Psychooncology

Psychooncology a subspecialty of oncology that deals with the psychological, social, behavioral, and ethical aspects of cancer. The subject focuses on the emotional dynamics of cancer. It deals with how a patient and his or her family respond to cancer and how psychosocial attitudes may influence the disease process.

Cancer is a vicious disease. The history of psychooncology goes back to times when cancer was first diagnosed. It was considered heartless to tell the patient of his or her disease diagnosis, while the family was told. Furthermore, investigating the feelings of a patient with cancer was an impossible task due to prevailing conservative attitudes. After World War II, peoples’ attitudes changed and there was a widespread upheaval of human rights, including those of patients'. The legal importance of informed consent from patients could not be overemphasized. However, ever since treatment options improved for patients, better prognosis due to better drugs helped patients share their experiences. Furthermore, groups of treated patients talked to those being treated. This promoted an encouraging environment for counseling of cancer patients.

Finally, in 1960s the ice broke, and the idea of “do not tell the patient” was challenged. The patient had a right to know what was wrong with him or her if he or she had cancer. Surveys took place, and after a long debate of oncologists in opposition of the idea, the psychiatrists won. It was unanimously decided that the patient must be told his or her diagnosis.

Psychooncology is an area of multidisciplinary interest and has boundaries with the major specialties in oncology. A cancer diagnosis results in a major psychological impact on the patient and his or her family. Reinforcement of a social support system is necessary to help these patients cope with stresses and optimize treatment. The patients often are reported to develop psychiatric disorders, causing suicidal behavior, depression, and anxiety. Furthermore, chemotherapy itself has considerable side effects of nausea, diarrhea, indigestion, idiosyncratic reactions, hair loss, and sterility. Patients must be cooperative during therapy for a better prognosis.

The psychiatry department at most hospitals plays a substantial role in dealing with the psychological handling of chronic diseases. Cancer treatment has an integrative approach using an oncologist and a psychiatrist. Counseling, medication management, pain management, and palliative care all are provided by professionals specializing in these areas.

Several recent research articles highlight that behavioral abnormalities in cancer patients have more than an emotional reason to them. Significant [Page 1446]amount of current literature focuses on how cancer progression is associated with neurochemical disorders in the brain. Stress and depression have been associated with increasing tumor frequency. Advanced cancer patients have also been shown to have diminished pineal function.

Whether the neurochemical alterations are psychosomatic or vice versa, the psychiatric aspects of this disease are intriguing and pivotal in improving the quality of life of any patient with cancer.