• Zoeken
« Terug naar home

Living after Cancer


In the past, when a patient was diagnosed with cancer, this often meant a short remaining time to live. Nowadays, patients live with cancer for a longer time. This implies a shift in the requested psychological help from palliative/terminal care towards help with finding meaningful ways to continue their lives, despite physical limitations and uncertainties. 

Literature shows that meaning-making is important for cancer patients: 1.meaning-focused coping is at the core of adequate adjustment to cancer; 2.despite a lack of psychopathology, up to 70% of cancer-patients have questions and needs regarding meaning-making; 3.up to 70% of the patients wish to be helped with meaning-making; 4.cancer patients who experience their life as meaningful are better adjusted, have better quality of life and psychological functioning.

Most psychological interventions focus at teaching adequate coping styles and preventing/treating psychiatric symptoms, and not at living with cancer. There are few evidence based interventions to help patients living meaningfully with cancer. Breitbart et al developed an 8-session meaning-centered group psychotherapy for cancer patients in New-York, based on Frankl's logotherapy. The therapy is directed at stimulating the patients' search for meaning, through creativity, experience, attitude and legacy, and consists of didactics, discussion and experiential exercises.

Breitbart found large improvement in meaning-making and psychological functioning (d=.8). These effects were larger than non-meaning centered psychological interventions. These effects were also larger than other existential therapies, possibly because the latter were often relatively unstructured/non-directive. The effects of Breitbart's therapy could be explained by its: 1.direct focus at meaning-focused coping and goal reengagement, with many sources of meaning; 2.structured/manualized approach; 3.actively stimulating and deepening experiences; 4.practical; 5.providing explanations; 6.unconditional positive regard.

Purpose of project
We want to develop and evaluate the effectiveness of an 8-session meaning-centered group psychotherapy for Dutch cancer patients, on the basis of Breitbart's intervention, entitled 'Group Training Living Meaningfully with Cancer'.

Purpose of therapy
The therapy purpose is to help cancer patients to find their own ways to satisfactorily design and live their lives meaningfully within the context of physical limitations and uncertainty of having cancer. Specific purposes are: search for meaning (e.g. reordering/evaluating old meanings, search for new meanings, overcoming practical limitations); concrete goal-reengagement in daily life; learning to distinguish between what can and what cannot be changed; integration of cancer in life history; emotional expression; social support; improved psychological functioning.

Plan of investigation
Before start of the study, 2 focus groups with 6-10 cancer-patients will be performed, and approval by the medical-ethical committee will be obtained. The project consists of 4 phases: 1.translation/adaptation of therapy, training of therapists, in discussion with experts; 2.pilot study in 2 groups of 6-8 patients; 3.randomized controlled trial in 180 patients (60 intervention-condition, 60 social-support-group-condition, 60 care-as-usual-condition); 4.analyses and generalization phase. Participants are at least 1 year after cancer treatment with curative intent in Leiden University Medical Center or VU University Medical Center and are able to follow all therapy sessions.

Outcome measures include valid, reliable outcomemeasures of meaning-making and psychological functioning (eg. personal meaning profile, Ryff's well-being, session-rating-scale). To assess possible determinants of efficacy of the intervention, sociodemography, comorbidity, cancer, treatment, and copingstyles will be included. Questionnaires will be filled-in before first and after last session, and 3 months later. 60 patients are needed in each group at baseline, assuming an effect size of 0.80, compensation for 30% loss to follow-up, 80% power and 5%-pvalue. Randomization will be stratified by cancersite and gender.

Possible results and relevance
An evidence-based, manualized intervention will be developed to help patients living meaningfully with cancer despite possible physical limitations and uncertainty.The intervention is expected to meet their meaning-related needs more explicitly than other therapies.More insight will be obtained in determinants of therapy success. A practical therapy manual and therapist training protocol will be developed and made available for implementation in other centers for oncological/psychosocial care.

Funding: VUmc and KWF/Alpe d'HuZes (2011-2015).

