Cancer pa­tients need sup­port for de­pres­sion, say health ex­perts

The National - News - - NEWS - NICK WEB­STER

A lack of emo­tional sup­port for re­cov­er­ing cancer pa­tients is leav­ing many suf­fer­ing in si­lence as lead­ing char­i­ties de­mand im­prove­ments to care.

Psy­chi­a­trists in the UAE have said many pa­tients ex­pe­ri­ence dis­rupted sleep, anger, stress, fear and some­times post-trau­matic stress dis­or­der (PTSD) fol­low­ing a cancer di­ag­no­sis.

Re­search by UK-based Breast Cancer Care has shown that more than a quar­ter of pa­tients it sur­veyed (26 per cent) said deal­ing with chemo­ther­apy or ra­dio­ther­apy was not as hard as cop­ing with life after be­ing dis­charged from hos­pi­tal.

One in 10 felt pos­i­tive and ready to move on when treat­ment was over, but more than half (53 per cent) strug­gled with anx­i­ety once hos­pi­tal treat­ment had ended.

Rahma, the cancer pa­tient care so­ci­ety, said although the UAE is mak­ing great strides in aware­ness pro­grammes, pa­tients are of­ten for­got­ten once a di­ag­no­sis is made.

“Psy­cho­log­i­cal sup­port is so im­por­tant for pa­tients and they shouldn’t feel they have to leave the UAE to ac­cess af­ford­able treat­ment,” said Nora Al Suwaidi, Rahma’s di­rec­tor gen­eral.

“Cancer wards are mor­bid and there can be a lack of com­pas­sion to­wards pa­tients.

“At Rahma, we want to help en­cour­age more com­mu­nity sup­port and vol­un­teerism to help pa­tients through what is a very dif­fi­cult time.”

Mrs Al Suwaidi is help­ing de­velop a part­ner­ship with ProVita In­ter­na­tional Med­i­cal Cen­tre in Abu Dhabi to im­prove pal­lia­tive care for pa­tients, as well as hos­pices in the UAE.

Rahma is one of the few non-profit or­gan­i­sa­tions com­mit­ted to help­ing cancer pa­tients in the UAE but is fac­ing chal­leng­ing fi­nan­cial times and re­quires gov­ern­ment sus­tain­abil­ity grants to con­tinue its work.

The World Health Or­gan­i­sa­tion said 40 mil­lion peo­ple a year world­wide need pal­lia­tive care but 86 per cent will not re­ceive it.

Sup­port for ter­mi­nally ill pa­tients is chang­ing. Last year, Fed­eral De­cree No 4 on Med­i­cal Re­spon­si­bil­ity was ap­proved, mean­ing doc­tors are no longer com­pelled to re­sus­ci­tate dy­ing pa­tients.

“The hospice cul­ture else­where has not de­vel­oped yet in the UAE,” Mrs Al Suwaidi said.

“Nurses car­ing for cancer pa­tients also need sup­port and this is of­ten over­looked as they suf­fer from com­pas­sion fa­tigue. It can be drain­ing for them.

“I’ve seen many cancer pa­tients in ICU units and it is hard for med­i­cal pro­fes­sion­als to deal with. Hours are long and the pay isn’t great, so they also need sup­port.

“We are try­ing to change the cul­ture to­wards cancer in the UAE, but it will take time. As a young na­tion, we have an obli­ga­tion to im­prove things for the fu­ture.”

Re­search pub­lished in the med­i­cal jour­nal The Lancet said that cancer pa­tients who were clin­i­cally de­pressed did not get the psy­cho­log­i­cal ther­apy they needed, partly due to a fo­cus on phys­i­cal symp­toms at the ex­pense of good men­tal health care.

Of 21,000 cancer pa­tients, they found 6 per cent to 13 per cent of peo­ple had clin­i­cal de­pres­sion, com­pared with 2 per cent of the gen­eral pop­u­la­tion at any time.

De­pres­sion is most com­mon in peo­ple with lung cancer, af­fect­ing 13 per cent of pa­tients, fol­lowed by gy­nae­co­log­i­cal, breast and colorec­tal cancer and then gen­i­touri­nary cancer, for which 6 per cent of pa­tients were di­ag­nosed as de­pressed.

Ac­cord­ing to the World Health Or­gan­i­sa­tion, the rate of de­pres­sion has in­creased by more than 18 per cent since 2005.

The Pri­ory’s Well­be­ing Cen­tre in Dubai of­fers sup­port for stress, anx­i­ety, de­pres­sion and PTSD.

Dr Walid Ab­dul-Hamid, a con­sul­tant psy­chi­a­trist at The Pri­ory, said doc­tors there are see­ing an in­creas­ing num­ber of peo­ple whose de­pres­sion fol­lowed cancer treat­ment.

“A cancer di­ag­no­sis can leave pa­tients feel­ing like they have no con­trol over their own bod­ies and this of­ten re­sults in a real mix of feel­ings from anger, fear and de­spair, to un­cer­tainty, lone­li­ness and hope­less­ness,” he said.

“These feel­ings can pre­vail even after treat­ment has fin­ished as the road ahead is sud­denly so dif­fer­ent.

“The im­pact a cancer di­ag­no­sis has on every­day life can­not be un­der­es­ti­mated.”

Cancer sur­vival is im­prov­ing and has dou­bled over the last 40 years. For a num­ber of can­cers, in­clud­ing breast and skin cancer, more than eight out of 10 peo­ple will sur­vive.

Re­search has led to bet­ter treat­ments, new drugs, more ac­cu­rate tests, ear­lier di­ag­no­sis and screening pro­grammes – giv­ing pa­tients a bet­ter chance of sur­vival.

“A pa­tient’s suf­fer­ing ex­tends far be­yond the phys­i­cal im­pli­ca­tions,” said Dr Ab­dul-Hamid. “It can lead to wor­ries and fears about a re­cur­rence, the im­pact on fam­ily and loved ones and mor­tal­ity. Be­ing able to sim­ply ‘move on’ can be harder to do than you might think.”

“Con­fi­dence and self-es­teem is of­ten at an all-time low. No­body should have to face a cancer di­ag­no­sis alone.”

De­pres­sion is most com­mon in peo­ple with lung cancer, fol­lowed by gy­nae­co­log­i­cal, breast and colorec­tal cancer

Chris Whi­teoak / The Na­tional

Dr Walid Ab­dul-Hamid, a psy­chi­a­trist, says no­body should have to face a cancer di­ag­no­sis alone

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