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Translated Tool From NCCN Measures Mental Health ‘Temperature’ of People With Cancer


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The National Comprehensive Cancer Network® (NCCN) recently announced that the NCCN Distress Thermometer has been translated into 46 languages. This free resource helps providers worldwide identify and address the multifactorial aspects of distress patients with cancer can experience.

The NCCN defines “distress” as an unpleasant experience of a mental, physical, social, or spiritual nature that can affect the way people think, feel, or act. Distress may make it more difficult to cope with having cancer, its symptoms, or its treatment. Using a tool such as the NCCN Distress Thermometer normalizes and encourages discussion without any of the stigma that can cause some patients to avoid talking about psychological or deeply personal issues.

Robert W. Carlson, MD

Robert W. Carlson, MD

“The NCCN Distress Thermometer acknowledges that undergoing treatment for cancer is distressing for everybody. This simple chart gives patients an easy way to let their doctor know how well they’re coping,” explained Robert W. Carlson, MD, Chief Executive Officer, NCCN. “We’ve found that a score of 4 or higher is an indication for further evaluation and possible intervention. The thermometer includes a corresponding list of problems to help health-care providers determine if a patient’s distress stems from practical problems, family problems, emotional problems, spiritual/religious concerns, physical problems, or a combination thereof.”

Improving Psychosocial and Physical Well-Being

The NCCN distress thermometer was first created in 1997 by psycho-oncology pioneer Jimmie C. Holland, MD. The late Dr. Holland was Founding Chair of the NCCN Guidelines Panel for Distress Management and Founding President of the American Psychosocial Oncology Society. Her goal was to make discussion of distress a routine part of oncology patient visits.

Sonali Johnson, PhD

Sonali Johnson, PhD

“Managing a patient’s emotional distress as well as physical pain is an essential part of medical treatment,” said Sonali Johnson, PhD, Head of Knowledge, Advocacy, and Policy at the Union for International Cancer Control, the world’s largest international cancer-fighting organization. “Cancer patients are particularly vulnerable to anxiety and depression, as well as stress at work and at home, all of which can affect their recovery and quality of life. The NCCN Distress Thermometer provides patients and caregivers with a valuable tool in addressing the psychological impact of illness.”

An International Resource

The NCCN Distress Thermometer translations are part of ongoing efforts by the NCCN Global Team to make NCCN Guidelines® and derivative products more accessible to non-English speakers. More than 100 new translations have been published this year alone, including clinical guidelines and patient-friendly versions. The organization also provides NCCN Framework for Resource Stratification of NCCN Guidelines and NCCN Harmonized Guidelines with optimal recommendations alongside pragmatic approaches to improve treatment in resource-constrained settings, such as low- and middle-income countries.

The translated NCCN Distress Thermometer can be found at nccn.org/global/international_adaptations.aspx#distress. The recently updated NCCN Guidelines for Patients: Distress are also available at nccn.org/patients. 


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Jimmie C. Holland, MD, who served as the inaugural Chairman of the Department of Psychiatry and Behavioral Sciences at Memorial Sloan Kettering Cancer Center, died on December 24, 2017, at the age of 89. The ASCO Post paid tribute to Dr. Holland in its January 25, 2018,...

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