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SUrivors’ Rehabilitation Evaluation after CANcer (SURECAN)

Centre for Psychiatry

Project Investigator:  Peter White

Overview

Some two million people in the UK are living beyond cancer, of which a third have a diminished quality of life or well-being. There is a wide variation in NHS provision for these patients, with unknown effectiveness and cost-effectiveness. The National Cancer Survivorship Initiative has highlighted these problems and sought solutions. We now know that poor quality of life is caused not only by the medical after-effects of cancer and its treatments, but also by related problems such as: fatigue, fear of recurrence, fear of dying, low mood, loss of self-confidence, altered body image, sexual problems, and physical inactivity.

Certain therapies can ameliorate some of these problems; both physical exercise programmes and cognitive behaviour therapy are moderately effective by themselves, but are rarely provided. There is an unmet clinical need to know whether both these interventions can be delivered by the same therapist in a more patient-centred, targeted way. In order to facilitate this, a development of cognitive behaviour therapy, known as Acceptance and Commitment Therapy, may provide a means to engage patients and facilitate change by encouraging patients’ flexibility to accept what cannot be changed and commit themselves to what can be. We need to know whether such an intervention is cost-effective, whether the effects persist, and who should deliver it (i.e. nurses or specialist therapists). Finally, these interventions may not help patients to resume work; vocational rehabilitation may also be required.

The study currently has a development grant and is conducting preliminary work;

1. A rapid review of current interventions

2. An audit assessing the validity and utility of quality of life and well-being measures in patients who have completed treatment or who are on maintenance/watch and wait treatments (with Heamo-oncolgy, Breast cancer, Colo-rectal cancer and Head and Neck cancer patients)

3. Nationwide survey of healthcare professionals regarding current practice for those living beyond cancer

4. Development of an ACT based intervention and tests of feasibility and acceptability

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