Biologic, psychological, and social health needs in cancer care: how far have we come?

about whether patients experiencing greater psy-chosocial distress—including depression, anxiety, and poor sleep—are more likely to report greater self-perceived peripheral neurotoxicity or whether cipn leads to an increased frequency of psychosocial difficulties. The potential to understand causation is further affected by the inclusion of a self-report measure of cipn comprising only two items, which precludes a broader clinical picture of additional chemotherapy side effects that might also be affecting psychosocial symptoms. Nevertheless, this research emphasizes a significant link between chemotherapy-induced neurotoxicity and psychosocial symptoms. Most notable is the finding that the relationship extends over and above those of other variables known to affect mood and anxiety, including social supports and fatigue. Today, almost 7 years since the Institute of Medicine report, research continues to overwhelmingly support an association of the prevalence of psychoso-cial symptoms with the physical side effects of cancer treatment. Has care for the cancer patient become better integrated with respect to assessing, monitoring, and treating the " whole patient " —that is, including the biologic, psychological, and social needs? Based on their research findings, Hong et al. conclude that ongoing assessment of peripheral neuropathies should be emphasized. As health care practitioners and academics, we have an ongoing responsibility to recognize, monitor, document, and treat psychosocial symptoms across the cancer continuum. Since the early 2000s, a tremendous movement has begun to screen for psychosocial distress in all cancer patients. Psychosocial distress is now acknowledged internationally as " the 6th vital sign " 2. The cost of unidentified psychosocial distress in cancer patients, survivors, and families is severe. Patients experiencing multiple stressors can have more difficulty making decisions and adhering to treatment recommendations. They can also strain the resources of oncology teams by requiring more health care personnel time to deal with nonmedical In 2007, the U.S. Institute of Medicine delivered a report titled Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs 1 , in which gaps in the provision of psychosocial care for cancer patients were identified. The report highlighted that, despite a burgeoning evidence base demonstrating the effectiveness of a variety of psychosocial health interventions for patients and survivors of cancer, the psychosocial health needs of patients were not being adequately met. That report brought to the forefront the necessity not simply to consider the psychosocial needs of cancer patients, but to carefully integrate psychosocial assessment and subsequent treatment with management of the physical needs of …