For People With Cancer, Cognitive Behavioral Therapy Eases Depression and Anxiety

A recent comprehensive study discovered that cognitive behavior therapy (CBT) enhances the mental well-being and quality of life for cancer patients and survivors.
All cancer types benefited from these interventions; however, younger patients and in-person sessions seemed to have a greater effect than virtual ones.

The most recent research supports the notion that CBT can help a great deal of individuals manage the negative emotions that arise upon a cancer diagnosis, according to corresponding author Anao Zhang, PhD, an assistant professor of social work at the University of Michigan in Ann Arbor.

According to Dr. Zhang, the research may also be used to determine which individuals might benefit most from cognitive behavioral therapy (CBT). This could have an effect on how patients are treated both before and after their cancer treatment.

What Is Cognitive Behavioral Therapy (CBT)?

The goal of cognitive behavioral therapy, or CBT, is to alter unfavorable thought and behavior patterns. It seeks to assist individuals in recognizing and reassessing any erroneous, harmful, or distorted thought patterns that are adversely affecting their feelings or actions.

“Assume the role of a woman who has just been informed she has breast cancer and is sitting in her doctor’s office. For many patients, that’s when intrusive thoughts can take control,” says Ian Sadler, PhD, a psychosocial oncology specialist at the New York City-based Columbia University Cancer Center.

Sadly, a lot of people—women in particular—have a tendency to place the blame on themselves, according to Dr. Sadler, who was not involved in the recent study.

“They might believe things like, ‘It’s my fault because I smoked in college,’ or ‘I overindulged in alcohol,’ or ‘I didn’t follow an organic diet.'” Thus, a lot of these negative notions enter their minds,” he claims.

According to Sadler, CBT therapy asks individuals to identify certain thoughts and then subtly question them.

These thoughts are going to come at us; you cannot stop them. As humans, we are predisposed to being alert to hazards. He claims that it is the sympathetic nervous system carrying out its intended function.

CBT Study Used Data From Over 13,000 People in Over 100 Trials

Researchers evaluated data from over 130 trials involving over 13,000 people to evaluate the effectiveness of CBT in comparison to other therapies such as conventional therapy. The subjects ranged in age from 4 to 76, with a mean age of 58. Of them, 79% were female.

Regardless of the type of cancer, the data showed that CBT, when applied to individuals with cancer, either past or present, moderately alleviated depression and anxiety. Improvements in quality of life were not significantly impacted by the treatment.

The benefits for mental health or quality of life when CBT was given remotely, through telehealth or an app, were determined to be statistically nonsignificant by researchers. The authors of this study recommend more research into this conclusion.

The benefits were also broken down by the age of the cancer patient or survivor, with the authors classifying people into three age groups: 4 to 39, 40 to 64, and 65 and above.

They discovered that whereas CBT improved quality of life and mental health in the two younger groups, therapy was statistically unsuccessful for seniors. The findings are alarming and need further research because the bulk of cancer patients are older, according to the scientists.

Zhang clarifies that this does not imply that CBT cannot be very successful for the older cancer population, but rather that therapists may require additional training to get past potential roadblocks like age mismatches between patients and clinicians.

How Does the New Research Match What’s Already Known?

These results align with several other meta-analyses on cognitive behavioral therapy (CBT) for cancer patients, which demonstrate the therapy’s ability to improve mood, anxiety, and quality of life, according to Barbara Andersen, PhD, a clinical psychologist and psychology professor at The Ohio State University in Columbus who specializes in the biobehavioral aspects of cancer research.

Dr. Andersen believes that the reason for the only slight gains in quality of life is probably that the majority of studies’ quality of life metrics are “not particularly good” in gauging the efficacy of CBT.

According to Andersen, who was not part in the meta-analysis, “it’s not because CBT doesn’t make a positive impact on quality of life — it does so very directly in terms of changing negative mood and affect.”

Andersen is skeptical of the study’s age-related conclusions.

She speculates that the subgroup analysis result could have resulted from the researchers’ method of data analysis.

For instance, it is problematic to examine the effects of CBT on individuals in their thirties and children as young as four, according to Andersen.

Here’s How CBT Can Help People With Cancer Face Everyday Challenges

According to Sadler, it can be useful to visualize a triangle with ideas, emotions, and behaviors at each corner when using CBT. He used the example of a patient who refuses to get out of bed after a chemotherapy session to demonstrate his point.

“I just want to stay under these covers and never wake up,” they could be thinking. Why would you even want to stand up? I feel awful,” he declares.

That may cause one to feel depressed, angry, or hopeless, and those feelings may encourage lying in bed. According to Sadler, feelings also have an impact on thoughts and vice versa.

“The goal of CBT is to teach the patient to recognize their current state. Accordingly, in this instance, people might actually need to get out of bed, get dressed, and take a shower when they feel like remaining in,” he explains.

While staying in bed for a while is perfectly acceptable if that’s what you feel like doing, Sadler notes that getting up and going about your day can frequently help you shift your perspective from one of negativity to one of optimism and begin to feel better.

Having said that, he clarifies that CBT is not about avoiding unpleasant ideas or constantly being strong or cheerful.

The key is to develop the ability to see things as they are presented to you and to recognize negative thoughts so that you may correct them by saying, “Wait a minute, that’s not a helpful thought.” I’m devoting far too much time to it,” Sadler remarks.

It’s possible that you’ve learnt about techniques to assist you stop ruminating if you’ve had cognitive behavioral therapy.

For the next minute or two, try to breathe mindfully and let those ideas pass. Be aware that if you let yourself get carried away by that idea, you can end up immersed in a terrible story for the next five hours. However, Sadler adds, “you have the power to let it go and move on if you can learn to recognize it.”