References

American Cancer Society Atlanta, GA, 2005. 2. Ahels, T., Saykin, A., Furstenberg, C., et al. Quality of life of long-term survivors of breast cancer and lymphoma treated with standard-dose chemotherapy or local therapy. J. Clin. Oncol. 2005 23(19) 4399-405. 3. Gotay, C.C., and Muraoka, M.Y. Quality of life in long-term survivors of adult-onset cancers. J. Natl. Cancer Inst. 1998 90(9) 656-67. 4. Dorval, M., Maunsell, E., Deschenes, L., Brisson, J., and Masse,...

Existential and Spiritual Issues

Considering existential issues, a heightened awareness of mortality and death is typically evoked in persons diagnosed with cancer. But rather than being a wholly traumatic experience, cancer can signal a life transition offering the possibility of both positive and negative psychosocial outcomes. Many people diagnosed with cancer describe personal growth consequent to their illness experience.29 Those impacted by challenging life events like cancer often perceive associated benefits such as...

Cancer Survivor Programs In Other Countries

Following the establishment of registries to help quantify the actual number of their populations identified with cancer, many countries have begun to develop comprehensive cancer care centers (e.g., Sweden, France, Germany), however, as previously mentioned most continue to be focused on the diagnosis and treatment of the condition, with some just beginning to broaden their focus to include cancer survivors in their care networks. As noted earlier, the health care systems in Europe, Canada,...

Determinants Of Exercise In Cancer Survivors

Given the low exercise participation rates in many cancer survivor groups both during and after treatments, researchers have turned their attention to understanding the determinants of exercise in cancer survivors. Most early research was descriptive and atheoretical, selecting various demographic, medical, and psychosocial constructs to test as correlates and predictors of exercise behavior. Most recent research has applied one of the currently validated social cognitive models of human...

Understanding Processes Of Loss And Change

Much of patients' and families' experience of living with advanced cancer can be understood as coming to terms with a series of losses. These losses may be related to many aspects of a person's life, for example, their functional ability such as to walk unaided, to talk, and to be continent. In some types of cancer, such as cerebral tumors or those with cerebral metastasis, intellectual function may be compromised or lost and emotional expression may be blunted or emotional control may be lost....

The Challenges

The chapters in this book provide a foundation for current research and practice in many areas that impact cancer survivors. Much of this work has evolved over the past decade with the support of federal agencies, and other public and private organizations around the world. The hard work of many is beginning to come to fruition. Although momentum has significantly increased, particularly in the past decade, it is clearlyjust the beginning. This early work forms a very important base. However, a...

A

Activities of daily living, 133, 215, 250-51, 370 adaptation to advanced cancer (AC). See also Living with Advanced Cancer memory and attention adaptation training adaptive tasks of individuals living with AC financial and legal issues, 218 interpersonal demands, 215-17 physical and medical demands, 213-14 practical issues, 217-18 psychological demands, 214-15 spiritual and existential concerns, 217 individuals living with advanced cancer (AC), 211-12 prognosis of , 212 treatment of, 212 adult...

Abdominal Surgery

Any abdominal surgery, whether for cancer or not, can put patients at risk for intestinal obstruction from adhesions. The cause of intestinal obstruction can be difficult to determine as it could also be a sign of peritoneal recurrence of cancer rather than benign adhesions. Peritoneal carcinomatosis can be very difficult to demonstrate without surgical exploration, as it often is not apparent on imaging. As a result, patients with this complication are often extensively investigated with each...

Accounts By Health Care Providers Religious And Family Support

An extensive review of the English language literature written by health professionals engaged in caring for dying cancer patients identified that there has been a number of transitions over the last 30 years which recognized improvements in palliative care and greater awareness of the benefits of hospice programs.60 There was also greater acknowledgment of the psychological needs of patients and an interest in providing care within the context of multiprofessional teams rather than merely from...

Cognitive Behavioral And Social Contributors To Emotional Wellbeing

If a trait perspective tells only part of the story of SWB, then what added elements are needed to complete, or at least expand, the tale My reading of the SWB literature suggests that traits function along with, and partly through, a variety of cognitive, behavioral, and social variables and that study of these additional determinants may promote a more comprehensive understanding of SWB under both normal and particularly stressful life conditions. Moreover, such variables are seen as largely...

Cognitive Behavioral Interventions

Cognitive-behavior therapy (CBT) embraces an empirical foundation that focuses on the inter-relationships among behavior, thoughts, emotions, and biological events regarding mental health problems and medical symptom development and persistence. CBT, in this context, incorporates a wide array of intervention strategies that attempt to change those behavioral, cognitive, and affective variables that mediate the negative effects of cancer and its treatment. Many strategies under the CBT umbrella...

