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CONCERT Member Of The Month: Ben Smith – tackling fear of cancer recurrence with online technologies

There’s a common theme underlying Ben Smith’s career. And it’s not just about cancer or cancer research. It’s a theme revolving around helping people who, despite being cancer free, are still scared.

Fear of cancer recurrence is the number one concern of cancer survivors, Ben who is Deputy Director of CONCERT, explains.

For some, this fear can be debilitating, affecting not only their emotional wellbeing, but also their work, their relationships and overall quality of life.

Tackling this issue has been the focus of Ben’s work since his PhD, in which he researched the psychological wellbeing of testicular cancer survivors  (Read more here).

What Ben discovered was that a third of the men participating in the study had major concerns their cancer would return despite their good prognosis, and one-in-five suffered from anxiety and depression. Many men were reluctant to seek help, citing time restraints as well as family and work commitments as their main reasons.

“The unfortunate reality is that the stigma attached to men seeing a mental health professional also stops men from seeking help, so we need to find ways of providing help which maximises confidentiality and convenience,” he explains.

Understanding both the importance of psychological interventions and the barriers preventing access to these interventions, led Ben to turn his focus online. Working together with the Psycho-Oncology Co-operative Research Group (PoCoG) and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP), Ben was instrumental in developing e-TC (https://e-tc.org) an online program for survivors of testicular cancer to help them manage the challenges encountered after treatment.

“This is one option for men who, for whatever reason, are reluctant or unable to access face-to-face help,” says Ben.

A pilot study found that e-TC was a feasible and acceptable psychological treatment option for men who are experiencing difficulties in adjusting to challenges following treatment for testicular cancer.

Following the success of the e-TC intervention, which is now publicly available, Ben has led the development of iConquerFear, a digital health adaptation of an effective face-to-face therapist intervention known as Conquer Fear developed by PoCoG. Although this therapist intervention is highly effective, it is only easily accessed by patients in metropolitan hospitals who employ specialised psychologists. This means, in the past, people who couldn’t access these services, missed out.

This is no longer the case. Patients who cannot access the face-to-face therapist intervention can now access a similar online program, iConquerFear, thanks to Ben and his team of leading psycho-oncology researchers from around Australia.

Unlike e-TC, iConquerFear is not specific to one type of cancer but instead focuses on reducing worry and anxiety for all cancer survivors.

“iConquerfear provides a number of ways to help alleviate worry. For instance, one aspect of the program is attention training which involves training your ‘attention muscle’ to give less attention to worries about recurrence. The program also includes ways to help people get less caught up in their worries, such as detached mindfulness and advice on how to respond to physical symptoms,” says Ben.

Ben and his team have shown that iConquerFear is a highly acceptable tool for delivering evidence-based strategies to reduce fear of cancer recurrence and are seeking further funding to definitively demonstrate the effectiveness of the website.

Ben is also heavily involved in improving outcomes for cancer patients of culturally and linguistically diverse (CALD) backgrounds who experience poorer outcomes across a range of areas when it comes to cancer.

“We’re looking into how we can improve the participation of people from CALD backgrounds in clinical trials so that CALD patients don’t miss out on the state-of-the-art treatments evaluated in trials. We’re looking at strategies to overcome barriers to trial participation at both the patient and system level.”

Ben’s work in improving the mental and emotional wellbeing of cancer survivors was recognised last year with not one, but two awards: the Ingham Institute’s Early Career Researcher Award and the Clinical Oncology Society of Australia New Investigator in Psycho-Oncology award.

Although he agrees that 2019 provided him with great personal recognition, Ben is quick to point out the excellence of others who work with him.

“The awards are a reflection of the great teams I have worked with. Although it’s might sound like a cliché, the old adage ‘no man is an island’ is no truer than in the research world.”

While this may be the case, Ben’s work is more than research.  It’s about caring enough to understand the real fears of cancer survivors. It’s about looking for ways to help alleviate these fears. And it’s about finding non-traditional pathways which provide access to those who need it most. 

“I want to ensure that I am helping people affected by cancer who are underserved, such as the CALD population, as well as people who don’t have access to psychosocial support due to their inability to access services,” says Ben.

By Linda Music