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Cancer Survivorship:

Its not just about the

treatment?

Suzanne Hyde LCSW

Virginia G. Piper Cancer Center at Scottsdale healthcare

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City of Hope Cancer Survivor Quality of Life Model

February 13, 2010 NCCN. (2007); Ferrell, Grant, & Dow, (2004).

Cancer Survivorship

Physical Well Being and Symptoms

• Functional Activities

• Sleep and Rest

• Overall Physical Health

• Fertility

• Pain

Psychological Well Being

• Control

• Anxiety

• Depression

• Enjoyment/Leisure

• Fear of Recurrence

• Cognition/Attention

• Distress of Diagnosis

• Control of treatment

Social Well Being

• Family Distress

• Roles and Relationships

• Affection/Sexual Function

• Appearance

• Enjoyment

• Isolation

• Finances

• Work

Spiritual Well Being

• Meaning of Illness

• Religiosity

• Transcendence

• Hope

• Uncertainty

• Inner Strength

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Why is it important to understand the impact cancer

survivorship has on us emotionally and socially?

• Assists in reduction of emotional distress

• Assists with effective treatment planning

• Honors the whole person

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Scope of the issue

• Patricia Fobair, author of Oncology Social Work for Survivorship, highlighted one study indicating “distress among patients diagnosed with cancer was 25% at the beginning of treatment and 40% four months later.” The author reported additional studies have found similar results.

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Scope of the issue cont.

• According to the National Cancer Institute Statistics 2007, 45% of cancer survivors reports some anxiety with 20% reporting significant anxiety

• 15 – 25% of cancer survivors suffer from depression

• Between 3% and 35% of cancer survivors have post traumatic stress disorder.

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Scope of the issue cont.

• The Institute of Medicine’s 2005 fact sheet reported that 1 in 5 cancer survivors will have cancer related work limitations for as long as five years after treatment ends

• In 2005, the Lance Armstrong Foundation conducted a poll of 1000 cancer survivors and found that nearly half felt that their nonmedical needs were not met.

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Cancer is a life changing event

• A diagnosis of cancer contradicts an understanding of how things are “supposed to be”.

• Disruption of sense of self and the world

• Shattering of illusion of control in our life

– Life After Trauma by Dena Rosenbloom, Ph.D and Mary Beth Williams, Ph.D

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Now, how do we apply this education to our

lives as we cope with these challenges?

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Social Well Being

• Understand that cancer will affect and challenge the both the patient’s and caregiver’s social well being

• Desire to return to old normal for both patient and caregiver

• “acknowledges the idea that illness creates trauma, loss, and grief and that trauma, loss, and grief must be affirmed and then expressed deliberately. The deliberate expression ultimately results in relief and movement towards a new normal.”-The Chronic Illness Workbook by Patricia A. Fennell, MSW, CSW-R.

• seek professional help to assist with the financial and work challenges that can come with cancer survivorship

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Psychological Well Being

• Understand that anxiety, depression, fear, and struggles with the concept of control is normal for cancer survivors and family

• Join peer support programs to help normalize, validate and give encouragement

• Seek out professional counseling to further coping skill development

• Talk to your oncologist if you are struggling emotionally

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Spiritual Well Being

• Cancer can challenge and/or strengthen spiritual well being

• Encourage exploration and discussion

• Seek out the use of professional assistance through the your place of worship as many churches and synagogues have cancer specific support groups.

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Health is a large word. It embraces not the body only, but the mind

and spirit as well;... and not today's pain or pleasure alone, but the

whole being and outlook of a man. ~James H. West

The Four Dimensions of Cancer Care