New research supported by the Cancer Institute NSW is giving new confidence to people with melanoma, during and after a cancer diagnosis.
What does it mean to live with the uncertainty of cancer? If you have had cancer, does that fear go away? How do you cope with not knowing whether cancer might return?
Over 70 per cent of melanoma survivors in NSW may be living with high anxiety their melanoma will return, reducing quality of life and creating potential health risks.
In response, research from the University of NSW, University of Sydney and Melanoma Institute Australia is testing the impact of incorporating psychological interventions as part of ongoing cancer care.
They're finding the interventions, telephone-based sessions with trained psychologists coupled with a new educational resource, are halving the number of people with melanoma who have fear of a cancer recurrence requiring treatment.
People taking part in the study also reported significantly less psychological stress, and greater melanoma-related knowledge compared to patients not receiving the intervention.
What problems can come from fear of cancer recurrence?
Fear of cancer recurrence is associated with increased anxiety and depression, reduced quality of life and lower satisfaction with cancer treatment.
It can influence behaviours that are important to melanoma care like skin self-examination and sun protection.
Associate Professor Nadine Kasparian, UNSW researcher and a lead on this work, sees the program as a way of really addressing these issues.
“Many patients live with high levels of fear that their cancer will return,” A/Professor Kasparian says.
“Despite this, we still see big gaps in access to mental health care for people with melanoma.”
The Cancer Institute NSW recommends people with cancer be overseen by a multidisciplinary team, where a psycho-oncologist can be incorporated as part of cancer care.
How does the intervention work?
Through the study, people with melanoma had three telephone-based psychotherapeutic sessions over a one month period.
Participants spoke with a psychologist trained specifically to provide the intervention, who worked with them to:
- understand each person’s experience of melanoma, including fears or concerns
- provide information and support for unmet needs
- set goals for their involvement in the program
- assist in developing new ways of thinking about and coping with cancer-related worries
- facilitate communications with the person’s health care team
- provide referrals for ongoing support and psychological care, if needed.
The study took into account and measured:
- fear of cancer returning
- psychological stress
- melanoma-related knowledge
- health behaviours
- satisfaction with melanoma care
- unmet needs
- health-related quality of life.
Where and how will the intervention be applied now?
A/Professor Kasparian hopes this research will build more support and mental health care for the 13,000 cases of melanoma expected to be diagnosed in Australia each year.
“Given the positive results of our trial, our hope is for this model of psychological care to be offered to all Australians affected by early stage melanoma.
“We are currently exploring avenues for funding the wider implementation of the intervention,” A/Professor Kasparian says.
“We will also undertake research to adapt the intervention for people with later stage melanoma, as well as people with other cancers.”
The study is been published in the Journal of Clinical Oncology. The work is also funded in partnership with beyondblue and Sydney Catalyst.