2023CCHIO Exclusive Interview | Dr. Lv Huifang: Psychological Counseling and Treatment Strategies for Patients with Esophageal Cancer

In our lives, the word cancer is undoubtedly a heavy burden. For esophageal cancer patients, in addition to physical pain, psychological pressure and distress cannot be ignored.

Recently, Dr. Lv Huifang from Henan Cancer Hospital answered many of our questions regarding psychological treatment for esophageal cancer patients.

Dr. Lui Hui-fang

Doctor of Medicine, Associate Chief Physician

Member of the Professional Committee of Integrated Rehabilitation of Esophageal Tumors of the Chinese Anti-Cancer Association

Deputy Secretary-General of the Esophageal Tumor Integrated Rehabilitation Committee of the Chinese Anti-Cancer Association

Standing Committee Member of the Professional Committee of Non-invasive Tumor Treatment of China Life Care Association

Member of the Digestive Tract Diseases Committee of China Medical Education Association

Vice Chairman of the Tumor Prevention, Treatment and Rehabilitation Science Popularization Committee of Henan Life Care Association

Mainly engaged in the medical treatment of digestive system tumors

Psychological therapy plays an important role in the integrated rehabilitation of esophageal tumors

Dr. Lv Huifang first pointed out that "diseases originate from the mind" and psychological factors play an important role in the occurrence, development and outcome of diseases. Physical illness can bring psychological pain, and psychological pain can in turn affect the recovery of physical illness. Therefore, psychological intervention is very necessary for patients with esophageal cancer.

Psychotherapy is to provide spiritual services for patients, deal with insomnia, pain, nausea and vomiting, boredom, fatigue, relieve psychological problems of anxiety and depression, embrace them with society, solve their loneliness and isolation problems, and let them return to their families and rediscover the meaning of life.

According to research, psychological intervention can improve symptoms such as malnutrition and pain in cancer patients, thereby reducing the symptom burden. In addition, studies on gastrointestinal tumors have also shown that psychological and nutritional interventions can prolong the survival of patients.

Esophageal cancer patients face a variety of psychological problems and urgently need psychological counseling

Data shows that 25% to 45% of cancer patients suffer from anxiety and depression, 28% to 87% of patients are afraid of recurrence, 25% of patients suffer from psychological pain, and 43% to 67% of patients have anxiety about death. The suicide rate is five times that of normal people.

Common psychological problems of esophageal cancer patients mainly include: 1) anxiety, depression, pessimism and despair; 2) suspicion, denial and avoidance; 3) fear, tension, etc.

These problems cannot be solved by surgery or radiotherapy alone, but require psychological intervention. So, how to provide psychological counseling for esophageal cancer patients? Professor Lv Huifang said that different psychological intervention strategies are needed for patients at different stages. For example, for patients at the early stage of diagnosis, they need to be helped to accept reality and be prepared for treatment; for patients during treatment, they need to be encouraged to maintain an optimistic attitude and actively cooperate with treatment; for patients after treatment, they need to be helped to rebuild their confidence and return to society and family.

Choose the appropriate treatment plan based on your own situation and doctor's advice

Patients with malignant tumors will face different psychological pains at different stages of the disease (such as the early stage of diagnosis, active treatment, recovery after treatment, disease progression, end of life, and bereavement). Doctors and patients should strive to achieve empathy.

Empathy means that I can understand that you feel uncomfortable because of being caught in the rain, I can empathize with your emotions, and I am willing to hold an umbrella for you. It emphasizes understanding the other person's feelings. Doctors should tell patients that your pain is not terrible, don't be afraid, don't panic, trust the doctor, and trust yourself. Relying on the support of medical staff, family members and society, through drug and non-drug treatment, we can ultimately achieve one center and two goals, maximize the benefits of patients, and make patients live longer and have a higher quality of life.

In addition to psychological counseling, Dr. Lv Huifang also introduced the main treatment strategies for esophageal cancer. For patients with early esophageal cancer, surgery is the preferred treatment method. For patients with locally advanced disease, preoperative synchronous chemoradiotherapy can significantly reduce the local recurrence rate and improve the patient's survival rate. In addition, chemotherapy, radiotherapy, immunotherapy, etc. are also important treatment methods. Regarding the domestic simple surgical treatment of esophageal squamous cell carcinoma, at present, the overall 5-year survival rate after radical surgery is about 27.7%~40.6%; among them, early stage (stage I, IIA) accounts for 1/3 of surgical cases, and the 5-year survival rate is 50.3%~80%; locally advanced (stage IIB-III) accounts for 2/3 of surgical cases, and the 5-year survival rate is 20.0%~25.0%.

In view of the current status of simple surgical treatment in China, Dr. Lv Huifang believes that preoperative synchronous chemoradiotherapy + surgery is significantly better than simple surgery in terms of survival rate, can reduce local recurrence rate and overall recurrence rate, and improve the survival rate of patients. At the same time, she also reminds patients to fully consider their own conditions and doctor's advice when choosing a treatment plan, and not to blindly pursue the treatment effect while ignoring the side effects of the treatment.

Finally, Dr. Lv Huifang once again emphasized the importance of psychological therapy for esophageal cancer patients. She said that for esophageal cancer patients, psychological therapy can not only relieve their anxiety, depression and other negative emotions, but also improve their quality of life.