Evidence based

The one-minute test – how measurement of one minute can help in treatment of cancer

The first in the world unique survey in the field of Psycho-Oncology, recognized by the most prestigious world congresses and uniting private, state and municipal hospitals.

Jul 18, 2019 |
5 min read

Albert Einstein’s contributions to science have long been commended. It’s his theory of relativity that remains his legacy, however. The man himself summed it best with arguably his most famous quote;

“Put your hand on a hot stove for a minute, and it seems like an hour. Sit with a pretty girl for an hour, and it seems like a minute. That’s relativity.”

The dubious politics of this statement are a little harder to swallow in the 21st Century. All the same, anybody can surely relate to Einstein’s thinking. Visualize yourself in the waiting room at the dentist, anticipating a root canal.

Think back to when you were a child, watching the clock tick agonizingly slowly on Christmas Eve. Imagine that you’re on hold to your telecoms provider, waiting to be connected and resolve an issue with your online connection.

While time is an invariable construct, moments can feel like hours in these instances. Naturally, however, these slightly flippant experiences are nothing compared to the anguish of an oncology patient. For anybody unfortunate enough to be battling cancer, it’s a period of emotional and physical distress that feels like an eternal struggle.

It only takes a minute

This is fed into the thinking of Dr. Ivan Shterev Donev, of the Medical University of Varna, who currently works for Clinic of Medical Oncology, MHAT “Nadezhda.” Dr. Donev wrote an enlightening paper on the correlation between time and distress in patients undergoing chemotherapy. The results have provided the opportunity to assess the psychological condition of oncology patients without the need for intrusive tests.

In a paper entitled, “One-minute time interval estimation as a novel ultrashort tool for distress screening,” published in the journal “Supportive Care in Cancer”, Dr. Donev surveyed 262 chemotherapy patients.

The intention was to measure the concept of time experienced by these individuals, alongside the level of distress they were negotiating. Dr. Donev defined distress as wholly understandable emotional sensations of fear and sadness, right through to clinical diagnoses of depression, anxiety.

It is a common belief that distress negatively impacts cancer treatment. The impact that such emotional turmoil places upon a patient’s quality of life are apparent. Also, however, distress provides a direct correlation to other problems.

A patient in a state of emotional anguish is less likely to think clearly, and thus may struggle to adhere to a strict medication schedule. It can also harm the doctor-patient relationship, leading to dissatisfaction with treatment.

Assessing distress

Dr. Donev assembled patients undergoing chemotherapy treatment that volunteered to take part in his study. These patients were a cross-section of Bulgarian society, including a range of genders, age groups, religions, and marital statuses. Also, the patients were seeking treatment for a variety of different cancers, with their diagnoses varying from Stage II through to Stage IV.

The distress of these patients was measured using the DT score. This test measures an individual’s emotional state on a scale of 0 (not distressed at all) to 10 (a state of heightened emotional trauma) based on a series of questions.

The individuals were divided into two groups. Those that scored 0 – 3 on the DT score were declared Low Distress, and anybody that ranked 4 or higher was dubbed High Distress.

The groups were very close in size; 51% of the patients were identified as High Distress, with a median DT score of 6.45.  It was discovered that female patients tended toward a higher stress score than males, and younger patients were likelier to score higher than their older counterparts.

Once these groups had been assigned, Dr. Donev made use of a simple stopwatch. He asked the patients to tell him when they felt that one minute had elapsed. The passing of sixty seconds is non-negotiable; the stopwatch told Dr. Donev everything he had to know. The assessment of this period, however, varied between patient groups.

Dr. Donev study found that patients with high levels of distress found to move faster than those with lower distress levels. Rather than time crawling by, those living in a heightened sense of emotional anguish felt that it was slipping through their fingers.

Clearly, when we fear that our time on earth may be cut short, the human condition is to worry that it will be taken from us before we are ready to say goodbye.

The outcome of the experiment

Dr. Donev had the following to say about his study.

What was the purpose of the work, though? Dr. Donev wasn’t simply experimenting on oncology patients for his own amusement. He discussed a second study into this topic at the ASCO 2019 Annual Meeting, entitled, “One-minute time interval estimation as a novel potent indicator of need for help in cancer patients prior to starting chemotherapy.”

As the name suggests, this study is designed to aid oncology patients. Dr. Donev used his findings to provide insight into whether – and if so, when – a patient may require additional help and support from healthcare professionals.

Chemotherapy is one of the most traumatic experiences that a human body or mind can experience. As discussed, high levels of emotional distress can make a testing time even tougher to negotiate. Unfortunately, while patients are already feeling vulnerable, they may be reluctant to concede this requirement for further assistance.

Based on the data compiled by Dr. Donev’s tests, the emotional state of an oncology patient can now be assessed with a simple stopwatch. Evaluating how long individual estimates it takes for 60 seconds to elapse can be a crucial indication into their emotional well-being.

Patients with high anxiety had a tendency to estimate a minute to last around 40 seconds. Those with lower levels of distress would allow as long as 90 seconds to elapse.

A glimpse into the future

This may prove to be invaluable in the battle against cancer. If a patient is reluctant to answer direct questions about their emotional and mental health, assessments can still be made using Dr. Donev’s ‘minute test’. If their reaction suggests they are living in a state of heightened distress, further support can be provided – without the patient compromising their sense of self by asking for help.

Such insights may save lives. The risks of suicide in young cancer patients were discussed at the same annual meeting, and Dr. Donev’s approach can provide an opportunity to reduce these unwelcome statistics.

Besides, additional support will reduce an individual’s distress levels, and further boost their chances of making a full recovery.

It turns out that, as smart a man as he was, Albert Einstein didn’t know everything. His theory of relativity does not necessarily stand up to scrutiny in the case of oncology patients, and the battle that lies ahead of them.

Fortunately for these courageous individuals, medical science has found a new theory to support them throughout their journey. It takes just one minute to change a patient’s life forever.

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