One In Four Cancer Patients Has Anxiety Disorder, Australia

Main Category: Cancer / Oncology
Also Included In: Anxiety / Stress;  Mental Health;  Psychology / Psychiatry
Article Date: 09 Nov 2010 - 4:00 PST window.fbAsyncInit = function() { FB.init({ appId: 'aa16a4bf93f23f07eb33109d5f1134d3', status: true, cookie: true, xfbml: true, channelUrl: 'http://www.medicalnewstoday.com/scripts/facebooklike.html'}); }; (function() { var e = document.createElement('script'); e.async = true; e.src = document.location.protocol + '//connect.facebook.net/en_US/all.js'; document.getElementById('fb-root').appendChild(e); }()); email to a friend   printer friendly   opinions  

Significant numbers of cancer patients experiencing anxiety post diagnosis are seeing their condition escalate to a clinical disorder because they are not being picked up early enough and referred for treatment.

In a presentation today (9/11) to the Clinical Oncological Society of Australia's Annual Scientific Meeting, psycho-oncologist Jane Fletcher will explain that around 25% of cancer patients meet the criteria for an anxiety disorder, with 3% suffering post traumatic stress disorder.

"There is a lot of under-reporting, unmet need and high levels of morbidity," Ms Fletcher said. "The impact on cancer patients and family members can be significant and long-term."

Disorders range from general anxiety to panic and post traumatic stress, phobic reactions such as needle phobia and conditioned responses such as anticipatory nausea.

"Patients' conditions can rapidly escalate from general anxiety to more serious issues, such as panic attacks. In some cases they are incapable of leaving the house.

"Unfortunately, we don't have the clinical culture or training to readily identify and intervene early enough. Without encouragement and support from health professionals, patients won't raise issues and tend to think anxiety is something they just have to put up with."

Ms Fletcher said there was high level evidence to support a range of non-pharmacological interventions such as relaxation therapies, cognitive behavioural therapy and hypnosis. "But we need oncologists, GPs and other health professionals to be more adept at noticing when their patients exhibit signs of anxiety or distress and to take appropriate action."

Clinical Oncological Society of Australia President, Professor Bruce Mann, said the push by COSA and other clinical groups around the world to have 'distress' recognised as the sixth vital sign (after temperature, blood pressure, pulse, respiratory rate and pain) would ensure health professionals became more cognisant of the issue and incorporate it as a routine part of patient assessment.

"For those of us working in chronic diseases like cancer, the disease itself is often so debilitating, we sometimes neglect to pay enough attention to what can be very serious issues such as anxiety," he said.

Ms Fletcher will present at 5pm today (Nov 9) at the Clinical Oncological Society of Australia Annual Scientific Meeting. Room 204, Melbourne Convention and Exhibition Centre.

Source:
Clinical Oncological Society

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Depression Associated With Reduced Cancer Survival

Main Category: Cancer / Oncology
Also Included In: Depression;  Psychology / Psychiatry;  Mental Health
Article Date: 10 Nov 2010 - 2:00 PST window.fbAsyncInit = function() { FB.init({ appId: 'aa16a4bf93f23f07eb33109d5f1134d3', status: true, cookie: true, xfbml: true, channelUrl: 'http://www.medicalnewstoday.com/scripts/facebooklike.html'}); }; (function() { var e = document.createElement('script'); e.async = true; e.src = document.location.protocol + '//connect.facebook.net/en_US/all.js'; document.getElementById('fb-root').appendChild(e); }()); email to a friend   printer friendly   opinions  

New Australian research has found that psychological factors may have a significant impact on the survival of people with cancer.

The Australasian Gastro Intestinal Trials Group study, presented yesterday (9/11) at the Clinical Oncological Society of Australia Annual Scientific Meeting in Melbourne, researched 421 patients with bowel cancer.

The study measured survival rates against psychological factors, including hope, optimism, depression and anxiety, while controlling for other biomedical variables. It found there was a significant decrease in survival times for those with depression.

Peter MacCallum Cancer Centre Associate Professor, Penelope Schofield, said the research suggested psychological factors played a potentially significant role in health related behaviours.

"It is likely that feeling either depressed or hopeful impacts a cancer patient's behaviours, with those high in hope more likely to seek information, second opinions, different treatment options and take better care of themselves than those who are depressed or anxious and feel they have no control over their illness," she said.

"This research highlights the importance of empowering cancer patients to be able make choices about their treatment and providing emotional support throughout their cancer journey," she said. The study did not find a relationship between optimistic thinking (simply believing there will be a good outcome) and survival.

COSA President, Professor Bruce Mann, recommended health professionals encourage their patients to ask questions and become more involved in decision making around their treatment.

