Ashlee R Loughan1,2,3, Kelcie D Willis4,5, Sarah Ellen Braun6,4, Gary Rodin7, Autumn Lanoye4,8, Alexandria E Davies5, Dace Svikis5, Suzanne Mazzeo5, Mark Malkin6,4, Leroy Thacker4,9. 1. Department of Neurology, School of Medicine, Virginia Commonwealth University, 1201 East Marshall St, Richmond, VA, 23298-0037, USA. ashlee.loughan@vcuhealth.org. 2. Massey Cancer Center, Richmond, VA, USA. ashlee.loughan@vcuhealth.org. 3. Division of Neuro-Oncology, Department of Neurology, Virginia Commonwealth University, School of Medicine, VCU Massey Cancer Center, 1201 East Marshall St, Richmond, VA, 23298-0037, USA. ashlee.loughan@vcuhealth.org. 4. Massey Cancer Center, Richmond, VA, USA. 5. Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA. 6. Department of Neurology, School of Medicine, Virginia Commonwealth University, 1201 East Marshall St, Richmond, VA, 23298-0037, USA. 7. Princess Margaret Cancer Center, Toronto, Canada. 8. Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA. 9. Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Abstract
BACKGROUND: Managing Cancer and Living Meaningfully (CALM) is an evidence-based, brief, semi-structured psychotherapy designed to help patients with advanced cancer cope with the practical and profound challenges of their illness. However, no study to date has investigated its feasibility, acceptability, and preliminary effectiveness in adults with malignant glioma, despite the well-documented incidence of psychological distress in this vulnerable and underserved population. METHODS: Fourteen patients with glioma and elevated symptoms of depression and/or death anxiety enrolled in the trial: 83% glioblastoma, 75% female, Mage = 56 years (SD = 15.1; range = 27-81). Feasibility was assessed based on established metrics. Acceptability was measured by post-session surveys and post-intervention interviews. Preliminary intervention effects were explored using paired t-tests, comparing psychological distress at baseline and post-intervention. RESULTS: Of the 14 enrolled patients, 12 were evaluable. Nine completed the study (75% retention rate). Three patients withdrew due to substantial disease progression which affected their ability to participate. Participants reported high perceived benefit, and all recommended the program to others. Baseline to post-intervention assessments indicated reductions in death anxiety, generalized anxiety, and depression, and increases in spirituality. Quality of life and fear of cancer recurrence remained stable throughout the study period. CONCLUSIONS: CALM appears feasible for use with adults with malignant glioma. Enrollment and retention rates were high and comparable to psychotherapy trials for patients with advanced cancer. High perceived benefit and reductions in symptoms of death anxiety, generalized anxiety, and depression were reported by participants. These findings are extremely encouraging and support further study of CALM in neuro-oncology. TRIAL REGISTRATION NUMBER: NCT04646213 registered on 11/27/2020.
BACKGROUND: Managing Cancer and Living Meaningfully (CALM) is an evidence-based, brief, semi-structured psychotherapy designed to help patients with advanced cancer cope with the practical and profound challenges of their illness. However, no study to date has investigated its feasibility, acceptability, and preliminary effectiveness in adults with malignant glioma, despite the well-documented incidence of psychological distress in this vulnerable and underserved population. METHODS: Fourteen patients with glioma and elevated symptoms of depression and/or death anxiety enrolled in the trial: 83% glioblastoma, 75% female, Mage = 56 years (SD = 15.1; range = 27-81). Feasibility was assessed based on established metrics. Acceptability was measured by post-session surveys and post-intervention interviews. Preliminary intervention effects were explored using paired t-tests, comparing psychological distress at baseline and post-intervention. RESULTS: Of the 14 enrolled patients, 12 were evaluable. Nine completed the study (75% retention rate). Three patients withdrew due to substantial disease progression which affected their ability to participate. Participants reported high perceived benefit, and all recommended the program to others. Baseline to post-intervention assessments indicated reductions in death anxiety, generalized anxiety, and depression, and increases in spirituality. Quality of life and fear of cancer recurrence remained stable throughout the study period. CONCLUSIONS: CALM appears feasible for use with adults with malignant glioma. Enrollment and retention rates were high and comparable to psychotherapy trials for patients with advanced cancer. High perceived benefit and reductions in symptoms of death anxiety, generalized anxiety, and depression were reported by participants. These findings are extremely encouraging and support further study of CALM in neuro-oncology. TRIAL REGISTRATION NUMBER: NCT04646213 registered on 11/27/2020.
Authors: Melissa Henry; S Robin Cohen; Virginia Lee; Philippe Sauthier; Diane Provencher; Pierre Drouin; Philippe Gauthier; Walter Gotlieb; Susie Lau; Nancy Drummond; Lucy Gilbert; Gerald Stanimir; Jeremy Sturgeon; Martin Chasen; Julie Mitchell; Lina Nuoxin Huang; Mira-Klode Ferland; Nancy Mayo Journal: Psychooncology Date: 2010-12 Impact factor: 3.894
Authors: Christopher Lo; Camilla Zimmermann; Anne Rydall; Andrew Walsh; Jennifer M Jones; Malcolm J Moore; Frances A Shepherd; Lucia Gagliese; Gary Rodin Journal: J Clin Oncol Date: 2010-05-17 Impact factor: 44.544
Authors: Gary Rodin; Christopher Lo; Mario Mikulincer; Allan Donner; Lucia Gagliese; Camilla Zimmermann Journal: Soc Sci Med Date: 2008-12-07 Impact factor: 4.634
Authors: S Moorey; E Cort; M Kapari; B Monroe; P Hansford; K Mannix; M Henderson; L Fisher; M Hotopf Journal: Psychol Med Date: 2008-09-02 Impact factor: 7.723
Authors: David K Wellisch; Thomas A Kaleita; Donald Freeman; Timothy Cloughesy; Jeffrey Goldman Journal: Psychooncology Date: 2002 May-Jun Impact factor: 3.894
Authors: N Scott Litofsky; Elana Farace; Frederick Anderson; Christina A Meyers; Wei Huang; Edward R Laws Journal: Neurosurgery Date: 2004-02 Impact factor: 4.654
Authors: Staci D Arnold; Leslie M Forman; Bart D Brigidi; Karen E Carter; Holly A Schweitzer; Heather E Quinn; A Bebe Guill; James E Herndon; Renee H Raynor Journal: Neuro Oncol Date: 2008-02-26 Impact factor: 12.300
Authors: Ashlee R Loughan; Farah J Aslanzadeh; Julia Brechbiel; Gary Rodin; Mariya Husain; Sarah E Braun; Kelcie D Willis; Autumn Lanoye Journal: Neurooncol Pract Date: 2020-04-10