Living with neuropathy after cancer: acceptance, optimism and values-based living
Approximately 70% of people who have had chemotherapy experience pain, numbness, and a tingling in the hands, fingers, feet, and toes. In 30% of patients, this form of neuropathy is chronic. 'Deal with it' is often the message. “It is important that some sort of solution is found for these people,” say researchers Cynthia Bonhof and Daniëlle van de Graaf. In their research, they look at the power of acceptance and optimism. “They do not reduce the symptoms, unfortunately, but they do help people to experience better quality of life.”
Scientific literature and biosocial models show that personality traits play a role in how you deal with issues. But also: what is people’s attitude to life? How do they deal with adversity? “The answers to these questions are an important indication of how people will cope with neuropathy,” Cynthia Bonhof explains. "This condition is very common in cancer survivors. It is important that ways are found to help these people manage their condition.”
Cynthia specifically studied the role of optimism. Does a positive attitude towards life reduce symptoms? "Optimism unfortunately does not reduce neuropathy, but it can be correlated to a better quality of life. When people suffer from anxiety and depression, however, the effect of optimism disappears. Possibly this is because people with low optimism, anxiety or depression have developed ways of dealing with neuropathy that are not optimal for them. For example, thinking in terms of 'disasters', avoiding certain situations (such as walking) or having great difficulty accepting the situation. We call these 'maladaptive coping styles'. In treatment we should possibly move more towards improving this.”
Optimism does not reduce neuropathy, but it can increase quality of life
Chronic neuropathy has long-term, limiting effects. Both researchers are aware of this: "We know that learning to live in a more values-oriented way can be enormously helpful. This changes the way you view your life. We are also learning more about what factors are predictive of the degree to which people experience limitations due to neuropathy. For example, how anxiety and depression affect how people experience symptoms. This will provide important insights, with which we can hopefully help many people."
Learning to live with persistent symptoms and ensuring that you can continue to do what you really find important. That is the central theme of Acceptance and Commitment Therapy (ACT). A form of therapy that is gaining a foothold alongside the standard cognitive behavioral therapy. "We know that this form of support works well with other types of chronic pain," says Daniëlle van de Graaf. "Pain has a lot of impact on daily life. But each type of pain leads to different ways of dealing with it. That's why, together with patients and experts, we are developing an online training course specifically for people with neuropathy after chemotherapy. We hope that with the help of this self-management tool, people will experience fewer limitations, despite their symptoms."
Within Tilburg University, a group of enthusiastic and committed researchers who investigate the psychosocial consequences of cancer. They work together to gain insight in the psychological and biological processes behind, for instance, fatigue, anxiety, and pain.
Date of publication: 3 February 2022