New standards of the International Psycho-Oncology Society (IPOS) advocate for psychosocial care as a human rights issue. In Romania, the psychosocial care of cancer patients is not yet included in the National Cancer Plan. Eight years after acceding to the European Union and endorsement of several cancer control agendas (e.g. including EPAAC and CANCON) the Romanian National Cancer Program, as there is not an integrated plan yet, does not include or cover psychosocial cancer care. Moreover, there are no guidelines, published clinical guides, or any professional recommendations at national level for the psychosocial care of cancer patients. Further, there is no official certification for psychosocial oncology care and/or psycho-oncology. There are only a few psychologists and almost no social workers in the four regional cancer institutions and the main public hospitals with oncology wards in Romania. Now, the quality of life and distress experienced by the cancer patients in Romania are almost completely omitted from the standard cancer treatment plan.

The APSCO - Assessment of Psycho-Social and Communication needs in Oncology - study ( initiated in 2001 follows the repeated cross-sectional design, while the proportional quota sampling method was applied in the four most important Romanian cancer centers (Bucharest, Cluj-Napoca, Iasi, and Oradea) to produce a nationally representative sample of oncology patients. A mixed and various sample (N=1220) of 800 oncology patients was screened in 2014, and 420 in 2007. In this situation we aim to analyze prevalence of diagnosis non-disclosure, cancer distress and quality of life in Romanian cancer patients prior and post EU accession, from 2007 to 2014. This book is based on the APSCO research project and is a first assessment-based report of trends and the present situation regarding unattended, unmet and unconsidered psychosocial needs within the oncological treatment in Romania, from the perspective of hospitalized adult cancer patients. Key data will be presented about the emerging psychosocial needs in cancer care in Romania.

Levels of neglected psychosocial needs in cancer patients reach an alarming level in Romania. The Romanian public health system can by no means offer qualitative psychosocial care for cancer patients, since cancer distress is not assessed and treated as the 6th vital sign after body temperature, blood pressure, pulse, breathing and pain, an IPOS standard of care. Cancer disclosure trends are positive in Romania, but age, gender, socio-economic backgrounds, and treatment-related factors still present specific risks for cancer diagnosis non-disclosure. Our results about moderate to high cancer distress and undermet well-being needs among Romanian cancer patients, burdened by tendencies of non-disclosure, support current efforts to put psychosocial cancer care on Romania’s priority health agenda. The investigation of intra-and extra-individual variables brings to light more contoured pathways that could guide the tailoring of efficient psychosocial programs in Romania, aiming to improve cancer patients psychosocial functioning and wellbeing.