Sockol, L. E. (2020, October). The call is coming from inside the house: A clinical psychologist’s experiences with reproductive psycho-oncology. Presentation accepted for the annual meeting of the North American Society for Psychosocial Obstetrics & Gynecology, St. Louis, MO.
This presentation is forthcoming at the 2020 Biennial Meeting of the North American Society for Psychosocial Obstetrics & Gynecology at the St. Louis School of Pharmacy in St. Louis, Missouri.
Background
It is well-established that cancer patients and survivors are at increased risk for psychosocial distress. Among women of reproductive age, fertility-related distress is common at the time of diagnosis, during treatment, and throughout survivorship. This knowledge is reflected in practice guidelines recommending screening for distress among cancer patients and the development and dissemination of a range of interventions for addressing both general distress and fertility-related concerns among cancer patients and survivors.
Objective
This presentation will juxtapose current research and practice guidelines with the recent experiences of a gynecologic cancer survivor whose experiences were shaped by her background as a researcher and clinician in the field of women’s reproductive mental health.
Methods
Laura Sockol has been a member of NASPOG since 2009. As a clinical psychologist, her research and clinical training have emphasized reproductive mental health, with a specific focus on risk factors for distress in perinatal patients. In 2018, at the age of 32, she was diagnosed with stage 2B cervical adenocarcinoma. Her experiences as a patient during fertility preservation treatments, surgery and chemoradiation, and follow-up care were shaped by her professional identity and expertise.
Results
Laura’s experiences highlighted important gaps between research and clinical practice. Despite robust research identifying the mental health needs of gynecologic cancer patients, few providers engaged in assessment of mental health needs. Screening procedures were not well-integrated with referrals for follow-up care. The expertise of providers with strong knowledge of both reproductive mental health and psycho-oncology was invaluable; however, identifying and accessing appropriate providers was challenging – even for a patient whose professional network was exceptionally well-suited to the task. Many patient resources did not adequately address specific problems she faced as a young, single, queer woman.
Conclusions
Integrating psychosocial care for gynecologic oncology patients requires specialized knowledge from medical, psychological, and legal perspectives. A lack of knowledge among non-specialist providers, and difficulty coordinating among multiple providers with siloed expertise, may contribute to patient distress and could increase risk for poor outcomes – not only for psychological well-being, but for cancer treatment and long-term fertility.
