Original PaperPsycho-oncology: where have we been? Where are we going?
Introduction
Over the past 20 years, psycho-oncology has developed as one of the subspecialities of oncology. This area deals with the two psychological dimensions of cancer: the patients', families' and staff's emotional reactions to cancer and its treatment (psychosocial); and the psychological and behavioural factors that influence cancer risk and survival (psychobiological) [1].
This has occurred as interest in the ‘human side’ of patients with cancer has increased. The dimensions dealing with the psychological, social, and spiritual were neglected for many years in most countries around the world. The focus was almost totally on the physical aspects of care. Patients' psychosocial problems were usually not addressed in their care. Suffering from unrecognised anxiety and depression was common: confusional states, common with opioid management of pain and vital organ failure, were often not diagnosed and were, therefore, untreated.
Through the activities of a few teams devoted to the psychosocial area around the world, psycho-oncology has become a recognised area of oncology and oncologic research [2]. It is called both psycho-oncology and psychosocial oncology, depending on preference. In Europe, the term psychosocial has been more widely used. However, the area—the ‘human’ side of cancer—is the essence of its concerns.
Section snippets
Historical perspective: where have we come from?
The word cancer was equated with death for centuries because there was no treatment for it until surgical removal became possible after the introduction of anaesthesia in the last half of the nineteenth century (Table 1). The disease was so frightening that the diagnosis was withheld from the patient. It was considered cruel to reveal it, so only the family was given the facts. This has been called the ‘conspiracy of silence’ which left the patient feeling isolated and alone. The result was a
The future challenges: Where are we going?
The new millennium provides a superb opportunity to review our experience and to look forward to directing the field in the most useful way. In terms of clinical services, the traditional focus of psycho-oncology has been at the time of diagnosis and while receiving active treatment. It is important to extend our focus: to survivors, palliative care; and to the ‘worried well’: people who are healthy but recognise that they have a high risk of developing cancer by virtue of genetic risk,
References (10)
- et al.
Posttraumatic stress disorder in mothers of pediatric cancer survivors
Psychosomatics
(1996) - Holland JC. Principles of psycho-oncology. In Holland JF, et al., eds. Cancer Medicine, 3rd edn. Baltimore, Williams...
Psycho-oncologyits aims, achievements and future task
Psycho-oncology
(1994)- et al.
Rapid screening for psychologic distress in men with prostate carcinoma
Cancer
(1998) - et al.
Screening for adjustment disorders and major depressive disorders in cancer patients
Br. J. Psychiatry
(1990)
Cited by (53)
Quality of life in caregivers of melanoma patients
2022, European Journal of DermatologyPsychological Factors and Survivorship: A Focus on Post-treatment Cancer Survivors
2022, Psychological Aspects of Cancer: a Guide to Emotional and Psychological Consequences of Cancer, their Causes, and their Management, Second EditionEmerging Psycho-oncological Unmet Needs of Breast Cancer Patients
2022, Hong Kong Journal of Radiology