Brief Intervention Eases Distress in Patients With Advanced Cancer

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Called CALM, the psychological intervention tries to help patients live with their disease rather than just prepare them for the end of life.
Called CALM, the psychological intervention tries to help patients live with their disease rather than just prepare them for the end of life.

CHICAGO—A brief psychological intervention relieves depressive symptoms in patients with advanced cancer, data reported at the American Society of Clinical Oncology (ASCO) 2017 annual meeting suggest.

In a randomized clinical trial involving 305 patients with advanced cancer, 52% and 64% of the 151 patients who received the intervention, called Managing Cancer And Living Meaningfully (CALM), experienced a clinically important reduction in depressive symptoms at 3 months and 6 months, respectively, compared with 33% and 35% of the 154 patients who received usual care.

In addition, the study found that CALM helped prevent depression among 137 patients who did not have depressive symptoms at study entry. At 3 months, depressive symptoms developed in only 13% of CALM recipients compared with 30% of patients who received usual care.

“This brief talking therapy helps patients facing advanced cancer, and their loved ones, sustain what is meaningful in their life despite its limitations,” lead investigator Gary Rodin, MD, head of the Department of Supportive Care at Princess Margaret Cancer Centre in Toronto, said in an ASCO press release.

Dr Rodin and his colleagues developed CALM specifically for patients with advanced cancer. It consists of 3 to 6 45- to 60-minute sessions delivered over 3 to 6 months by trained healthcare professionals. According to the investigators, the sessions focus on 4 domains: symptom control, medical decision-making, and relationships with healthcare providers; changes in self-concept and personal relationships; spiritual well-being and the sense of meaning and purpose in life; and future-oriented concerns, hope, and mortality.

“CALM is distinct from other interventions in that it is meant to help patients live with advanced disease, rather than just prepare them for the end of life, and in that it is focused on both the practical and the more existential concerns faced by those with advanced cancer,” Dr Rodin said.

Commenting on behalf of ASCO, Don S. Dizon, MD, Clinical Co-Directory of Gynecologic Oncology at Massachusetts General Hospital in Boston, stated, “A diagnosis of advanced cancer weighs heavily on patients and families, and this study gives a new approach that can ease this burden. As oncologists, our job isn't just to treat our patients' physical symptoms. It's also to connect them with other forms of support to help them cope and plan for the futures.”

Reference

Rodin G, Lo C, Rydall A, et al. Managing cancer and living meaningfully (CALM): A randomized controlled trial of a psychological intervention for patients with advanced cancer. J Clin Oncol 2017;35 (suppl; abstr LBA10001).

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