PSYCHOEDUCATIONAL Needs of Patients and Loved Ones Affected by Pancreatic Cancer

Pancreatic cancer rarely causes symptoms in its earliest stages and is usually diagnosed at an advanced stage. Diagnosed at an advanced stage, patients with pancreatic cancer may have higher rates of anxiety and depression than those with other cancer types. During this process, patients' loved ones may also experience distress similar to, or even greater than, that of the patient.

People affected by pancreatic cancer need, in relation to symptom management, communication with healthcare workers, concerns about loved ones, and uncertainty about the future, extensive information and supportive care. However, the psychosocial and educational support needs of patients with pancreatic cancer and their loved ones are often unmet. It is a fact that most patients with advanced cancer are not referred for specialized psychosocial care.

An article by Eryn Tong from the Department of Supportive Care at Princess Margaret Cancer Centre in Toronto, Canada, explains the importance and development of a group psychoeducational intervention to address the informational and supportive treatment needs of people affected by pancreatic cancer. Let us look together at Tong and colleagues' article on how to develop a psychoeducational intervention.

What Is Psychoeducation, What Does It Do, and Why Is It Important?

Psychoeducation is a treatment method that provides information for self-management within a supportive social setting and incorporates both education and psychological care into routine care.

Systematic reviews of studies involving patients with different cancer types have shown that psychoeducational interventions have significant and sustained benefits in relation to emotional distress and quality of life.

How Can a Psychoeducational Intervention Be Developed for People Affected by Pancreatic Cancer?

Psychoeducational intervention aims to promote effective and sustainable self-management interventions in cancer treatment. It emphasizes targeting interventions to the type and stage of cancer and adapting them to individual needs. It also prioritizes evidence-based content, low-intensity delivery, and acceptance by the study team.

Step-by-Step Development of Psychoeducation

Assessing the External and Internal Environment

Throughout the illness trajectory, from diagnosis to the end of life, the importance of holistic supportive treatment has gained global recognition. Although formulating a comprehensive treatment plan is important for patients and their families, an early psychoeducational intervention in this context may also be valuable for providing information and support and encouraging the use of such specialized evidence-based services.

Forming the Team and Assessing the Existing Team

To develop the intervention, it is important to form an interdisciplinary team from the pancreatic oncology and supportive care clinics of the comprehensive cancer center.

A psychiatrist or a psychologist specializing in the field, a dietitian, and a palliative care specialist can jointly deliver the intervention, each taking primary responsibility for their own area of expertise. As part of usual care, these professionals should provide personalized assessments and care regarding pain and symptoms, nutrition, advanced treatment planning, and how to live well with pancreatic cancer.

Physical and Psychosocial Challenges and Their Management

Evidence from numerous studies shows that patients with advanced cancer experience a range of physical and psychosocial challenges. In pancreatic cancer, these include:

• Problems with digestion and nutrition, loss of appetite, and rapid weight loss
• Physical signs and symptoms such as abdominal and back pain, nausea, jaundice, and diarrhea
• Fears and concerns about the future
• Adapting to the impact of progressive disease.

Open communication with the healthcare team and the patient's active role in treatment early in the disease process improve symptom management and end-of-life outcomes.

The cancer experience affects not only patients but also their loved ones. Relatives perform many important care tasks for their loved ones affected by a cancer diagnosis, but their role and unique supportive care needs are often underestimated. Without adequate support, the burden of caregiving and worry about losing a loved one can lead to health problems and distress, especially as the disease progresses.

Supportive interventions that treat patients and their families as a single group acknowledge the mutual solidarity between members of the family system. From this, we can understand the importance of patients' loved ones receiving psychoeducational support alongside the patient in psychosocial interventions.

Conclusion

In this article, we examined the phased development of an interdisciplinary-led group psychoeducational intervention to meet the informational and supportive care needs of individuals affected by pancreatic cancer.

Finally, I would like to emphasize that living with pancreatic cancer is extremely difficult for both patients and their loved ones. Because it is usually diagnosed at an advanced stage and treatment options are limited, it may encapsulate people's greatest fears about developing cancer. There is therefore a need to encourage adaptation and preparedness and to provide support to patients as soon as possible after diagnosis. Implementing this intervention in routine practice disseminates information and provides support regarding the predictable physical and psychosocial concerns that arise throughout the course of this disease. Psychoeducation may form the first line of supportive intervention, with more specialized individual treatment provided later within a stepped-treatment structure or stepped supportive-care delivery model.