Frank Wagner: Disease burden and interventions in psych-oncology - using the example of gastrointestinal tumor diseases

The rising incidence of chronical diseases and cancer in both sexes can be observed worldwide. The increased amount of people suffering from diseases can be mainly attributed to the rising share of elderly people within the population (demographic development). With regard to the advancements in medicine, one consequence of this development is the increase of chronical, in some cases even multimorbid, patients. The psychosocial care of cancer patients in Russia needs to be of high importance in the future of oncological care.

Cancer includes a wide range of multi-layered stress factors, that occur in all areas of life and that can be divided into five significant areas: the burden of cancer itself and its treatment, stress within the family, financial and professional burdens, existential and spiritual problems, and problems of the care system.

This thesis aims at investigating the long-term possibilities and benefits of psycho-oncological intervention in the treatment of cancer patients, with a special focus on the above-mentioned stress factors. Furthermore, this research is motivated by the findings that cancer which affects the gastrointestinal tract often causes massive stress for patients and their socio-cultural environment. The research has been adjusted to the collective of patients (gastrointestinal tumor patients) and will be performed with the support of a modified version of the Hornheider Methode. The goal is to provide a long term instrument for intervention that is able to combat the stress factors, mentioned above.

Additionally, this thesis aims at answering questions with regard to the quality of the measuring instruments, the Hornheider questionnaire, psycho-oncological treatment demand and the importance of stress spectra for the course of the disease and the course of the treatment. Due to the increasing share of elderly people in society, Russia will face a rising number of absolute tumor patients in the coming decades. The treatment of oncological patients will become more important in the future. As controlled studies have shown, psycho-therapeutical interventions can effectively reduce stress and improve the quality of these patients’ life. Therefore, the necessity of treating oncologically ill patients is undisputed. Research has shown that a large portion of cancer patients develops psychological mood disorders. It has furthermore been proven that psychological factors can positively affect the healing process. For this group of patients, it would be crucial to provide psychosocial support as early as possible. But the identification of these particular patients remains problematic. The “Hornheider Kurzfragebogen”, developed by Strittmatter, seems to be an adequate instrument to measure the degree of need for support of cancer patients.

This wants to contribute to the structural improvement of the care and treatment of Russian cancer patients and encourage the professional exchange between Russia and Germany.