Not surprisingly, cancer patients experience unique life problems and high levels of distress throughout the diagnosis and treatment process, yet this phenomenon has been acknowledged only in the past 25 years.[1] The National Comprehensive Cancer Network (NCCN) recommends distress screening for cancer patients,[2] and the literature supports the use of distress screening to address problems before a crisis necessitates intervention.[3-5]
From the July 2005 opening of the Moores UCSD Cancer Center, a National Cancer Institute (NCI)-designated Comprehensive Cancer Center, all patients have been screened for problem-based distress at first visit. Based on 10 years of experience in cancer problem–related distress screening,[6] we have developed a biopsychosocial screening instrument titled How Can We Help You and Your Family? (see Figure 1). For clinical purposes, individual screening data have been used to refer distressed patients for supportive care within the Science of Caring team. For research purposes, screening data have been entered into a database for analysis to identify common problems and trends. Using this information, we have developed and continue to modify our educational and intervention programs in a way that is tailored to the needs of our patient population.
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A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
