Feasibility of CALM Therapy in Korean Cancer Patients

Feasibility and Preliminary Effectiveness of 'Managing Cancer and Living Meaningfully'

This feasibility study examined the cultural adaptation and implementation of Managing Cancer and Living Meaningfully (CALM) therapy for advanced cancer patients in Korea. CALM is a brief manualized individual psychotherapy designed to address psychological distress and existential concerns in patients with advanced disease.

This single-arm feasibility study evaluated the acceptability, tolerability, and preliminary effectiveness of CALM therapy in the Korean cultural and healthcare context. Patients with advanced or metastatic solid-tumor cancers received 3-6 individual therapy sessions over 3-6 months, delivered by trained psychiatrists.

The study assessed feasibility through recruitment rates, therapy completion rates, and outcome measure completion. A mixed-methods approach included quantitative outcome measures (depression, death anxiety, attachment, quality of life, anxiety) and qualitative interviews with patients and caregivers to evaluate implementation barriers and facilitators.

This study was conducted in collaboration with the developers of CALM therapy at Princess Margaret Cancer Centre, Toronto, Canada. Therapists were trained through the international CALM training program, including workshop attendance and supervised training cases under the supervision of the intervention developers.

Inclusion Criteria:

• Age ≥19 years

• Fluent in Korean

• Able to provide informed consent

• Diagnosis of advanced or metastatic solid-tumor cancer, including:

  • Stage III or IV lung or ovarian cancer
  • Any stage of pancreatic cancer
  • Stage IV gastrointestinal, gynecological, breast, genitourinary, sarcoma, melanoma, or endocrine cancer
  • Unresectable cholangiocarcinoma, liver, ampullary, or peri-ampullary cancer

Exclusion Criteria:

• Major communication difficulties
• Inability to commit to 3-6 psychotherapy sessions (e.g., too ill to participate, lack of transportation, insufficient motivation)
• Cognitive impairment as indicated by clinical team or patient chart