Cancer can be a frightening, nerve-wracking disease, and medical science often overlooks the emotional toll it takes on patients.
Children with Cancer can suffer even worse as they have to deal with all the hospital and clinic appointments, tests, tubes, operations, scans and treatments.
When dealing with Childhood Cancer, not only does the disease take its toll on the Child with Cancer, but also on the Parents and siblings.
The stress of dealing with cancer in a child can cause many problems in the family unit, with siblings feeling that they are being ignored, parents being overworked and run ragged as the disease takes its course, and many fathers are unable to cope as they feel helpless and that they have failed their child – on top of which the mother often has to stop working to support the Child with Cancer – leaving the father as the only breadwinner and the only one at home to take care of the rest of the family.
Childhood Cancer often causes the break-up of the family unit, ending in divorce and leaving the mother to deal with everything on her own.
Three recent studies show that three therapy programs can help people deal much better with the turmoil and stress of cancer.
One study focused on a brief series of therapy sessions developed by Canadian researchers to help patients with advanced cancer manage the practical and emotional problems they face.
That program, called Managing Cancer and Living Meaningfully (CALM), consists of three to six 45- to 60-minute sessions delivered by trained health care professionals.
CALM addresses issues related to:
- Symptom management and communication with health care providers;
- Changes in self and relations with close others;
- Spiritual well-being, or maintaining a sense of meaning and purpose; and
- Preparing for the future, sustaining hope and facing mortality.
CALM sessions focus on ways to best handle health care decisions, personal relationships and fears related to the end of life, said lead researcher Dr. Gary Rodin, head of supportive care at the Princess Margaret Cancer Center in Toronto.
“These are challenges that patients and families predictably have to face, and there can be a lot of distress around them, a lot of anxiety, a lot of fear, a lot of sadness,” Rodin said. “And yet there hasn’t been a systematic approach to help patients deal with this.”
To test CALM’s effectiveness, Rodin and his colleagues conducted a clinical trial involving 305 patients with advanced cancer.
Within three months, CALM therapy had caused a clinically important reduction in symptoms of depression for 52% of patients, compared with 33% of patients who received the normal care, according to the researchers.
“Not only did it cause a reduction in depressive symptoms, but those who received the treatment were less likely to become depressed,” Rodin said.
Health care professionals in more than 20 countries have been trained in CALM procedures, Rodin said, and its developers are organising a global training network.
The second study involved therapy developed by Australian researchers to help cancer survivors deal with the fear of their cancer coming back.
The therapy, called Conquer Fear, involves five individual sessions over 10 weeks. Cancer Survivors learn techniques to control their worry, accept the inherent uncertainty of cancer recurrence, and to redirect their focus on what they want to get out of life.
Researchers conducted a clinical trial involving 222 survivors of breast cancer, colon cancer or melanoma, all of whom were cancer-free but reported a high fear of their cancer recurring. The survivors were randomly assigned to receive either Conquer Fear therapy or basic relaxation training.
Patients who underwent Conquer Fear therapy experienced a greater reduction in their fear of cancer recurrence than people who received relaxation training, researchers reported. The effect continued for as long as six months.
The results were to be presented earlier this month at the annual meeting of the American Society for Clinical Oncology (ASCO), in Chicago. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.
Therapy for cancer survivors has become increasingly important as cancer doctors have become better at curing the disease, said ASCO President-Elect Dr. Bruce Johnson.
“Between half and two-thirds of all of our patients who get cancer are cured of it. Thank goodness, it’s a relatively substantial proportion of our population,” said Johnson, chief clinical research officer at Dana-Farber Cancer Institute in Boston. “This shows there’s a potentially effective intervention for people whose lives are being affected by the worry that they have about cancer coming back.”
While the two reports above involved face-to-face therapy, the third study used a web-based stress management program to help newly diagnosed patients.
That eight-week program, developed by cancer doctors and psychologists, utilises concepts rooted in Cognitive Behavioral Therapy — a short-term, goal-oriented type of therapy. Called STREAM, it helps people recognize and manage potential sources of stress.
In a clinical trial, 129 patients undergoing cancer treatment were assigned to either receive STREAM therapy or manage their lives without help.
Within two months, people receiving STREAM therapy experienced a greater improvement in their quality of life than those who didn’t, the Swiss researchers said. They also had a decrease in their emotional distress, while distress levels remained constant in people who didn’t receive STREAM.
Patients have little time to devote to psychological support early on in their treatment, said lead researcher Dr. Viviane Hess. She’s a medical oncologist at the University Hospital of Basel in Switzerland. “With this online intervention, we aim to close this gap,” she said in an ASCO news release.