D

Delivery of smoking interventions in health care settings guidelines for provision and coordination of care for cancer survivors, 314 long-term follow-up visits and ongoing cancer surveillance, 314 15 stepped-care approaches, 313 stepped-care model, 313-14 depression in cancer survivors assessment techniques, 175 self-report measures, 175 structured clinical interviews, 175-76 consequences of depression, 183-84 pretransplant depression, 183-84 correlates of depression in longer term survivors...

Educational Interventions

The major goal of educational strategies is to reduce cancer patients' distress and improve their sense of control that may be engendered by lack of knowledge and feelings of uncertainty. The topics covered include technical aspects of the disease and its treatment, potential side effects, navigating the medical system, and the physician-patient relationship. Research suggests that providing such information can lead to beneficial effects, such as decreases in depression and anxiety.23

Epidemiology

One survey of QOL in French testicular cancer survivors with a median survival of 11 years found no difference in scores for pain between patients and controls.144 In a larger study of 1409 testicular cancer survivors with median 11 years of follow-up, survivors reported more bodily pain than controls, and this was statistically but not clinically ignificant. Approximately, 15 of patients reported peripheral sensory neuropathy, and 20 reported Raynaud's phenomenon. Patients who had received...

Future Research And Theoretical Directions

While many of the individual paths in both the normative and restorative models have been examined in prior research, there is much room for additional inquiry testing the models' predictions. A few particular research needs will be highlighted here. First, although the models were designed to be consistent with existing research findings, there have been relatively few tests of the full normative model, and no tests of the complete restorative model. Therefore, it would be valuable to test the...

I

Impact of cancer on interpersonal relationships evaluation for bone marrow transplantation, 195 study of breast cancer survivors, 195 implications for families and informal careers Australia survey reduced opportunities to engage in social and recreational activities, 441-42 availability and willingness of family caregivers, 442 financial hardships for family members, 442 UK survey domestic and personal care tasks, 441 Institute of Medicine, 19-22, 67, 92, 400, 490-91

Integrating Trait And Socialcognitive Perspectives On Wellbeing

Having identified a variety of variables trait, cognitive, behavioral, and social that have each been linked to SWB, it is important to consider whether they may be brought together under the umbrella of a common conceptual framework. Such a framework might offer several benefits. For instance, rather than viewing them as entirely orthogonal sources of SWB, an integrative framework may suggest processes by which these variables function together to promote and restore well-being. It might also...

Introduction

The focus of this chapter is on the presence of depression in cancer survivors. We will not focus on the related issues of anxiety (including posttraumatic stress disorders), or the broader concept of distress. We will also try to restrict our discussion to the occurrence of depression as a unitary construct, although we are fully aware that depression commonly co-occurs with pain and fatigue, as well as the aforementioned psychiatric conditions. The definition of depression that we will use...

Kathryn McPherson and Rod Mac Leod

Understanding what constitutes quality is complex. This seems a particular issue in conditions like cancer because they are themselves complex, being variable in nature, presentation, and outcome. Some would argue that we have in fact failed to ask some of the key questions that would really help us develop our understanding of what comprises quality, instead making health professional assumptions and therefore ending up somewhat errant in the conclusions we have tended to reach. An inescapable...

Methods

We searched the PsycINFO and MEDLINE databases for relevant articles. Included in the review are articles published in 1998 or later, following the comprehensive review by Gotay and Muraoka,3 and focused on more than one dimension of QOL. Thus, a study focusing only on comorbidity would not be included. The sample had to be, at least, 5 years post-diagnosis. In studies whose sample ranged in the number of years following diagnosis, a measure of time post-diagnosis treatment needed to be...

Miscellaneous Effects of Systemic Treatment

A series of other long-term and late effects are associated with specific systemic cancer drugs. For example, bleomycin causes pulmonary fibrosis at doses above 450 mg m2, especially in the elderly and those on supplemental oxygen,66 and the acrolein metabolite of cyclophosphamide and ifosfamide causes a hemorrhagic cystitis that in a small proportion of unfortunate patients can become chronic after a severe acute episode. Cisplatin can affect renal function, which can be either acute or of...

Pain Syndromes

Post-radical neck dissection syndrome is defined as neck and or shoulder pain starting within 2 months after radical neck dissection. Patients complain of sharp or shooting pains in the ear, neck, and shoulder. The prevalence of this syndrome is unknown. In one survey of 25 patients with this diagnosis, all had neuropathic pains in the distribution of the superficial cervical plexus and 72 experienced regional myofascial pain.94 There are no specific recommendations. Carbamazepine has been...

