Cancer Crusaders Club – Group Psychosocial Therapy For Cancer Patients

Group Psychosocial Therapy for Cancer Patients

Reynaldo O. Joson, MD, MHA, MHPEd, MS Surg
Jacqueline I. Joson, MD
Ma. Lilibeth R. Tumambing

1999


 

Abstract

This paper contains a description of a mode of group psychosocial therapy for Filipino cancer patients. It includes suggestions for longer sustenance. The reactions of patient participants and their relatives to the group therapy are also represented.

 


 

Group Psychosocial Therapy for Cancer Patients

Reynaldo O. Joson, MD, MHA, MHPEd, MS Surg
Jacqueline I. Joson, MD
Ma. Lilibeth R. Tumambing

Introduction

Treatment of cancer consists of two inseparable parts. These are the treatment of the cancer itself and the management of the person who has been afflicted with the cancer. Surgery, chemotherapy, radiotherapy, and other modalities of cancer treatment constitute only one part of the treatment. The second part, which is as important as the first, is psychosocial therapy, which consists mainly of emotional and behavioral support.

Psychosocial therapy may be done within and outside health care centers. Health care centers may be the physician’s clinics, hospital rooms, and clinics specializing in psychosocial therapy.

Psychosocial therapy may be done by the health care providers such as physicians and nurses and nonhealth care providers as well, such as relatives and friends. Self-help groups providing psychosocial therapy are those organized primarily by patients themselves. Psychosocial therapy may be done on an individual patient basis or in group.

This paper describes a mode of group psychosocial therapy for cancer patients, how it was designed for longer sustenance and how patients and relatives reacted to it.

The Annual Get-Together of Cancer Patients as a Mode of Psychosocial Therapy

From 1988 up to the present (1999), on every first Sunday of December, upon the invitation of the authors, a group of cancer patients accompanied by their relatives and friends would troop to a theatre in the Manila Doctors Hospital for an annual Christmas get-together. The program would consist of the following: registration; introduction of members of the Cancer Crusaders Club; sharing of experiences both in public as well as on an individual basis; inspirational talks; entertainment (songs, dances, raffles, gift-giving); awarding, lunch, and then group picture taking.

The Design for Longer Sustenance

The present design of a mode of group psychosocial therapy was influenced by the senior author’s (ROJ) past personal experience. In 1979, when the senior author was in his senior year of surgical residency at the Philippine General Hospital, a government hospital, he formed the Philippine Stoma Association [1, 2]. The members consisted of patients with an abdominal stoma, such as colostomy, ileostomy, and ileal conduit. Most of the patient-members had permanent colostomy as a consequence of cancer.

There was great difficulty in maintaining the association and administering the intended group psychosocial therapy. The Philippine Stoma Association lasted only for two years. The major lessons learned from this experience were:

1. Getting the members to come together on a regular frequency and often at that, such as monthly or even quarterly, would be difficult, if not impossible. The difficulty could originate from both the organizers and the members. Lack of motivation and commitment, hesitancy for group dynamics, conflict with priorities at home and in work, and travel expenses were the major causes of difficulty identified.

2. News of death of officers had a dampening effect on the zest of members for a group gathering.

3. Attachment to and rapport with organizers tended to promote attendance and participation.

4. An imposition of a fee could deter participation.

In 1988, when the authors decided to put up the Cancer Crusaders Club, the following design was adopted aiming for longer sustenance:

1. The central group activity would be an annual get-together. Other peripheral group activities might be organized during the year as the need arises.

2. There would be no officers. The authors would serve as organizers and coordinators.

3. The members would primarily consist of patients of the senior author. However, patients of other physicians would be welcome.

4. There would be no membership fee. The only requirement would be a manifestation of intent to join. There would be no fee charged for the annual get-together. The expenses would be taken care of by the authors.

The Sustenance

Since 1988 up to 1999, 12 years now, on every first Sunday of December, there has been an annual Christmas get-together of the club members. The participants averaged 100 per gathering, 50 cancer patients and 50 guardians. Of the average 50 cancer patient participants per gathering, about 20 were regular annual attendees; the rest were newly treated cancer patients. Of these 20 regular annual attendees, 5 had been attending the gathering for the past 12 years without fail.

