Keep­ing calm in can­cer

The Star Malaysia - Star2 - - Health -

MED­I­TA­TION, re­lax­ation and psy­cho­log­i­cal coun­selling are be­com­ing im­por­tant tools in the care of peo­ple with can­cer, ac­cord­ing to mul­ti­ple clin­i­cal tri­als re­leased at the world's largest con­fer­ence on can­cer.

The re­search un­veiled at the Amer­i­can So­ci­ety of Clin­i­cal On­col­ogy (ASCO) 2017 An­nual Meet­ing, which con­cluded on Tuesday in Chicago, United States, is part of a new push by on­col­o­gists to fo­cus on not just killing tu­mours, but also boost­ing the morale and men­tal health of peo­ple who are reel­ing from the shock of be­ing di­ag­nosed with can­cer.

For many women who sur­vive a bout with can­cer, the fear that it will re­turn can be de­bil­i­tat­ing, and may in­ter­fere with work and fam­ily re­la­tion­ships.

About 50% of all can­cer sur­vivors and 70% of young breast can­cer sur­vivors re­port mod­er­ate to high fear of re­cur­rence, ac­cord­ing to one study led by Dr Jane Beith, a med­i­cal on­col­o­gist at the Uni­ver­sity of Syd­ney in Aus­tralia.

She and col­leagues de­vel­oped an in­ter­ven­tion called Con­quer Fear, in which trained ther­a­pists met 222 pa­tients for five one-hour to 90-minute-long ses­sions over 10 weeks.

They talked about ac­cept­ing un­cer­tainty and learn­ing strate­gies to con­trol wor­ry­ing, as well as how to fo­cus on life goals.

Stretch­ing and med­i­ta­tion were also part of the treat­ment.

“The re­duc­tion in fear of re­cur­rence in the psy­cho­log­i­cal in­ter­ven­tion group was large enough to im­prove sur­vivors' psy­cho­log­i­cal and emo­tional well­be­ing,” said Dr Beith.

Us­ing a 42-item ques­tion­naire called Fear of Can­cer Re­cur­rence In­ven­tory (FCRI), re­searchers found that the fear of can­cer was re­duced sig­nif­i­cantly in those who went through ther­apy – by 18 points on av­er­age in the in­ter­ven­tion group, com­pared to 7.6 points in a con­trol group that did not re­ceive the same at­ten­tion.

Talk ther­apy

An­other study, car­ried out in Canada, showed that brief ses­sions of psy­chother­apy could also ben­e­fit peo­ple with ad­vanced can­cer.

A ran­domised clin­i­cal trial en­rolled 305 pa­tients with lat­estage can­cer to study an in­ter­ven­tion, called Man­ag­ing Can­cer And Liv­ing Mean­ing­fully (CALM).

Af­ter three months, 52% of pa­tients who re­ceived CALM had a clin­i­cally im­por­tant re­duc­tion in de­pres­sive symp­toms, com­pared to 33% of pa­tients who re­ceived usual care, re­searchers re­ported.

Af­ter a few months, pa­tients who had un­der­gone the ther­apy were more pre­pared for the end of life.

“This brief talk­ing ther­apy helps pa­tients fac­ing ad­vanced can­cer, and their loved ones, sus­tain what is mean­ing­ful in their life de­spite its lim­i­ta­tions, and face the fu­ture,” said lead study au­thor Dr Gary Rodin, head of the de­part­ment of sup­port­ive care at the Princess Mar­garet Can­cer Cen­tre in Toronto, Canada.

“It pro­vides time and space for re­flec­tion on the threats and chal­lenges as­so­ci­ated with ad­vanced can­cer.”

On­line ther­apy

A third study ex­am­ined the pos­si­bil­ity of us­ing the in­ter­net to de­liver psy­cho­log­i­cal help to can­cer pa­tients who may not be able to get it in per­son.

Called the STREAM in­ter­ven­tion, the eight-week pro­gram de­vel­oped by on­col­o­gists and psy­chol­o­gists, of­fered web-based stress man­age­ment.

Weekly top­ics in­cluded bod­ily re­ac­tion to stress, cog­ni­tive stress re­duc­tion, feel­ings and so­cial in­ter­ac­tions.

A to­tal of 129 can­cer pa­tients – mostly women with breast can­cer – were ran­domised to ei­ther re­ceive writ­ten and au­dio in­for­ma­tion, and then, com­plete ex­er­cises and ques­tion­naires, or join a con­trol group that did not go through the pro­gram.

Those who com­pleted STREAM re­ported a greater im­prove­ment in qual­ity of life than pa­tients in the con­trol group, and less dis­tress than be­fore. How­ever, there were no sig­nif­i­cant dif­fer­ences in anx­i­ety or de­pres­sion be­tween the two groups.

“I think on­line psy­cho­log­i­cal sup­port will be much more im­por­tant in the years to come, as the dig­i­tal gen­er­a­tion reaches the age when they are at higher risk of can­cer,” said lead study au­thor Dr Vi­viane Hess, a med­i­cal on­col­o­gist at the Uni­ver­sity Hos­pi­tal of Basel in Basel, Switzer­land.

“For them, it will be nat­u­ral to use such on­line tools and com­mu­ni­cate with­out face-to-face in­ter­ac­tion, and so now is the time to stan­dard­ise and val­i­date the tools.” – AFP Re­laxnews

Stretch­ing and med­i­ta­tion, both prac­tised in yoga, are among the tech­niques shown to help im­prove the psy­cho­log­i­cal and emo­tional well­be­ing of can­cer sur­vivors. — AFP

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