J. S. Abelson1, A. Chait2, M. J. Shen3, M. Charlson4, A. Dickerman2, H. L. Yeo1,5 2Weill Cornell Medical College,Psychiatry,New York, NY, USA 3Weill Cornell Medical College,Psychology,New York, NY, USA 4Weill Cornell Medical College,Integrative Medicine,New York, NY, USA 5Weill Cornell Medical College,Healthcare Policy And Research,New York, NY, USA 1Weill Cornell Medical College,Surgery,New York, NY, USA
Introduction: Distress is common among cancer patients and is associated with worse post-operative outcomes. Surgeons are often the first physicians to have in-depth conversations with patients about new diagnoses of colorectal cancer. As a result, it is important for them to understand ways patients cope with their diagnosis in order to offer them support as needed to minimize distress. However, there are no clear data on how these patients cope with their diagnoses, surgery and recovery. We performed qualitative in-depth interviews trying to explore their coping mechanisms throughout the surgical experience.
Methods: Patients diagnosed with colorectal cancer were recruited from an outpatient surgery clinic at a single academic medical center. Purposive sampling was used to recruit both patients who were planning to undergo surgery or had undergone surgery within six months. Validated qualitative methods were used, including in-depth, open-ended, individual interviews; demographic data were also collected. Constant comparative methodology and grounded theory were used to develop themes regarding patients’ coping strategies and beliefs regarding patients’ view of the role of the surgeon in helping them cope.
Results: A total of 24 patients were interviewed. Most participants were interviewed during the post-operative period (n=15; 62%), were White (n=18; 75%), and had a diagnosis of rectal cancer (n=15; 62%). Three major themes emerged from the data that described how patients with colorectal cancer cope throughout the surgical experience. First, patients cited their own internal coping strategies such as problem-focused, emotion-focused, and meaning-focused techniques. Second, patients cited their social support network including family, friends, and cancer support groups as being helpful. Third, patients believed surgeons and their teams should be involved in helping patients cope with the cancer diagnosis and surgical experience, especially if patients were experiencing high levels of distress or had inadequate coping skills. They did not believe surgeons themselves should be primarily responsible.
Conclusion: This is the first study to evaluate coping strategies used by colorectal cancer patients as they undergo surgical treatment. These findings are important for surgeons to guide initial management of distress in patients with a new diagnosis of colorectal cancer, as mandated by the National Comprehensive Cancer network and the American College of Surgeons Commission on Cancer. Surgeons should screen patients for distress, identify and strengthen a patient’s own coping strategies, facilitate a strong social support network, and provide patients with the option to obtain further support from the surgeon’s office. Future research should evaluate the impact of a comprehensive strategy to enhance coping strategies in colorectal cancer patients undergoing surgery on post-operative outcomes.