N. van der Spek, PhD
Prof I.M. Verdonck-de Leeuw, PhD, Psychologist, Speech & Language Therapist, Linguïst, dpt. of Clinical Psychology, VU Faculty of Psychology and Education, Amsterdam.


For questions, please contact:
prof dr IM Verdonck-de Leeuw
E-mail: s.biemans@vumc.nl


naar boven ↑

News flashes


PhD thesis Mirjam de Vries

March 22, 2019 Mirjam de Vries defended her thesis “Physicians‘ defence mechanisms during communication with advanced cancer patients”. 


PhD thesis Joeri Kalter

September 28, 2018 Joeri Kalter defended his thesis “Exercise and psychosocial interventions to improve quality of life in patients with cancer”. 


PhD thesis Sanne Duman-Lubberding

July 4, 2018 Sanne Duman-Lubberding defended her thesis "Online Patient Reported Outcome Measures to faciltate supportive care in Head and Neck Cancer patients".


PhD thesis Femke Jansen

January 15, 2018  Femke Jansen defended her thesis “Supportive care in head and neck cancer patients. Patient-reported needs and costs”. 

PhD thesis Janneke Rood

September 11, 2017 Janneke Rood defended her thesis "Perceived need for information and treatment decision-making in patients with hematological malignancies: not "one size fits all".


Amsterdam Public Health project

Within the context of the alliance VUmc-AMC Prof dr Ellen Laan (AMC) and prof dr Irma Verdonck-de Leeuw (VUmc) received a grant for the project "Sexual well-being in head and neck cancer patients".


Treatment of psychological distress in patients with head and neck or lung cancer cost-effective.
A recent study of PhD-student Femke Jansen and colleagues, recently published in the Journal of Clinical Oncology


PhD thesis Nadine Köhle

December 15, 2016 Nadine Köhle defended her PhD thesis "Hold on, for each other. Supporting partners of cancer patients via eHealth and positive psychology". 


PhD thesis Anne-Marie Krebber

December 2, 2016 Anne-Marie Krebber defended her PhD thesis "Stepped care targeting psychological distress in head and neck cancer and lung cancer patients".


PhD thesis Nadia van der Spek

September 7, 2016, Nadia van der Spek defended her PhD thesis "Meaning-centered group psychotherapy for cancer survivors: development, efficacy, and cost-utility". 


EORTC QLG Newsletter Spring 2016
The EORTC QLG  Spring Meeting took place on April 20th and 21th 2016 in Oslo. The Spring newsletter of the EORTC QLG is now available. 

PhD thesis Ingrid Cnossen

April 12, 2016, Ingrid Cnossen defended her PhD thesis entiteld “Self-management Supporting Rehabilitation in Head and Neck Cancer Patients”. 


VU/VUmc and Red-kite sign agreement for the provision of the Oncokompas in healthcare.

The VU University Amsterdam and VUmc Cancer Center Amsterdam work with Red-kite, distributor of software for hospitals in Netherlands. (November 3, 2015)


PhD thesis Christine van Gogh

December 4, 2015, Christine van Gogh defended her PhD thesis entiteld “Functional outcome of early glottic cancer”. 

Book presentation

On June 15th, 2015, Irma Verdonck presented the book "In Tune Without Cords" (in Dutch: VerderZonderStembanden) to Rob Burdorf, the president of the patient society for patients after laryngectomy.


PhD thesis Florien Boele

May 11 Florien Boele defended her PhD thesis, entitled "Towards improving health-related quality of life in glioma patients and their informal caregvers".


PhD thesis Trille Kristina Kjaer

May 8, Trille Kjaer will defend her PhD thesis entitled "Late effects after treatment of head and neck cancer and use of patient reported outcomes in clinical practice." Irma Verdonck is member of the committee.


Niels Stensen Fellowship
Florien Boele has received a Niels Stensen Fellowship. This is a scholarship that is awarded annually to a number of outstanding researchers who have recently obtained their PhD degree, to gain working experience abroad. Florien Boele will go to Pittsburgh (United States) and Edinburgh (Scotland) in 2015 and 2016.

