Beyond The Cancer Diagnosis: Dialogue with Wendy Lam, Hosted By Adrian Pogacian

In this episode of ‘Beyond the Cancer Diagnosis’, Adrian Pogacian emphasizes the activities of International Psycho-Oncology Society and defines terms and notions related to psycho-oncology with Dr. Wendy WT Lam, RN, PhD, FFPH, and acting IPOS President.

Dr. Wendy WT Lam is an Associate Professor and the head of the Division of Behavioural Sciences at the School of Public Health, The University of Hong Kong. She is an academic director of the Master of Public Health Program. Wendy is the founding director of the HKU Jockey Club Institute of Cancer Care (JCICC). She is an active contributor to the International Psycho-oncology Society, currently the President of IPOS.

She was awarded the 2007 Hiroomi Kawano Young Investigator Award by the International Psycho-Oncology Society for her work on Chinese women with breast cancer. She was also awarded the 2023 Distinguished Merit Award by the International Society of Nurses Cancer Care. Her research interests focus on psychosocial adaptation patterns and service optimization in cancer patients.

She is the principal investigator in research programs, including studies on fear of cancer recurrence and progression for cancer survivors and patients living with advanced cancer, return to work and activity impairment after cancer diagnosis, implementation of symptom distress screening, and optimization of cancer survivorship. She is currently leading the JCICC team to develop a care model that integrates psychosocial services into routine cancer care.

Under her directorship, JCICC recently established the first cancer survivorship clinic in Hong Kong offering support in managing post-treatment symptoms, as well as personalized diet and physical activity advice. She has produced over 200 outputs. She is the co-editor of the 4th Edition of Psycho-oncology Textbook. She is appointed Associate Editor for Psycho-oncology and for Patient Education and Counseling.

Moderator

Adrian Pogacian, MS Psychology, licensed clinical psychologist with executive education in Psycho-oncology, considerable time active in the field of Health Security, holding a degree in Global Health Diplomacy from Geneva Graduate Institute.

Currently, an advocate of Psycho-education in the field of oncology, researcher and associate lecturer with focus on Communication in Cancer Care, Coping with Cancer and Fear of Recurrence, working with young people and their caregivers on self-blame and disease acceptance.

Additionally, co-author of the first Romanian Pediatric Oncology and Hematology Guide Book, Founder of INCKA Psycho-oncology Center, ESO (European School of Oncology) Podcast contributor, Writer and Host Content in Psycho-oncology and Beyond the Cancer Diagnosis Interview Series at OncoDaily.com, IPOS Fear of Cancer Recurrence Special Interest Group (FORwards) member and IPOS Early Career Professionals in Psycho-Oncology board member.

Beyond The Cancer Diagnosis: Dialogue with Wandy Lam, Hosted By Adrian Pogacian

00:00 Introduction
00:53 Brief presentation of IPOS
3:26 Definition of psycho-oncology
5:29 Main differences between psycho-oncology and psychosocial oncology
9:28 Concept of SIG (Special Interest Group) in IPOS
11:31 Is IPOS mainly an academic-based community?
13:19 Outcomes of annual congresses
16:18 Do psychologists complain about the lack of training programs or executive education?
21:14 Connections with other international institutions dealing with cancer
24:42 Impact of AI in the field of psycho-oncology

The transcript of Beyond The Cancer Diagnosis: Dialogue with Wandy Lam, Hosted By Adrian Pogacian

Adrian Pogacian: Hello everyone, nice to meet you again at a new episode of the Beyond the Cancer Diagnosis interview series. Today our guest is Dr. Lam, the president of the International Psycho-Oncological Society.

Dr. Lam, thank you for accepting our invitation and welcome to our interview series.

Wendy Lam: Thank you, Adrian, and thank you for inviting me to have the interview. So it is my great pleasure to be able to take part in this. Thank you.

Adrian Pogacian: For sure, it will be an interesting discussion because we are trying to cover all over the world and maybe IPOS in some parts of our globe, it’s not so well known. Therefore, I will ask you as a first question to make a brief presentation of what IPOS is in terms of history, beliefs, values and future plans. 

Wendy Lam: Sure, so IPOS was established in 1984 by Dr. Jimmy Holland to promote global multidisciplinary collaboration in the field of psycho-oncology.

So this year is our 40th anniversary of the IPOS. So for IPOS, it’s basically the main purpose is to serve as a platform for clinicians, educators and researchers from various disciplines to come together and exchange knowledge, insight and advancement in the field of psycho-oncology.

