Beyond skin deep: assessing outcomes of a ScarWork clinic treating people living with and beyond cancer from a range of tumour sites


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Beverley de Valois, Teresa Young, Clare Scarlett, Katrina Mindel

Abstract

Background

A reported 68% of people in the UK diagnosed with early stage cancer undergo surgical resection.  Cancer survivors can then experience a range of troublesome symptoms, both physiological and psychosocial, from scars associated with this curative surgery.  Over 12 months we evaluated a clinic using ScarWork , a novel manual intervention developed by Sharon Wheeler (USA), for its potential as a service offering  and further research.

Method

A ScarWork service in an NHS cancer centre offered up to eight ScarWork treatments to survivors who had undergone surgery (and/or radiotherapy) for breast, colorectal, head and neck cancers or melanoma. Outcome measures administered at beginning and end-of-treatment included the Patient Scar Assessment Questionnaire (PSAQ) and Measure Yourself Medical Outcomes Profile (MYMOP). Patients could prioritise one or more scars. A semi-structured questionnaire administered at end-of-treatment collected patients’ impressions of ScarWork.

Results

Nineteen patients, reporting 25 scars with a mean scar age of 4.2 years (range: 6 months to 17 years) received a median of 6 ScarWork treatments (range: 0 to 12). PSAQ showed significant improvements for subscales Appearance, Consciousness, Satisfaction with Appearance, and Satisfaction with Symptoms. Improvements in the Symptom subscale were recorded for itching, frequency of discomfort, sensations of numbness and overall troublesomeness. Mean MYMOP profile score showed 1.8 (SE=0.3) points improvement on a 7-point scale where a change of 0.5-1.0 points is clinically significant and meaningful to the patient.  Patients’ written feedback recorded physiological and psychosocial benefits, including improved appearance, texture and mobility, as well as improved mental wellbeing and acceptance of scars.

Conclusion

ScarWork is a novel intervention recently introduced to the UK and this, to our knowledge, is the first formal clinical assessment of its use across a range of tumour types. Feedback from this clinic assured funding for a further year of clinical activity.  Much valuable information about administering, analysing and reporting outcome measures, especially PSAQ, was gathered. This will be invaluable for improving data collection and analysis when designing and conducting future research, which is planned. 

 

Impact statement

By reducing scar-associated physical and psychosocial symptom burden, ScarWork may prove a valuable intervention for improving quality-of-life for people living with and beyond cancer.