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WA Psycho-Oncology Service

WA Psycho-Oncology Service. Susan Thorman Specialist Clinical Psychologist Team Leader. Ph: 9382-7480 Fax: 9382-7479. Some psychological impacts of brain tumour in adults. WA Psycho-Oncolgy Service. WA Psycho-Oncology Service established 2007

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WA Psycho-Oncology Service

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  1. WA Psycho-Oncology Service Susan Thorman Specialist Clinical Psychologist Team Leader Ph: 9382-7480 Fax: 9382-7479

  2. Some psychological impacts of brain tumour in adults

  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

  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

  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%

  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

  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

  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

  9. The Whole Family is Affected

  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

  11. 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 Common Cognitive Deficits

  12. Depression Anxiety and Brain Tumour • Difficulty with identifying depression • Seek medical advice • Normal shock and adjustment

  13. 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 Depression Symptoms

  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

  15. Treatments • Psychological : CBT, Mindfulness and Relaxation skills • Combination of psychological and drug treatments • Support groups

  16. The Tip of the Iceberg Cancer Physical Sx Unfamiliar Situation Med Side-effects Daily Stressors Don’t Understand Procedure Psychological distress has complex underpinnings. It affects our behaviour our emotions and our capacity to think and communicate. Myths Effects of Tumor Uncertainty of Future Spiritual & Existential Concerns Self-esteem Cognitive Difficulties Conditioned Response to Setting Drug-Seeking (sedatives) Existing Mental Health Disorder Past Trauma & Loss Personality Temperament

  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

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