1. Results
Background: As 21st century cancer patients become
more technologically savvy, their need to become more
actively involved in their cancer care allows them to feel
more empowered to take care of themselves physically-
mentally-emotionally throughout their cancer journey. It
is no longer enough to provide cancer-related supportive
care, without augmenting services to actively engage
cancer patients in their own bio-psycho-social-spiritual
self-care and personal growth throughout cancer care.
Methods: A new Behavioral Health Oncology
Consultation Service model was developed to integrate
the bio-medical, psycho-social and spiritual-existential
realms of cancer care as an integrative hybrid approach
to meet the growing needs of the 21st century cancer
patient. This service was built from a PCMH-based
Population Science approach of extending the widest
cancer-care net to the greatest cancer
populations. Receiving direct referrals from Texas
Oncology physicians housed at Baylor Sammons Cancer
Center for all cancer diagnoses + stages, the Behavioral
Health Oncology Consultant provides time-limited cancer-
focused bio-psycho-spiritual-existential supportive care to
promote overall HR-QoL and well-being. Based on a
three-pronged hybrid infrastructure, the service integrates
three primary interventional treatment models:
1) Integrated Behavioral Health Consultation model
providing cancer-related healthy lifestyle
management;
2) Psycho-Oncology model providing cancer-related
psycho-social supportive care; and
3) Existential-Spiritual Care model providing meaning-
centered/purpose-driven interventions to promote
legacy-building + vital involvement through cancer.
Measures: The Duke Quality of Life questionnaire
[assessing physical, mental, social + general QoL
domains] was administered at each appointment, and the
Schedule of Meaning in Life Evaluation [SMiLE] was
administered at the initial evaluation appointment to
assess patients’ meaning & purpose in life as identified
via demarcated levels of importance + satisfaction.
Discussion
As the multidisciplinary fields of medical oncology and
cancer care continue to grow and innovate based on
new scientific research, treatments + cultural trends,
so, too, must psycho-social supportive services in
cancer care meet the growing needs of its 21st
Century cancer populations. By building an integrative
Behavioral Health Oncology Consultation Service
model that challenges patients to take care of
themselves on bio-psycho-social-spiritual-existential
levels of engagement, patients feel far more invested,
empowered + vitally involved in their cancer journey.
BEHAVIORAL HEALTH ONCOLOGY CONSULTATION SERVICE:
Building an Integrative Hybrid Cancer Care Model
to Meet the Growing Needs of the 21st Century Cancer Patient
Shannon R. Poppito, Ph.D. & Donna L. Copher, M.A.
Behavioral Health Oncology (BHOPE) Service
Baylor Sammons Cancer Center, Dallas TX
BODY
INTEGRATIVE BEHAVIORAL HEALTH
HEALTHY LIFE STYLE MANAGEMENT
 Diet / Exercise Mgmt
 Coping & Stress Reduction
 Cancer-Related Pain Mgmt
 Sleep / Fatigue Mgmt
 Mood/Hormone Regulation
MIND
PSYCHO-ONCOLOGY
 Cancer-Related Stress Mgmt
 Life-Transitional Stress Mgmt
 Fear / Worry / Anxiety Mgmt
 Demoralization/Depression Mgmt
 Mindfulness & Relaxation
 Restorative Self-Care
SPIRIT
SPIRITUAL-EXISTENTIAL SUPPORT
 Meaning-Centered Therapy
 Purpose-Driven Support
 Spiritual / Religious Support
 Grief & Bereavement
 Post-Traumatic Growth
 Vital Involvement
PHYSICAL & MEDICAL
SYMPTOMS
 Cancer-Related Pain
 Cancer-Related Fatigue
 Sleep Disturbance
 Anxiety/Worry/Panic
 Depression/Sadness
SPIRITUAL DEMORALIZATION
Crisis in Meaning & Purpose
Crisis in Faith & Hope
(Religious/Spiritual Beliefs)
End-of-Life Exploration
Post-Traumatic Cancer Stress
vs. Post-Traumatic Growth
EXISTENTIAL SUFFERING
 Death Anxiety
 Existential Distress
 Existential Guilt
 Existential Ambivalence
 Existential Isolation
 Existential Despair
BEHAVIORAL HEALTH ONCOLOGY SERVICE:
AN INTEGRATIVE HYBRID
BIO-PSYCHO-SOCIAL-SPIRITUAL-EXISTENTIAL
APPROACH
CANCER-RELATED SYMPTOMS & CHALLENGES 43%
13%
14%
5%
5%
4%
3%
2%
3% 8%
BREAST = 145
BRAIN = 42
BLOOD = 48
COLO-RECTAL = 16
GI-GASTRIC/PANCREATIC = 18
GYN = 13
LUNG = 10
ORAL, HEAD & NECK = 8
SARCOMA = 10
OTHER = 25
BEHAVIORAL HEALTH ONCOLOGY SERVICE
REFERRALS BY DISEASE MANAGEMENT: APRIL 2015 TO OCTOBER 2016
This new Behavioral Health Oncology Service was
launched in late April 2015. Though beset with multiple
significant institutional challenges (e.g., non-existent
psycho-social service infrastructure, institutional divisions
between clinical and programmatic services, no shared
electronic medical record), the service experienced a quick
demonstrative uptake from its inception last year. To date,
the Behavioral Health Oncology Service has grown
exponentially, with more than a 300% increase in oncology
referrals compared to past supportive care services:
Total Referrals = 335
Total appointments scheduled = 1154
Total patient encounters = 964
Total % Cancellations/No Shows = 10.68%
Abstract