Life Tapes Project Boosts Ca Patients' Sense of Well-Being

SAN ANTONIO—The Life Tapes Project (LTP)—a 2-hour videotaped cancer patient interview aimed at reducing feelings of isolation and existential anxiety—significantly improved patients' FACT-G functional and overall quality of life (QOL) subscale scores only 2 weeks post-taping, with many patients reporting they were better able to enjoy life, sleep well, and accept their illness.

Videotaping occurs in the patient's home and typically portrays family members, meaningful objects, and photos during a discussion focused on genealogy and personal history, life philosophy, and the cancer experience. This psychosocial intervention, in male and female patients with a variety of cancer diagnoses, was described in a poster session at the 29th Annual San Antonio Breast Cancer Symposium (abstract 2057).

A Powerful Tool

"The Life Tapes Project shows that any format that helps patients talk about their lives and the legacy of their family is a powerful tool, because it helps them pass on information about who they are and what their lives have been about," said coinvestigator Laura J. Esserman, MD, MBA, director of the Carol Franc Buck Breast Cancer Center, University of California, San Francisco. "We live in a culture that is very much afraid to talk about dying, but giving people the opportunity to talk about issues of concern can bring them a sense of peace."

The LTP was developed by Ernest H. Rosenbaum, MD, and David Spiegel, MD, of the Cancer Supportive Care Program, Stanford Hospitals and Clinics, and initiated in January 2002. The project is supported by Cancer Supportive Care and the Mount Zion Health Fund, San Francisco. Its purpose is to open lines of communication and strengthen family support, while instilling in the patient "a sense of symbolic immortality."

The interviewer arrives at the patient's home with a list of topics, including genealogy (stories and memories of parents and grandparents); philosophy of life and personal values; stories (eg, first love, raising children); turning points (milestones, struggles, adventures); how the patient coped with cancer; and the patient's legacy to his/her children and grandchildren. The videotape is edited off-site, and the final video/DVD is mailed to the participant.

The LTP utilizes QOL instruments and questionnaires pre- and post-taping "to systematically document benefits and identify possible unwanted effects," the investigators reported. Participants complete baseline questionnaires prior to the interview and follow-up packets 2 and 10 weeks afterward.

In a pilot study of 23 LTP participants from the San Francisco Bay area, most of whom were terminally ill, 92% answered Moderately, Very, or Extremely True for Me with respect to at least one benefit in the Perceived Benefits Questionnaire (PBQ), and 77% answered this way for at least eight items. The themes most frequently identified as Very or Extremely True were patients' sense of Imparting Personal Philosophy/Personal Record (73%), Reduction in Existential Dread (69%), and gaining Perspective, Meaning, and Dignity (65%). More than half reported improved family communication and sharing.

FACT-G functional and QOL subscales increased significantly from baseline (P < .05). No serious unwanted effects of the LTP were identified in patient exit interviews.

The investigators concluded that the LTP is "a powerful, safe, and accessible intervention that can make an excellent addition to any supportive care program."

Going forward, Dr. Esserman said, it would be useful to have a variety of interactive tools with goals similar to those of the Life Tapes Project available on the internet.

A Life Tape Do-It-Yourself Guide

Lead author of the Life Tapes Project (LTP) study, Cancer Supportive Care webmaster Alexandra Andrews, told ONI that the LTP is accessible on the internet to cancer patients from around the world at

www.cancersupportivecare.com/lifetapes.html

. For information on how to self-produce a life tape go to

www.cancersupportivecare.com/interview.php

.

Cancer Fatigue Awareness Day

April 3rd is National Cancer Fatigue Awareness Day. Fatigue is the most common and disruptive side effect of cancer and its treatment. The NCCN in collaboration with the American Cancer Society has developed guidelines for treatment (www.nccn.org).