Transcript WA Psycho-Oncology Service - James Crofts Hope Foundation

WA Psycho-Oncology Service
Susan Thorman
Specialist Clinical Psychologist
Team Leader
Ph: 9382-7480
Fax: 9382-7479
WA Cancer & Palliative Care Network
Some psychological impacts
of brain tumour in adults
18 July 2015
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WA Psycho-Oncolgy Service
• WA Psycho-Oncology Service established 2007
• Primary purpose to offer specialist psychological care to
adult cancer patients and family (Not Breast Cancer)
• Free, state-wide, private and public, all adult cancers
• Located Shenton Park + In-reach SCGH, RPH, FH
• 3.8 FTE Clinical Psychology + 1 FTE Admin Assist
• Psycho-oncology vs Clinical Psychology
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Cancer and mental health
• Psychological distress after cancer dx/tx is common
• Clinically significant distress found in (NHMRC)
20-30% new diagnosis
50% recurrence
• Few studies specific to Brain Cancers support similar
levels of distress
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Brain Cancer and Mental Health
• Lack of studies = new area + small case numbers
• Brain Cancers 1.5 % of all cases (144 cases, 2007 WA Ca Reg)
• ‘Big 5’: high volume cancers
Breast+Prostate
30%
(2900 cases)
Colorectal
12%
(1189 cases)
Skin
10%
Lung
9%
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Future Research:
% Cases Dx
Breast/Prostate 30
high volume vs high distress?
% WAPOS Cases (2007-2009)
11
Colorectal
12
9
Skin
10
8
Lung
9
12
Haematological
7
12
Brain Cancers
1.5%
14
Head & Neck,
11
Upper GI, Gynaecological
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7
Brain Cancer and Mental Health
• Wellisch et al 2002
89 adult brain cancer patients given clinical interview
28% MDD (DSM-IV)
• Mainio et al 2006
101 adults high/ low grade gliomas
Depression associated with lower survival time low
grade
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Brain Cancer and Mental Health
• Janda et al (2007)
Queensland study
75 patients and 70 carers HADS
Anxious mood:
30% patient
40% carers
Depressed mood:
17% patient
10% carers
• Significant psychological impact on the patient and the whole
family system
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The Whole Family is Affected
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Effects of Brain Tumour
• Neurologic Symptoms
Headaches, dizziness, impaired speech or movement
• Cognitive Deficits
Memory problems
Behavioural Changes
• Due to the tumour, surgery, medication and treatments
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Common Cognitive Deficits
•Anger/labile affect
•Inappropriate behaviour
•Attention and concentration
•Emotional changes
•Communication
•Apathy
•Confusion and disorientation
•Personal care
•Self-focus
•Memory
•Problems solving
•Repetition
•Fatigue
•Impulsive behaviour
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Depression Anxiety and Brain
Tumour
• Difficulty with identifying depression
• Seek medical advice
• Normal shock and adjustment
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Depression Symptoms
• more tearful than usual
• miserable most of the time
• withdrawing from peoples
• guilty at being a burden
• loss of enjoyment in things
•bad person, worthless
• unable to concentrate/ watch TV
•hopeless thoughts “no point”
• increased alcohol or other drugs
•sleep disturbance
•friends, or feeling like a bad
person
• appetite disturbance
• frustrated irritable
• weight loss or gain.
• tired fatigued
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Anxiety Disorders
• constant uncontrollable worry
• restless, on edge, tight muscles (e.g. sore jaw or back)
• Butterfies, churning stomach, sweaty, breathless
• easily tired, irritable, easily startled
• difficulty concentrating, racing thoughts, busy mind
• difficulty falling or staying asleep or restless sleep
• Recurrence of traumatic memories, dreams, flashbacks
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Treatments
• Psychological : CBT, Mindfulness and Relaxation skills
• Combination of psychological and drug treatments
• Support groups
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Cancer
Physical
Sx
Med
Sideeffects
Unfamiliar
Situation
Daily
Stressors
Myths
Spiritual &
Existential
Concerns
Don’t
Understand
Procedure
Effects of
Tumor
Uncertainty
of Future
Self-esteem
Conditioned
Response to
Setting
DrugSeeking
(sedatives)
Existing
Past
Mental
Trauma
Health
& Loss
Disorder
Personality
Temperament
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Cognitive
Difficulties
Psychological distress
has complex
underpinnings. It affects
our behaviour our
emotions and our
capacity to think and
communicate.
WA Psycho-Oncology Service
Tel: 9382-7480 Fax: 9382-7479
Email: [email protected]
Postal Address:
Thorburn House Lv 3 East Wing
RPH: Shenton Park Campus Selby St
Shenton Park WA 6008
18 July 2015
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