By fostering international communication, IPOS facilitates the dissemination of clinical practice, educational resources and research findings that contribute to the well-being of patients with cancer and their families.

And one of our main goals is to enhance the support provided to patients with cancer and their families throughout the cancer journey, from the moment of diagnosis through the treatment phase and into survivorship and palliative care.

By addressing the psychosocial impact of cancer, IPOS seeks to improve the quality of patients and to promote quality of life of patients and to promote their overall well-being. In order to achieve these objectives, IPOS emphasizes the importance of a multidisciplinary approach.

Psychiatry, psychology, social work, nursing and palliative medicines are predominantly disciplined in the field of psycho-oncology. By collaborating across these disciplines, professionals can provide comprehensive care that addresses the psychological, emotional and social needs of cancer patients and their families.

Adrian Pogacian: Thank you for your brief introduction.

So as far as I think, we are talking about psycho-oncology officially like for 40 years. It’s almost half of a century. For some, it’s quite a big number, for some, quite not. Even though psycho-oncology within psychology, it’s a new notion. And there are many definitions of what psycho-oncology is or means or intends to be, even though the foundation of each definition, it’s quite the same.

But I want to ask you this time as a researcher, not unofficial position of IPOS president, what can you define or how can you define psycho-oncology in terms for every patient to understand this word?

Wendy Lam: Sure. So from my perspective, psycho-oncology is really a subspecialty of oncology in which we focus on addressing the emotional responses of patients, the family and caregivers at all stages of the disease. And also in this particular subspecialty, we recognize the psychosocial aspect of cancer and identify the psychological, social and behavioral factors that may impact cancer, morbidity and mortality.

And in the field, we integrate psychological support and intervention to improve the overall well-being and treatment outcomes of cancer patients. So that’s how I conceptualize, so to speak, in terms of what psycho-oncology is about.

Adrian Pogacian: Very, very interesting definition, because you said that it’s quite a division of oncology.

Many people and researchers think that it’s a subdivision of psychology. For example, in Eastern Europe, we were taught that psycho-oncology is something within psychology. Now, in the Western part, to put it this way, it’s treated as a part of oncology. So this is very interesting.

And also, it’s very interesting that I noticed also on the IPOS website and on the events that sometimes a specialist refers to psychosocial oncology. And it seems to me that there are two terms that sometimes they are using incorrectly or apply incorrectly because psychologists this time may not understand exactly what is psycho-oncology, what is psychosocial oncology.

Can you or could you point out the main differences if there are between these two terms?

Wendy Lam: Sure. So from my perspective, I see that psycho-oncology typically refers to the psychological aspect of cancer, specifically focusing on the emotional and mental well-being of the patients with cancer. And it often involves the assessment and treatment of psychological distress, such as anxiety, depression and adjustment issues that can arise from cancer diagnosis.

And also  psycho-oncology may involve looking at an individual’s counseling, using cognitive behavioral therapy and other psychological intervention to help patients cope with emotional challenges associated with cancer.

On the other hand, if you separate psycho-oncology with the psychosocial oncology, I would say psychosocial oncology encompasses a broader perspective as it addresses not only the psychological aspect, but also the social aspects of cancer. And psychosocial oncology recognizes that cancer impacts not only the individuals with the diagnosis, but also the family, friends and also a broader social network and even impacts on society as well.

It considers the social support system, communications dynamics and societal factors that may influence the well-being of the cancer patients and their loved ones. So I guess psychosocial oncology may also involve support groups, family therapies, intervention to address social challenges such as financial concern, relational relationship issues and caregivers’ burden.

So overall, I think the two terms are often used interchangeably, where psychosocial oncology can be seen as a more comprehensive approach and that includes both the psychological and social aspects of cancer, whereas psycho-oncology primarily focuses more on the psychological well-being of patients with cancer.

But as I mentioned earlier on, in terms of the role or the goal of psych on IPOS, I think we actually cover a much broader perspective rather than just looking at the psychological aspect. So to me, that’s the difference between the two. But as you said, I think there’s a lot of overlapping between the two definitions, you know.

Adrian Pogacian: Thank you very much. You said within IPOS, you try to cover also the social aspect of the patient, which is very important because statistics say that family support, for example, it’s hard for free covering. So this is very, very important.

And this is, I guess, a part of the IPOS community, which is divided in working groups. And here, I will ask you to develop this concept of special interest groups. I saw on the IPOS websites, you have a different SIG that covers the main aspect of the oncological patient from an oncologic point of view.

