How Can We Improve Stress Levels in Cancer Patients?

October 8, 2018
Lori Smith, BSN, MSN, CRNP
Lori Smith, BSN, MSN, CRNP

Dianne Shumay, PhD, director of psycho-oncology at UCSF, weighs in on how we can use psychological interventions to improve stress levels in cancer patients.

With the uncertainty of a cancer diagnosis also comes high levels of stress. High levels of stress and poor quality of life have been demonstrated to negatively affect prognosis; however, results of a recent study show that the use of combined medical and psychological interventions may yield a positive impact on patients’ stress levels and quality of life.

Dianne Shumay, PhD, clinical psychologist and director of psycho-oncology at the University of California, San Francisco’s Helen Diller Family Comprehensive Cancer Center, who was not involved with the research, spoke with Cancer Network about this issue. “Nearly every aspect of a person’s life is impacted when they are dealing with cancer. It is incredibly stressful. Not only do they worry for their own physical well-being, but they also are concerned about family, the ability to work, how to manage all the doctor appointments, and what their future holds. The stress compounds and can be overwhelming.”

The study evaluated 30 cancer patients with head and neck, breast, or lung cancers, with ages ranging from 27 to 65 years (mean, 52 years), who did not present with a comorbid psychiatric or physical condition. Study participants received some type of medical intervention, such as surgery, chemotherapy, and/or radiation therapy, as well as a psychological intervention, such as psychoeducation, relaxation technique training, and cognitive behavioral therapy, over a 6-week period.

“When we experience stress, our body responds with a cascade of neurological and endocrine changes. Responding this way to temporary stressors is normal and healthy, but ongoing and multiple stressors keep the individual in a state of chronic stress, impacting the immune system and healing processes. We do better by learning to be less reactive to stress and learning ways to return ourselves to a state of restorative calm after a stressor,” said Shumay.

Researchers found that there was a reduction in overall stress when a combination of medical and psychological interventions were used in this population. Additionally, they noted improvement in stress scale-fear, psychosomatic complaints, information deficits, and everyday life restrictions. Physical symptoms, such as fatigue, pain, insomnia, appetite loss, diarrhea, and constipation, were also less frequent.

“Cancer doesn’t just affect a body part, it affects the whole person, their family, and even their community. Comprehensive cancer care must include addressing psychological, social, and practical needs. Psychologists, social workers, chaplains, and therapists can help patients to get their life back and thrive, even in the face of cancer,” noted Shumay.