Psycho-Oncology

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Psycho-Oncology

• Psychosocial and Behavioral Issues in Cancer

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Psycho-Oncology

• Psychosocial and Behavioral Issues in Cancer
• I. Intro
• II. Etiology
• III. Prevention and Intervention
• IV. Adjustment to Cancer

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What Is Cancer?

• Cancer
• A set of diseases (neoplasms) in which abnormal
  body cells multiply and spread forming a tumor.
• In the U.S.,
• gt1,000,000 new diagnoses each year
• 2nd leading cause of death
• 1 in 2 men 1 in 3 women will get cancer

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Estimated New Cancer Cases and Deaths
What are most common and most deadly cancers?
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Increasing incidence

• Cancer continues to increase in incidence and
  prevalence throughout the world
• improved methods of diagnosis
• more widespread efforts at early detection
• people are living longer, giving more years for
  cancer to develop
• increase in cancers stemming from AIDS, exposure
  to the sun, pesticides, diet, etc..

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II. Psychosocial Behavioral factors in etiology

• A. Psychosocial
• Personality
• Social Support
• Depression
• not a lot of evidence for psychosocial
  etiological factor
• B. Behavioral
• Tobacco
• Diet
• Toxic exposure (e.g., radiation from sun, toxic
  chemicals like asbestos, etc.)
• Physical activity

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Tobacco Use

• responsible for 90 of lung cancers
• also linked to cancers of the mouth, pharynx,
  larynx, esophagus, pancreas, cervix, kidney, and
  bladder

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Risk Factors for Cancer

• Diet
• a primary factor in one-third of all cancer
  deaths, (lung, colon, bladder, stomach, rectum,
  breast cancer)
• Reduce saturated fats, particularly animal fats
• Increase Fs Vs (colorful diet! Soy?)
• Nurses Health Study women who consumed 5 or more
  servings of fruits and vegetables were 23 less
  likely to develop breast cancer

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Risk Factors Physical Activity

• Overall physical activity levels negatively
  correlated with colon cancer in both women and
  men
• Nurses Health Study Physically active women
  have lower rates of breast cancer than do
  sedentary women

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III. Psychosocial Behavioral factors in
prevention and intervention

• Personality
• Avoidant, repressive coping style correlated with
  poor disease course
• Social Support
• Assoc w/ longer survival
• Group support interventions
• Screening techniques
• Breast self-exams?
• Mammography?
• Stress
• Animal studies (e.g., crowding, inescapable
  shock)
• Humans?

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Stress and possible effects on cancer

• Stressful events suppress
• cancer-fighting NK cells, B cells, etc.
• the bodys ability to repair DNA errors (during
  cell division)
• Stress may also negatively impact health
  behaviors and adherence to treatment

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Cancer Prevention (using skin cancer as ex.)

• Consistent with the health belief model,
  perceived susceptibility to skin cancer is
  positively associated with intentions to protect
  the skin from the sun
• Peer influence is a strong factor in sunscreen
  use, as are image norms for attractiveness and
  style

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IV. Adjusting to cancer

• Distress upon diagnosis
• Disruption to life Depends on
• Type and degree of cancer
• Side effects of illness and treatment
• Personal factors
• coping style (e.g., hardiness challenge,
  commitment, control)
• social support
• life-stage
• Psychosocial interventions (next slide)

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Psychosocial interventions

• Stress management, group support
• Andersen Golden-Kreutz (1997) women with
  metastatic breast cancer who were encouraged to
  discuss their fears showed an 18-month increase
  in survival
• I know it sounds crazy, but Im glad I have
  cancer
• Specific coping skills
• Counterconditioning for nausea
• Pain management
• Coping with sexual dysfunction (e.g.,
  post-prostatectomy)