NY JENN BERGIN
When she tells people about her work as an oncology social worker, Sandra Sabatka tends to receive the same reaction from everyone she meets. They always comment “that must be such a sad, hard job,” she says.
“And I answer the same every time,” says Sabatka, LMSW and Senior Social Worker at Wilmot Cancer Center. “I find it a privilege to assist people at a difficult time in their life. If I can relieve even a small burden for them – I feel that I have made this experience a bit easier. I have learned so much more from my patients than I could ever imagine. They have such tremendous strength, fortitude, grace and hope and I am honored that they allow me to be a small part of their journey.”
Over 12 million people in the United States are living with a cancer diagnosis. Highly regarded are those who dedicate their careers to cancer research and the teams of doctors, nurses and surgeons who specialize in oncology. Far less is known about the field of oncology social work, which helps to manage the often equally devastating emotional impact of cancer diagnosis and treatment for patients and their families.
Oncology social workers are skilled at using a biopsychosocial approach, says Sabatka. This means that they strive to understand the “whole” person and all of the many ways a cancer diagnosis can impact a person’s life.
“We understand the physical issues but also the stress that affects patients and their families psychologically, financially, socially – and the overall impact on their life,” she says. “We seek to help patients cope with their diagnosis and treatment, remove barriers to care, communicate with their family, their health care team, employer and other people in their life. We look at a patient’s strengths and work to mobilize them during a time of crisis.”
Some of the daily challenges in oncology social work revolve around addressing the financial burden that a cancer diagnosis can have on a patient and their family. Many patients are not financially prepared for an unexpected diagnosis. Social workers make patients aware of available resources and help aid in the understanding of the intricacies of insurance coverage.
Accessing financial assistance and optimizing resources for patients is a priority, says Susan Nelson, Director of Complementary Services and Social Work at Pluta Cancer Center. Access to care can be challenging when insurance companies fail to cover certain chemotherapies or require an unaffordable co-pay or deductible. Some patients even benefit from assistance in finding transportation or affording gas money to simply make it to their treatments.
“The most significant challenge facing oncology is the same as in health care in general: poor access to all medical science has to offer. There just aren’t enough strategies to get patients all that could help them because of cost,” says Therese O’Connor, LMSW and Social Worker at Lipson Cancer Center at Rochester General Hospital. “Insurance covers less and less every year with the majority of patients having huge co-pays and deductibles that average Americans simply can’t afford.”
An example of this is oral chemotherapy, says O’Connor. Medical advancements now allow for chemotherapies in pill form as opposed to the traditional IV treatment, but patients can’t afford $2400 a month at the pharmacy to get it.
In addition to working to alleviate the financial stress of a cancer diagnosis, oncology social workers strive to ease the emotional impact of the disease and its treatments, and offer resources such as massage therapy, acupuncture, nutritional counseling, Tai Chi, yoga, support groups, and cooking classes for patients and caregivers.
“We recognize that there are many paths to healing,” says Sabatka. “We seek to provide education, support research, foster an environment of open communication, and develop programs that honor the whole person – body, mind, and spirit.”
Participation in organizations such as the Association of Oncology Social Workers (AOSW) is critical in keeping up to date with skill building, national resources and trends, and networking, says Nelson.
AOSW is an international non-profit organization dedicated to the enhancement of psychosocial services to people with cancer and their families. The organization was created in 1984 by social workers interested in oncology and by existing national cancer organizations. AOSW now has over 1000 current members who embrace the AOSW Mission: “to advance excellence in the psychosocial care of persons with cancer, their families, and caregivers through networking, education, advocacy, research and resource development.”
Through conferences, specialty certifications, partnerships and educational programming, AOSW and other such organizations help to recognize the importance of oncology social work in cancer care and advance the excellence of this care.
Any type of social work can be hard to simply leave behind at the end of the work day – and oncology social work can become truly personal. Upon her own mother’s breast cancer diagnosis in 1994, Nelson decided to transition into the role of oncology social work and Sabatka became interested in the specialty after dealing with her mother and other family members’ cancer diagnoses.
As a result of her profession, Sabatka says she tries to make the most of every day. Her mother passed away in 2009.
“I truly understand what it is like to be a caregiver and the potential negative impact of this disease,” she says. “I also have a tremendous amount of hope. As cancer survival rates increase, I am amazed at how many more treatments we have available for patients then when I first started 12 years ago.”
As the first oncology social worker hired at Rochester General years ago, O’Connor learned some profound lessons – many of which she is bringing home to her own children.
“Working in the cancer field has taught me to be incredibly grateful for all the positives in life, and to teach my children that as well,” says O’Connor. “I’ve also learned that it’s a privilege to be able to take control of things I can control. Sometimes cancer still wins despite a person’s best efforts to make improvements to his or her health.”
“Life is not about the time that you have – but how you choose to spend your time, “ says Nelson.
“Oncology social work has and continues to teach me life lessons,” she says. “Witnessing what my patients experience has taught me to live in the moment, love and cherish those close to you and to not take anything for granted.”
The role of the oncology social worker is anticipated to continue to grow amid changes in healthcare reform and increased focus on the development of cancer survivorship plans and clinics. Social workers are highly regarded by their medical colleagues and considered a vital part of any cancer care team. The capacity of oncology social work to enhance medical care and advance healing through treatment of the “whole” patient is now considered critical to care.
“One of my patient’s mothers gifted me with a beautiful sign for my office that says Believe,” says Sabatka. “It serves as daily reminder to maintain hope so I can provide support and encouragement to our patients.”
These gifts offered through oncology social work can often ease the pains that traditional medicine can’t touch.