Expert Summary: Session chaired and summary compiled by Dr Addie Wootten, clinical psychologist, Royal Melbourne Hospital.
COSA Annual Scientific Meeting, Melbourne, Australia
Cancer is known to have a significant psychological impact, both for patients and their family members or caregivers.
The reported prevalence of depression for people affected by cancer ranges from 8-24% and clinical levels of distress have been reported to be experienced by 40% of people with cancer. However, reported rates most likely underestimate problem.
Access to appropriate and timely psychosocial care can be challenging for many people diagnosed with cancer, particularly for those living in rural or regional locations. Some studies have reported that only 6% of those identified as distressed are actually referred to psychosocial services. There are multiple barriers to accessing psychosocial care including confusion and lack of clarity about what services are available and what they offer, personal, cultural and system barriers and staff shortages and access difficulties.
There is growing interest in the delivery of clinical services using internet enabled technology, particularly the delivery of psychological interventions online.
As part of the COSA Annual Scientific Meeting on Wednesday 3rd December a symposium exploring the benefits of delivering psychological interventions online was convened. This symposium explored the growing body of research investigating the feasibility, acceptability and efficacy of delivering online psychological interventions in the context of cancer care.
My Road Ahead
Dr Addie Wootten presented findings from her study evaluating an online psychological intervention for men with localised prostate cancer called My Road Ahead (www.myroadahead.org). This randomised controlled trial indicated that the self-guided online intervention in combination with access to a peer forum significantly reduced patient distress, health worry and regret, and significantly improved sexual confidence and masculine self-esteem. Men engaged well with the program and participant feedback indicated that the anonymity provided by the online environment was appealing.
Dr Louise Heiniger presented details about the development and pilot testing of a web-based psychological intervention to reduce anxiety and depression in survivors of testicular care, called e-TC.
This program aims to engage men with testicular cancer in a program designed to support them emotionally, provide tools and resources to manage distress and provide a platform that empowers men to improve their health, wellbeing and self esteem following a testicular cancer diagnosis.
e-TC shows promising results in engaging men, with excellent feedback about the relevance of peer experience videos, communication tools and practical support.
Prostmate Partners Program
Dr Jo Abbott presented details about the development and pilot testing of an online psychological support program for partners of men with prostate cancer (www.partners.prostmate.org.au).
Research has indicated that intimate partners of men with prostate cancer report higher levels of psychological distress than patients, however, very few interventions have been developed and evaluated specifically for partners.
This online program shows promise in supporting partners to manage the challenges associated with prostate cancer by offering a tailored, interactive program which complements online support available for men with prostate cancer.
Finding My Way
Dr Emma Kemp presented preliminary findings from an RCT evaluating an internet self-help program for cancer-related distress called Finding My Way (www.findingmyway.org.au). This program offers psychological, social and practical support for people affected by any type of cancer and is focussed on supporting patients through their treatment experiences. This multi-site study being conducted across Australia has recruited more than half of the projected participants needed and results to date indicate that this internet cognitive-behavioural therapy (iCBT) intervention.
Dr Catalina Lawsin presented Rekindle (www.rekindleonline.org.au), a web-based psychosexual resource for all cancer survivors and their partners. 40-100% of cancer survivors experience sexual problems after cancer. This tailored interactive program delivers resources, patient experiences and expert guidance aimed to help patients and their partners overcome the sexual challenges often faced in the context of cancer.
Dr Haryana Dhillon was the discussant for the symposium and facilitated a lively discussion from the large audience. A common theme across programs was feedback from participants that the program helped them feel less isolated and ‘not alone’ and practical advice and strategies were commonly reported to be useful. The ease of accessing the program online appears to overcome some barriers but ensuring that patients have access to these types of programs at the right time in their cancer experience is important and many participants reported that they needed access closer to initial diagnosis of cancer.