Pelvic Surgery

Bladder and bowel dysfunction can greatly affect patients' quality of life. The mechanism of injury to these organs from surgery in the pelvis is obvious, however, operations to remove tumors involving the brain and spinal cord can also impact urinary and bowel control. Urinary continence can be affected by any procedure in the pelvis, but prostatectomy and hysterectomy are the most common culprits. Pelvic muscle exercises and medications such as oxybutanin or tolterodine can be helpful, but...

Research Needs

The IOM stated that survivorship care plans have strong face validity and can reasonably be assumed to improve care unless and until evidence accumulates to the Table 5. Examples of Key Quality of Care Research Questions for Cancer Survivors Basic science studies to elucidate the mechanisms of late effects Observational studies to assess the incidence and predictors of late effects Clinical trials of interventions (medical, psychological, risk behaviors) to prevent or reduce the severity of...

Statement Of The Problem

Considerable medical progress has been made in treating the set of diseases known as cancer. Many forms are curable and there is a sustained decline in the overall death rate from cancer when one focuses on the impact on the total population.1 Because of improvements in medical science, however, more people are living with cancer than ever before. Although the extensive medical needs of such patients may be well attended to, psychosocial and emotional needs are often overlooked.2 Almost every...

Summary

The most important thing about the disparity in cancer survival is that it exists and all health care providers should be aware of this fact. Understanding that there is a problem is the first step in identifying where the problem lies and tackling possible solutions. There is no doubt that research is needed to identify the specific causes for this disparity in cancer survival. This disparity as highlighted in the previous paragraphs includes differences in health care delivery, in access to...

Supportive Group Therapy Approaches

The potential strengths of group psychotherapy for cancer patients are threefold (a) it can provide for a milieu in which people with similar experiences can provide emotional support to each other (b) it is cost-effective for the patient and (c) it is time-efficient for the mental health professional. One cautionary note research suggests that group therapy programs which focus primarily on providing peer support and emphasize the shared expression of emotions are less effective than either...

Survivors

In the Chapter by Lent a model for restoring emotional well-being is presented. He refers to Ryan and Deci's concepts of hedonic vs. eudiamonic perspectives of well-being, wherein well-being is attributed to either to the valance between positive and negative affect, or the quest to achieve growth, purpose, and meaning in one's life, respectively. Lent relates the hedonic view to the development of research on subjective well-being, while the eudiamonic position is more pertinent to the study...

Systemic Effects

Although surgery is a local treatment, its effects can be systemic. For example, removal of endocrine and sexual glands in the course of cancer surgery can leave patients hypothyroid, diabetic, osteopenic, or menopausal. Removal of, or damage to, the sexual organs can render younger patients infertile, and so maneuvers such as sperm banking and embryo freezing must be anticipated and offered prior to surgery. Splenectomy may put patients at risk of overwhelming sepsis from encapsulated organs,...

T

Trait and social-cognitive perspectives on well-being, integration of. See also emotional well-being restoration of cancer survivors maintenance of normative well-being, 238 overall life satisfaction, 238 personality traits' effect on life satisfaction, 238 restoration of well-being under stressful conditions, 239-41 clinical implications, 242 cognitive, behavioral, and social routes, 242-43 coping mechanisms, 239 domain satisfaction, impact on, 239-40 environmental supports and resources, 240...

The Battle For Quality

The world is ready for a well-coordinated approach to cancer survivorship. Many researchers, providers, and policy makers have been working very hard to improve the lives of cancer survivors. For this we are grateful, but much more needs to be done. The chapters in this book point to challenges that remain to be solved and secondary prevention programs that need to be fully realized. It may even be possible to prevent many of these problems from occurring through effective primary prevention....

The Dispositional Perspective On Emotional Wellbeing

It has been found that people tend to display fairly stable levels of SWB over time, especially when their life circumstances remain stable. For instance, Headey and Wearing15 reported that life satisfaction and the experience of positive and negative affect each showed moderate levels of stability over 2- to 6-year periods. However, these three aspects of SWB were not set in stone some individuals showed considerable change in them over time, and the occurrence of significant life events was...

Victor T Chang and Ryuichi Sekine 10 Introduction

Pain has been studied in patients with advanced cancer, but not generally studied during the extended period of cancer survivorship. Comprehensive review articles are silent about pain in cancer survivors.1,2 There appears to be a widespread lack of knowledge and recognition of common pain syndromes. Yet many cancer survivors live and deal with pain on a regular basis. The incidence and types of pain vary with the cancer and sometimes with treatment modalities. In some groups of patients, pain...

Empirical Support For Mbsr In Cancer Survivors

Our first study of MBSR specifically for cancer patients was also the first published in the scientific literature, in the year 2000, so this area is still in its infancy. Nonetheless, a growing body of empirical support indicates that MBSR may be helpful to survivors in ways that would theoretically be expected. A recent review paper of MBSR studies in cancer95 joins several prior review papers which document what is known about the efficacy of mindfulness-based interventions within diverse...

