Country support

Rural cancer patients often face a range of unique needs and stressors, compared to patients who live in metropolitan areas.

The below list demonstrates some of the financial, social, emotional, cultural and practical issues your rural patients may face, to help you understand and support them:

The need to travel for specialist treatment
Financial strain

• Accommodation and travel costs
• Absence from home (and associated costs of maintaining two residences)
• Absence from work (and associated loss of income)
• Incidental relocation expenses (e.g. telephone).

Social strain

• Disruption to family life and traditional social/gender roles
• Isolation from family, friends and support networks
• Loss of contact with other cancer patients when returning to their rural community.

Emotional strain

• Feelings of confusion and alienation when staying in an unfamiliar city
• Fearing that their absence from home is a burden for others.

Practical strain

• Extensive organisation required to relocate for treatment (e.g. care for animals)
• Difficulty navigating unfamiliar city and facilities
• Lack of adequate local medical services to deal with treatment side effects on returning home, such as lymphedema
• Lack of information that is relevant to people from rural areas.

Cultural and social issues

• There is often stigma surrounding the discussion of a cancer diagnosis within rural communities
• Concerns about gossip within the rural community and lack of personal privacy.

There are some important considerations urban-based health professionals must make when it comes to treating rural patients.

The list below will help you understand ways you can make specialist appointments and treatment as supported and manageable as possible for your rural patients:

• For many rural patients, both arriving in and finding their way around the city can be very stressful.
• Staff in small rural hospitals are often familiar with their patients. Therefore, these patients can find the anonymity of large urban hospitals overwhelming, impersonal and difficult to navigate.
• Being away from family, friends and usual support networks during their cancer treatment adds to the levels of distress.
• As travelling long distances is tiring, difficult and often costly, scheduling appointments together and not changing them at the last minute is essential. Most rural patients also appreciate the acknowledgement that they have travelled from their rural homes for the appointment.
• Ask your patient, “what do I need to know about you that will help me to help you?” This helps build rapport and gives them an opportunity to raise preferences about how their treatment can be structured to accommodate their work and family commitments.
• Where possible, suggest making arrangements for tests (e.g. blood tests prior to chemotherapy) to be done close to the patient’s home to minimise the amount of time spent away from home. If possible, check that this will not cost the patient any extra.
• Stigma and rural values, such as reluctance to complain or ask for help, can make it difficult for rural patients to access support services and hesitant to report any difficulties they face, such as side effects or emotional issues. It is helpful to explain that psychosocial support is recommended as a standard part of treatment for all cancer patients. It may also help to ask your patient directly about what sorts of difficulties they have experienced so far to help broach this subject.
• Clear communication between rural GPs and urban specialists is a necessity. Rural patients may experience feelings of anxiety upon leaving urban-based treatment facilities, particularly if these patients are concerned that their local GP does not have a good understanding of their medical situation.
• Discharge planning is very important. Be familiar with exactly what services are available in rural communities to support patients on their return home.
• Make a referral to psychosocial services in metropolitan treatment centres and/or inform rural patients about relevant support services available in their local area.
• When explaining medical jargon, including the diagnosis, and treatment plans to your patient and their family members, use simple, easy to understand language.
• Encourage patients and their supporters to take notes, ask questions and report any side effects.
• Try to demonstrate a personal interest in the person beyond their illness by asking about what they do for work and what their favourite hobbies are etc.
• Ask patients if they need assistance with completing a Patient Assistance Transport Scheme (PATS) form.

Regional Cancer Services

There are 15 chemotherapy units in hospitals across regional South Australia, each classified as low or medium risk, depending on the complexity of the treatment they offer. Each unit has between one and six chemotherapy chairs.

Staff at these units are trained and accredited to administer chemotherapy treatment and also offer other supportive services for cancer patients, such as chemotherapy education and central venous access device maintenance. These units are also equipped with Digital Telehealth Network facilities.

Contact details for each health service are available below:

Medium risk

• Port Pirie
• Whyalla
• Mount Gambier

Low risk

• Ceduna
• Clare
• Gawler
• Kangaroo Island
• Mount Barker
• Murray Bridge
• Naracoorte
• Port Augusta
• Port Lincoln
• Riverland
• Victor Harbor
• Wallaroo

There is increasing evidence that rural patients may be more likely to experience poor mental health, reduced treatment outcomes and unmet psychosocial needs, compared to urban patients. Therefore, a focussed effort in linking rural cancer patients with psychosocial services is important.

Support is available through:

• Cancer Council SA’s 13 11 20 information and support service, 9.00 am – 5.00 pm Monday to Friday (excluding Public Holidays).
  • Cancer Counselling Service
  • Peer Support programs – face to face, telephone and online
• General practitioners
• Psychology services
  • These services may be available through your Cancer Treatment Centre
  • Australian Psychological Society – Find a psychologist here.

You can also consider a Mental Health Care Plan to provide access to subsidised psychological support.

• Rural and Remote Mental Health Triage Service on 13 14 65 (24 hours per day, 7 days per week at the cost of a local call). This service provides emergency mental health information and assistance for health professionals and their clients, families and carers.

The Patient Assistance Transport Scheme is a financial support scheme available to eligible patients who live rural and need to travel into the city for appointments and specialist treatment.

By using this online calculator, a patient can see their eligibility for the scheme.

Click here to access the PATS online calculator