Our magic potion for cancer?

Richard M. Suinn

Imagine this: Cancer cells have been discovered in your body and you are hoping desperately to be told what treatment will work. Instead, the oncologist suggests several options: radiation, chemotherapy, surgery or wait-and-see. Then you stumble across an article about an experimental drug that would activate your immune system, calling up thousands of natural killer cells to attack the cancer.

When properly administered, this drug reduces your pain, controls your worries and dissipates your anxieties. Somehow, the drug can also clear obstructions to your interpersonal and communication skills, and energize you to have a positive attitude towards life. You ask for this treatment and find that some health insurers will not cover it because it hasn't been classified as appropriate "medical" treatment. Further, your oncologist appears reluctant to use this drug because it requires hiring additional help. Imagine the disbelief, disillusionment and depression you would experience, and then the outrage when you also discover that preliminary documents suggest the drug prolongs survival for some patients.

The value of psychosocial interventions

This may seem like pure fantasy--and a terrible one to suggest for the two of three families who experience cancer. No, there is no experimental drug that has all these healing properties. But if you substitute "psychosocial interventions" for "drug," the fantasy approximates life. For at least a decade, research has confirmed the value of psychosocial interventions for controlling asthma, reducing hypertension, helping arthritis patients and enhancing quality of life for many afflicted with chronic disease. With cancer, studies have demonstrated the effectiveness of psychoeducational group sessions for removing distress and the emotional turmoil after diagnosis, strengthening the immune system, controlling pain, improving communications between patients and oncologists, strengthening family and other support systems, raising self-esteem and optimism, and resolving the many problems of daily adjustment facing those with this catastrophic disease.

Some have already documented the cost effectiveness of adjunctive psychological treatment for medical events. For instance, when provided prior to surgery, patients spend fewer days in the hospital. One such study estimated savings per patient of more than $12,000. Yet, as with our fantasy experimental drug, psychosocial treatment is not yet offered routinely.

I need your help

We may not have the cure for cancer, but we do possess treatments that offer hope for an enhanced quality of life. Psychosocial approaches possibly act in synergy with medical therapies and can make the pain of diagnostic techniques tolerable, as well as reduce the distressing effects of chemotherapy. Cancer takes away from physicians one of their greatest assets: the ability to communicate confidence, to provide reassurance, to convey unambiguous answers. And herein lies the crucial role for the psychosocial interventions.

However, in much the same way as a patient may be deprived of an experimental drug, cancer patients are prevented from accessing psychosocial treatment because of poor public awareness or availability of training. As psychologists we have identified ourselves well as mental health professionals, but not well enough as primary-health-care professionals. The lay and medical communities need to know about our "experimental drug" and the benefits it brings--this is one of my presidential goals and I ask your involvement. to work toward the same ends. In your locale, find ways to speak in public forums, inform the news media, include the topic in classroom materials, write articles, volunteer a briefing to a hospital group, duplicate and distribute informational brochures (see Div. 29's example). Help me identify prominent nonpsychologists for an advisory panel.

A second factor is the need for more psychologists competent in psycho-oncology. Building on basic clinical and counseling skills, psychosocial programs for cancer patients require capability in leading groups focused on a solution-based approach to emotional issues, teaching communication skills, opening support networking, development of pain management techniques, and active commitment to self-management instead of passive suffering.

In addition to public education, we need a resource database of proven training manuals and patient workbooks. APA's Practice Directorate, in collaboration with Blue Cross and Blue Shield of Massachusetts and the Linda Pollin Institute, Harvard Medical School, has developed a group treatment manual and a psychoeducational workbook for women with primary breast cancer. I ask you to send me other manuals you know to be effective.

We need training opportunities. I urge regional and state psychological organizations and university-based programs to design workshops to meet this need. Join me in this war against cancer. Let us make this year our year to provide hope.



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