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Psychiatric aspects of cancer 

Psychiatric aspects of cancer
Chapter:
Psychiatric aspects of cancer
Author(s):

Jimmie C. Holland

and Jessica Stiles

DOI:
10.1093/med/9780199696758.003.0143
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date: 10 December 2019

Psycho-oncology addresses the two major psychiatric and psychological dimensions of cancer: first, the responses of patients and their families at all stages of disease and the psychological stresses on health professionals delivering their care. The patient and physician relationship, dependent on effective communication, impacts the care of all patients, at every visit, at all sites and stages of cancer, and during all treatments. The second dimension addresses the psychological, behavioural, and social factors that influence cancer risk, detection, and survival. Many cancer centres and hospitals now have multi-disciplinary psychosocial teams consisting of clinicians and clinical investigators from psychology, psychiatry, social work, nursing, and clergy. These teams provide consultation for patients and their caregivers, psychosocial education for oncology staff, and collaboration in studies in which quality of life is important. In addition, active research in brain, immune, and endocrine links is occurring, particularly in the mechanism of cytokines in producing ‘sickness behaviour’ that may provide a biological basis for common symptoms of fatigue, depression, anxiety, weakness, and cognitive chances in cancer patients. Despite the fact that many cancer centres and oncology divisions now have a psycho-oncology or psychosocial unit, only a few centres have programmes that include both research and training. This chapter describes the common psychiatric disorders and psychosocial challenges experienced by cancer patients and the range of interventions available.

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