Group Mental Health Program Shows Promise for People Facing Incurable Blood Cancer

Multiple myeloma is one of medicine’s most psychologically punishing diagnoses. The incurable blood cancer, which arises from plasma cells inside the bone marrow, follows a relapsing and remitting course that forces patients into endless cycles of toxic therapy, monitoring scans and prognostic uncertainty. Roughly half of newly diagnosed patients report clinically significant symptoms of anxiety or depression, while those with the precursor condition, smouldering multiple myeloma, carry a different but equally heavy burden: they are told they have a malignant condition yet must simply watch and wait until the disease progresses before treatment can begin. Now, a team of Australian researchers has taken a deliberately humble but potentially transformative step, pilot-testing whether an existing, evidence-based mental health program can be adapted to serve this uniquely distressed population, with patients themselves guiding every stage of the process.

The study, published in Supportive Care in Cancer, was led by Natalie Tuckey of the South Australian Health and Medical Research Institute and Adelaide University, working in partnership with the advocacy organisation Myeloma Australia. Rather than designing a bespoke intervention from scratch, the team chose to evaluate an existing program called the Be Well Plan, a group-based mental health and wellbeing course typically delivered live over five weekly sessions. The program draws on techniques from cognitive behavioural therapy, acceptance and commitment therapy, mindfulness practices and positive psychology, all distilled from a systematic review of what genuinely improves mental wellbeing. Participants learn about thirty evidence-based activities and then build a personalised wellbeing plan, supported by a tracking tool that gives them feedback on their own resilience, strengths and distress.

Crucially, the researchers deferred any myeloma-specific adaptation until after the feasibility testing, a decision grounded in implementation science. The Be Well Plan had already been tested successfully in university students and, in a previous pilot by the same group, in women with breast cancer, where it showed clear mental health benefits. Before launching the myeloma pilot, the team consulted consumer advocates, specialist nurses, experts in culturally and linguistically diverse populations and mental health program designers, who agreed the intervention was likely suitable as delivered. The logic was that real-world feedback from actual patients would reveal refinements that a priori co-design could not anticipate, increasing the likelihood that a future adapted program would be accepted, implemented and sustained in clinical practice.

Twenty consumers aged between 38 and 72 took part, sixteen with multiple myeloma and four with smouldering myeloma, alongside four Myeloma Australia nurses who joined the sessions to inform future delivery. Recruitment ran for four weeks, drawing thirty-seven expressions of interest, of whom twenty-four completed baseline questionnaires. Twenty attended at least one session, averaging 4.2 of the five planned sessions, and all five sessions were delivered as planned via Zoom by a clinical psychologist and certified facilitator. The nurses were placed in separate breakout rooms during peer discussions so that patients could speak freely. Notably, more than half of those who withdrew before starting were from rural or regional areas, a signal the authors flag as a critical accessibility issue for future rollouts.

The quantitative results, while preliminary, were striking. Using a repeated measures multivariate analysis of variance across seventeen participants who completed both pre- and post-intervention measures, the team found a significant multivariate effect of time, with follow-up univariate tests revealing large improvements in mental wellbeing, measured on the Warwick-Edinburgh Mental Wellbeing Scale, and in empowerment, assessed with a modified health empowerment scale. Wellbeing scores rose from an average of 49.42 to 53.21, and empowerment scores climbed from 22.58 to 24.95, with partial eta squared values of 0.24 and 0.25 respectively, both well above the conventional threshold of 0.14 for a large effect. Changes in anxiety and depression, measured with the GAD-7 and PHQ-9, did not reach statistical significance, but their effect sizes fell in the medium to large range, suggesting that a properly powered trial may yet detect meaningful reductions in clinical symptoms.

