WA Cancer & Palliative Care Network

WA Psycho-Oncology ServiceSusan ThormanSpecialist Clinical Psychologist Team Leader

Ph: 9382-7480

Fax: 9382-7479

12 April 2023 Slide 2

Some psychological impacts of brain tumour in adults

12 April 2023 Slide 3

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

12 April 2023 Slide 4

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

12 April 2023 Slide 5

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%

12 April 2023 Slide 6

Future Research: high volume vs high distress?

% Cases Dx % WAPOS Cases (2007-2009)

Breast/Prostate 30 11

Colorectal 12 9

Skin 10 8

Lung 9 12

Haematological 7 12

Brain Cancers 1.5% 14

Head & Neck, 11

Upper GI, Gynaecological 7

12 April 2023 Slide 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

12 April 2023 Slide 8

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

12 April 2023 Slide 9

The Whole Family is Affected

12 April 2023 Slide 10

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

12 April 2023 Slide 11

Common Cognitive Deficits

•Anger/labile affect

•Attention and concentration

•Communication

•Confusion and disorientation

•Self-focus

•Problems solving

•Fatigue

•Impulsive behaviour

•Inappropriate behaviour

•Emotional changes

•Apathy

•Personal care

•Memory

•Repetition

12 April 2023 Slide 12

Depression Anxiety and Brain Tumour

• Difficulty with identifying depression

• Seek medical advice

• Normal shock and adjustment

12 April 2023 Slide 13

Depression Symptoms

• more tearful than usual

• withdrawing from peoples

• loss of enjoyment in things

• unable to concentrate/ watch TV

• increased alcohol or other drugs

•sleep disturbance

• appetite disturbance

• weight loss or gain.

• miserable most of the time

• guilty at being a burden

•bad person, worthless

•hopeless thoughts “no point”

•friends, or feeling like a bad person

• frustrated irritable

• tired fatigued

12 April 2023 Slide 14

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

12 April 2023 Slide 15

Treatments

• Psychological : CBT, Mindfulness and Relaxation skills

• Combination of psychological and drug treatments

• Support groups

12 April 2023 Slide 16

Past Trauma & Loss

CognitiveDifficulti

es

Med Side-

effects

Existing Mental Health Disorder

Unfamiliar Situation

Spiritual & Existential Concerns

Conditioned Response to Setting

Uncertainty of Future

Don’t Understand Procedure

Self-esteem

Personality

Temperament

Drug-Seeking (sedatives

)

Myths

Cancer

Physical Sx

Daily Stressor

s

Effects of Tumor

Psychological distress has complex underpinnings. It affects our behaviour our emotions and our capacity to think and communicate.

12 April 2023 Slide 17

WA Psycho-Oncology Service

Tel: 9382-7480 Fax: 9382-7479

Email: psychooncology@health.wa.gov.au

Postal Address:

Thorburn House Lv 3 East Wing

RPH: Shenton Park Campus Selby St

Shenton Park WA 6008