Cancer, Health & Spirituality

Funding of this research will help the innovative CREATE Program show evidence of enhanced health outcomes, including through spiritual counselling and a structured combination of therapies and assess feasibility of CREATE’s use of group therapy

(The following team previously offered to lead and support this research project – other team members are available)

Principal Investigator: Dr Gillian Bendelow Reader in Sociology; expertise in lay concepts of health and illness; medical sociological approaches to the body, pain and emotions

Program Coordinator: Allan Sweeney International Therapy & Training Centre, Margate, UK; Instigator of CREATE; practitioner-teacher of Energy Based Complementary Medicine (EBCM)

Research Fellow: Dr Rachel Cane Research Fellow at Centre for Research in Health and Medicine, University of Sussex, UK; expertise in qualitative research in Medical Sociology and Science and Technology Studies; professional and lay understandings of health issues

Research and Statistical Advisor: Hilary Watt Lecturer in Medical Statistics and Honorary Lecturer at the Institute of Neurology, London, UK; 51 publications covering epidemiology, clinical trials, tumour growth rates, magnetic resonance images and psychometric scans

Political and Public Policy Advisor: Dr Michael Dixon OBE, MA, BS, MRCS, LRCP, DA Trustee of Prince of Wales Foundation for Integrated Health; Senior Associate Kings Fund London; UK Government Cabinet Committee on Bureaucracy; Honorary Research Fellow at University of Exeter; Senior Fellow in Public Policy at University of Birmingham

Spiritual, Medical and Healing study Consultant: Dr Craig Brown MBchMB, MRCGP, General Medical Doctor, UK; ex-President National Federation of Spiritual Healers; in-surgery healing studies; Doctor-Healer Network

Religious Consultant: The Right Reverend Professor Elizabeth Stuart B.A. (Hons), M.A., D. Phil., Dip Pastoral Care Presiding Bishop of Diocese of Great Britain and Ireland

Anthropology Consultant: Dr Susan Greenwood Anthropologist; University of Sussex teacher of religion, magic, altered states of consciousness and the Other World; expertise in research methods for overcoming the Western division between mind, body, spirit, and matter  


Introduction

The field of Complementary and Alternative Medicine (CAM) and health is emerging strongly due to population migration bringing diversity within nations, and a grassroots rising of consciousness within individuals that governments are taking into account in policy decisions (UK Parliament, House of Lords Report, Complementary and Alternative Medicine, 2000). Links between CAM and orthodox medicine need to be more closely defined in terms of links to physical, emotional and mental health states of being (i.e. best health outcomes). Testing this through the systematic treatment of potentially dying patients with this proposed study may give the clearest possible way to standardise effective treatment.

The literature concerning the incidence of cancer and patient use of CAM reveals that cancer currently affects 1 in 3 persons; that cases will treble over the next 20 years and that up to 80% of cancer patients try CAM (Bendelow 2004, presentation). At a conference on ‘Complementary Therapy and Cancer Care’ in 2004, the Prince of Wales suggested that only by taking a truly collaborative approach to the multitude of factors that affect our wellbeing and hence our response to disease, can we hope to bring about substantial change in our health. 

The pioneering Program Cancer Research and Education using Active Therapeutic Evaluation (CREATE) was formulated in a German cancer hospital by Allan Sweeney in the late 1990s.  Since then Sweeney has developed CREATE further by incorporating other elements of CAM, and Energy based Complementary Medicine (EBCM) for a comprehensive and integrated chronologically ordered patient Program. Due to successful patient experiences, CREATE is now ready for further investigation through rigorous and inter-disciplinary research.

The 2-week CREATE Program

CREATE was originally designed as a 12 near-consecutive day plan for cancer patients with less than one month to live, with the prime objectives of prolonging life and/or gaining better palliative care outcomes. It could include a one day weekly, 12 consecutive week option for patients whose life expectancy is longer. CREATE’s chronological holistic structure using varied psycho-social, CAM and EBCM mechanisms can be adapted to the individual need of each patient. 

 

The first three days assesses the patient’s physical, emotional, mental, spiritual and soul problems related to the past, present, and future; uses auric bio-healing to provide energetic strength to survive; and teaches calm and peace techniques for better quality of sleep.

 

The next four days is a multi-disciplinary approach including therapies such as counselling, exploring the person’s spiritual ideals, healing, Neuro Linguistic Programming, EBCM, visualisation, image work, and meditation. Patients may opt for personal preferences according to need. Possible issues include current pain and anxiety, relationship ties, fears of the dying process, fear of what may happen after death, and bereavement, past trauma etc.   

During the second week the patient explores two paths in preparation for possible survival, and for eventual death. This includes affirmation, goal-setting, imagery, and perceptions of the meaning of suffering, for instance spiritual concepts of ‘giving back something to help our world’.