"This research also highlights the importance of health professionals being aware of signs of anxiety or depression and helping patients who exhibited symptoms get a proper diagnosis and appropriate treatment."

Source:
Cancer Council Australia

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Physical Activity Link To Breast Cancer Recovery

Main Category: Breast Cancer
Also Included In: Cancer / Oncology;  Sports Medicine / Fitness
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Physical activity in breast cancer survivors has been found to be important in reducing the risk of breast cancer recurrence and improving quality of life, according to new research to be released today (9/11).

Researchers from the Peter MacCallum Cancer Centre in Melbourne, will release preliminary results today of research based on a structured physical activity program, to the Clinical Oncological Society of Australia's Annual Scientific Meeting.

Principal Investigator, Annabel Pollard, said physical activity levels declined during treatment and most breast cancer survivors did not engage in physical activity at recommended levels. "Enabling cancer survivors to recover or improve their health after cancer treatment is perhaps as important as treating the disease," Ms Pollard said. "Cancer survivors are often motivated to have a healthier lifestyle, but many do not carry out their good intentions."

Staff at Peter Mac have developed a program which, on preliminary testing, shows promise for increasing physical activity and improving quality of life in breast cancer survivors over 12 weeks.

Ms Pollard said the results of the pilot study suggested that, compared to women who receive usual care, successful lifestyle change after breast cancer was more likely in women who received a targeted structured intervention that aimed to increase physical activity behaviours. "The research indicates that simply providing information alone does not change behaviour; a structured approach is more conducive to change.

"While still part of a pilot study, these results reveal that we need to facilitate better ways of supporting women in the recovery process. There is value in incorporating cancer rehabilitation interventions as part of the continuum of treatment and care."

Clinical Oncological Society of Australia President, Professor Bruce Mann, said health professionals needed to motivate and support their patients to make lifestyle changes that could reduce the risk of recurrence.

"Rehabilitation after breast cancer is a challenging process for patients and their families," Professor Mann said. "Physical activity is not usually high on the list of priorities for patients, but we should be encouraging and supporting them to undertake structured programs."

Ms Pollard will present her research at 4pm today (Nov 9) at the Clinical Oncological Society of Australia Annual Scientific Meeting. Room 211, Melbourne Convention and Exhibition Centre.

Source:
Clinical Oncological Society

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Side Effects Of Hormonal Breast Cancer Therapy Increased; May Affect Treatment Adherence

Main Category: Breast Cancer
Also Included In: Cancer / Oncology
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Women being treated for breast cancer with aromatase inhibitors may experience extremely low estrogen levels resulting in a wide variety of side effects that a typical postmenopausal woman without cancer may not experience.

Data presented at the Ninth Annual AACR Frontiers in Cancer Prevention Conference, held here Nov. 7-10, 2010, showed that women assigned to take aromatase inhibitors had increases in side effects such as hot flashes, decreased appetite, fatigue, fever, breast sensitivity, etc.

"Aromastase inhibitors represent one of the most major advances in breast cancer treatment," said Lisa Gallicchio, Ph.D., an epidemiologist at The Prevention and Research Center at Mercy Medical Center, Baltimore. "Their incorporation into the breast cancer treatment armamentarium has led to impressive reductions in breast cancer recurrence and mortality rates.

"Despite this, many breast cancer patients stop taking their aromatase inhibitor treatment - which is usually prescribed for five years - or do not adhere to their treatment prescription," she said, adding that this may be due to, at least in part, the side effects associated with the drugs.

To better define the full spectrum of side effects associated with aromatase inhibitor treatment, Gallicchio and colleagues surveyed 100 women with breast cancer who were about to start treatment with aromatase inhibitors. Their side effects were compared with those of 200 similarly-aged women without a history of breast cancer.

Questionnaires about symptoms were completed prior to treatment initiation by women with breast cancer and at the start of the study for the healthy women. Women were followed for six months and completed additional questionnaires at three months and at the completion of the study.

Women taking aromatase inhibitors were five times more likely to report having hot flashes, breast sensitivity and chest pain than healthy women. In addition, they were four times more likely to report night sweats, cold sweats and hair loss and about three times more likely to report leg cramps, weight gain, sleep disturbance, tendency to take naps and forgetfulness. Other increased symptoms included intestinal gas, cough, depression, interrupted sleep and irritability.

"We know that aromatase inhibitors are effective in treating breast cancer," Gallicchio said. "Knowing the side effects of aromatase inhibitor treatment and how to treat them is critical for keeping women on their aromatase inhibitor treatment and improving their chances of surviving and living cancer free."

