The changing landscape of cancer care - the impact of psychosocial clinical practice guidelines.

The International Psycho-Oncology Society (IPOS) has championed the need for quality care to incorporate attention to the psychosocial concerns of cancer patients. Widespread international endorsement of distress as the '6th vital sign' is a major step towards improving access to psychosocial care and reducing the isolation and stigma experienced by many affected by cancer. However, the integration of psychosocial care into routine clinical practice also requires active multidisciplinary engagement, and demonstration that evidence-based psychosocial interventions are effective and feasible to deliver in practice. Clinical practice guidelines are valuable in this context. Typically, they provide a synthesis and evaluation of existing evidence, critically appraised by stakeholders and clinicians, presented in a way which allows for translation of research evidence into practice. Such guidelines are also tools for informing and educating those who do not have psychosocial expertise, potentially increasing the status of psycho-oncology. This paper describes the background to the development of psychosocial clinical practice guidelines in Australia as a means of understanding the factors that can underpin the evolution of attitudes and integration of psychosocial care in oncology, and considers the current status of psychosocial care in Australia and internationally, including challenges for the future.