answered Jul 09, 2009 at 01:01PM
Dear Sir,
Basically, I agree with my colleague Abramsom that one should visit an oncologist, preferably one that is specialised in myeloma; in Holland that would likely be an hemato-oncologist. Specialised centers usually have better figures; that is: better survival statistics and, the other meaning of figure (in dutch): medical experts, more experienced in the diagnostics, treatment and follow-up.
Next to that I would advise to find psycho-oncological treatment. By now, we have about four studies showing better survical after psycho-oncological treatment, and we have four studies that did not show such an effect. This the current state of knowledge. If I try to summarise these studies, I would say that existential and experiential types of psychotherapy, performed by therapists that are experienced in treating cancer patients, are more promising than cognitive behavioral therapies (CBT) or supportive expressive therapy by oncologically in-experienced therapists. Yet, one out those four postive studies showed longer disease free period in melanomapatients after a course in problem focused coping. So, there may be more ways to Rome.
Melanoma is no myeloma, but so far we have no data to say that psycho-oncological treatment is promising in specific types of cancers and less in others. As a medical doctor with a PhD in psycho-oncology, I would say that it is wise for any cancer patient to explore the dimensions of his or her life and personality. Almost any patient reports afterwards that this was of great personal value, and there is a chance that it may affect survival in a positive way. As my teacher, the late prof Marco de Vries used to say: "False hope doesn't exist". Clearly, we should not raise false expectations; but this is a promising form of additional treatment for people with cancer, and thus worth mentioning. As I have just done.
My personal experience in treating people with cancer, is that roleplay with the disease, as in psychodrama, is a very dynamic way to foster experiential process and to access -and re-inherit- the 'cancer related potential'. This specific term is from Alvin Mahrer. One assumes that specific personal qualities, ways of experiencing, ways of coping and expressing, somewhere in life may have gotten 'barried under snow'. As Lawrence LeShan used to say: these parts of the person are like parts of the garden, that were forgotten or overgrwon, and got undernourished. Roleplaying with the disease is a way to get specificity into the couseling process, in order to ensure that one doesn't spend many hours to all sorts of items that are not related to the disease. Rather, by focusing on the disease, at least in the first session, this sort of psychomedical help fosters contact with personal qualities that in some way got hidden behind the disease and deserve to be inheritied by the patient himself. In roleplaying, the disease initially is played by a groupmember or the therapist. It may be strong, autonomous and decisive. It is rewarding to see, that if the patient takes that chair, you see him growing, re-taking his strong posture and reinheriting that sort of strength and freedom that used to be part of him earlier in life.
I wish you well,
Johannes Schilder