In the final two days an auditory recording is made of all the techniques the patient found most helpful. This is to be used after their individual CREATE Program ends so that they can play it daily to continue and consolidate the healing processes.

 

Literature validates many components of CREATE. For instance healing can be effective in decreasing physical problems and anxiety associated with illness (Bullock, 1997); imagework may access latent and unexpressed feelings (Edgar, 1999); and positive spirituality has been shown as a means towards better mental and physical health (Larimore et al 2002). However there appears to be no literature on a systematic, individualised, chronological Program for cancer patients incorporating CAM and EBCM.


Research aims and objectives

We will examine theoretical and empirical questions with scientific and methodological rigour to advance the understanding of a link between CAM and EBCM healing outcomes. Specifically we will attempt to

  • Demonstrate the value of the patient-centred and adjustable chronological structure of the CREATE Program
  • Evaluate how CREATE may assist therapist’s and patient’s spiritual values and beliefs
  • Develop research methods based on effectiveness, experience and meaning
  • Incorporate cross-cultural techniques and modalities.
  • Use innovative interdisciplinary research
  • Assess the health outcomes of patient participants (e.g. increase in life expectancy and quality of life)

Study design

The study will triangulate qualitative and quantitative methods to assess the effectiveness of CREATE’s integrated CAM and EBCM Program. 10 clinicians will be trained in-depth to use CREATE with a total of 80 cancer patients. This number allows for a potential drop-out rate of 20% due to death, natural attrition or other reasons. Patients will be recruited from orthodox medical referral, hospices, or privately. They will be assessed at pre-treatment, post-treatment and followed-up at 3 months after treatment. The health outcomes will be measured using performance status, biochemistry, as well as survival data and CREATE-specific quality of life questionnaires.

There will be three patient groups of 40 patients in each group -

Group 1            12-days of individual consecutive treatment with 2 follow-ups.

Group 2            12-days over a 3 month period combining individual and group treatment. 60% administered in group sessions, and 40% in individual sessions.

Group 3            Control group – no treatment

Inclusion criteria for participation may include histological proven cancer; informed consent; documented progressive disease; age over 21 years; no more medical intervention planned.

Timeline

Months 1-6 Establish Steering Committee and ethics approval; undertake extensive literature search; write training syllabus; recruit and train clinicians; pilot innovative research methods with cancer patients (e.g. image work as a research tool); design final research tools and treatment protocols

Months 7-14 Establish database for patient’s data (qualitative and quantitative); start Group 1 individual 2-week Program and undertake Group 3 Control Group assessment; follow-up of Groups after 3 months

Months 15-22 Start Group 2 group/individual 3-month Program; ongoing 3-month follow-ups of all Groups and patient data entry

Months 23-25 Complete 3-month follow-up for Group 2; complete data entry, commence data analysis

Months 26-36 Data analysis; report writing; dissemination of findings (by publication and conferences across the disciplinary backgrounds of the CREATE Team)  

Methodological Innovation

As CREATE pioneers an individualistic-integrative CAM and EBCM approach, there is genuine scope to develop substantial innovation in research methods.  We intend to adapt published assessment tools as a means towards better mental and physical health such as the index of core spiritual experiences (INSPIRIT).  We also intend to develop patient-centred measurement tools; a new or adapted quality of life questionnaire applicable to the CREATE Program’s assessment of health outcomes; explore the use of instruments such as EEG and PET; and the physiological basis for effects. Measurement tools may also be sensitive to change as well as being context specific.

Ethical considerations

Patients in the Control Group are not eligible for the CREATE Program, but can continue to access orthodox medical treatment. Confidentiality of patient information will be assured and patients can discontinue the Program at any time.

Project management & personnel issues

We may also link to cancer support networks, funding bodies, non-profit organisations, or medical and government departments. We may apply for co-funding and/or follow-up funding, and seek support for this process.

Potential of the study

Through new CAM and EBCM combined and chronologically structured approaches, CREATE intends to develop a new cancer Program model, increase quality of palliative care, improve life expectancy, and show cost-savings. Effectiveness and cost-effectiveness may also be shown in the numbers of medical establishments and patients interested in the Program. By these and other potentials our diverse and influential team can open numerous paths of exploration and understanding. Through our willingness to experiment with novel efforts to bring together science, spirituality, health, and healing, via research, education, and media promotion we will provide a base for research prioritisation/clinical decision-making.  To further the education about CREATE we will develop an advisory board to provide information to newcomers in the field. This new outlook for cancer treatment should add vast value to academics, institutions, opinion leaders and government policy advisors. Far-reaching impacts include attracting funding for furthering the evidence base; integrating with hospitals and hospices; and attracting free enterprise for worldwide CREATE centres.