The SURECAN trial: A new holistic psychological therapy for people living with and beyond cancer
The SURECAN study (Survivors’ Rehabilitation Evaluation after Cancer) is a £2.7 million initiative funded by the National Institute for Health Research (NIHR), which evaluates a new type of psychological therapy for improving the wellbeing of people living with and beyond cancer: Acceptance and Commitment Therapy (ACT) combined with work and/or physical activity interventions (ACT+).
At Oncology Professional Care 2024, we are privileged to be hosting a deep dive into the lessons learnt from the trial in our Living with and Beyond Cancer Theatre. Until then, let’s take a look at why this trial is turning heads in the oncology community.
The Challenge
In the UK, three million people are living with and beyond cancer and it is estimated that this will increase to 5 million by 2040. Roughly one third of people with a cancer diagnosis report poor quality of life or wellbeing due to problems such as fatigue, fear of cancer recurrence and concerns about returning to work.
Having surveyed cancer services to see what aftercare is provided, the team found they did not sufficiently address important issues highlighted by patients, with NHS ‘aftercare’ varying widely. Therefore, there is a need for better aftercare for 'cancer survivors'.
The Solution – ACT+
SURECAN are developing a talking therapy based on Acceptance and Commitment Therapy for people who have completed cancer treatment and have a low quality of life (QoL). ACT puts patients’ values at the heart of therapy by helping patients to accept what they cannot change (eg the cancer might recur), and commit themselves to goals they are able – and want – to achieve, based on their own values (eg becoming closer to loved ones).
Exercise is helpful and return to work and vocational activity is important to many patients, therefore the project integrated ACT with options for physical activity and work support, if these are deemed important by the patient – ACT+.
The Questions
- What should the ACT+ Therapy include?
- How could ACT+ be designed so that everyone can benefit from it, including different ethnic and religious groups?
- How do we optimise the way therapists deliver ACT+?
- Does a clinical trial show that ACT+ is more effective and cost-effective in improving QoL than the current treatment offered?
The Objective
The review seeks to achieve an understanding of the potential cultural influences on cancer-related
psychological interventions. The aim is to inform the adaptations necessary to deliver ACT+ in more culturally informed ways so that it is more generalisable. ACT+ combined with a cultural humble approach to reflect the ethnic diversity of the UK, hopes to improve quality of life for people living with and beyond cancer.
The SURECAN study seeks to address gaps in aftercare services by introducing a more comprehensive and tailored approach. Integrating psychological therapy with targeted interventions, the study aims to redefine the landscape of cancer survivorship.
The Trial
This study is being run as a randomised control trial, comparing ACT+ and usual aftercare, with usual aftercare only. It aims to understand if ACT+ with usual aftercare is more effective and cost-effective in improving the quality of life of participants living with and beyond cancer than usual aftercare only.
The SURECAN programme consists of six inter-digitating work streams designed to develop, trial and evaluate the ACT+ intervention in improving the quality of life for those living with cancer. The work packages are as follows:
- Meta-synthesis of qualitative studies of cultural influences on psychological interventions in survivors
- Development of Acceptance and Commitment (plus) therapy (ACT+) pre-pilot
- Pilot randomised controlled trial (RCT)
- Main RCT of ACT+ versus usual aftercare.
- Qualitative studies
- Evaluation of predictors, moderators and mediators
Who is involved
Led by the National Institute for Health Research (NIHR), the SURECAN team is a collaboration of academics, clinicians, and active patient and public participation (PPI). The patient's perspective is integral to the project, ensuring a patient-centric approach.
Currently the following secondary care sites are participating:
- Barts Health NHS Trust
- UCLH NHS Foundation Trust
- Sheffield Teaching Hospitals NHS Foundation Trust
- King's College London
- Barking, Havering and Redbridge University Hospitals NHS Trust
- Hertfordshire Partnership University NHS Foundation Trust
- Homerton University Hospital Foundation Trust
In addition to a number of services from Increasing Access to Psychological Therapies (IAPT) centres with the flowing trusts:
- iCope Camden & Islington
- North East London Foundation Trust
- East London Foundation Trust
- City & Hackney (Homerton University Hospital Foundation Trust)
- Barnet IAPT (Whittington Health NHS Trust in Harringey and Barnet, Enfield & Haringey Mental Health Trust)
- Hertfordshire Partnership University NHS Foundation Trust
- Cavendish Cancer Care Charity
The Results?
Oncology Professional Care (21-22 May 2024) at the ExCel London will host members of the SURECAN trial team to share exclusive insights into lessons learnt, and how this new therapy was developed, piloted and trialled within the NHS.
Join us to hear more about this groundbreaking trial and the amazing work being undertaken by the team.
