Tailored Psychotherapy Combats Depression in Advanced Cancer

Just three to six sessions of a tailored psychotherapy program called CALM, or Managing Cancer and Living Meaningfully, reduced symptoms of depression or prevented the onset of depression in patients with recently diagnosed advanced cancer, according to findings from a study published in the Journal of Clinical Oncology (https://doi.org/10.1200/JCO.2017.77.1097).

Researchers randomly assigned 305 patients recently diagnosed with advanced or metastatic cancer and an expected survival of 12–18 months to receive either usual care (154 patients) or usual care plus CALM (151 patients). The CALM intervention consisted of three to six 45- to 60-minute sessions held over three to six months.

During assessments at both three and six months, patients receiving the CALM intervention reported less severe depression symptoms than those in the usual care group. The benefits appeared greater at the six-month assessment. Patients also reported that CALM provided them a way to talk about their feelings, face their fears, and live their lives meaningfully at the end of life.

CALM can be conducted by many types of oncology and palliative care providers, including oncology nurses. Training is required and consists of an intensive two-day workshop and ongoing supervision on at least three cases before a practitioner can provide CALM independently.

The researchers are evaluating use of CALM in 20 countries to determine its generalizability to diverse ethnicities and cultures. An online version is also being developed to help patients with limited access to oncology and palliative care services.