GUIDA DA PONTE
Centro Hospitalar Barreiro-Montijo, Psychiatry and Mental Health, Barreiro, Portugal
Advanced cancer anticipates to the patient the imminence of death and our finitude as human beings. Cancer patients are faced with an existential crises that can lead up to intense suffering, hopelessness, demoralization and desire for hastened death.
Although depression can be treated with antidepressants, there wasn´t no proven therapeutic intervention to this kind of end of life despair, until the emergence of new treatment modalities as Meaning Center Psychotherapy (MCP) and the use of some drugs as psychedelics and cannabis.
MCP is a new modality of psychotherapy that successfully integrates themes of meaning and spirituality into end-of-life care; it specifically address the loss of spiritual well-being or sense of meaning in life and existential distress. This kind of psychotherapy gives the tools to the patients to find meaning and purpose in living until their death. The attitude facing suffering is, in the last analysis, of man´s responsibility, as human being. So, we can choose our attitude face cancer and it´s limitations. Concepts as responsibility, legacy, courage and transcendence are present and the patient is encouraged to achieve meaning by using it´s inner sources.
It´s suggested that more severe existential suffering responds better to this kind of existential interventions.
Also, research using psychedelics in the end on life is rising again. Psilocybin produces mystical experiences and help to restore a sense of meaning, a sense of who we are, allowing to live more fully in the present, and reframing life and death as a continuum.
The use of cannabinoids as a medical therapy remains controversial, but currently have proven efficacy in symptom management in advancer cancer, as chemotherapy-induced nausea and vomiting, pain, anorexia, insomnia, anxiety and depression.