A Type of Psychotherapy Might Help Cancer Survivors Deal With the Long-Term Thinking Problems Some Experience After Chemotherapy, Researchers Say
It's estimated that about half of those who undergo chemotherapy for cancer develop what's often called "chemo brain." For instance, they may have trouble following conversations or remembering the steps in a project, according to background notes with the new study.
Although usually mild, these changes can affect quality of life, job performance, and relationships, said the researchers from the Eastern Maine Medical Center and Lafayette Family Cancer Center in Bangor, Maine. The researchers developed a cognitive-behavioral therapy (CBT) program called Memory and Attention Adaptation Training to help cancer survivors prevent or manage these memory problems. Their study involved 47 breast cancer survivors who underwent chemotherapy an average of 4 years earlier. Some were assigned to receive eight CBT sessions that lasted about 30 to 45 minutes each. The rest received supportive talk therapy sessions. For both groups, the sessions were conducted via videoconference to minimize patients' travel time. Participants also completed thinking tests and answered questionnaires about their memory issues and related anxiety. Verbal memory and processing speed were also tested.
Participants were retested after completing all eight sessions and again 2 months later.
The CBT participants reported significantly fewer memory problems and better processing speed than those who received supportive therapy, according to the study published online May 2 in the journal CANCER. They also reported much less anxiety about mental problems 2 months after their psychotherapy ended. "This is what we believe is the first randomized study with an active control condition that demonstrates improvement in cognitive symptoms in breast cancer survivors with long-term memory complaints," said study leader Robert Ferguson in a journal news release. He is currently at the University of Pittsburgh Cancer Institute. "Participants reported reduced anxiety and high satisfaction with this cognitive-behavioral, non-drug approach," Ferguson said. Also, because treatment was delivered via videoconference device, he said the study demonstrates it's possible "to improve access to survivorship care."
Guideline Applies to People in Their 50s, and Many in Their 60s, Who Are Already at Higher Risk for Heart Disease
People in their 50s who are at increased risk of heart disease should take a low-dose aspirin each day to reduce their risk of both heart disease and colon cancer, the U.S. Preventive Services Task Force (USPSTF) recommends. Americans in their 60s who are at increased risk of heart disease can also benefit from taking aspirin, the influential expert panel said, but the benefit is somewhat smaller for this age-group. Therefore, the decision to take low-dose aspirin between age 60 and 69 should be made with a doctor, based on the patients' risk of heart disease and gastrointestinal bleeding, as well as their overall health and personal preferences. A low-dose aspirin is typically 81 mg. The USPSTF said that there is not enough evidence to determine the risks or benefits of daily low-dose aspirin in adults who are either younger than 50, or older than 70.
"Palliative Care" Gets a Bad Rap, Study Finds
The term "palliative care" triggers negative feelings among many cancer patients, and needs "rebranding," researchers say. The stigma surrounding palliative care can mean patients wait too long to receive supportive care that improves their quality of life, said researchers at the Princess Margaret Cancer Center in Toronto. This study shows there's a "branding issue," said principal investigator Dr. Camilla Zimmermann, head of palliative care for the hospital and the University Health Network. She and her colleagues analyzed interviews with 48 patients who had advanced cancer and an estimated survival of between 6 and 24 months. Half the patients received early palliative care in an outpatient clinic along with standard cancer care, whereas the other half received standard cancer care only. Quality of life improved for those who received early palliative care. At first, "both groups perceived palliative care as synonymous with death; as care at the end of life in a setting where they would die, and in general as a frightening, anxiety-provoking thing they wanted to avoid," said Zimmermann. But that perception changed among those in the palliative care group, the researchers found. "They began to see palliative care as relevant early in the course of their illness and as being beneficial to them by supporting them and improving their quality of life," Zimmermann said. However, those patients still felt stigmatized by the term "palliative care." "Patients told us if palliative care were called something else, they wouldn't feel so stigmatized," Zimmermann said. "Importantly, the source of this stigma was mainly in the medical system because doctors and nurses had given the impression that palliative care was only end-of-life care," she said. The media was another source of stigma, she said. "I think those are two powerful institutions where we could affect change and give a different perception to families and caregivers about what palliative care really is," Zimmermann explained. The study was published in the Canadian Medical Association Journal.
Fatal Strokes Seven Times More Likely if Drugs to Control Blood Pressure, Cholesterol Aren't Taken as Prescribed
People at risk for heart disease are much more likely to die from a stroke if they don't take cholesterol-lowering statin drugs and blood pressure medications as prescribed, a new study reports. Folks with high blood pressure and high cholesterol had a seven times greater risk of suffering a fatal stroke if they didn't follow their drug regimen to lower cholesterol and blood pressure. The study findings were published in the Journal of the American College of Cardiology. Fatal stroke risk also increased if these patients stuck to one type of medication but not both, the researchers found. For example, if patients kept taking blood pressure medication but dropped their statins, their risk of dying from a stroke increased by 82%. Turning the tables, they had a 30% added risk of stroke if they took their statins but didn't take their blood pressure medications.
Understanding Anxiety Disorders: When Panic, Fear, and Worries Overwhelm
National Institutes of Health (NIH) News in health reports anxiety disorders affect nearly one in five American adults each year. People with these disorders have feelings of fear and uncertainty that interfere with everyday activities and last for 6 months or more. Anxiety disorders can also raise your risk for other medical problems such as heart disease, diabetes, substance abuse, and depression. The good news is that most anxiety disorders get better with therapy. The course of treatment depends on the type of anxiety disorder. Medications, psychotherapy ("talk therapy"), or a combination of both can usually relieve troubling symptoms. "Anxiety disorders are one of the most treatable mental health problems we see," says Dr. Daniel Pine, an NIH neuroscientist and psychiatrist. "Still, for reasons we don't fully understand, most people who have these problems don't get the treatments that could really help them." One of the most common types of anxiety disorder is social anxiety disorder, or social phobia. It affects both women and men equally-a total of about 15 million U.S. adults. Without treatment, social phobia can last for years or even a lifetime. People with social phobia may worry for days or weeks before a social event. They're often embarrassed, self-conscious, and afraid of being judged. They find it hard to talk to others. They may blush, sweat, tremble, or feel sick to their stomach when around other people. Other common types of anxiety disorders include generalized anxiety disorder, which affects nearly 7 million American adults, and panic disorder, which affects about 6 million. Both are twice as common in women as in men.
Cancer Patients Who Choose to Die at Home Live Longer
Cancer patients who chose to die at home lived longer than those who died in hospitals, a large study from Japan found. The findings suggest that doctors shouldn't hesitate to allow dying cancer patients to receive palliative care at home. Palliative care does not attempt to cure a person, but is often described as comfort care or symptom management. Most people would like to be at home when dying, but there have been concerns about whether the quality of care would be the same as in a hospital. "The cancer patient and family tend to be concerned that the quality of medical treatment provided at home will be inferior to that given in a hospital and that survival might be shortened," said study author Dr. Jun Hamano, of the University of Tsukuba in Japan. "However, our finding - that home death does not actually have a negative influence on the survival of cancer patients at all, and rather may have a positive influence - could suggest that the patient and family can choose the place of death in terms of their preference and values." The researchers looked at almost 1,600 patients who died in hospitals and almost 500 who died at home. The investigators found that those who spent their last days at home lived considerably longer. The study results appear in the online issue of the journal Cancer, which is published by the American Cancer Society.