BY HEATHER CAMPBELL
A young boy has survived the arduous treatment for brain cancer and is getting some help from Dr. Matias Mariani, clinical psychologist and neurospsychologist with the Sudbury Regional Cancer Program. The young patient will undergo a neuropsychological assessment with Mariani who will then be able to quantify any neurocognitive deficits he is experiencing.
From there, a treatment plan is developed to help overcome damage so he can return to school and have a better quality of life.
Dr. Mariani’s research on neuropsychological assessments for brain tumour patients was recently recognized by the Brain Tumour Foundation of Canada at this year’s annual conference of the Canadian Association of Psychosocial Oncology.
According to the Brain Tumour Foundation of Canada, primary brain tumours - those originating in the brain - occur in eight out of 100,000 people. Secondary, or metastatic brain tumours originating in other areas of the body affect 32 out of 100,000 people. Thought, emotion and movement are significantly affected by brain tumours.
Dr. Mariani assesses patients who are experiencing neurological, cognitive and/or psychological changes and challenges as a result of their cancer and its treatment. He is one of three neuropsychologists in Sudbury and the only one working in oncology in northeastern Ontario.
Cancer treatments leave patients with a variety of symptoms such as memory problems, slowed thinking (also known as “foggy” mind), low motivation, depression, comprehension deficits and behavioural and emotional problems.
“The neuropsychology service that Dr. Mariani provides as part of our oncology team at the Regional Cancer Program helps cancer patients manage the daily impacts of their illness,” said Mark Hartman, interim vice president of the Regional Cancer Program. “This award is acknowledgement of Dr. Mariani’s exceptional contribution to this important aspect of cancer care.”
Mariani was honoured to receive the award. “It means a lot to me to be recognized for the work I am doing,” he said.
He completed his postgraduate studies in Clinical Neuropsychology at the University of Windsor and did his pre-doctoral training in Detroit at Wayne State University Health Center and the Rehabilitation Institute of Michigan, and in Toronto at Sunnybrook Health Sciences Centre and the Centre for Addiction and Mental Health. He did his residency in Edmonton at Glenrose Rehabilitation Hospital.
He and his wife are happy to be living and working in Sudbury, especially since his wife grew up in the city and he became familiar with the community during family visits. The Regional Cancer Program operated without a neuropsychologist before Mariani’s arrival in October 2009.
“The needs in the city are great, but I want people to know there is help available,” he said. “Part of my goal is to educate the public. We are just scraping the surface here in Sudbury. There is much potential to improve the quality of life for cancer survivors.”
A neuropsychological assessment can help determine how a brain tumour is affecting a person’s neurological, psychological, and /or daily functioning. The assessment can also help determine whether a brain tumour is responding to treatment.
“Based on the results, I can customize a treatment plan that will provide the most improvement to a patient’s quality of life,” explained Mariani.
Cancer patients will go through an extensive assessment with him - sometimes lasting many hours - to determine how the brain is functioning following either systemic or direct injury to the brain or central nervous system. “The assessment is by paper and pencil, and computer, with no invasiveness,” explained Mariani.
“I believe there is no point in conducting an assessment without coming up with a treatment plan. In the assessment, I determine if there is a quantifiable neurocognitive deficit and to what degree a person’s psychological status and/or coping strategies are impacting their clinical presentation. From there, I can see how I can intervene to help their transition. Depending on the case, I may have to liaise with employers or the school if they are a pediatric patient or survivor. I may also provide therapy or neuropsychological intervention, recommend a medication review, or request further evaluations.”
Some of those treatment options include cognitive behaviour therapy, which identifies adaptive ways for dealing with thoughts, moods and behaviour. Another option is interpersonal psychotherapy which works on improving communication skills and interpersonal relationships.
Mariani says cognitive behavioural therapies show at least equivalent rates of efficacy in treating certain disorders when compared to psychiatric medication, and that research has demonstrated that a combination of talk therapy and medication is the most effective approach.
All psychological treatment offered is structured and most often involves 16, 50 minute sessions tailored to improve mood and optimize cognitive and social functioning.
Aside from working with brain tumour survivors and pediatric survivors, Mariani has started a rehabilitation program for survivors of breast cancer who are experiencing “chemo fog.” He is also researching radiation injury.
