Psychology has played, and will continue to play, a critical role in cancer prevention, treatment and control, according to the flagship journal of the American Psychological Association.
In a special issue of American Psychologist entitled "Cancer and Psychology," researchers review the many contributions of psychological science to cancer research, screening, medical adherence, prevention and quality of life, among other related topics. The issue highlights the discoveries and accomplishments that have rooted the psychological sciences as one pillar of cancer control research, practice and policy.
"Up to one-third of the annual cancer diagnoses in the U.S. are attributable in part to risk factors like tobacco use, obesity, physical inactivity and poor nutrition," according to Paige Green McDonald, PhD, MPH, one of the three scholarly leads on the issue. "Psychological science and evidence-based practice are making important contributions to address the pressing needs of people with cancer."
The other scholarly leads on the issue were Russell Glasgow, PhD, with the University of Colorado School of Medicine, and Jerry Suls, PhD. Suls and Green McDonald work for the Behavioral Research Program in the Division of Cancer Control and Population Sciences at the National Cancer Institute.
"As evidence linking certain behaviors to cancer risk and outcomes accumulated, psychology emerged as a 'hub science' in the nation's cancer control program," according to the article "Cancer Control Falls Squarely Within the Province of the Psychological Sciences." Psychology helps people learn to modify unhealthy behaviors that can lead to disease, and enhances the lives of people who have survived or are living with cancer.
Among the other articles in the special issue:
"Fostering Multiple Healthy Lifestyle Behaviors for Primary Prevention of Cancer," by Bonnie Spring, PhD, Northwestern University Feinberg School of Medicine; Abby King, PhD, Stanford University; Sherry Pagoto, University of Massachusetts-Worcester; Linda Van Horn, PhD, Northwestern University Feinberg School of Medicine; and Jeffrey Fisher, PhD, University of Connecticut
The odds of developing cancer are increased by behaviors such as smoking, excess alcohol use, physical inactivity, risky sexual behaviors and inadequate sun protection. These behaviors are largely absent in childhood, but emerge and tend to cluster over the lifespan, according to the authors. Even though these risk behaviors are modifiable, few are diminishing in the population over time. The authors review the prevalence and distribution of these behaviors and describe effective or promising healthy lifestyle interventions targeted to the individual, the sociocultural context, or environmental and policy influences.
"Screening for Prevention and Early Diagnosis of Cancer," by Jane Wardle, PhD, University College London; Kathryn Robb, PhD, University of Glasgow; Sally Vernon, PhD, University of Texas School of Public Health at Houston; and Jo Waller, PhD, University College London
Cancer screenings have become a rite of passage in modern health care. Examinations such as the Pap test and colonoscopy can detect disease before any symptoms are manifest. For other cancers -- such as breast, prostate, lung and ovarian -- screening can improve outcomes by early diagnosis. However, screening poses risk-benefit considerations for patients. Psychological research can shed light on decision-making processes and help develop strategies to promote greater use of screening, according to the authors.
"Life After Diagnosis and Treatment of Cancer in Adulthood: Contributions From Psychosocial Oncology Research," by Annette L. Stanton, PhD, University of California, Los Angeles; Julia H. Rowland, PhD, National Cancer Institute; and Patricia A. Ganz, MD, University of California, Los Angeles
As cancer patients transition to cancer survivors, they encounter distinct psychosocial challenges. Survivors -- an estimated 13.7 million in the U.S. today -- face the loss of the supportive treatment milieu and lingering effects of treatment. With expanding attention to the psychosocial and physical consequences of surviving illness, psychological science and evidence-based practice are making important contributions to addressing the pressing needs of cancer survivors. In this article, the authors describe the major psychosocial and physical conditions survivors face, along with promising treatments.
"The Integration of Psychology in Pediatric Oncology Research and Practice: Collaboration to Improve Care and Outcomes for Children and Families," by Anne E. Kazak, PhD, Nemours Children's Health System and Thomas Jefferson University, and Robert B. Noll, PhD, University of Pittsburgh
Childhood cancers are life-threatening diseases that are universally distressing and potentially traumatic for children and their families. For more than 35 years, pediatric psychologists have partnered with pediatric oncology teams to help understand the impact of cancer and its treatment on children and families. After discussing the incidence of cancer in children, its causes and the treatment approaches to pediatric oncology, the authors present seven key contributions of psychologists to collaborative and integrated care in pediatric cancer: managing pain, nausea and other symptoms; understanding and reducing neuropsychological effects; treating children in the context of their families and other systems; applying a developmental perspective; identifying competence and vulnerability; integrating psychological knowledge into decision-making and other clinical care issues; and facilitating the transition to palliative care and bereavement, when necessary.
"Decision Making and Cancer," by Valerie F. Reyna, PhD, Cornell University; Wendy L. Nelson, PhD, National Cancer Institute; Paul K. Han, MD, Maine Medical Center; and Michael P. Pignone, MD, University of North Carolina at Chapel Hill
The authors review decision-making along the cancer continuum in the context of a system where patients are encouraged to take a more active role in their health care. They discuss challenges to achieving informed and shared decision-making, including cognitive limitations and emotional factors, but argue that understanding the mechanisms of decision-making offers hope for improving decision support.
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