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Michelle Bittenbender


Senior Adult Oncology Program
• Aimed at preventing and treating cancer in older people (age 70+) as well as
improving their quality of life.
• Comprehensive geriatric assessment that helps to identify problem areas related to
cancer, as well as other issues that are directly related to aging – such as missed
diagnoses and day-to-day functioning.
• Takes into account take other conditions of aging that may affect older people,
including accompanying diseases, limitations on activity, transportation problems,
volume of medications, nutritional problems and memory disorders or depression.

• Half of all cancers occur in people age 70 and older; 60 percent of all cancer deaths
occur in this specific population.
Goal of Service Learning Project
• To consider the innate connection between the health of one’s
physical, emotional and spiritual body in relation to the stressors of
cancer diagnosis.
• Using Moffitt’s Arts in Medicine Program, demonstrate the
importance of approaching health on a holistic level.
• Participants will gain a deeper understanding of the effectiveness of
Art Therapy/relaxation techniques through evidence based research
and hands on experience.
Healthy People 2020 Objective
• Increase the mental and physical health-related quality of life of cancer survivors

• Art Therapy, through it’s positive, productive distraction has been proven to
reduce stress, pain, fatigue, and anxiety while simultaneously increasing
relaxation, comfort, self-esteem and overall well-being.
• Important to note that Art is a vehicle of expression available to those who
otherwise might be uncomfortable with traditional psychotherapy, or those who
are unable to express them selves with words (ie. Head and Neck Cancer
Art Therapy in Cancer Treatment
• The diagnosis of cancer is often a stressful experience for patients and
family members alike. Pain, fatigue, anxiety & other symptoms are
common in those experiencing cancer.
• Several studies suggest more than 80% of cancer patients use some
form of complementary therapy in conjunction with standard medical
• Art therapy is one of the complementary therapies used to relieve
cancer symptoms.
• Based on the belief that the expressive arts can play a vital role in
health care and in the being of patients and staff alike, offering
calming and humanizing antidote to the stressful environment of
oncology care.
• Reinforces positive coping behavior and increases self-esteem and
encourages a sense of control.

Arts In Medicine Program

• Research shows that creative expression has am impact on body-mind
• Dr. Herbert Benson of Harvard Medical School identifies these
benefits of Art Therapy:
• The Relaxation Response - meditative states such as the creative process bring about
a natural body-mind shift and its related beneficial chemistry that balances and
neutralizes stress responses.
• Remembered Wellness - Accessing positive memories, beliefs, attitudes, and images
initiates a cascade of advantageous body-mind chemistry associated with lower
• The Breakout Principle - Creative problem solving begins with the struggle that gets
results up to the point where stress causes blockage or burn out. Stepping away
from the problem allows brain activity to change, and a moment of clarity or peak
experience happens, moving you to a new plateau of functioning.

Modifications Made Along the Way
• Originally Origami Hearts were planned to be created with my
participants, but with further preparation I realized the instructions
were too complicated and time consuming. I wanted something easy
and inspiring that could be done by those waiting in the waiting room
without any further formal instruction.
• I recalled making Origami wishing stars when I was in grade school.
This proved to be simple enough for children and elders alike with
only a strip of paper( similar to a straw wrapper) needed.
• This alternative was more cost effective and appropriate for my vision.
Implementation & Response
• Presented to 3 nurses and 3 patients.
• Patients reported a sense of positive distraction and recognized the
value of providing these handouts in waiting areas.
• Participants expressed interest and desired to create more as gifts for
family and friends, one stated she would decorate for Christmas
exclusively with Wishing Stars.

• On Thursday I present again to the
Coordinator of Arts in Medicine for
further guidance.
What can be done in future to achieve goal?
• Provide this handout with attached strip of paper to those patients
and family members in hospital waiting rooms throughout Moffitt.
• Inspire creativity and distraction
• Appropriate for ages young and old
• Simultaneously introduce the Arts in Medicine Program to otherwise
unknowing participants.

• Art Therapy is a relatively inexpensive intervention that may have ling lasting
effects by teaching individuals long-term techniques and self-efficacy.
Education of Creative Art Therapy to Cancer
Patients: Evaluation and Effects
• In a study conducted in 2008 the program ‘Cancer and Creative Art’
offered five groups of 35 participants, primarily women with breast
cancer, an opportunity to evaluate the effects of creating art.
• Participants indicated it both served as an experience in personal
growth as well as providing solidarity among the participants.
• Indicated positive changes in coping with their emotions and
awakened the process of ‘conscious living.’
• Supported meaning in their lives as well as improved their general
quality of life.
Relieving Symptoms in Cancer: Innovative Use of
Art Therapy
• A 2006 study conducted by an interdisciplinary research team reports:
• Common symptoms reported by cancer patients include pain, fatigue,
breathlessness, insomnia, lack of appetite, and anxiety
• Statistically significant reductions in these cancer symptoms were
documented with the use of traditional art therapy methods.
• The study found a strong correlation between the use of art therapy and a
significant decrease in pain, tiredness and anxiety.
Pain and Palliative Care Policy
• According to Moffitt’s Mission Statement, ‘We are committed to providing
patients with comprehensive palliative care from the time of diagnosis
throughout the course of illness to help alleviate pain and other symptoms.’
• Psychosocial & Palliative Care Services include:
• Palliative care
• Psychiatric evaluation and treatment
• Psychological testing
• Psychotherapy
• Individual and family counseling
• Support groups
• Nutritional counseling
• Pharmaceutical counseling
• Expressive arts
• Integrative medicine services such as acupuncture, massage, yoga, relaxation
training and guided imagery
American Cancer Society
• Supports the use of Art Therapy as a complimentary treatment
• Stating it helps people express hidden emotions; reduces stress, fear,
and anxiety; and provides a sense of freedom.
• Artwork may also be used as a diagnostic tool, particularly with
• Art therapy is considered safe when conducted by a skilled therapist.
It may be useful as a complementary therapy to help people with
cancer deal with their emotions.
Visser, A. (2008). Education of Creative Art Therapy to Cancer Patients: Evaluation and Effects.
Journal of Cancer Education, 20(8). Retrieved from: http://

Nainis, M. Paice, J. Ratner, J. (2006). Relieving Symptoms in Cancer: Innovative Use of Art.
Therapy. Journal of Pain and Symptom Managment. 31(2). Retrieved from:

Moffitt Cancer Center. (2010). Arts In Medicine. Retrieved from:

American Cancer Society. (2008). Art Therapy. Retrieved from: http://

Healthy People. (2010). Cancer. Retrieved from: http://