Key paper

The publication “Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments” of A.M.H. Krebber et.al is chosen by the Editors as one of the key papers in Psycho-oncology, (issue June 2014).


On April 10th, 2014, the first edition of the Value Based Healthcare Prize took place. The prize for the most exceptional initiative in collaborations went to Jippa, a collaborative by VUmc, CZ, Radboud UMC and Tilburg University.


In November 2013 the NVPO organised the International Congress "Innovation in Psycho-Oncology". The researchgroup held several presentations and posters.


Interested in oncological care chain? Come 2 October 2013 to the 3rd MuON symposium in hospital Gelderse Vallei. Keynote speaker Michel van Schaik (Director Rabobank) about Innovation in the care!


12 april 2013: KWF Kankerbestrijding / Alpe d’HuZes has granted the research proposal Netherlands Quality of life and Biomedical Cohort Studies in Cancer (NET-QUBIC).

Marieke de Bruijn will defend her PhD thesis on 10 juni 2013 at 15.45 pm.

Support our bicycle team for Alpe d'HuZes 2013!

On 6 June 2013 our team living together with cancer will cycle the Alpe d'HuZes! This in the fight against cancer. At this moment there is already more than 1500 euro donated. Do you support us too?


The 15th World Congress of Psycho-Oncology and Psychosocial Academy will be held in Rotterdam, 4-8 November 2013. www.ipos-society.org/ipos2013/.


29 January 2013. Pink Ribbon has granted a project to develop and evaluate an online training for cancer patients with insomnia (Annemieke van Straten), and a project to develop and evaluate a breast cancer module for the OncoKompas (Nelly van Uden).


Charity Symposium "Living with cancer"

On December 19, 2012 there will be a Symposium ''Living with Cancer''. This is a charity symposium on meaning centered psychotherapy for cancer patients. Read more about it at the tab News at the left.


15 November 2012: Hoe?Zo! Radio interview with Irma Verdonck on stress and cancer.


October 2012: Interview with Irma Verdonck in Psychologie Magazine.


September 9, 2012. Interview Hans van Willigenburg with Irma Verdonck on Radio 5.


August 2012. Five students finish their MSc thesis and graduate as MSc in Clinical PSychology.


June 28-30, 2012: International symposium on Supportive Care in Cancer (MASCC ISOO) at New York. Kevin Yap and Irma Verdonck organise a workshop on e-health and supportive care.


Record for Alpe d'HuZes 2012. The sponsor action Alpe d'HuZes (6 and 7 June) 2012 has already yielded the record amount of 28.5 million euros.


June 6-8, 2012: Our research group contributes to Alpe d'HuZes as volunteers.


April 20, 2012: Nelly van Uden will give a presentation about OncoKompas at a conference about  ICT in health care in Barcelona.


March 16, 2012: NVPO congress in Utrecht, we contribute with 2 oral and 2 poster presentations and a workshop.


January 1, 2012: The project POLARIS project has officially started.


December 22, 2011: Radio program DeGids.fm, Felix Meurders interviews Corien Eeltink on sexuality and cancer. 


November 2, 2011: KWF / Alpe d'HuZes funds a grant for the development and evaluation of an online intervention for informal caregivers of cancer patients.


October 30, 2011 In the national television program "Gesprek op 2", Daphne Bunskoek interviewed Irma Verdonck on living with cancer.


October 28, 2011: www.oncokompas.nl is online!


October 23, 2011: Alpe d'HuZes hands over more than 20 million euros to the Dutch Cancer Society!



Team work

Our research projects are embedded in the two largest research institutes of VU University in Amsterdam: VUmc CCA-VICI (Cancer Center Amsterdam) www.vumc.nl/afdelingen/CCA-V-ICI/ and EMGO+ (Institute for Health and Care Research emgo.nl

We work closely with patients and their caregivers and with researchers and physicians at VU University and VU University Medical Center in Amsterdam and other research institutes and hospitals in the Netherlands and worldwide. Team work is crucial  improving research and translating results into clinical practice.

© Copyright 2011 - Samen leven met kanker - Alle rechten voorbehouden | Disclaimer