SolarisCare Integrated care for cancer Complementary Therapies for Cancer Patients Anna S Petterson PhD Postdoctoral Research Fellow & Medical Art Psychotherapist SolarisCare Foundation, Perth, Western Australia

SolarisCare 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 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 Therapies Goldrosen M, Straus S. Nature Rev. Immunol. 2004, 4:

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 Therapies Acupuncture Beauty Therapy Bowen Therapy Chemo Club (Aspire Gym) Counselling Creative Visualisation Expressive Art Therapy Healing Touch Kinesiology Massage - Aromatherapy – Relaxation - Hand & Foot Meditation/Mindfulness Men in the Kitchen - Bereavement Group Music & Sound Therapy Pranic Healing Qi Gong Reflexology Reiki (current October 2010)

Literature review 1 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:

Nurses perceptions of providing reflexology on day cancer unit

Measurements & Methodological Challenges Patients complete initial consultation form age, cancer type, metastases, co-morbidities, mainstream treatment SDS and QoL Scales before and after sessions 1, 3 and 6 7-point Edmonton Symptom Distress Scale Adapted Kristjanson et al., (1999) pain, 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 coping, worried

Reduction in symptom distress

...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 life

...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:

Dancing with NED

Some 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 Hope Providing Complementary Therapies for Cancer Patients & Their Carers