“Where Now?” – Pilot Study Of A Course For People Living Beyond Cance

Aim

“Where now?” is a seven-week survivorship course devised by Maggie’s (www.maggiescentres.org) for people making the challenging transition between active treatments and building the life they want beyond cancer. Aims to provide the support needed to: -

·      Make lifestyle changes in exercise, nutrition and managing stress

·      Adjust to living with uncertainty and fears of cancer recurrence

·      Make effective post-treatment partnerships with medical teams

·      Take a fresh look at priorities in work and relationships.

Study aim is to evaluate the course’s effectiveness and feasibility of delivery.

Methods

Pilot courses held in 3 Maggie’s Centres. Thirty-two participants had a mean age of 52yrs (33yrs: 72yrs); were predominantly female (84%); educated to technical college level (74%); and within 24 months post treatment. Cancer diagnosis included breast (41%); colorectal (25%); ovarian (22%); cervical (3%); prostate (3%); NHL (3%); lung (3%). Standardised measures administered pre and post included: Impact of Cancer Scale, Distress Thermometer.

Results

Significant reduction was observed on two Impact of Cancer subscales: Health Worries (including fears of recurrence) (f=24.642;n=31;p<0.000) and Negative Outlook (f=4.514;n=31;p=0.042); and the overall Negativity Scale (f=4.701;n=16;p=0.048) including worries about cancer’s long-term life interference. Distress reduced significantly (f=15.988;n=23;p=0.001). The five most important aspects of the course experience: “Getting Support and Encouragement”, “Learning my problems are not unique”, “Getting direct advice, suggestions or education”, Learning that I am responsible for how I cope with my life” and “Confronting difficult problems and fears”.

Conclusion

“Where Now?” is feasible to deliver, universally well received and pilot results suggest it enables important changes in a person’s psychological adaption to the challenges of survivorship. A controlled longitudinal trial is required to fully establish whether observed changes can be attributed to the course and are maintained over time.