The patients who attended were mostly those who had been managed by the senior author. The bulk of patient attendees had breast cancer (85%), thyroid cancer (10%), colorectal cancer (5%), and others such as melanoma, lymphoma, soft tissue sarcoma, and osteogenic sarcoma (5%).

Author MLRT would take care of the invitations of members and entertainers as well as the whole program. Author JIJ would take care of the foods and financial support. ROJ would serve as a stimulus for the members to attend.

The total expenses would ranged from PHP 15,000 to 20,000 ($480 – $500), shouldered by the authors. There would be occasional voluntary donors. Manila Doctors Hospital would provide the venue for free.

The Reactions of the Members

In 1996, the authors conducted a survey to get a formal feedback from cancer patients and their relatives who had attended the annual get-together of the Cancer Crusaders Club. The questionnaires are seen in Appendices 1 and 2.

The main objective of the survey was to determine the effects of the annual get-together on the cancer patients and their relatives.

Feedback from Cancer Patients

The number of respondents consisted of 30 patient attendees.

Practically all respondents liked the usual programme of the annual gathering. Two mentioned that they felt shy talking about their experience in public.

Practically all considered the gathering to have the following beneficial effects:

1. It made them feel stronger in living through life with a cancer.

2. It boosted their morale; it boosted their hope for living.

3. It changed their outlook in life for the better.

4. It made them feel like an ex-cancer patient already.

5. It helped them accept their cancer.

6. It made them realize that they are NOT the only persons on earth with a cancer.

7. It gave them an opportunity to share experience with and to listen to the experience of other cancer patients.

8. It made them learn more about cancer in general, the cancer that they have, and about patients with cancer.

9. They felt the get-together was a reunion for cancer patients.

10. They looked forward to attending the get-together each year.

11. They looked forward to getting the most durable award.

12. The gathering was a form of therapy for them; it provided psychosocial support to them and their relatives.

Nobody considered the gathering to have harmful effects.

Feedback from Relatives

The number of respondents consisted of 20 relative or guardian attendees.

Practically all considered the gathering to have beneficial effects, like those mentioned in the feedback from cancer patients. Nobody mentioned the gathering had harmful effects.

All of them attended the gathering to accompany their cancer relatives who wanted to attend. Three mentioned they encouraged their cancer relatives to attend.

All considered the get-together as helpful to them as guardian in the care of their cancer relative and by attending, they also learn more about cancer and cancer patients.

Comments

In the Philippines, there are various support groups for cancers. To mention a few, aside from the Cancer Crusaders Club, there is the Philippine Cancer Society Cancer Support Group; LAKAS (Laban sa Kanser), Coalition for Breast Cancer in the Phillippines; the cancer support groups of St. Lukes’ Medical Center, Philippine General Hospital, and Rizal Provincial Hospital.

All these support groups have one common objective, that is, to provide psychosocial therapy for cancer patients. Most of these support groups are led by lay persons. Some by oncologists.

All these support groups have one common problem, sustenance. The factors affecting sustenance of these support groups have been mentioned in the early part of this paper.

The authors have described a design for sustenance of a group psychosocial therapy. Being in continuous existence for 12 years is enough proof of the effectiveness of the design in sustenance used for the Cancer Crusaders Club. Sustaining it is not very taxing for both the organizers and the participants, in terms of time and financial resources. At the same time, the objective of psychosocial therapy of cancer patients is always achieved year in and year out.

Summary

This paper contained a description of a mode of group psychosocial therapy for Filipino cancer patients. It included suggestions for longer sustenance. The reactions of patient participants and their relatives to the group therapy were also represented.

References:

1. Joson, RO. Problems and Rehabilitation of Filipino Stoma Patients. J Enterostomal Ther (USA) Sept-Oct, 1983;

2. Joson, RO. Problems and Rehabilitation of Filipino Stoma Patients. J Phil Med Assoc 6(1):13-17. Jan-Mar 1985.

 

Retrieved from (13nov30):

http://ca_crusaders_club.tripod.com/grpther/grpther.htm

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