Psychosocial Considerations for Patients with Metastatic Bone Disease

Supportive care services are an integral component of comprehensive cancer care for patients with bone metastases. One critical aspect of supportive care services is the psychosocial needs of patients, families, and caregivers. Supportive care services are broad and best attended to with a multidisciplinary team approach that should include an oncology-trained provider. Patients with metastatic bone disease have a variety of needs physically, medically, financially, and psychologically that should be followed and managed through the end of life. Appropriate psychosocial care includes screening for distress, assessing and treating adjustment and mood disorders, assessing and treating suicide ideation, providing therapeutic interventions with families and caregivers, referring patients to community resources, and facilitating end-of-life discussions. Often overlooked yet vital are conversations regarding body image, sexuality, and social support mechanisms. Patients with substance abuse disorders or preexisting psychiatric disorders will require more care and navigation throughout their cancer treatment. Spiritual and religious needs are important psychosocial considerations and may affect treatment decisions and end-of-life planning. 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. 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.