SolarisCare SolarisCare Integrated care for cancerIntegrated care for cancer

Complementary Therapies for Complementary Therapies for Cancer PatientsCancer Patients

Anna S Petterson PhDAnna S Petterson PhDPostdoctoral Research Fellow & Medical Art Psychotherapist

SolarisCare Foundation, Perth, Western Australia

SolarisCare FoundationSolarisCare Foundation

2001 Brownes Cancer Support Centre SCGH Initiated by Dr David Joske, Head of Haematology

2002 Introduced symptom distress and quality of life measurements Data on 1244 cancer patients 2002 - 2007

2006 SolarisCare Foundation established (charity)

2008 Operates with donations (plus Liberal-National Govt

Grant)

2008 Opened St John of God, Subiaco, WA

2010 Opened in Bunbury, SouthWest, WA

.

Complementary TherapiesComplementary Therapies

Goldrosen M, Straus S. Nature Rev. Immunol. 2004, 4:912-921.

www.solariscare.org.au

Despite dazzling technological progress in diagnosis

and treatment, doctors sometimes lack the capacity

to recognise the impact of illness on patients, to

extend empathy towards those who suffer and join

honestly and courageously with patients in their

illness.

Complementary Integrative Therapies are evidence-

based and provide supportive care to improve quality of

life and assist in reducing physical and psychological

distress to achieve the best possible health outcome

SolarisCare TherapiesSolarisCare Therapies

Literature review1

Ability to share clinical dialogue

Availability

Risk reduction Medico-legal risk: primum non nocere

Public sector volunteer guidelines

12 months experience + ‘active listening training’

Optimal training/ highest available + continued PD

Four weeks as meet-and-greet before starting

Self-awareness training + mainstream cancer info.

1. Joske, Kristjanson, Rao. Critical review of complementary therapies in Haematology-Oncology.

Int J Med 2006; 36: 479-586.

www.solariscare.org.au

Nurses perceptions of providing reflexology on Nurses perceptions of providing reflexology on day cancer unitday cancer unit

Measurements & Methodological Measurements & Methodological ChallengesChallenges

Patients complete initial consultation formage, cancer type, metastases, co-morbidities, mainstream treatment

SDS and QoL Scales before and after sessions 1, 3 and 6

7-point Edmonton Symptom Distress ScaleAdapted Kristjanson et al., (1999)

pain, fatigue, nausea, bowels, breathing, appetite, sleeppain, fatigue, nausea, bowels, breathing, appetite, sleep

7-point Psychological Quality of Life Scale Adapted from the McGill Quality of Life Questionnaire Molzahn, A.E., (1998) “Quality of Life: Definitions, Measurements, Application to Practice”. Focus on Research pp55-71

disempowered, depressed, anxious, frustrated, confused, not disempowered, depressed, anxious, frustrated, confused, not coping, worriedcoping, worried

Reduction in symptom distressReduction in symptom distress2

2.2

2.4

2.6

2.8

Me

an

SD

S s

core

1 2 3 4 5 6Number of therapy visits

Symptom distress score before therapy 95% CI

P < 0.0001

Change in Symptom Distress Scale over time

...patient feedback.......patient feedback....

Patients receiving complementary treatments report

significantly lower levels of symptom distress and

depression and high levels of quality of life both

immediately and six weeks following treatment

Improved quality of lifeImproved quality of life6

.87

7.2

7.4

7.6

Me

an Q

OL

sco

re

1 2 3 4 5 6Number of therapy visits

Quality of life score before therapy 95% CI

P < 0.0001

Change in Quality of Life Score over time

...patient feedback.......patient feedback....

Patients reported improved quality of life following

a complementary therapy treatment including

themes of empowerment, relaxation, social support

and hope

Scientific competent medicine alone cannot help

a patient grapple with the loss of health or find

meaning in suffering. Along with scientific ability,

doctors need the ability to listen to the narratives

of the patient, grasp and honour their meaning

and be moved to act on the patients behalf. Charon, R., (2001) JAMA 286:1897-1902

Dancing with NEDDancing with NED

Some ConclusionsSome Conclusions

1. Using selected community-based complementary

therapies for self-selected cancer patients is

feasible and safe.

2. Using modified symptom distress and quality of life

scales, there was a measurable reduction in

symptom distress, and improved quality of life in

1244 cancer patients.

3. A beneficial effect of complementary therapy

interventions appears the most likely explanation.

Building HopeBuilding HopeProviding Complementary Providing Complementary

Therapies for Cancer Patients & Therapies for Cancer Patients & Their CarersTheir Carers

anna.petterson@solariscare.org.auanna.petterson@solariscare.org.au