Aside from the threat it poses to continued life and good health, cancer is a major disruptive force in the lives of patients and their families. Cancer supportive therapy, by definition, addresses these concerns–those created not by the illness itself but by the repercussions of diagnosis and treatment. It includes a wide range of services and therapy to help the patient and his or her family.
These problems may be:
• physical, such as fatigue, nerve problems, sexual dysfunction and incontinence;
• psychological/emotional, including stress, anxiety and depression;
• social, such as altered relationships;
• lack of information regarding the disease, treatment options and self care;
• practical matters such as self care and coping with daily function; and
• spiritual issues related to the life-threatening nature of the disease and uncertainty about the future.
Asking for Help
In a recent study conducted at a cancer outpatient center in Ontario, Canada, women with gynecological cancers reported experiencing problems in all of the above areas. Most frequently mentioned were emotional, psychological and social issues–feelings of sadness, depression, anxiety and worry about lack of control over the results of treatment. The authors concluded that physical issues apparently were being fairly well met but that many women needed and wanted help with non-physical issues.
Supportive therapy need not be anything formal. Having doctors, nurses, nutritionists and other health professionals who are willing to talk and answer questions–whether in person or by phone or email–is a major advantage. As a patient, it’s important not to be shy about asking. Often there are helpful tips to gain for asking. For example, two physical issues reported frequently by women are lack of energy and not being able to do things previously taken for granted. Some patients are reluctant to bring these matters up or think they are a normal result of their illness. In fact, they often can be managed through an exercise program, physical therapy or medications.
Friends and family are invaluable sources of emotional and social support. But again, you may have to make the first move. Many people feel uncomfortable and worried that they will say the wrong thing. By talking openly about your cancer and your treatment, you open the door for interaction. If others make specific offers of help, accept. Friends feel less helpless when you allow them to do things for you.
Some cancer centers offer individual counseling and other support services from psychiatrists, psychologists, social workers, sex therapists or clergy. In most cases, however, support therapy refers to group therapy or self-help groups. There are many forms of supportive therapy, but the general goal is to provide empathy, understanding, reassurance and release of painful emotions while giving advice and strengthening the person’s ability to cope and function. Supportive therapy does not aim to produce major psychological change or insights.
Support groups may be structured or less directive and structured. They may be led either by a therapist or a fellow cancer survivor. The focus need not be on expression of deep emotions. The basic idea is to gather individuals with similar experiences to share thoughts and feelings and exchange practical information, such as how to manage side effects or deal with the reactions of colleagues when they return to work. Support group meetings are usually free of charge and are often posted in the daily newspapers.
There are general support groups for cancer patients and specialized groups designed for men, women, seniors, adolescents, persons with a certain type of cancer or family concerns such as role and relationship changes. Online support groups work well for persons who live in rural areas or simply prefer that kind of environment. Additionally, some prefer to confide in one individual, such as another cancer victim.
Nearly all cancer patients feel a need for supportive care. Even so, some do not want it, and their wishes and privacy should be respected. On the other hand, some patients who believe they don’t want help actually thrive when they get it.
Michelle Herbert Thomas, PharmD, CDE
Clinical Director
Richmond Apothecaries, Inc.
