Existential distress and meaning-focused interventions in cancer survivorship

Abstract

Existential distress can be understood as a distinct dimension of cancer-related distress requiring attention from healthcare professionals. Psychosocial interventions can facilitate dealing with existential challenges during and while transitioning to longer term survivorship. Such interventions can effectively support survivors to manage uncertainty, link cancer to their life story and engage in meaningful activity despite an uncertain and potentially foreshortened future.

Effects of existential interventions on spiritual, psychological, and physical well‐being in adult patients with cancer: Systematic review and meta‐analysis of randomized controlled trials

“…As cancer becomes more and more a chronic condition and more patients survive, long‐term assessments of desirable and adverse effects would provide valuable information. No moderator effects for cancer stage or type were found in this review, indicating that indeed patients of all cancer stages and types might benefit from existential interventions as they are all prone to experience existential distress . It should be kept in mind, however, that existential issues might vary substantially during the course of the disease, which should be addressed by existential interventions.…”

“…Potential moderators such as cancer stage and type or intervention concepts have been scarcely explored. Because existential distress may occur at any time in the course of a cancer disease and have significant impact on patients' lives, exploring the effectiveness of existential interventions across the cancer trajectory is of high relevance …”

Effects of psychosocial interventions on meaning and purpose in adults with cancer: A systematic review and meta‐analysis

“…[83][84][85][86] Meaning and purpose are a salient aspect of well-being: patients identify these issues as important to them, [15][16][17] and investigators have increasingly recognized their significance. [87][88][89] Struggles to maintain meaning or purpose are thus important concerns in their own right, as many writers have emphasized (eg, Cohen et al, 37 Lethborg et al, 87 Winger et al, 89 Simonton and Sherman, 90 and Spira 91 ). Difficulties with meaning or purpose may also have notable implications for other patient-reported and objective health outcomes among patients with cancer.…”

Dignity‐related existential distress in end‐of‐life cancer patients: Prevalence, underlying factors, and associated coping strategies

“…Advanced oncological illness may imply different challenges for patients, not only regarding the worsening health conditions and physical symptoms but also a profound existential suffering, related to multiple existential concerns associated to the disease . When exposed to a life‐threatening and potentially life‐limiting disease such as cancer, people are often forced to face existential worries such as a perceived lack of control, the loss of important social roles and life goals, feeling of being a burden to others, fear of an uncertain future and death, as well as the loss of meaning …”

“…In this context, existential distress (ED) is defined as a multidimensional phenomenon and as a distinct dimension of the cancer distress, which can result from fundamental loss and change …”