Although psychosocial interventions for cancer patients--such as support groups, individual counseling and psychiatric evaluation--have become increasingly common over the past two decades and have been shown to greatly improve a patient's quality of life, they are rarely made a routine part of cancer care, said a University of California San Francisco cancer psychologist.
One reason for this is practicality. Most of the psychosocial interventions that have been studied and proven effective, are too expensive, too demanding of patient time, and too far-reaching in scope to be easily and routinely offered as part of cancer care, said Andrew Kneier, PhD, UCSF clinical cancer psychologist.
In addition, while individual counseling and psychiatric consultation are often available to patients while they are receiving treatment in the hospital, these services are seldom integrated into a comprehensive program of care for cancer outpatients, he said.
Kneier is collaborating with the UCSF Urologic Oncology Practice, part of UCSF Stanford Health Care, headed by Peter Carroll, MD, to evaluate the efficacy of a short-term counseling intervention in patients with newly-diagnosed prostate cancer. Patients who participate in the study will receive three one-hour individual counseling sessions that are tailored to their needs. The sessions will focus specifically on supporting and/or improving how they are coping with problems or challenges that are most relevant to their situation.
"This is the first study of its kind with prostate cancer patients," Kneier said. "What is unique about our study is that we are trying to help people in coping with their cancer in just three sessions to establish a realistic and practical model that other cancer centers around the country can adopt." He added that the study has the potential to demonstrate for the first time that a short-term, individually-tailored counseling program for newly-diagnosed prostate cancer patients has positive benefits with respect to coping, emotional well-being, health related quality of life, resource utilization, and patient satisfaction.
During the study, which will involve a control and intervention group of 65 newly-diagnosed prostate cancer patients, UCSF researchers will determine whether or not three one-hour sessions are adequate to make a significant difference in men with prostate cancer.
Although intervention services have not typically been part of patient care, Kneier said that cancer care is evolving. For instance, many medical oncologists, such as those at UCSF, are beginning to practice a "whole person" approach that includes psychosocial interventions by addressing all aspects of a patient's well-being--physiological, biological, spiritual and psychological.
In addition, the notion of coping strategies is fairly new among the medical community. Fifty years ago, when someone had cancer, there was little discussion about how he or she was "coping," the patient was just dealing with it. In the last 25 years, patient coping strategies have received a tremendous amount of attention from health care professionals because research has shown that some patients' styles of coping are more effective than others, Kneier said.
After reviewing the vast amount of research on coping strategies and drawing upon the experiences of cancer patients, Kneier and colleague, Ernest Rosenbaum, MD, UCSF clinical professor of medicine, developed ten positive coping strategies that they believe to be the most effective for newly-diagnosed cancer and terminally ill patients. These ten steps aim to help a patient's psychological adjustment with cancer that will ultimately improve quality of life and make them feel less vulnerable.
Moreover, some studies have shown that a positive attitude achieved through effective coping skills improves not only a patient's emotional well-being, but also medical outcome and survival rate. However, Kneier emphasized that there is no guarantee that a patient's emotional state, no matter how positive, will increase their survival.
The ten coping strategies, developed by Kneier and Rosenbaum, are described in a booklet that will be given to study participants during their first counseling session. During the subsequent intervention sessions, they will discuss with a psychologist how any of the coping strategies may be applicable to their own situation.
The coping strategy booklet is also available to all UCSF cancer patients.
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For a copy of the ten coping strategies for cancer patients, please call UCSF
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