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NCCN Guidelines for Patients



Distress, Version 1.2017


What help is there?

Mental health services

Mental health services

Your cancer care team may refer you to a mental

health professional. There are many types of mental

health professionals. Examples include clinical social

workers, psychologists, advanced practice clinicians,

psychiatric nurses, and psychiatrists. The work of

these professionals overlap but their expertise varies.

Your cancer care team will refer you to someone who

is a good fit.

The first step of care is often an evaluation to assess

the problem. Evaluations differ between people

based on the type of distress. Evaluations can

consist of one or more of the following: interviews,

surveys, and testing.

Based on the evaluation, your provider will make a

treatment plan for you. Research has shown that

mental health treatment works well to reduce distress

and improve quality of life among people with cancer.

The common types of mental health treatment are

described next.


Psychoeducation is a learning event for people

with specific types of distress or health conditions.

The focus of the event may be general, such as

on stress management. Other events may have a

specific focus, such as sun protection for people with


There are many methods to deliver psychoeducation.

One method is one-to-one teaching. Group

psychoeducation is also common. Besides in-person

learning, you may receive reading materials, DVDs,

and online resources.


Some people need eyeglasses to function better.

Likewise, some people need medicines to function

better. Psychiatric (or psychotropic) medicines are

drugs that improve mental health. These medicines

work by changing the amount of certain chemicals in

the brain. Psychiatric medicines can be prescribed by

psychiatrists, nurse practitioners, oncologists, and in

some states, psychologists.

There are different types of psychiatric medicine.

They are grouped by how they are commonly used.

However, be aware that some medicines have other

uses. An example is an antidepressant that can also

help some women with hot flashes. The common

classes of psychiatric medicines are listed next.


. These medicines treat depression.

Two key features of depression are feeling down or

irritable and losing interest in things that you used to

like. Depression that is present at cancer diagnosis

or during treatment may last a long time. There is

strong proof that antidepressants work well to treat


Antidepressants may be used with psychotherapy

to treat depression. Antidepressants also treat

anxiety and certain physical problems. Such physical

problems include nausea, hot flashes, pain, and

sleep problems. Read


to learn more

about anxiety.


. These medicines may be used with

psychotherapy to treat anxiety. They are also called

anti-anxiety medicines. Key features of anxiety