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Abstract
Patients facing a diagnosis and treatment for cancer often have anxiety, depression, psychological distress, loss of control, and fear. These emotions are better controlled with psychological support such as counseling, group therapy or good supportive care (Institute of Medicine., 2007). A ll patients and survivors not only have medical problems from cancer and its therapy, but also emotional and social well-being challenges. The stress of coping with a cancer diagnosis ranges from mild to severe, often depending on the severity of the diagnosis and treatment and the prior mood of survivors (Jacobsen et al., 2002) A third or more of patients report psychological distress during the early months of treatment. Ongoing distress levels may be similar. The prevalence of psychological distress in one study of 4496 cancer patients at John Hopkins Cancer Center was 35%. (Carlson et al., 2004) M ood usually improves over time for many survivors. Although some patients have adjusted their lives and actually feel better, others have anxiety, depression, and feelings of isolation, as well as problems interacting with friends and family. Subgroups of survivors remain vulnerable to distress or depression for a long period of time. Clinical depression affects around 18-21% survivors at various points of time. (Bodurka-Bevers et al., 2000) Cancer survivors who were depressed prior to their diagnosis are most at risk for shortened survival time (Brown et al., 2003) Cancer survivors are vulnerable to both acute and post-traumatic stress, a result of the life threat and loss of control experienced following diagnosis and treatment. (Carlson et al., 2004) Nu kopen! PDF-XChange www.easycomputing.com Nu kopen! PDF-XChange www.easycomputing.com Click to buy NOW! PDF-XChange Viewer www.docu-track.com Click to buy NOW! PDF-XChange Viewer www.docu-track.com 72 These responses are similar to that of the acute and post-traumatic stress syndromes, seen in soldiers on the battle front or returning from war or among those who have experienced extreme psychological or physical problems. (DeVoto and Kramer , 2006). C li nical evaluation, counseling and educational programs offered immediately post-diagnosis and following treatment can reduce stress and lead to a better adjustment to the consequences of having cancer and its therapy. (Capuron et al., 2000). The Cancer Center at Stanford University Hospital has been a leader in offering Group Support, Individual Counseling, Massage, Medical Qigong, Restorative Yoga, Healing and Guided Imagery, Expressive Art and Imagery, Creative Writing, Healing Touch, and Exercise. Educational programs are provided, like Managing and Understanding Your Chemotherapy, Look Good and Feel Better, and Nutritional Consultations. Group therapies are provided for patients with breast cancer, brain, ovarian, colorectal, leukemia and lymphoma, patients with multiple diagnoses and for husbands of women with cancer. (Carlson et al., 2004) Psychosocial and behavioral interventions have demonstrated the ability to reduce cancer-related burdens, but the majority of interventions have focused on psychological or quality of life outcomes. Treatment compliance is an important area in need of study (Pirl , 2004). S tu d ies show that psychosocial and behavioral interventions are effective for reducing cancer-related problems, but additional work is needed. Studies should be conducted to further test intervention strategies such as relaxation training, assertive communication training, communicating with healthcare professionals, diet, and exercise. Identifying the intervention strategies responsible for positive outcomes will help us Nu kopen! PDF-XChange www.easycomputing.com Nu kopen! PDF-XChange www.easycomputing.com Click to buy NOW! PDF-XChange Viewer www.docu-track.com Click to buy NOW! PDF-XChange Viewer www.docu-track.com 73 design and implement treatments with larger effect sizes and longer lasting benefits (Chang et al., 2000).