April 29, 1997
(Adapted with permission from CANCER PRACTICE January/February, 1997, Vol. 5, No.1 - For more information or for a copy of CANCER PRACTICE, please contact Mark Naples: 202/955-6222.)
The Effects of New Cancer Treatments on Cancer Survivors and Their Families
The way we care for those living with cancer is changing, with more cancer patients recuperating at home. Therefore, it is important to understand how the demands of cancer care influence family members across the phases of cancer. For example, if cancer recurs, it will generally imply a change in treatment goals and a changed perspective on patient progress. At the time of recurrence, hope for cure of the patient must be revised and optimism about a long-range, positive outcome generally becomes more limited than at initial diagnosis.
Today's improved drug treatments reduce the frequency of cancer recurrence, allowing more cancer patients to be at home and enjoy a better quality of life with their families due to shorter hospital stays. No fewer than five potent, anti-cancer drugs have become available in the past five years, with the leading chemotherapy drug TAXOL(r) as a key example. TAXOL has been shown to increase the life expectancy of ovarian cancer patients by 50 percent, and can be given on an outpatient basis so more cancer survivors can be with their families and not in the hospital.
Because of the increasing frequency of the home-cancer care model, the response to and psychological impact of cancer survivorship and recurrence on both the cancer patient and their families is being examined. One such study is led by Barbara A. Given, Ph.D., R.N. and Charles W. Given, Ph.D., both of Michigan State University. Information from studies like the Givens' and the concomitant improvements in cancer care - as well as the aforementioned improvements in drug treatments - are an integral part of cancer care at-home success.
The Givens' study matched - according to age, gender, and sites of cancer - 62 newly diagnosed patients and 62 patients with recurring cancer. Caregivers of these two groups were compared at intake into treatment and six months later to determine if recurrence had a unique effect on them. Caregivers of patients with recurrent cancer were not more depressed or burdened either at intake or six months later, and there was no unique effect of recurrent disease on caregiver reports of burden or depression. Therefore, in this matched group of patients and caregivers, it was the patient's status, i.e., their physical functioning and number of symptoms that were related to caregivers' reported distress and burden. This finding indicates that while recurrent diseases may be a milestone in the clinical course of cancer, family caregiver distress was related not to the milestone but to the patients' physical states and their care needs. So, at all phases in the cancer care trajectory, healt
"Cancer care is changing from an in-patient setting to an out-patient and home care model," said Dr. Charles Given. "There are a variety of drugs - TAXOL among them - that are having an impact on improving cancer patient outcomes and quality of life," said Given.
"It's important to remember that the success of home care depends on patients and families who are supported to provide care for symptom management and to restore physical functioning," said Dr. Given. "They must know when and how to contact their health care provider to get the support they need for the problems they may encounter."
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