Acknowledging the Complexities of Chronic Illness

Using a tailored, whole-health approach and tapping into patient resilience, social worker Feia Vancuyck helps patients with metastatic breast cancer regain life balance


For 10 years, social worker Feia Vancuyck has worked with metastatic breast cancer (MBC) patients at the University Hospital Leuven in Belgium. She also works with the Belgian Foundation Against Cancer’s cancer information service and mentors students of social work. She talks about the complex needs of MBC patients.

What is your role in assisting MBC patients?
First, it’s important to keep in mind that health is a total combined state of physical, mental, and social well-being—it’s not simply determined by the presence or absence of disease or physical complaints. All these factors must be considered in helping a patient. The demand for care is often complex, requiring more than just medical answers.

What are your first steps in working with an MBC patient?
I talk with her to assess her physical and psychological functioning and supportive resources already accessible to her. I try to evaluate her situation to understand the full impact of the illness on her and other persons in her life. I try to clarify her particular situation and perceptions by asking questions and listening to her story. This all helps to identify the themes we focus on during follow-up contacts.

What are some of the challenges you have observed for MBC patients?
In my unit, patients are hospitalized for all kinds of issues such as chemotherapy, complications, fever, physical weakness, and disease progression. It’s important to view MBC through the lens of chronic disease. Chronic illness usually results in loss of income, disability, and burdensome medical expenses, among other stressful effects. In other cases, a patient may already face issues related to finances, relationships, housing conditions, addiction, etc., when she is diagnosed with MBC. A chronic medical condition only complicates these issues further.

What kinds of issues do you find are most common for MBC patients? How do you respond?
Patients often need help with psychosocial issues such as anxiety, family relationships, and changes in their roles during and following the treatment. For example, I can support a woman’s role as a parent by exploring ways she can communicate with her children about her illness. Empowering patients is very important in my work. Overall, I am willing and available to cooperate and communicate with everyone involved in the patient’s care to help her with these challenges.

What is ultimately your most valuable resource in helping patients?
Support should be sensitive and tailored for an individual’s difficulties, but our starting point is always the strength, self-reliance, and resilience of patients. It’s crucial always to respect patients’ independence and privacy. For example, for a patient leaving the hospital, the whole care team must collaborate to help her develop a plan to ensure her “continuity of care.” This enables her to be independent despite her illness.