Often, patients describe feeling swept into this fast-moving medical system where they really are in the hands of their clinicians, and all of a sudden, the future feels very fragile and unpredictable.

I think how clinicians can help is by letting patients know that those feelings are normal. Normalizing that emotional reaction is important; say, "Many people feel that way. You’re not alone." It is about breaking the information into manageable pieces because it can be overwhelming. I deal with it every day here in the office, where patients are worried about whether they are going to be alive and the cosmetic aspect of it — are they going to be deformed? Are they going to be living long into the future?

We know it is important to offer clear expectations about timelines, decision points, what we do know and what we don't know, while encouraging patients to really vocalize their fears rather than trying to be tough and brave. There is certainly anxiety around things like skin cancer coming back and surveillance; even after treatment, scans and follow-up visits can really ignite worry.

How we can help as clinicians is to utilize communication skills, set up predictable follow-up timelines, and explain why each visit and each scan matters. We can teach patients about grounding techniques and refer them to social workers or supportive oncology services. Again, validating their feelings — telling them that anxiety is common and that it gradually gets better — and providing reassurance is so important.

Then there are other psychosocial issues, like body image and visible treatment effects such as scars and hair loss. How we as clinicians can help is to have those conversations. Patients may feel a little uncomfortable bringing that up; they may feel like they are being weak. It is about providing that guidance to them and letting them know that even the best patients can be consumed by overwhelm. There is so much going on between coordinating insurance issues, disruptions to life, work and caregiving. How we can help, again, is to connect people to social workers and counselors. That is the whole other aspect of making people feel better.

Transcript has been edited for clarity and conciseness.

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