Psychosocial and Behavioral Issues in Cancer Psycho-Oncology Psychosocial and Behavioral Issues in Cancer

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

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

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

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..

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

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

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 F’s & V’s (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

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

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?

Stress and possible effects on cancer Stressful events suppress: cancer-fighting NK cells, B cells, etc. the body’s ability to repair DNA errors (during cell division) Stress may also negatively impact health behaviors and adherence to treatment

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

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)

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 I’m glad I have cancer…” Specific coping skills Counterconditioning for nausea Pain management Coping with sexual dysfunction (e.g., post-prostatectomy)