Know Cancer

forgot password

Creating Meaning Following Cancer: An Cognitive-existential Intervention to Improve Existential and Global Quality of Life

18 Years
Open (Enrolling)
Non-metastatic Cancer, Adjustment Disorder

Thank you

Trial Information

Creating Meaning Following Cancer: An Cognitive-existential Intervention to Improve Existential and Global Quality of Life

People diagnosed with cancer must learn to cope with loss of meaning and empowerment which
compromises quality of life. Questions regarding "Why me?", along with universal existential
concerns about death, search for meaning, and sense of control over one's life, often
constitute the principal source of overall suffering. Since there is no single and
identifiable cause for cancer, those existential questions are commonly observed among
patients who demand specific interventions to properly address this central issue. The
existential approach can be used to help patients find meaning in the midst of a crisis. It
addresses a central issue of survivorship in cancer.

The conceptual model explains the relation between being exposed to a stressful and
traumatic life event such as cancer and the risk of progressing toward adjustment
difficulties which compromises quality of life and existential integrity. Cancer constitutes
a major stressor involving significant losses that confronts the person's beliefs system. A
set of therapeutic strategies can help to cope with this inevitable challenge: 1)
cognitive-behavioral strategies; 2) direct existential intervention; and 3) social support
through supportive-expressive strategies. Adjustment first involves cognitive reframing of
the perception of the situation (situational meaning). Cognitive reframing also contributes
to a readjustment of personal beliefs and values (global meaning and existential dimension).
Existential strategies enable to further this process by including cognitive (beliefs, sense
of coherence, expectations), motivational (choice, goal setting, and goal driving) and
affective dimensions. The expressive-supportive strategy promotes active listening and
non-judgmental support to encourage expression of emotions. The use of these active coping
strategies (meaning-based) to the threatened-life challenge enables optimization of
existential and global quality of life, as opposed to employing passive strategies such as

Inclusion Criteria:

- Be of 18 years of age or more;

- Speak French;

- Have received a diagnosis of non-metastatic cancer;

- Be available to participate in the program of 12 weekly group or individual sessions.

Exclusion Criteria:

- Depressive mood (score greater than 10 on the Hospital Anxiety and Depression Scale
depressive subscale or high psychological distress (HADS overall score above 14) that
could interfere with the intervention. Since we specifically target the existential
dimension and it might temporarily provoke questioning in patients, high
psychological distress must first be addressed using other approaches.

- Diagnosis of metastatic cancer or diagnosis of non-metastatic cancer with a usually
fast-growing and unpredictable course, making it unlikely to adhere to the
intervention (e.g., pancreatic cancer, acute leukemia, glioblastoma).

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Supportive Care

Outcome Measure:

Existential quality of life

Outcome Description:

At every time frame, we use two questionnaires to measure the primary outcome: The McGill Quality of Life Questionnaire (MQOL): 16 items plus a single-item global scale. Spiritual well-being (FACIT-SP): The FACIT-SP is a sub-scale of the FACT-G (Functional Assessment of Cancer Therapy-General) and a French version of the "FACIT-SP, FACIT-Spiritual well-being scale". This questionnaire has two sub-scales: Meaning/Peace (8 items) and Faith (4 items).

Outcome Time Frame:

T0: Pre-intervention

Safety Issue:


Principal Investigator

Pierre Gagnon, MD, FRCPC

Investigator Role:

Principal Investigator

Investigator Affiliation:

Laval University


Canada: Ethics Review Committee

Study ID:




Start Date:

February 2009

Completion Date:

June 2013

Related Keywords:

  • Non-metastatic Cancer
  • Adjustment Disorder
  • Creating meaning
  • Therapy
  • Cancer
  • Oncology
  • Existential
  • Spirituality
  • Quality of life
  • QOL
  • Psycho-oncology
  • French-canadian
  • Quality of Life
  • Cognitive therapy
  • Existentialism
  • Adjustment Disorders