Based on clinical trials, psychedelic substances such as psilocybin show great promise as a treatment option for cancer-related distress.
There exists no shortage of treatment options for cancer, from radiotherapy and chemotherapy to experimental options like immunotherapy. Yet, in spite of all the research and experimentation around the disease itself, there are relatively few options for treating cancer's psychological effects. Those invisible ailments occur with enough frequency that there's even a name for them — cancer-related distress.
In a recent survey published in the American Society of Clinical Oncology Journal, roughly 30 percent of patients reported symptoms identified as "clinically meaningful." Psychological issues reported included fatigue, worry, insomnia, sadness, nervousness, fear and memory problems. Physiological symptoms included tingling, skin problems, issues with appearance and pain.
It's no coincidence that many of these symptoms have also been linked to extreme stress. Cancer-related distress is very likely a stress response to the disease, one only exacerbated by the isolation that often accompanies treatment.
In severe cases, patients suffering from the condition have even been known to become disabled by feelings of depression, anxiety, and panic. Those suffering from the psychological ailments that are often comorbid with cancer can experience doubts regarding the meaning and purpose of one's life — known as existential or spiritual crises. Unfortunately, many of the treatment options that would typically be applied to these conditions are either ineffective or unavailable in cases of cancer-related distress.
A distressing reality
It isn't that cancer patients lack a means of seeking mental health support. Therapists and counselors specializing in cancer-related distress do exist and work frequently with oncologists. The issue is that, in many cases, counseling simply isn't enough.
A patient suffering from especially crippling distress may require pharmaceutical options in addition to therapy. Unfortunately, depending on the medications prescribed to treat the disease, oncologists may choose to forgo antidepressants or antianxiety drugs. To an extent, this is entirely understandable.
For instance, many antidepressants have a documented history of contraindications when interacting with chemotherapy medication. Studies show that standard selective serotonin reuptake inhibitors (SSRIs), a first-line approach to mental health issues in healthy patients, can risk the effectiveness of the chemotherapy or risk lethal interactions with other cancer medications.
One can hardly blame a physician for their unwillingness to put a patient's life at risk. At the same time, one must acknowledge that mental health is as important as physical wellbeing.
As it stands, pharmaceutical treatments for cancer-related distress are frequently in short supply — it's an unmet need.
Why standard mental health treatments fall short for cancer patients
Therapists and psychologists may not always be equipped to help patients manage the complex fears and emotions that accompany cancer. It's with this in mind that a specialized field has emerged. Known as psychosocial oncology, psychiatric oncology, psycho-oncology, or supportive care services, the discipline includes people from multiple backgrounds, ranging from psychologists to psychiatrists to chaplains.
Per the American Psychosocial Oncology Society, psychosocial oncology addresses the psychological, emotional, social, and behavioral challenges faced by cancer patients alongside their loved ones. It primarily focuses on helping patients treat cancer-related distress. However, it also examines background factors that may influence cancer-related distress or make coping more difficult.
Although psychiatrists or nurse practitioners specialized in psychosocial oncology may opt to provide pharmaceutical treatments to patients, this will not always be the case. This comes down to two issues. First is the relative lack of medication without potential contraindications.
Second, and perhaps more pressing issue is the fact that cancer-related distress, while it may overlap or share symptoms with diagnosed mental illnesses, is a distinct condition on its own. It frequently manifests in patients who are otherwise neurotypical. These patients represent another class for whom therapy and counseling alone will likely fall short.
It's here that psychedelic treatments emerge as a viable alternative.
A way forward with psychedelics
Over the past several years, there have been multiple studies and clinical trials examining the effect of psilocybin on mental illnesses such as anxiety and depression. A recent study by Johns Hopkins Medicine, for instance, gave a small group of adults with severe depression two doses of the substance paired with supportive psychotherapy.
The majority of patients experienced significant and rapid reduction in their depressive symptoms, with half displaying virtually no signs of depression over the course of a four week follow up program.
“The magnitude of the effect we saw was about four times larger than what clinical trials have shown for traditional antidepressants on the market,” explained Alan Davis, PhD, adjunct assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, “Because most other depression treatments take weeks or months to work and may have undesirable effects, this could be a game changer if these findings hold up in future ‘gold standard’ placebo-controlled clinical trials.”
Multiple studies have been conducted on the efficacy of psilocybin as a treatment option for cancer-related distress. They have almost universally concluded that the drug shows great promise. Yet these trials, highly controlled as they are, do not paint a complete picture.
They demonstrate that the drug may be effective in a clinical setting, yet cannot account for real-world factors. These include, but are not limited to, variable treatment patterns, long-term patient safety and affordability. This clinically meaningful data is necessary in the face of a shifting healthcare landscape — with modern care increasingly focused on personalization, randomized trials alone are no longer sufficient.
Researchers must endeavour to understand how the drug will behave under complex and unpredictable conditions. Moreover, they must pursue an alternative to the years- (or sometimes decades-) long approval process for new treatments. In the case of psilocybin, this may also help overcome the undue stigma under which psychedelics currently operate.
Albert Labs (CSE:ABRT) is one of the companies dedicated to generating such evidence. The company is presently concentrating on developing psilocybin-based medication for patients with cancer-related distress. Albert Labs has an existing relationship with the largest oncology center in Europe, which will allow the company to deploy its innovative treatment to cancer patients rapidly.
In an interview, Dr. Malcolm Barrat-Johnson, chief medical officer of Albert Labs, shared, “We’re looking at depression and anxiety in cancer patients. We haven’t looked into this area very much over the last 20 to 30 years because of the interaction posed by many antidepressants in cancer patients. With psilocybin, we can look at this group because the potential risk of interaction is significantly lower.”
Psychedelics are unfortunately still demonized in many circles, though their negative reputation is largely based on hearsay. Real-world evidence from clinical trials indicates that drugs such as psilocybin can be immensely helpful in relieving not only stress but the symptoms of many mental illnesses. More importantly, they can achieve this with minimal adverse side effects.
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