Patients diagnosed with some type of cancer face an anxious time. They may be fearful about their own survival or worry the the impact that their death could have on their family members. They may have concerns about their treatment including their ability to deal with pain, nausea or surgery; or relating to the impact on their appearance, on their body, on their career, on their finances, on their relationships or on their family. They may feel overwhelmed or unable to control their emotions; and they may feel anxious as they await tests or scans to clarify their situation. It’s quite a list. And most all of the 3650,000 people diagnosed with cancer in the UK every year will have most of these worries. And so too will their loved ones.
Besides anxiety, as they await medical professionals to make perhaps life changing decisions, patients may feel helplessness or have low mood. Some may fear the worst or start to anticipate a poor outcome. In fact those admitted as in-patients are nearly twice as prone to depression related to their cancer in comparison with those who are treated as out-patients.
Now, there are many studies that show just how effective Mindfulness Based Cognitive Therapy (MBCT) is in reducing depression and anxiety within cancer patents. I have posted before about a study involving 245 cancer patients: “Face-to-Face and Internet-Based Mindfulness-Based Cognitive Therapy Compared With Treatment as Usual in Reducing Psychological Distress in Patients With Cancer: A Multicenter Randomized Controlled Trial” (2019 published in Journal of Clinical Oncology). Each of the cancer patients taking part in the study was categorised as experiencing “psychological distress” — i.e. demonstrating a score ≥ 11 on the Hospital Anxiety and Depression Scale (HADS). The study compared patients treated with the usual psychological support with those receiving an eight week course in either “therapist lead” MBCT or self-help (internet based) eMBCT. The results demonstrated that both face-to-face and internet-based self-help mindfulness based cognitive therapy significantly reduced psychological distress in patients with cancer – reducing fear of cancer recurrence and improving mental health–related quality of life. See here
The results showed:
- “Usual treatment” produced a small change in mean HADS score from 17.04 at baseline to 16.37 at post-intervention
- Yet “Face to face MBCT” achieved a change from 18.81 to 13.25
- and the “eMBCT group” achieved a change from 17.24 to 11.87 – almost eliminating “psychosocial distress”
So, both MBCT and eMBCT significantly reduced fear of cancer recurrence and rumination; thereby increasing mental health–related quality of life, mindfulness skills, and more positive mental health compared with usual treatment. The investigators concluded, “Compared with treatment as usual, MBCT and eMBCT were similarly effective in reducing psychological distress in a sample of distressed heterogeneous patients with cancer.”
As you may be aware we are currently working on a version of our Rezl app to provide information, advice and support to those diagnosed with cancer and those close to them.
As part of building the justification-case for the use of MBCT within cancer clinics I spotted this paper from the Netherlands: “Cost‐utility of individual internet‐based and face‐to‐face Mindfulness‐Based Cognitive Therapy compared with treatment as usual in reducing psychological distress in cancer patients” (April 2019 by Compen et al).
The study was an random controlled trial tracking three groups of patients: one given MBCT; one given access to an online MBCT programme (eMBCT); and a control group given treatment as usual (TAU). The paper investigated the “societal costs” (loss of employment earnings, cost of psychological treatment and “quality of life” measures) through-out treatment and through to nine months post-treatment.
The results showed:
- The MBCT and eMBCT patients both demonstrated a 40% reduction in the cost of the psychiatric/psychological care required in comparison with the TAU group;
- The MBCT and eMBCT patients both demonstrated a 70% reduction the earnings lost in comparison with the TAU group;
- The MBCT and eMBCT patients both reported significantly higher quality of life than the TAU group
The researchers concluded that “Results indicate that eMBCT and MBCT are cost‐saving treatments whilst simultaneously improving quality of life for distressed cancer patients.”
It seems to me that that healthcare insurers would benefit from the reduced treatment costs; and disability income or income protection scheme providers would see reduced claims – maybe they should consider the provision of MBCT/eMBCT to reduce their costs (and their premiums) and to increase the “quality of life” of their customers.