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WA Cancer & Palliative Care Network
WA Psycho-Oncology ServiceSusan ThormanSpecialist Clinical Psychologist Team Leader
Ph: 9382-7480
Fax: 9382-7479
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12 April 2023 Slide 2
Some psychological impacts of brain tumour in adults
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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
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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
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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%
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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
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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
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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
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12 April 2023 Slide 9
The Whole Family is Affected
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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
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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
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12 April 2023 Slide 12
Depression Anxiety and Brain Tumour
• Difficulty with identifying depression
• Seek medical advice
• Normal shock and adjustment
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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
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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
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12 April 2023 Slide 15
Treatments
• Psychological : CBT, Mindfulness and Relaxation skills
• Combination of psychological and drug treatments
• Support groups
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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.
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12 April 2023 Slide 17
WA Psycho-Oncology Service
Tel: 9382-7480 Fax: 9382-7479
Email: [email protected]
Postal Address:
Thorburn House Lv 3 East Wing
RPH: Shenton Park Campus Selby St
Shenton Park WA 6008