P3.05-001 Psychological Intervention to Treat Distress and Suffering Experienced by People with Lung Cancer Nearing the End-Of-Life: Topic: Symptoms, Therapeutic Interventions

Abstract

Despite advances in medical interventions, lung cancer continues to be associated with a poor prognosis with approximately 16% of people with lung cancer living five years post diagnosis. This poor prognosis can contribute to depression, anxiety, death anxiety and existential concerns and fears relating to meaning and purpose of life. There is a growing body of evidence indicating that behavioral and psycho-educational interventions are efficacious in treating depression and anxiety in lung cancer patients, however, little is known about how to psychologically treat suffering and distress nearer to the end-of-life. A comprehensive search using PsycINFO and Medline was undertaken to identify existential and meaning centered psychotherapies that were used towards the end-of-life with people with cancer. As the research in the area is in its infancy, all quantitative study designs and qualitative studies were included. Studies that focused on physical symptom management, dyads and bereavement interventions, measurement of psychological distress or existential concerns were excluded. The search yielded a total of 62 articles, of which only 34 examined the use of psychotherapies towards the end-of-life care of people with cancer. The majority of these studies were focused on women with breast cancer, used different outcome measures and included very few, if any, participants with lung cancer. These studies identified and described at least 14 novel psychotherapeutic interventions that could be used towards the end-of-life. These interventions included: Legacy Activities, Life Review Therapy, Meaning-Centered Group Psychotherapy, Individual Meaning-Centered Psychotherapy, Dignity Therapy, Forgiveness Therapy, Meaning-Making Psychotherapy, Outlook Psychotherapy, Supportive Group Interventions, The Healing Journey Intervention, Cognitive Existential Interventions, Re-creating Your Life Therapy, Mindfulness Interventions and Managing Cancer and Living Meaningfully. These interventions varied in the number of sessions and the level of training required to administer the interventions. Some of these interventions were manualized and others were less structured in their approach. Some of these interventions show potential in alleviating distress and suffering, improving life satisfaction, self-esteem and mood. There are only a small number of studies that evaluate the efficacy of psychotherapeutic interventions to be used with people with advanced cancer towards the end-of-life. Although results are promising it is difficult to conclude that one intervention is better than another. Further research is required to trial and adapts these interventions for use with people with lung cancer towards the end-of-life.