CHAPTER 12
Psychosocial Oncology
ARTHUR M. NEZU, CHRISTINE MAGUTH NEZU, STEPHANIE H. FELGOISE, AND MARNI L. ZWICK
267CANCER: A BASIC PRIMER 267
Cancer Statistics 268
Staging Cancer 269
Cancer Treatment 269
BEHAVIORAL RISK FACTORS 270
Smoking 270
Alcohol 270
Diet 270
Sun Exposure 270
Socioeconomic Status 271
Personality 271
Summary 271
PSYCHOSOCIAL EFFECTS OF CANCER 271
Prevalence of Psychiatric Disorders 271
Depression 272
Anxiety 272
Suicide 273
Delirium 273
Body Image Problems 273
Sexual Functioning Difficulties 273
Psychological Issues among Terminal Patients 274
Psychological Responses to Specific
Cancer Treatments 274
Summary 275
PSYCHOSOCIAL FACTORS INFLUENCING THE
IMPACT OF CANCER 276
Coping 276
Social Support 277
Summary 278
PSYCHOSOCIAL INTERVENTIONS FOR
CANCER PATIENTS 278
Educational Interventions 278
Cognitive-Behavioral Interventions 279
Group Therapy Approaches 281
Telephone Counseling 281
Effects of Psychosocial Interventions on
Health Outcome 281
Effects of Psychosocial Interventions on
Immune Functioning 282
Prevention Issues 283
Summary 283
FAMILY AND CAREGIVER ISSUES 283
Impact of Cancer on Caregivers 284
Psychosocial Interventions for Caregivers 284
Summary 285
SUMMARY AND FUTURE DIRECTIONS 285
REFERENCES 286Like most wars, the •war on cancerŽ leaves casualties, scars,
and lives in need of healing in its wake. It has only been re-
cently that the community of health and mental health pro-
fessionals has focused on the psychosocial needs of cancer
patients and their families. An increasing awareness of the
signi“cant emotional, interpersonal, family, vocational, and
functional problems experienced by such individuals, and
how these problems potentially impact on their overall health
quality of life and even health outcome, has led to the
creation of the “eld of psychosocial oncologyorpsycho-
oncology.According to Holland (1990), the two major areas
of interest characterizing this cancer subspecialty involve:
•(a) the impact of cancer on the psychological function of the
patient, the patient•s family, and staff; and (b) the role that
psychological and behavioral variables may have in cancer
risk and survivalŽ (p. 11). In addition, an important out-
growth of these areas of scienti“c inquiry involves develop-
ing and evaluating the ef“cacy of psychosocial interventions
geared to improve a cancer patient•s quality of life (Baum &
Andersen, 2001; A. Nezu, Nezu, Freidman, Faddis, & Houts,
1998). This chapter provides an overview of this “eld, begin-
ning with a brief description of cancer itself.CANCER: A BASIC PRIMERThe wordcancerwas “rst used to describe various types
of tumors by the Greek physician, Hippocrates. In Greek,
words such ascarcinosandcarcinomarefer to a crab and
initially described tumors that were probably due to the