Stage IV malignant melanoma. Psychosocial issues

The diagnosis of Stage IV malignant melanoma presents a difficult challenge for the patient with cancer, family, and health care providers. All must deal with a variety of psychosocial issues that range from the existential to the pragmatic. In the past decade an evolution in health care reimbursement methods has occurred, resulting in decreased length of stay in acute care facilities. It is at the point of hospitalization that patients' increasing needs most often become apparent. Physicians, nurses, and hospital social workers face the dilemma of providing care and support services in the reality of shrinking resources brought about by prospective payment, managed care, and cost containment policies. Health care delivery systems strive to meet the needs of patients with cancer through case management methods that link patients with a wide variety of medical and community resources. A case history is presented to demonstrate the need for collaboration among the members of the health care community in order to meet patient and family psychosocial needs.