Download Resilience in Cancer Survivors

Are Cancer Survivors Resilient?
By: Julie Wright
Intro to Lifespan-Psych 1100
First Study
In 2002, a study came about that would examine
resilience in long-term cancer survivors. This
study was sponsored by the National Cancer
Institute(NCI) and the American Cancer
Society(ACS).
For all information see work cited: (first study)
Survival Rate
• Early detection, treatment, and supportive
care have all led to an increase in survivorship.
• At the time of the study in 2002, there was a
64% chance of at least a 5 year survival rate.
• There is an increase in surviving a childhood
cancer. Of the survivors, 75% will survive at
least 10 years after treatment.
• There are over 10 million survivors in the US
and 24 million in the world.
• “Being disease free doesn’t mean being free
of the Disease”
• Cancer effects:
– Physical
– Functional
– Psychological/Cognitive
– Social
– Economic
– Spiritual
• Cancer survivors show great resilience:
– They will experience both positive and negative
emotions.
– The attitude of an enhanced quality of life when
faced with a life threatening illness; is it real or is it
beneficial?
– When they experience positive emotions and
beliefs others should not interpret it as being
inappropriate, naïve, or lack of understanding in
dealing with the situation.
– If they show early positive reactions they may
have fewer problems adapting long term.
Does Optimism lead people to tune
out important negative information?
• Positive beliefs help people deal with the
emotions they feel when receiving the diagnosis
and prognosis.
• Positive beliefs help people focus on dealing with
the problems that are within their control and
recognize that some problems are beyond their
own abilities or resources.
• Positive beliefs may help people gain coping skills,
knowledge, and social resources, that help in
dealing with a serious illness.
Quality of Life: longitudinal and cross-sectional
study
• Consider the patients age or life stage
• Consider the differences of personality
• Consider cultural differences
• Does the patient participate and benefit from
survivorship programs that are offered such as
counseling, nutrition classes, yoga, etc.?
• How does the family deal with the diagnosis,
supporting the patient, caregiving and the
emotional disruption to the balance of family
life?
Are there ways to foster resilience?
• People are goal oriented. Cancer is an
interruption to a persons life and their goals.
• Cancer can become a new goal the patient can
conquer in order to get back to “normal life”
• Individual personalities affect how people react
to adversity.
• Optimism plays an important role in predicting
long term emotional well being.
• Those who report distress short term are likely to
experience greater distress long term.
After Cancer Treatment: The process
of resuming life or the re-entry phase
• Most are ill-prepared for problems they face
when trying to resume their lives.
• Patients need to be Proactive in their attitude
towards their health by:
– Continuing with follow up appointments
– Following an exercise and diet regimen
– Taking responsibility for lowering health risks and a
high sense of control
– Give up smoking and limit alcohol consumption
– Get psychiatric help if needed
Who would benefit from psychosocial
and behavior intervention?
• Survivors with physical problems like chronic
fatigue, infertility, lymphedema etc.
• Survivors with psychiatric or psychological
problems interfering with daily function and
quality of life.
• Survivors who have trouble returning to
normal life and have a diminished sense of
purpose or direction.
Second Study
This study was conducted for childhood cancer
survivors and how they adapt psychologically to life
after treatment.
For all information see work cited (second study)
How do childhood cancer survivors
adapt psychologically?
• Survivors were more prone to think of others
rather themselves as compared to their peers.
• Survivors were more likely to prefer and were
happier when interacting with others.
• Overall the survivors of childhood cancer are
mentally well adjusted compared to their
peers.
• Survivors felt psychologically healthy despite
the traumatic childhood cancer experience.
• Aspects of the illness may have led many
survivors to develop values, expectations and
assumptions that enhance appreciation for
being alive.
• Survivors felt:
– Their experience had a positive impact
– Their experience had a low negative affect
– High sense of personal control
– High Motivation for interpersonal intimacy
Survivors and Personal Control
• Survivors reported a higher degree of control in
everyday life situations
• It seems to be an exaggeration termed the
“illusion of control”
– They really don’t have greater control over their
future health because of the risk of secondary cancers
or other physical/mental ailments.
– The exaggerated sense of control did not appear
problematic because there is no evidence of survivors
behaving in unrealistic or self destructive ways.
High Intimacy Motivations in
Childhood Cancer Survivors
• They tend to think more about others than
themselves.
• Prefer interacting with others.
• Attachment Theory
– Heightened need for, and valuing of, interpersonal
relationships
– Cancer experience led to improvements in family and
friend relationships.
– More aware of enjoying life to the fullest including
wanting to invest in meaningful relationships to the
greatest possible degree.
The negative side:
• An exaggerated unhealthy dependency
behavior caused for being so dependent on
their parents during their illness.
• Survivors report lower satisfaction in their
important relationships.
• Dissatisfaction relates to high expectations for
interpersonal relationships.
• Post-treatment relationships may be
something of a “let-down”
In Summary
• Adult survivors are as well adjusted as their
peers.
• Survivors reported feeling more positive and less
negative emotions than their peers.
• They reported more perceived personal control
and greater satisfaction with control.
• Illusionary Control is an adaptive way of coping.
• More motivated to seek interpersonal intimacy
which was positive except in the case of excessive
dependent behavior.
Work Cited
First Study:
Introduction: Resilience of cancer survivors across the lifespan
Rowland, J. H. and Baker, F. (2005), Introduction: Resilience of cancer
survivors across the lifespan. Cancer, 104: 2543–2548.
doi: 10.1002/cncr.21487
Second Study:
Psychologic adaptation of survivors of childhood cancer
Gray, R. E., Doan, B. D., Shermer, P., Fitzgerald, A. V., Bery, M. P., Jenkin, D. and
Doherty, M. A. (1992), Psychologic adaptation of survivors of childhood
cancer. Cancer, 70: 2713–2721. doi: 10.1002/10970142(19921201)70:11<2713::AID-CNCR2820701124>3.0.CO;2-T