Wendy Lam: Sure. So special interest groups in psych oncology or in IPOS, we refer to groups of professional researchers and advocates dedicated to advancing understanding and treatment of psychological and social issues related to cancer. And this group focuses on specific areas such as pediatric oncology, cancer survivorship, palliative care, fear of cancer recurrence, geriatric oncology, e-health intervention.

And also, we have a special interest group focused on psycho-oncology work within LMIC countries. So they provide a platform for members to collaborate and share knowledge and also to develop strategy to improve the quality of life of cancer patients and their families. We also advocate policies that support patients with cancer and promote access to quality care.

So as you probably see on our website, we now have nine special interest groups to cover a variety of topics.

Adrian Pogacian: That’s quite good. And as far as I know, it will be the 10th of early career professional in psychology, which I am also part of the board and we are eager to develop because we believe that we have to share our knowledge and therefore I will ask you if the next statement is true or false because many of outsiders said that IPOS is mainly a research and academic based community.

Not such a practical, let’s say, community. Is it true or false?

Wendy Lam: I would say it’s false, because as I mentioned earlier on, IPOS offers a platform for clinicians, educators and not only just researchers from various disciplines to come together and exchange knowledge, insights and advancements in the field. Hence, we are not just members of the research and academic community.

For instance, in our annual World Congress, we fostered international communication and facilitated the dissemination of clinical practice, educational resources in addition to research findings that contribute to the well-being of cancer patients and their families. And as you know, we will be hosting the 25th World Congress in Maastricht this year.

Adrian Pogacian: And about the Congress, anniversary Congress, what do you think will be the outcome of this anniversary Congress?

Wendy Lam: Sorry, say again?

Adrian Pogacian: The outcome, what do you think it’s an anniversary Congress should be something and a special event? And with many researchers, I guess, is the Congress with the most number of participants so far.

So regarding this year’s Congress, as well as the previous Congress, which are the sequels or the outcomes of each Congress, because I saw that there is a book of abstracts, which is free for the audience. But this Congress came with something, let’s say, that researchers can use in practice.

Wendy Lam: Yes. What we’re trying to do, I hope I understand your questions. In terms of the Congress, yes, you will see a lot of participants. They are research focused and they come and share their work with others in terms of the research work.

And I think partly it’s because this is like an academic, more like an academic culture that is part of your jobs that you will have to go and disseminate your research findings.

But in terms of the World Congress, we also encourage very much having clinicians to come and take part because research findings, it’s not going to help to advance the field unless clinicians are able to apply the research efficiency to clinical practice. So from IPOS perspective, the research and the clinical practice, they come hands in hands.

So you can’t just ignore the clinical practice side. But obviously, what we advocate is practice should be evidence based, which means we need the research evidence to guide us to improve clinical practice and also to establish clinical guidelines.

So that’s how I see what’s the main goals of the Congress is to really try to bring everyone together in order to enhance the service provision for our cancer patients.

Adrian Pogacian: Those were the questions and thank you very much for your explanation. And in addition with this question and discussion, more and more researchers from different countries joins IPOS and we notice, let’s say people from Iran or I don’t know which other country, then they are the first members of IPOS from their countries and also a significant part of let’s say all members.

They are not, let’s say, complaining, but it seems they need that part of training also or executive education because I’m coming from Eastern Europe and in Eastern Europe, when you join an international society or your first thought is where should I do an executive education to have my knowledge, you know, proved by a diploma.

This is our mentality. And I want to ask you if in the future, IPOS is planning to do at least online, except the webinars, but an executive education, maybe on foundation of psycho oncology in order to give a diploma to the future participants. Right, yes.

Wendy Lam: I think this is a great question because we do have a plan. And what we have done in IPOS that is we have actually developed guidelines for psycho oncology curriculum aimed at enhancing and standardizing education and training. So I think you are probably also aware of our curriculum as well.

And so we currently, currently we have 13 modules covered various domains. And it also has been translated into 10 languages. So that’s what we currently have in terms of curriculum content.

But we, but we, you are correct, we don’t have a training program, except the training program for the LMIC countries, which I will touch on a little bit, just a moment.

But what we are trying to do at the moment is to actually establish a taskforce for developing core competency in psycho-oncology, because we have the curriculum, but we actually don’t have the core competency to define what are the essential skills in order to, you know, for people to practice in psycho-oncology.

