Psychosocial Oncology
Psychosocial oncology, also called psycho-oncology, addresses the psychological, social, and behavioural dimensions of cancer for patients and their families. It encompasses the emotional response to diagnosis and treatment, the recognition and care of distress, anxiety, and depression, and the influence of psychological and social factors on coping and wellbeing.
Definition
Psychosocial oncology is the field concerned with the psychological, social, and behavioural aspects of cancer, including the assessment and care of emotional distress and its effects on patients and families.
Scope
This entry covers the scope of psychosocial oncology, the concept and screening of distress, the prevalence of anxiety and depression in cancer, and the integration of psychosocial care into oncology. It is a reference overview and does not provide diagnostic criteria for individuals or treatment recommendations for mental-health conditions.
Core questions
- What psychological and social responses accompany a cancer diagnosis?
- How common are anxiety and depression among people with cancer?
- What is meant by distress, and how is it screened for?
- How is psychosocial care integrated into oncology?
Key concepts
- Distress as the sixth vital sign
- Anxiety, depression, and adjustment disorder in cancer
- Screening for psychological distress
- Coping and adjustment
- Family and caregiver impact
- Integration of psychosocial care into oncology
Clinical relevance
Anxiety, depression, and broader distress are common across the cancer trajectory and among survivors, and meta-analyses document their substantial prevalence (Mitchell, 2011; Mitchell, 2013). Guidelines describe screening for and addressing these symptoms as part of comprehensive cancer care (Andersen, 2014; IOM, 2008). This entry summarises the field for orientation and is not a basis for diagnosing or treating mental-health conditions in individuals.
Epidemiology
Meta-analyses of interview-based studies estimate that a meaningful proportion of patients in oncological, haematological, and palliative-care settings meet criteria for depression, anxiety, or adjustment disorder, with combined mood disorders affecting a large share (Mitchell, 2011); elevated anxiety and depression also persist among long-term survivors relative to comparison groups (Mitchell, 2013).
Evidence & guidelines
The Institute of Medicine's 2008 report Cancer Care for the Whole Patient framed psychosocial care as a standard component of cancer care, and professional guidelines address screening, assessment, and care of anxiety and depressive symptoms in adults with cancer (Andersen, 2014).
History
Psycho-oncology emerged as a distinct field in the latter twentieth century, associated with the work of Jimmie Holland and colleagues, as attention turned to the emotional and social experience of cancer. The framing of distress as a routinely screened dimension of care and the 2008 Institute of Medicine report consolidated psychosocial care within oncology.
Debates
- How should distress screening be implemented?
- While distress screening is widely endorsed, questions persist about which tools to use, how to ensure screening leads to effective referral and care, and whether routine screening improves outcomes.
Key figures
- Jimmie Holland
- Alex Mitchell
- Barbara Andersen
Related topics
Seminal works
- iom-2008-psychosocial
- mitchell-2011
- andersen-2014
Frequently asked questions
- What is 'distress' in psychosocial oncology?
- Distress is a broad term for the unpleasant emotional, psychological, social, or spiritual experience that can accompany cancer, ranging from normal worry and sadness to disabling anxiety, depression, or crisis; it is often promoted as a dimension to be screened routinely.
- Does psychosocial care concern only the patient?
- No. Psychosocial oncology also attends to the impact of cancer on families and caregivers, whose wellbeing and coping are part of the field's scope.