A Review of Psychosocial Interventions in Patients with Advanced Cancer in Latin America and the Value of CALM Therapy in This Setting

Background: Advanced cancer is associated with multiple profound and practical challenges, including physical suffering and support needs. Depressive symptoms and other manifestations of distress are common in this population. At present, little professional support is available to help to alleviate the psychological distress of patients and families living with the burden of advanced cancer. Effective interventions and their integration into local health systems are needed to meet this challenge. Managing Cancer and Living Meaningfully (CALM), a brief psychotherapy intervention for patients with advanced cancer. Research conducted in Canada has demonstrated its feasibility, acceptability and effectiveness in reducing and preventing depressive symptoms, in managing distress related to death and dying, and in preparing for the end of life. Research is needed to demonstrate the feasibility and acceptability of CALM in Latin America, a developing region comprised of 35 different low- and middle-income countries in South and Central America, where more than one million people are presently in need of end-of-life care.

Aim: Review evidence for psychosocial oncology interventions in Latin America and the potential applicability and implementation of CALM therapy in patients with advanced Cancer in this setting.

Methods: We used an iterative search process to locate information about psychological interventions for patients with advanced cancer in South/Central/Latin America. Multiple searches were performed in Medline, Google Scholar, National Guidelines Clearinghouse, Trip Database, Redalyc, Scielo, and Latindex for terminology describing cancer, end-of-life, psychology, and psychological interventions. In the larger resources, we added either limits or search terms for Latin America.

Results: The literature identified describes psychological interventions for patients with cancer, including psychoeducation, support therapies, group therapies, cognitive behavior therapy, spirituality and hypnosis. However, very few of these interventions were specifically designed for patients with advanced cancer. The majority of articles describe psychological/ psychotherapeutic interventions being implemented in Europe, North America, and Australian settings and we could identify only two papers describing psychological interventions being applied in an advanced cancer setting in Latin America.

Conclusion: The availability and practice of psychological interventions in advanced cancer in Latin America are scarce. However, interest in applying such interventions appears to be growing. The application of the CALM intervention in multiple cultures and international settings suggests that it may be feasible and acceptable and effective in Latin America. Research is needed to demonstrate this and to support advocacy for its implementation in this region