Is every psychiatrist an oncology psychiatrist?-Special needs for special populations: a scoping review

The evolution of psychiatric care for patients with cancer has played out over the last century. The first collaboration of psychiatry, oncology surgery, and radiation-oncology occurred in the mid-1950s and represented the early seeds of psycho-oncology. The role of a psychiatrist specializing in treating patients with cancer, a psychosocial oncologist or psycho-oncologist, spans the care continuum from prevention to end of life. The specific needs of patients with gastrointestinal (GI) malignancies range from management of anxiety and depression to focused management for adjustment to an ostomy to sexual dysfunction to treatment in the face of a neuroendocrine tumor (NET).

This is a scoping review; we compiled and summarized psychiatric illnesses commonly encountered in care of patients with cancer in addition to unique GI oncology-related issues. We conducted an electronic PubMed search between 1990-2022. We are presenting the data and providing our insight into psychosocial oncology care for this special population.

The field of psycho-oncology is relatively new. We failed to identify any randomized prospective studies, the majority of the studies were retrospective or longitudinal. The majority of the publications were in the form of review. We reviewed the GI literature to identify the psychological impact of ostomies, sexual impairment and metabolically active NETs. We provide suggested treatment interventions targeting the biological, psychological, and social aspects of patient and family lives.

The role of a psychosocial oncologist as part of the collaborative multidisciplinary treatment team provides nuanced care with attention to unique cancer-related issues that arise during the disease course. The psycho-oncologist brings expertise in combining targeted therapeutic strategies with pharmacologic interventions to address the multi-dimensional symptomatology patients experience. Using a layered approach, patients with mild symptoms can be supported by the general team, while those with moderate to severe symptoms require specialty psychiatric consultation.