MARK COLVIN: It seems that for cancer sufferers, there are limits to the power of positive thinking. There’s a warning today for doctors that they should treat cancer sufferers case by case, to avoid the problems of depression or anxiety that sometimes come from telling them to think positive. Guidelines released today point out that around 50,000 Australian cancer sufferers a year develop anxiety or depression because of the disease. And as Louise Yaxley reports, today’s launch showed just how much difference there can be between different cancer sufferers. LOUISE YAXLEY: Around 80,000 Australians a year are told by their doctors that they have cancer. The guidelines released today aim to help those people avoid developing depression or anxiety as well as their cancer. It urges doctors to ensure patients are treated sensitively and not blinded with jargon. But it’s a huge task, as psychiatrist Jane Turner, who drew up the guidelines, explains. JANE TURNER: It’s certainly very hard to be in the same space with a young woman with advanced cancer who tells you that her five year-old son has asked her ‘how many sleeps till you die, Mummy?’ and says that he will cry and cry when she dies. LOUISE YAXLEY: Doctor Turner says cancer sufferers are extremely vulnerable. JANE TURNER: Imagine you’re drowsy. You’ve had some medication. You’re lying on your back on a hospital trolley. You’re clad only in a white gown. You’re being wheeled backwards under the glare of lights, being spoken to by people you’ve never met before, and they’re all wearing masks that cover half their face.
That’s the scenario being taken into theatre to have an operation for cancer, and it’s pretty frightening. But what we know from the guidelines is that giving people detailed information about what they’ll face, how it will feel and what they can do to cope actually helps improve their outcomes. People who’ve been adequately prepared for surgery emotionally and in terms of information have less pain and fewer post-operative complications. LOUISE YAXLEY: One of the difficulties doctors face is just how much people’s needs can differ, and how the best approach for one can be wrong for another. Cancer survivor Emma Sayers says getting more information about the potential downsides would have helped prevent the sort of distress she faced.EMMA SAYERS: I finished my treatment for Hodgkin’s lymphoma in January 1996 and rode on the high of a wave for about 12 to 24 months where I felt wonderful that I’d made it through to the other side, I was in remission and hopefully going to be cured for the rest of my life. Then about two years later I started to wonder why did this all happen, what does this all mean, what does this mean for how I should live my life from now, will it come back, and so on. And I started to feel very, very afraid. And I experienced a long period of chronic distress, where I worried about these things.But more than anything else, I worried about why am I feeling this way? What is wrong with me? Everybody else that survives cancer feels great – goes out, climbs mountains, writes books, gets interviewed by Oprah. (Audience laughs) Why am I feeling very, very sad a lot of the time and very, very tired a lot of the time? But I mustn’t tell anyone. Because being a good patient, being a good survivor, is about being brave, is about being tough.So I just won’t tell anyone and I’ll just and keep going to university and going through all the motions and no one will notice, it will be okay. Great: trained as a lawyer – know how to fake it. No one will ever notice!Unfortunately people did start to notice and the distress went on for a much longer period than it needed to go on for because the permission for me was absent. LOUISE YAXLEY: But in complete contrast, the veteran actor Bud Tingwell, who is both a cancer survivor and has lost many family members to the disease, wanted a different approach.BUD TINGWELL: We as a family copped it a lot. In about a two-year period there were three brothers – me, my younger brother and my little brother – and three wives. And after a couple of years there was one sister-in-law left and two brothers – me and the little brother, all with various forms of bowel cancer. Then of course I copped prostate cancer in 1993. And my wife died in June of ’96. A month after that we made the film The Castle. Since The Castle I’ve had the busiest seven years I’ve ever had in my life. One thing I found I didn’t want was sympathy. I didn’t want people saying ‘oh you poor fellow, how sad’ – it made me feel sad. I didn’t mind a bit of encouragement – ‘never mind, you’ll be right’ – that’s okay, but I found the more sympathetic people got, the more difficult it was to cope. LOUISE YAXLEY: Fran Boyle from the Medical Oncology Group of Australia says giving the doctors the skills to work out their patients’ needs requires time and training.FRAN BOYLE: Some people cope with cancer by not thinking about it too much and focussing on what they need to do to get on with their lives. Other people actually need to talk about it, and need help in dealing with their family’s reactions. Doctors are very good at knowing what the right answer is, and not so good at asking individual patients ‘How best can I help you?'(Source: ABC, PM – Thursday, 14 August , 2003 18:46:00, Reporter: Louise Yaxley)