A cancer diagnosis affects more than the body. Patients often experience new concerns and challenges when they hear the words “you have cancer.” What does this mean for my future? How will I continue to provide for my family? How do I tell my friends and coworkers? Am I going to die? Can I trust my body?
While many of these concerns are strongest during treatment, the psychological impacts of cancer last into survivorship, too. At Dana-Farber Cancer Institute, thanks in large part to support from our philanthropic community, we have pioneered many services that support patients holistically as they journey through and beyond a cancer diagnosis, including a robust social work program. In fact, Dr. Sidney Farber hired the first full-time oncology social worker in the nation in 1952. We recently spoke with several social workers across Dana-Farber’s network to learn more about their work and the challenges their patients face.
“Being a social worker means each day looks different,” says Kim Kisil, LICSW, who sees patients in-person, via telephone, and virtually from Dana-Farber’s Milford location. “Individuals who live with serious illness are at greater risk of developing post-trauma stress disorder symptoms including increased hyper-awareness, re-experiencing, avoidance, and anxiety. The difference for cancer patients is that the trigger for these symptoms is not a one-time event, rather an ongoing threat to safety. Because the threat is coming from within someone’s own body (versus an external source), it can feel as though there is no escape.”
Kim and her colleagues across the Adult Social Work Division provide support to patients and their families to help manage these threats and their impact on patients’ lives, assist in resource navigation, facilitate conversations about advanced and end-of-life care planning, and serve on patients’ multidisciplinary care teams. For many of these clinicians, whose careers require great empathy, the role seems almost pre-determined.
“I have always wanted to work with oncology patients since I was in high school, and always dreamed to work for Dana-Farber in some capacity,” explains Aileen Gummow, LCSW, who sees patients at Dana-Farber’s South Shore location. “My mom is who inspired me. When I was 13, she was diagnosed with early stage breast cancer, which recurred when I was 17. In 2019, she was diagnosed with metastatic breast cancer and has been the most revered person in my life as I’ve witnessed her kick cancer’s butt for 14 years!”
“Both of my parents are physicians, my father in pediatric oncology, so I was familiar with the medical field and have always been drawn to hearing and sharing stories and emotional experiences,” adds Christina Palis, LICSW, who is based at Dana-Farber’s Longwood campus and sees patients with blood cancers.
For Leora Lowenthal, LICSW, senior social worker at Dana-Farber – Chestnut Hill and the 2023 president of the Association of Oncology Social Work (AOSW), her work is also a tribute to her family. “In 1990, my mother died following 13 months of treatment for a rare and aggressive cancer. During that time, my family endured significant practical, financial, and emotional duress. I decided to dedicate my professional life to figuring out how I could have made that experience a better one—for us and for other families.”
One of the biggest challenges for cancer patients, no matter their age, diagnosis, or life situation, is uncertainty about the future. “There is a lot of waiting and wondering involved with a cancer diagnosis and treatment—for test results, for a procedure, to know how side effects may impact you, to learn if treatment is working,” Leora explains. “It’s a lot to handle while also trying to live and plan one’s life.”
The uncertainty of cancer also causes significant grief for patients, which starts the moment they hear the word “cancer,” even if their disease is treatable. Patients often struggle with the loss of their independence and freedom, physical function, body parts and/or hair, their idea of the future, and more. “Patients want to be seen and heard, and for their feelings to be normalized,” Aileen says. “Often, validation from others about these feelings—from clinicians and loved ones—helps patients feel cherished and helps manage their mental health.”
Christina adds that every patient, from the young adults she works with to patients in their 90s, will cope with these challenges in a different way; there is no guidebook for patients—or for their loved ones. “It’s important for loved ones to be patient, humble and understanding. This may look like offering space to talk, helping with distractions, providing meals or practical support. Take the patient’s lead and continue to show up, even after treatment,” she says. “The power of being present is so much stronger than most loved ones realize,” Aileen adds.
Vital members of the Dana-Farber community, these clinicians are dedicated to giving back, even beyond their day-to-day work. Christina is a two-year participant (and more to come, she says) in both the Boston Marathon® Jimmy Fund Walk presented by Hyundai and the Pan-Mass Challenge Winter Cycle, experiences that have stuck with her for their inspirational mission, the physical endurance required, and the shared experience with other participants.
“The Jimmy Fund Walk was honestly one of the hardest things I’ve done to date, both physically and emotionally,” adds Kim, who first participated in the 26.2-mile route in 2010, before joining Dana-Farber. “One’s experience with cancer is often described as a marathon, and it provided great insights into the emotional roller coaster oncology patients face.”
Learn more about social work at Dana-Farber on our website, where you can also download tip sheets for patients, family members, and caregivers to manage the challenges mentioned in this article and many others.
You can help support services like these by joining a Jimmy Fund event, the Pan-Mass Challenge, or donating to The Dana-Farber Campaign, our ambitious, multi-year fundraising effort to prevent, treat, and defy cancer. The Dana-Farber Campaign will accelerate the Institute’s strategic priorities by supporting revolutionary science, extraordinary care, and exceptional expertise. As a community, we have the power to create a more hopeful, cancer-free future—in Boston and around the world. Together, we can defy cancer at every turn. Learn more about The Dana-Farber Campaign and how you can get involved at DefyCancer.org.