Quality-of-life Program May Help Cancer Patients

(Reuters Health) - A therapy program focused on improving quality of life can help people being treated for advanced cancer, researchers from the Mayo Clinic in Rochester, Minnesota, have found.

Patients who attended the sessions - a combination of physical and talk therapy, along with relaxation techniques and spiritual discussions - reported a stable quality of life during treatment, while cancer patients who didn't get the extra help declined on those measures.

Researchers said that although such comprehensive programs might not be available at smaller cancer centers, doctors can still help patients seek out spiritual or emotional help, or encourage them to be more physically active.

"Dealing with a cancer diagnosis is a big stressor for lots of people. It's still a really scary health diagnosis," said psychologist Matthew Clark, the lead author on the new study.

What's more, he said, patients are dealing with the side effects of treatment, and many with the additional stress of being away from their families and friends if they don't live near a cancer center.

His team's study involved 131 patients with advanced colon, brain and lung cancers, all of whom were diagnosed within the last year and being treated with radiation therapy.

Clark and his colleagues randomly assigned patients to undergo six 90-minute sessions aimed at improving their physical, mental and spiritual quality of life or to be treated with standard medical care.

Patients attended most of the sessions along with their primary caregiver.

When researchers surveyed patients about their quality of life four weeks later, people who had gone through the program scored a 75 on a 0-to-100 scale, on average, compared to a 69 for the standard-care group.

However, six months later - after a series of follow-up phone calls for the therapy group - cancer patients reported their quality of life at around 77 or 78, regardless of whether they'd gotten the extra support.

Allison Applebaum, a clinical psychologist at Memorial Sloan-Kettering Cancer Center in New York, said she sees many patients who are struggling with depression and anxiety as well as existential issues during cancer treatment.

"A lot of patients also present with some symptoms of post-traumatic stress," Applebaum, who wasn't involved in the new study, told Reuters Health.

"With cancer comes a lot of role changes and losses, such as loss of the ability to work, perhaps the loss of a relationship (and) loss of physical capacity."

NO BENEFIT FOR CAREGIVERS

The Mayo Clinic program didn't have any impact on how caregivers reported their own quality of life, the researchers wrote in the journal Cancer.

At the end of the study, caregivers said they would have preferred a caregivers-only therapy group, as well as specific strategies on how they could improve their own quality of life.

Applebaum noted that rates of depression can be just as high if not higher in caregivers than in cancer patients. In 2011, she started a clinic targeted solely toward caregivers.

While more researchers are recognizing the importance of treating the mental and emotional needs of people with cancer, there are still limitations to reaching everyone who could benefit.

"Likely such structured, well-supervised interventions may not be available at smaller cancer centers," Applebaum said. But that doesn't mean it isn't possible - especially if social workers and nurse practitioners are recruited to lead the sessions.

And some people without any access to such services may be able to get counseling over the phone or Internet, she added.

Clark said patients can ask their oncologists what types of resources are available to help them cope with cancer and their treatment - from chaplains to exercise programs - and decide what's best for them.

"Think about what really helps you maintain your quality of life," he said.

"Caring for cancer is not just caring for the body," Applebaum emphasized. "Attending to quality of life, the mental health, the spiritual components, is really important."

SOURCE: bit.ly/QKPTNi Cancer, online August 28, 2012.