Beyond The Cancer Diagnosis: Dialogue with Sonia Amin Thomas, Hosted By Adrian Pogacian

For this latest episode of ‘Beyond the Cancer Diagnosis’, Adrian Pogacian debates the Psychological Dimension of NSCLC (Non-Small Cell Lung Cancer) with Sonia Amin Thomas, PharmD, BCOP, Associate Professor at a pharmacy school in Georgia and clinical oncology specialist. This marks Sonia’s second insightful interview in the series.

Sonia Amin Thomas, PharmD, BCOP is an Associate Professor at a pharmacy school in Georgia and a clinical oncology specialist at a community hospital in Georgia where she mainly practices in an outpatient setting.

Her main role is with supportive care including educating patients, assisting with side effect management, treatment selection with the oncologist, and serving as a preceptor to pharmacy students and residents on rotation. She is also the residency program director with the school and hospital.

Dr. Thomas is also certified as an integrative nutrition health coach and integrative oncology pharmacy specialist and is currently pursuing her desire for functional medicine by getting credentialed (AFMCP) through the Institute of Functional Medicine.

She has published many papers and given numerous presentations as well as medical writing and creating CME’s for oncology. She has also written pharmacy board questions and been invited to speak at conferences locally, nationally and internationally last year in Vienna for oncology supportive care and integrative topics.

Adrian Pogacian, MS Psychology, clinical psychologist with executive education in Psycho-oncology, holding a degree in Global Health Diplomacy from Geneva Graduate Institute. Currently, researcher and associate lecturer with focus on Impact of Cancer Diagnosis on Couples and Families, Communication in Cancer Care and Posttraumatic Growth.

His expertise is on Coping with Cancer and managing Fear of Recurrence.

Additionally, Founder of INCKA Psycho-oncology Center, Host of Beyond the Cancer Diagnosis Interview Series as well as Writer and Host Content in Psycho-oncology at OncoDaily.com, Editorial Team Member of OncoDaily Medical Journal, co-author of the first Romanian Multimodal Care Guideline in Pediatric Onco-hematology, active contributor to the International Psycho-oncology Society, presently IPOS Fear of Cancer Recurrence SIG member and IPOS Early Career Professionals in Psycho-Oncology Committee founder member.

Psychological dimension of NSCLC (Non-Small Cell Lung Cancer)

Adrian Pogacian: Lung cancer remains the leading cause of all cancer-related mortality worldwide. It is also known that there are two primary types of lung cancer, and the most prevalent type is non-small cell lung cancer (NSCLC). Therefore, Dr. Thomas, what is NSCLC, and what are the risks for developing it?

Sonia Amin Thomas: NSCLC, or non-small cell lung cancer, is the most common type of lung cancer and involves a certain type of histology. The biggest risk factors for NSCLC are smoking, age, and second-hand smoking. In fact, second-hand smoking became a higher risk factor than smoking itself a few years ago. Age greater than 65 is typically a higher risk. Other risk factors include exposure to asbestos, family history, and other long-standing lung diseases such as COPD.

Adrian Pogacian: Additionally, I would like to ask you, what are the symptoms of NSCLC?

Sonia Amin Thomas: Symptoms of NSCLC can include shortness of breath, cough, fatigue, coughing up blood, chest pain, and weight loss.

Adrian Pogacian: Consequently, what are the recommended treatments for NSCLC?

Sonia Amin Thomas: Treatment for NSCLC includes surgery, chemotherapy, immunotherapy, oral targeted drugs, and sometimes radiation.

Adrian Pogacian: These treatments that you’ve mentioned above are based on complicated clinical information for the patient to understand and move ahead. Integrating them into a treatment plan is challenging.

Hence, two issues come as natural: communication in cancer care and the Shared Decision Making With Patients process. Could you please elaborate on each of them, especially nowadays when we are talking about patient-centered oncology care?

Sonia Amin Thomas: Communication in cancer care is extremely important. It is vital that the patient understands the whole treatment process, which can take 6 months to 1 year or even longer in some cases. It can be very complex and complicated, so it is best that it is written out and communicated to all parties involved. This is where a pharmacist can play a crucial role and assist the patient and family in education.

Shared decision-making is the only way any cancer treatment can occur. Both the provider and the patient need to weigh the benefits and risks of every option available. It should be explained thoroughly to the patient so that they can make an educated decision. There are many options in oncology, and it is important that the patient understands how each treatment regimen works, along with the side effects, benefits, and impact on quality of life.

Adrian Pogacian: Dr. Thomas, prior studies have found negative emotions, particularly depression, associated with NSCLC. Could you identify other emotions that patients might experience related to this disease?

Sonia Amin Thomas: So many emotions! Anxiety, stress, guilt, hopelessness, and fear are the most common that I’ve seen due to the push and pull of emotions from an NSCLC diagnosis. Patients often feel burdened, and others may push themselves harder to make sure they are pulling their weight in everything, adding more stress onto the body. There are quite a few who feel grateful and are thankful to be diagnosed earlier rather than later.

Adrian Pogacian: The diagnosis of lung cancer increases the psychosocial distress of the patient as well as social isolation. In such circumstances, what could be the main coping strategies to improve the patient’s quality of life (QOL), as a primary goal during treatment and survivorship?

Sonia Amin Thomas: Support groups are extremely helpful, as well as support from friends and family. Coping with mental health is not an easy task. Integrative strategies such as exercise, meditation, yoga, proper nutrition, and sleep are essential for handling psychosocial distress. The NCCN guidelines really emphasize whole-being care and being mindful of the individual’s overall well-being.

Adrian Pogacian: As for the last question, I would like to reinforce the impact of any cancer diagnosis on caregivers (including family and friends).

Furthermore, previous studies suggest that as a patient’s disease progresses, the physical well-being of the caregiver has been shown to decrease. Dr. Thomas, according to your specialized expertise, how challenging is it to be a caregiver to an NSCLC patient?

Sonia Amin Thomas: Being a caregiver is no easy task. It can be very challenging to place the patient first and forget about yourself. My biggest advice to a caregiver is that the best way to truly care for someone else is to take care of yourself first.

It can be difficult to cater to each person’s needs, which may be different, and to do so in a way that the patient may want. There has to be a balance between the patient’s and caregiver’s needs, and once harmony is established, it can be very rewarding to take care of someone else.