After medical school in Peru and an oncology fellowship at CU Denver, Sonia Okuyama, MD, took a turn from the study of drugs and devices to the study of cures for the mind as well as the body. As the new director of the Cancer Center’s Cancer Information and Counseling Line (CICL), Dr. Okuyama develops and implements interventions that help patients cope with the many challenges of cancer outside the traditional conception of physical health. Here we talk with Dr. Okuyama about her work.
C3: How did you get interested in the psychosocial aspects of cancer care?
Okuyama: Where I trained in Peru, we had none of the modern medicines or technologies. The psychosocial aspect was fundamental to patient care—many times it was all we had—so it’s close to my heart. I see similar challenges during my clinical work at Denver Health, where about half our patients are uninsured. Even with insurance it can be very difficult to get appropriate psychological support, since coverage is so limited. My work is to gather evidence that can help patients access this integral part of cancer care.
C3: So instead of treatments targeting cancer, what’s the focus of your research?
Okuyama: I have projects looking at the psychosocial care of cancer patients at every stage of the disease. For example, the Dignity Therapy Project is testing a structured videotaped interview as an intervention to improve psychosocial outcomes in advanced cancer patients. This allows patients to reflect back on their lives, what they want to leave behind and what they’re most proud of.
I remember one patient in particular who was nearing the end of the medicines we could offer to treat his colon cancer. We talked about palliative care and end-of-life planning, but there was a wall we couldn’t penetrate; he would shut us down. We were worried that without a proper discussion he would end up dying in the ICU. Then he took part in the Dignity Therapy Project and it was such a breakthrough. Two or three months down the road, when the time came, the transition to end-of-life was completely opposite to what we feared. It was dignity.
Okuyama: We’re studying programs for cancer survivors as well. For example, the C-STEPS [Cancer Survivorship Telephone Education and Personal Support] program is a six-session telephone counseling program delivered by the CICL, where survivors learn to manage and cope with the increased distress that can be very poignant in cancer survivors.
The other component of this counseling program is to help patients adopt healthy lifestyles—eating more fruit and vegetables and exercising. As you can see, my research is about helping people through the cancer journey, not from the medical/drug standpoint, but from the psychosocial, whole-person standpoint.
C3: How do you think being trained as an oncologist and not necessarily as a psychologist affects your work?
Okuyama: We have phenomenal psychologists as part of our research team, but I do think it helps in many ways to have an oncologist bridge the gap between these worlds to ensure a collaborative effort—and I’m happy to be such person. As any oncologist will tell you, every day we deal firsthand with highly distressed patients who seek not only the best medical treatments, but also a more holistic understanding of the cancer experience. Cancer care is definitely moving in that direction. I hope I can help the University of Colorado Cancer Center offer the most outstanding care, in the broadest definition of the word.