Number 5 Cancer-related Stress and Psychological Intervention

The plan is for me to write a series of blogs about cancer. You will read this small paragraph every time you read one of these blogs because it is an explanation and a disclaimer. First of all, why should I do this and what qualifies me to do so? The answer to the second question is that I am a cancer immunologist with a PhD from the University of Pennsylvania and have 30-years experience in not only research, but also in the experiences of cancer patients. I have published numerous articles and a book about immunity to cancer and have two other books about my experiences with research and cancer patients as well as a fictional account of the final cure for the disease. However, none of this experience allows me to give advice or otherwise tell people what to do if they have cancer. I can be viewed as a participant/observer who will be relaying current and past observations about this world called “cancer”, which many people do not understand. That’s the answer to the first question, which is why I should do this. The first step in overcoming anything is to understand it first. With that being said, here they are:

Number 5 Cancer-related Stress and Psychological Intervention

In order to understand how, why and which types of psychological interventions are helpful to cancer patients a more detailed look at the magnitude and type of psychological distress experienced by patients in the diagnostic phase is warranted. The period immediately after the diagnosis for the patient is the beginning of a series of emotional states that in some cases, cascade into radical social, familial, and personal dysfunction. This is similar to the effects of recurring cancer as mentioned above, but now the focus is on the period right after the diagnosis because it is the origin of all psychological responses to the disease. In a recent after-diagnosis survey of patients with a variety of cancers (hematologic, bone, and respiratory) revealed that 56% of these patients experienced anxiety and almost 40% depression. The initial diagnosis of cancer is a life-changing event that has the ability to radically change a persons value system and beliefs. Anxiety and depression was discussed previously, but the nature of the psychological distress was not. This initial distress includes alterations of cognitive (mental), behavioral, and emotional abilities. Often they feel vulnerable, unable to solve simple problems, feelings of panic, social isolation, and in some cases a spiritual crisis. This can lead to psychiatric morbidity, which in and of itself can degrade the quality of life, increase cancer mortality and make it very difficult for the patient to understand what’s happening as far as their cancer is concerned. The levels of anxiety, depression, and basic psychological distress are at least 10 percent higher in patients with high-mortality diagnosis such as the case with pancreatic cancer. The psychological distress associated with a cancer diagnosis in adolescents is just beginning to be addressed. A cancer diagnosis can disrupt their ability to establish an adult identity, develop a positive body image, development of their sexual identity and ability to separate from their parents. The proper psychological interventions are necessary in these case involve ways to return them to their normal cycle of life by strengthening their ability to cope with the changes caused by the diagnosis.

Psychological intervention and its survival benefit for cancer patients is a relatively new approach to the treatment of cancer. This type of treatment is totally separate in form from the medical treatment of the cancer, but in some respects just as important. A recent literature survey of studies that have investigated the effect and value of psychological intervention reveal that the effects of this type of treatment are effective and long lasting. The data from these studies indicate that these treatments increase the ability of the immune system to fight cancer. This is a specific function of stress reduction directly related to the ability of a patient to survive their cancer. However, psychological distress has been show to induce cancer-prone states such as obesity (breast cancer risk), increased DNA damage and repair (cause of most cancers), and of course induction of cells that suppress the anti-cancer immune response (mentioned earlier) as well as a panoply of other negative immune events, which leave patients on chemotherapy prone to deadly infections. The authors of this literature survey found several studies that studied breast cancer patients and used cognitive behavior stress management (CBSM) as an intervention method. This technique along with anxiety-reduction not only reduced cancer-related stress, but also reduced the levels of neuroendocrine (cancer promoter) and increased the levels anti-cancer lymphokines (immune proteins) when compared to similar patients that were not in the study The authors point out that the most important aspect of this type of intervention is that the benefits lasted over a year. Just recently this observation was confirmed in Germany with post-operative patients that had multiple types of cancer. The results of this literature survey clearly point out the benefits of psychological intervention, but at this point it’s not know which of these psychological techniques or combination there of are the most effective in protecting the patient from the deleterious effects of cancer-related psychological stress.