Since the theme of this edition of Leap is marking the Alberta Cancer Foundation’s 30th anniversary, I thought we could look back on cancer care 30 years ago as compared to today, from the lens of whole person care and patient access to that care. Back in the early 1980s, it would have been considered heresy to put a group of patients together to talk about having cancer. People thought it would be upsetting to patients to hear stories of what other people were going through. This was before the dawn of psychosocial oncology as we know it – the study of the psychological, social and emotional impacts of cancer.
In the past three decades, many hundreds of studies have investigated the impact of support groups for people with cancer and found a wide range of benefits – from decreases in levels of depression and anxiety, to improved coping, social support and comfort with medical treatment. These days, you would be hard-pressed to find a cancer centre that didn’t offer psychological support of some kind, and that’s a good thing. Not only do people benefit from group support, but they also benefit from individual and family counselling where they can find a safe place to work through difficult emotions, from fear, sadness and anger to grief and loss.
Psychosocial support is expanding to include not just support groups and individual counselling, but also more of the complementary mind-body therapies: meditation, yoga, hypnosis and imagery. At the Tom Baker Cancer Centre in Calgary, we developed a program in 1997 called Mindfulness-Based Cancer Recovery (sometimes referred to as Mindfulness-Based Stress Reduction). It teaches patients and support people techniques of mindfulness, defined as present-centred non-judgmental awareness, using daily training in meditation and gentle yoga. The benefits are many, including stress reduction, decreases in anger, depression and fatigue, and improved sleep and quality of life. To date, thousands of patients in Calgary have taken the eight-week group program.
With new technology advances in the last decade, we decided to offer the program to Albertans across the province who were not able to attend the program in person. This may have been due to living far away, an inability to travel, financial restraints, the burden of symptoms, low energy, infection concerns, advanced stages of cancer or a host of other practical and medical reasons.
We did a pilot study in 2012 and enrolled 63 Albertans, who did the eight-week program online. We sent them web cameras, audio headsets and helped them set up their computers so they could log in to the virtual classroom and see the instructor (who was in California) as well as all the other participants around Alberta. They attended weekly meetings similar to the in-person group and had online discussions about mindfulness, meditation, stress reduction and yoga. They learned how to meditate and practised at home daily between classes. Amazingly, they reported all of the same benefits of those who participated in person! This paper has been published in a scientific journal and we are now seeking funding to make it a permanent clinical program offered to patients, survivors and support people across the province.
This is just one example of how advances over the last 30 years in psychosocial support services have allowed us to reach more people in need using novel and innovative techniques. To read more, visit Tbccintegrative.com.
Dr. Linda Carlson is the Enbridge Chair in Psychosocial Oncology at the University of Calgary and a clinical psychologist at the Tom Baker Cancer Centre.