One finding illustrates the messy reality of psychosocial research in cancer populations. The results proved sensitive to a single participant who experienced a substantial health decline during the intervention period, dragging down the group’s mental health outcomes. When exploratory analyses were repeated with that individual removed, all four outcomes showed significant, large effect size improvements. Yet the same participant continued attending the program and reported finding value in it, a paradox the authors say highlights why future trials must plan for the physical health fluctuations that are inevitable in this population. In a disease where bone pain, fatigue and chemotherapy-related cognitive fog can strike without warning, even the most carefully designed psychological study must accommodate the body’s unpredictability.

The qualitative arm of the study, analysed through inductive thematic analysis of focus groups, interviews and survey free-text responses, yielded three central themes. The first was the power of peer connection: patients described moving from distress and anger toward acceptance and gratitude, and valued meeting others living with the same condition, even when they were at very different disease stages. One participant noted that someone might suggest an approach you had never considered, helping your days get better. The second theme was the need for myeloma-specific content, with patients calling for clearer disease psychoeducation, simplified materials and better pacing, with one respondent pointing out that chemotherapy fog affecting concentration is a real thing and that bone pain or severe fatigue can make attending sessions extremely difficult.

The third theme concerned implementation: how the program should be delivered, by whom, and how it could be woven into routine myeloma care rather than offered as a separate service. Patients and nurses alike emphasised promotion by specialist nurses, collaboration with rehabilitation services and alignment with organisations such as Myeloma Australia. They also acknowledged risks, including potential distress for participants and emotional burden for facilitators, underscoring the need for structured facilitator support and clear strategies for managing group dynamics and sensitive content. Interestingly, the authors caution that the program must not drift into becoming purely a peer support group, since some participants preferred to focus on mental health strategies rather than hear detailed personal stories, which occasionally caused them distress.

Satisfaction with the program was encouraging, with 79 percent of respondents reporting they were satisfied or very satisfied, and nearly three-quarters saying the content presented new information most of the time. However, 36.9 percent indicated the program was not relevant to them some or most of the time, a figure that directly motivates the planned myeloma-specific adaptation. The study’s limitations are candidly acknowledged: the one-arm pre-post design without randomisation or a control group precludes causal inference, the sample was small and entirely self-selected among Caucasian and European consumers who expressed interest in research, and there was no long-term follow-up to determine whether gains persisted. The authors are explicit that these findings establish feasibility and identify necessary adaptations, not clinical effectiveness.

What makes the study notable is its methodological honesty and its commitment to consumer-informed research, an approach that remains inconsistently executed across health research despite widespread endorsement. By involving patients from the initial forums that identified the gap in myeloma mental health support through to the final review of themes, and by including both multiple myeloma and smouldering myeloma patients in recognition of their shared psychosocial challenges across the disease continuum, the team has built a foundation for a program designed to resonate with its intended audience. The next step is a co-designed, myeloma-tailored version of the Be Well Plan, tested in a larger randomised controlled trial with longer follow-up. For a patient population facing an incurable disease, the message from this pilot is quietly hopeful: psychological support built with patients, not just for them, can move the needle on wellbeing and empowerment, and the roadmap for proving it at scale now exists.

Subject of Research: Feasibility of a consumer-informed mental health program for people with multiple myeloma and smouldering myeloma

Article Title: Adapting a mental health program for people with multiple myeloma and smouldering myeloma: a consumer-informed feasibility study

Article References: Tuckey, N., Iasiello, M., Cantley, M., van Agteren, J., Beer, H., Fassnacht, D. B., Ramsey, I., Edney, L. C., Moussa, R. S., Grundy, L., Ryan, M., Ali, K., & Wardill, H. R. (2026). Adapting a mental health program for people with multiple myeloma and smouldering myeloma: a consumer-informed feasibility study. Supportive Care in Cancer, 34(10), Article 937. https://doi.org/10.1007/s00520-026-11163-2

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11163-2

Keywords: multiple myeloma, smouldering myeloma, mental health, wellbeing, consumer-informed research, psycho-oncology, Be Well Plan, feasibility study, empowerment, anxiety, depression, implementation science