the last two frozen pea friday entries were a bit more introspective and heavy. today’s post is heavy, too, but only on science. i wanted to see what solutions health psychologists are looking at in terms of frequently occurring problems for cancer patients,e.g. how to talk about cancer, how cancer impacts family life, cancer and personal development, and the fatigue that comes with cancer.
cancer and family life
i was quite moved by this slide show about cancer and the family by dr. lea baider, a pioneer in psycho-oncology in israel (actually, it’s a lecture but i couldn’t get the audio part to play on my laptop). she asks hard questions such as “how can couples incorporate cancer into their relationship?” and uses beautiful illustrations from art and literature. she uses kafka’s short story “fellowship” to make us sensitive to the intrusion of cancer into family life:
we are five friends, one day we came out of a house one after the other, first one came and placed himself beside the gate, then the second came, or rather he glided through the gate like a little ball of quicksilver, and placed himself near the first one, then came the third, then the fourth, then the fifth. finally we all stood in a row. people began to notice us, they pointed at us and said: those five just came out of that house.
since then we have been living together, it would be a peaceful life if it weren’t for a sixth one continually trying to interfere. he doesn’t do us any harm, but he annoys us, and that is harm enough; why does he intrude when he is not wanted? we don’t know him and don’t want him to join us. there was a time, of course, when the five of us did not know one another, either, and it could be said that we still don’t know one another, but what is possible and can be tolerated by the five of us is not possible and cannot be tolerated with this sixth one.
in any case, we are five and don’t want to be six. … but how is one to make all this clear to the sixth one? long explanations would almost amount to accepting him in our circle, so we prefer not to explain and not to accept him. no matter how he pouts his lips we push him away with our elbows, but however much we push him away, back he comes.
talking about cancer
understanding the difficulties people have with talking about cancer may assist not only the person with cancer but health professionals and those who care for cancer patients. it may help them figure out how support from friends and family may be most beneficial. these were the findings of a study by rosemary chapman, a PhD student at loughborough university.
even managing normal everyday greetings such as being asked ‘how are you?’ could be problematic for someone with cancer. sometimes, responding with how they actually are may create a problem for the person they are talking to since that person is wondering how should they react. consequently, the person with cancer is often faced with an additional predicament; how do they deal with other people’s difficulties of not knowing what to say or how to respond?
it occurs to me that that’s at least part of the explanation for why i keep posting about cancer – it’s about opening the doors of communication, so that we can figure out how we can better support those among us who have this horrible disease (after all, one out of every four north americans is touched by cancer, either themselves, or a close family member or friend).
cancer and personal development
annette l. stanton, PhD, of the university of california-los angeles … discussed how some individuals cope by finding benefit in this adverse circumstance. some individuals look for the positive aspects in their life while experiencing stressors and look for good things that can be learned from that experience. they try to “grow” as a result of the stressful experience. in a sample of 92 women after treatment for breast cancer, 83% found benefits from their experience of breast cancer, and 46% found they related better to others after their experience with breast cancer.
as many of you know, one of my interests is journaling for healing, so this was good to hear:
dr. stanton … and her colleagues recently published the results of a randomized, controlled trial in which 60 early stage breast cancer patients were randomly assigned to write over 4 sessions about either: (1) their deepest thoughts and feelings regarding breast cancer; (2) positive thoughts and feelings regarding their experience with breast cancer; or (3) facts about their experience with breast cancer. after 3 months, those in the first 2 groups who wrote about their emotions had fewer medical appointments for cancer-related illness than those in the control group who wrote about breast cancer facts.
cancer and fatigue
cancer patients suffering from symptoms of fatigue might find some relief through regular exercise and psychological counseling to deal with stress, a review found.
fatigue is one of the most common symptoms of patients with cancer and those undergoing treatment with radiation and chemotherapy. according to the american cancer society, 90 percent of patients in cancer treatment experience fatigue that can range from “mild lethargy to feeling completely wiped out.”
the reviewers evaluated 41 studies. of these, 17 looked at activity-based interventionsin which patients either performed supervised or home-based exercises three to five times a week.
twenty-four studies evaluated psychological interventions. there were a variety of types of interventions, including techniques such as weekly telephone counseling about how to conserve energy and group therapy to teach skills like stress management and relaxation training.
jacobsen and his colleagues found that 44 percent of the activity-based trials and 50 percent of the psychological studies that were of good quality reported significant, if not earth shattering, results. patients who received either of the two types of interventions reported less fatigue than patients in the control groups did, the researchers concluded.
jacobsen concluded the results only provide “limited support” for the use of these types of nonpharmacological treatments to manage cancer fatigue.
steven passik, associate attending psychologist at the memorial sloan-kettering cancer center, said that although there is currently limited research that interventions such as counseling or exercise have a strong benefit on fatigue, patients prefer to try these methods rather than take more medications.
“some of the main barriers of managing cancer fatigue have proven to be a lack of communication from health care providers to patients about how to battle fatigue, as well as an overall reluctance of many patients to take any more drugs to treat the symptom.”
it seems to me the next thing that researchers could look at would be the effect of a combination of mild exercise and counselling on reducing fatigue.
this post is written in support of all my friends who have cancer, and in support of fellow twitterer susan reynold’s frozen pea fund, a cancer fund created especially for bloggers and social media fiends.
(the image of the pea blossom struggling along the fence is by lillian bennett)