Nurturing healthy coping strategies in cancer patients
Dr Joachim Weis - Universität Freiburg, Freiburg, Germany
The key factor of coping is that the coping process is a very complex interaction of the individual with his doctors and also with his family members. The idea of the coping is that it helps the person to cope with the distress of dealing with cancer and dealing also with the sequenceof treatment. We know that coping is taking place on various areas, on various levels; you have emotional paths, cognitive paths and also behavioural paths.
How do you help patients in coping with pain?
Pain is primarily in cancer patients a somatic issue, psychological overlaps. So we help patients to relieve the pain by psychological techniques, for example, relaxation techniques or also focussing their alertness to other cues and using diverse techniques of psychotherapy, hypno-psychotherapy and so on. This is very helpful but it’s an add-on on the pharmaceutical treatment of cancer pain. Fatigue is an excellent example because fatigue is always mixed up with a depressive reaction of patients also. So, first of all, you have to make very clear a differentiated diagnosis – is this just somatic fatigue or is this a part of a depressive reaction. In most of the cases it’s an overlapping between so we try to give the patient, the older patient, an understanding of what’s happening due to the treatment and what he can do to fight against this fatigue.
How do you help patients who want to work?
The older patients, for them, most of them, are not the issue of returning to their working place but they want to have a good quality of life, they want to do their daily activities. There are a lot of techniques of psycho-educational help to restructure the day, help to pace their activities, help to make priorities and fatigue is not always the same over the day. So we try to help the patient identify which is the time period when I’m a bit less fatigued and then I put my activities in that period. In addition, we help him to do physical exercises with them. Not sport for the elderly but to get in moving, not a sedentary lifestyle but going out, making some walking and so on. This is proven by research to be very helpful in those fatigue issues.
What advice would you give to doctors in helping patients to cope with cancer?
The most important message is to ask, to ask the patients for their distress what type of help they need in addition to medical oncology treatment because older patients tend to under-report their psychological distress, although they are suffering from depression or other psychological problems. So the main message is ask your patients how they feel, how their well-being, and what you can do to improve their health status.