The prevalence of cancer
In 1991, it was reported that there were 6 million new cases of cancer in the world
every year, and that one-tenth of all deaths in the world are caused by cancer. In 1989,
it was reported that cancers are the second leading cause of death in the UK and
accounted for 24 per cent of all deaths in England and Wales in 1984 (Smith and
Jacobson 1989). The main causes of cancer mortality among men in England and Wales
are lung cancer (36 per cent), colorectal cancer (11 per cent), prostate cancer (9 per
cent); and among women are breast cancer (20 per cent), lung cancer (15 per cent),
colorectal cancer (14 per cent), ovarian cancer (6 per cent), cervical cancer (3 per cent).
While the overall number of cancer deaths do not appear to be rising, the incidence of
lung cancer deaths in women has risen over the past few years.
The role of psychology in cancer
A role for psychology in cancer was first suggested by Galen in 200 – 300, who argued
for an association between melancholia and cancer, and also by Gedman in 1701, who
suggested that cancer might be related to life disasters. Eighty-five per cent of cancers
are thought to be potentially avoidable. Psychology therefore plays a role in terms,
attitudes and beliefs about cancer and predicting behaviours, such as smoking, diet and
screening which are implicated in its initiation (details of these behaviours can be found
in Chapters 2, 5, 6, 7, 8 and 9). In addition, sufferers of cancer report psychological
consequences, which have implications for their quality of life. The role of psychology in
cancer is also illustrated by the following observations:
Cancer cells are present in most people but not everybody gets cancer; in addition
although research suggests a link between smoking and lung cancer, not all heavy
smokers get lung cancer. Perhaps psychology is involved in the susceptibility to
cancer.
All those who have cancer do not always show progression towards death at the same
rate. Perhaps psychology has a role to play in the progression of cancer.
Not all cancer sufferers die of cancer. Perhaps psychology has a role to play in
longevity.
The potential role of psychology in understanding cancer is shown in Figure 14.2.
The role of psychology in cancer will now be examined in terms of (1) the initiation
and promotion of cancer; (2) the psychological consequences of cancer; (3) dealing with
the symptoms of cancer; and (4) longevity and promoting a disease-free interval.
The psychosocial factors in the initiation and promotion of cancer
1 Behavioural factors. Behavioural factors have been shown to play a role in the
initiation and promotion of cancer. Smith and Jacobson (1989) reported that 30 per
cent of cancers are related to tobacco use, 35 per cent are related to diet, 7 per cent
HIV AND CANCER 339