So if we have the competency, which ultimately will help us to guide us to actually develop the training program based on the core competency.

So that’s where we are at the moment. So I’m leading a taskforce, currently working on that. As I mentioned just now, IPOS also devote a lot of time and effort for capacity building in psycho-oncology,  especially with low middle income countries.

For instance, in recent years, we have conducted a series of training in Pan-Africa for capacity building. And we work with local representatives and offer support for capacity building by offering training, which is applicable for the local practitioner to apply in their local setting. Because IPOS highlights the importance of engaging the local representatives or champions, because it is very important to make sure that, you know, the skills that they learn or they equip are actually applicable to the countries, because that’s very important.

Adrian Pogacian: Thank you. Thank you very much for your interesting descriptions and interest also in this part of executive education, which is so necessary in this field. IPOS, it’s also a community that it’s part of, let’s call a big family of global public health services.

And in this context, I will want to ask you about the relations with other international institutions dealing with cancer, such as European cancer organizations or even World Health Organization, even an association of psychoncology. How do you work together or how are things going?

Wendy Lam: Right. In recent years, IPOS actually, yes, you’re correct that IPOS has established partnerships with other international and also regional organizations as well.

So, for instance, in 2014, IPOS had an official partnership with WHO. And we now regularly have meetings, like online meetings with the WHO representative to talk about how we can further enhance psycho-oncology services which are also in line with the WHO missions as well. We also have formal partnerships with the UICC, Global Cancer Control, and obviously also European cancer organizations as well.

So we also partner with them. And also we have an active collaboration with other oncology societies as well. For example, like MAS, the Multinational Association of Supportive Care in Cancer, and also the European Society for Gynecological Oncology.

So just named a few that we have a partnership with them. And these partnerships are actually very important for us because it helps to promote our standard of quality cancer care, which is the psychosocial cancer care must be integrated into routine care. And in addition to that, in September 2007, IPOS Board of Directors and also the participant at the National Society meeting, which we held during the World Congress annually and agreed at the time in 2007, we agreed to establish the IPOS Federation of Psycho-oncology Society.

So we have federation members who comprise national and regional psycho-oncology society. And the aims of the IPOS Federation is to advocate for psycho-oncology globally by delivering a consistent message that emphasizes the importance of providing comprehensive psychosocial support to patients with cancer and the family at every stage of disease and also survivorship. And currently we actually have 33 societies in total that are under the IPOS Federation.

Adrian Pogacian: Thank you. We are not have much time, so I will ask you the last questions. Starting from what you mentioned earlier, routine care, cancer care.

I had a very interesting discussion recently with a representative of Harvard Medical School Executive Education who argued that artificial intelligence today is not a luxury, but a necessity. You talk about routine care in cancer care. How do you think artificial intelligence will influence this routine care regarding psycho-oncology?

Wendy Lam: Right. I think with the global challenge of manpower shortage in the healthcare system, AI certainly has the potential to improve the care and outcomes of cancer patients, especially by, you know, by providing personalized treatment plans, early detection, even psychological support and symptom monitoring and predictive analytics, for instance.

So if you look at the literature, you will notice that recent study have used, for example, machine learning to identify risk factors or, you know, develop, trying to develop a risk model to predict who will be more likely to experience persistent or chronic psychological distress in response to cancer diagnosis. So those informations will be very helpful in terms of developing screening program and also early prevention intervention as well.

And on the other hand, there’s also study have tested the effects of using chatbot or virtual assistant to provide emotional support for cancer patients. So these are some of the ongoing or more recent studies that you have, you will probably come across in the research area. And of course, in IPOS, one of our special interest group is looking, also looking into the application of AI in the field as well.

So we have the same special interest group that focuses on intervention. So this year, we actually expanded to also cover the AI side as well.

Adrian Pogacian: Thank you. Thank you very much. And thank you very much, Dr. Lam, for being with us today. And hopefully, we’ll see each other soon, maybe with the news.

Maybe we’ll do another interview after the Massey conference. I think it will be interesting. Thank you very much.

Wendy Lam: You’re very welcome.

Adrian Pogacian: Good luck on your activity.

Wendy Lam: Thank you.

Previous editions of Beyond The Cancer Diagnosis

Edition 1: Beyond The Cancer Diagnosis: Psycho-Oncological Aspects Of Kate Middleton’s Diagnosis

Edition 2: Beyond the Cancer Diagnosis with Sonia Amin Thomas – Survivorship