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

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

3. 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

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

5. 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..

6. 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

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

8. 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

9. 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

10. 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?

11. 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

12. 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

13. 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)

14. 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)