Source:
American Association for Cancer Research (AACR)

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New Guide Can Predict Patients' Survival - Cancer Research UK

Main Category: Cancer / Oncology
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A new way of predicting how long terminally ill cancer patients have to live, has been devised by Cancer Research UK-funded research.

The new guide, presented at the National Cancer Research Institute (NCRI) Cancer Conference in Liverpool* is based on blood tests, white cell blood count, pulse rate and patient symptoms and can predict survival at least as well as a doctor.

Scientists said that the model differed from previous scales in that it could help to give a more accurate picture of whether patients might have only two weeks or two months left to live, independently of a doctor's estimate.

The scale could help families, carers and nurses make plans with cancer patients who are close to the end of their life.

The study, funded by Cancer Research UK, looked at 18 palliative care services including hospices, hospital support teams and community service and more than 1000 patients with advanced cancer who were no longer receiving treatment.

A combination of markers like blood tests, pulse rate, weight loss, tiredness, breathlessness and white blood cell count were used to produce two versions of the scale.

Dr Paddy Stone, lead study author based at St George's University of London, said; "These scales can provide valuable information for patients, carers and health professionals. It is important to remember that these results do not provide a definitive model for predicting how long someone will live, but it will give everyone concerned a clearer idea of what it is likely to happen. "This study provides a solid starting point for improving accuracy in survival predictions which can continue to be refined and improved."

Professor Chris Todd, another author based at the University of Manchester, said: "An instrument like this will also help us identify which patients could take part in studies aimed at improving the quality of life for people receiving end of life care. We are already looking at how to improve the prediction models and how to make them readily available to clinicians through, for example, iPhones and other mobile devices."

Scientists claim that one form of the scale, which does not require a blood test, provides a prediction of survival as good as a doctor's estimate; while another version using a blood test is better than a clinician's prognosis.

The model could also be adapted to a patient who may not be able to respond to questions about their health.

Mike Hobday, head of campaigns at Macmillan Cancer Support said: "This scale could prove useful to patients, families and clinicians who are wondering whether to begin discussions around palliative care arrangements. "All too often this conversation is left until it is too late to make arrangements while patients wait to know what their future is. Having the conversation at an earlier point, alongside ensuring a 24 hour community nursing service is in place will vastly improve the chances of the 57%** of people with a cancer diagnosis who want to die at home being able to do so."

Reference

* Gwilliam B et al., The prognosis in palliative care study (PiPS)

Notes

**Macmillan Cancer Support, Unpublished survey conducted February 2010 of 1019 people

Source:
NCRI Cancer Conference
NCRI

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Complementary Therapies Improve Lives Of People Living With Cancer, Australia

Main Category: Cancer / Oncology
Also Included In: Complementary Medicine / Alternative Medicine
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A new study shows simple therapies, such as massage, boost the quality of life and reduce distress symptoms in cancer patients.

The study by the SolarisCare Foundation, to be presented today (9/11) at the Clinical Oncological Society of Australia Annual Scientific Meeting in Melbourne, found a 14 per cent reduction in symptom distress, with patients reporting improvements in pain, fatigue, nausea, appetite, sleep, breathing and bowels.

Patients also reported an eight per cent increase per session in their quality of life, using a scale which measures empowerment, depression, anxiety, frustration, confusion, coping and relaxation.

The researchers measured the quality of life and symptom distress of 1244 cancer patients receiving complementary therapies in addition to the mainstream cancer treatment.

The therapies were based on:

- Touch: bowen therapy, aromatherapy, reflexology
- Energy: reiki, pranic healing
- Mind: meditation, chi breathing
- Support counselling

According to lead researcher and Head of Haematology at Sir Charles Gairdner Hospital, Dr David Joske, the research demonstrates the positive impact complementary therapies can have on cancer patients. "It's too early to know whether these therapies have a real biological impact or merely create a placebo effect," Dr Joske said.

"In any case, there's no doubt that there is an improved outcome for cancer patients. I have seen my patients change their mentality to feel empowered about the management of their cancer. The research creates a compelling case for integrated medicine.

"We also see a change in the attitude of patients towards attending their treatment, most likely due to the complementary therapies they are receiving in addition to the less enjoyable treatments like chemotherapy. This probably improves compliance with mainstream treatment."

COSA President, Professor Bruce Mann, said the findings were interesting, although other research would be presented at the meeting indicating symptoms generally settled with time. "The suggestion complementary therapies may contribute to patients having a more positive approach to conventional treatment is welcome and merits further investigation."

Dr Joske will present his research at 4.40pm today (Nov 9) at the Clinical Oncological Society of Australia Annual Scientific Meeting. Rooms 105/106, Melbourne Convention and Exhibition Centre.

Source:
Clinical Oncological Society

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