"Beyond Cancer":Fostering transitions post-treatment
The relative 5-year survival rate for all cancer sites has increased over the past 20 years. More patients are completing treatment and entering the early post-treatment phase of coping with their illness. The end of treatment phase may be emotionally and physically crippling. These issues are typically not recognized and addressed by health care providers, and therefore, there are long-term survivors who never resume a 'normal' life. Most existing interventions use a face-to-face format, thus limiting their use to individuals who have the ability to 'get to' the intervention site. The proposed two-stage pilot study seeks to modify and then evaluate the acceptability and feasibility of the modified intervention strategy designed to enhance the return to a productive existence and improve quality of life. The proposed study addresses the previously identified gaps and limitations by: studying men and women cancer patients using two tumors that are gender neutral; incorporating the patient's and caregiver's perspectives; controlling for potential gender differences by blocking on gender; delivering the intervention during the first 3 months post-treatment; and using a format that makes the intervention widely accessible [videotapes, a manual, telephone conference calls]. In particular, this proposal addresses the following questions: (1) How does an existing cognitive behavioral intervention program need to be adapted for use during the first 3 months following treatment with patients completing treatment for colorectal cancer, Hodgkin's disease, or Non-Hodgkin's lymphoma and their primary caregivers?; (2) How acceptable is the modified cognitive behavioral intervention program to patients and caregivers during the first 3 months after completing treatment?; and (3) What effects does the intervention have on the perceived control, coping, perceived social support, and quality of life reported by the participants? How sizable are the effects? In the first stage, we will conduct a descriptive study to elicit feedback about the existing intervention. Participants will be given the existing intervention videotapes and workbook along with evaluation questions. After reviewing the materials, a focus group to elicit specific feedback will be conducted. For Stage Two, a randomized clinical trial will be conducted to evaluate the acceptability/feasibility of the modified intervention as well as to determine the effects on quality of life and other related outcomes.