(In reference to this paper)

– – –

In a recent issue of Biological Psychology, Ratnakar, et al., sent shock waves through the scientific community when they concluded that “family caregivers of advanced cancer patients undergo anxiety and depression associated with stress.”

Making yet another daring leap, the intrepid authors suggested that “these changes might have health implications, warranting appropriate stress management counseling for them.” Their novel conclusions, which could never have been obviously anticipated, will undoubtedly turn the field on its side. It appears the textbooks need revision, or do they?

Conventional wisdom tells us that caregivers of advanced cancer patients often undergo bouts of intermittent lock-jaw, foaming at the mouth, erections lasting longer than 48 hours, a heightened sense of smell, and an overall disposition of “feel[ing] good” as “[they] knew that [they] would now.” A classic vignette in “Hematology and Oncology Pearls” recommends that physicians get a “twofer” by preventively treating caregivers with Haldol at 20 micrograms/liter during palliative care decision-making to reduce the likelihood of both “intractable hiccups” and “acute psychotic euphoria.” Moreover, “Pearls” strongly encourages the use of charades, if not LOLCATS, to describe hospice care.

Prior to Ratnakar, et al., there was but a single controlling study on the subject of caregivers of advanced cancer patients. That famous familial study asked 3000 new patients and their caregivers to complete a twelve page self-administered questionnaire on their emotional state. The study revealed that 86.7% of first-degree relatives felt “a little blue” but also insisted that it was “no biggie.” Likewise, 92.3% of all second-degree relatives felt that providing care for an advanced cancer patient “ain’t no thing but a chicken wing” and ranked their shock over their loved one’s prognosis slightly below the top-24 cut of Josiah Leming on American Idol. The prevalence of anxiety was again extremely low with 89.1% of first-degree relatives reporting that they would not let their loved one’s cancer “ruin their sexy.” Most notably, caregivers of all degrees experienced an increased desire to quote the movie “Anchorman” and run through clinic halls declaring themselves “Frank the Tank.”

Depressed? Caregivers of advanced cancer patients? How now?

Thanks to this publication, we now know that these caregivers experience a phenomenon known as “stress” and this “stress” often leads to “psychological changes” including anxiety and depression. But where do we go from here? If caregivers experience anxiety and depression, as the authors contend, then perhaps they may indeed require stress management counseling rather than simply “tell[ing] them you’ve got ‘a thing’ and get[ting] the hell out of there,” as Harrison’s currently advises.

While certainly detractors exist, one advantage these authors possess is a lack of competing financial interests. Indeed, the authors completed the research for this study thanks in part to a prestigious MacArthur “Genius Prize” Grant. The award cited their previous landmark paper: “A Little Knowledge Goes a Long Way.”