Biopsychosocial and Cancer Patient Care

Dr. Baraki,

How do you think the Biopsychosocial model translates into the oncology world? I work with both patients and survivors in an exercise setting and, although it is the minority of the overall population i’m sure, many of the people I work with are constantly looking for things to help them recover better, relieve pain, and overall help to improve their tolerance to the negative symptoms associated with treatment. This leads them to many of the snake oil products and methods that, as you have discussed many times, are not supported by evidence in any sort of mechanical context. Do you think that with proper education of the current understanding of pain, it could help patients/survivors to tolerate symptoms of their current and/or past treatment? I realize cancer is a completely different situation than chronic, non-specific low back pain but it is my understanding that both situations are multi-factorial, albeit cancer much more complex.

Working with these people has made me realize that as much as I would love for them to get training, small changes are what work. I figured that educating them on the current model could give them a new sense independence and possibly allow them to live higher quality lives while they cope with the unfortunate reality. Although, things like lymphedema in which there is such an obvious change to their physical appearance, have me doubt patient buy-in against a purely mechanical model.

At the end of the day, cancer sucks and there is no magic fix, but as science continues to evolve I figured to try and use what we have to help.

Hi Zac,

As you have said, while nonspecific low back pain is a different entity than cancer, the BPS model adequately encompasses and influences all experiences of pain, both acute and chronic, malignant and non-malignant. Psychosocial factors have a major influence on chronic cancer pain.

If you have a particular interest in this area, there’s plenty of published literature on the topic going back several decades - try searching for: biopsychosocial pain cancer

For example, here’s a relatively recent review paper on the topic you may find helpful: The biopsychosocial model in cancer pain - PubMed