Sleep and Fatigue

Our recent work has focused on sleep problems in cancer patients, and how MBSR may be beneficial in treating this common problem in cancer patients. Similar to what others have reported, we found a very high proportion of our cancer patients with disordered sleep (approx. 85 ) in a sample of 63 patients attending the MBSR program. In these patients, sleep disturbance was closely associated with levels of self-reported stress and mood disturbance, and when stress symptoms declined over the...

Assessment Approaches And Issues

Depression has been assessed using a variety of approaches including self-report, brief screening measures, and structured clinical interviews. Common self-report measures include the Hospital Anxiety and Depression Scale (HADS),6 the Rotterdam Symptom Checklist (RSCL),7 the Beck Depression Inventory (BDI regular and short forms),8,9 the Brief Symptom Inventory-Depression scale (BSI-D),10-12 Center for Epidemiologic Studies Depression Scale (CES-D),13 and the Zung Self-Rating Depression Scale...

Internationalcultural Perspectives On Quality Of Life

With the likelihood of cancer survivorship increasing, support and ongoing care for the survivors moves to the focus of care however, survival and living with the deficits that the cancer and its treatment may have caused is colored by the culture within the individual survivor resides. Notably, until recently in Japan, physicians would not share a cancer diagnosis with a patient, feeling that such knowledge would have a dramatic psychological effect on the individual, thus harming their...

What Is Emotional Wellbeing

In recent years, there has been a major shift in psychology toward the study of optimal human functioning and adaptive tendencies.5 This positive psychology movement has been intended as a corrective to the field's long-term tendency to focus on ill-being and psychopathology rather than on well-being and positive adjustment. Part of this movement has involved a rekindling of earlier interest in what might be termed hygiology that is, locating and developing personal and social resources and...

Distress and Quality of Life

We published, in 2000, a randomized clinical trial comparing MBSR to a waiting-list control group for a mixed group of cancer patients, some of whom were on active treatment and some who were beyond the treatment phase.102 Patients in this study had a wide range of cancer diagnoses of all stages, and were not restricted in terms of treatment-related variables. Following the intervention, participants in the intervention group had significantly less overall mood disturbance, less tension,...

The Impact Of Pain On Emotional Functioning Of The Cancer Survivor

Of all mental health outcomes associated with persistent pain, depression is by far the most prevalent. Community surveys indicate that approximately 20 of individuals with persistent pain symptoms suffer from a diagnosable depressive condition.30 Much higher rates are seen in specialty pain treatment centers.31,32 There is considerable research indicating that prevalence rates of depressive disorders are higher in cancer patients than in the general population.27,33,34 However, no research has...

Jamie S Ostroff and Lara K Dhingra

In the past two decades, cancer has shifted from an acute disease with certain fatality to a curable or chronic condition with increasing rates of long-term survival. Due to advances in early detection and treatment, nearly 64 of the U.S. adults diagnosed with cancer will survive beyond 5 years compared to only 33 of individuals diagnosed in I960.1 With more than 10 million cancer survivors in the United States2 and this number expected to double by 20503 there is a growing need to understand...

Virginia Uhley and KL Catherine

The prevalence of obesity has become an epidemic. It is estimated that in the United States, 64.5 of the general population is either overweight, defined by body mass index BMI, body weight (kg) height (m)2 between 25.0 and 29.9 kg m2, or obese (BMI > 30.0 kg m2).1 The major medical complications associated with obesity include metabolic syndrome, type 2 diabetes, cardiovascular disease, hypertension, and certain types of cancer,2 to name a few. Cancers strongly associated with obesity...

Cranial Irradiation

Cranial irradiation can be the primary or adjuvant treatment for brain tumors, and may be carried out prophylactically, for example, in limited-stage small cell lung cancer and some hematological malignancies. While neurons do not have the rapid dividing characteristic usually targeted by radiation, radiation has effects on their glial supports and vasculature. Leukoencephalopathy typically occurs at doses above 55 Gy and appear 1-2 years following treatment.30 As a result, slowed mentation and...

The Extremities and Bone

Radiation can damage lymphatics and cause lymphedema independently of surgery. When combined with surgical lymph node dissection, however, the risk of lym-phedema is compounded. Radiation weakens bone. For example, painful sacral fractures are a late effect of pelvic radiation that can be concerning for local recurrence or osseous spread of a malignancy like rectal cancer. A history of radiation is associated with increased risk of spinal compression fractures within the field. Recently an...

Epidemiology Of Pain In Cancer Survivors

While surveys have not been done specifically for pain, some information can be gleaned from quality of life surveys of cancer survivors. Information on the prevalence of pain in cancer survivors is sometimes contradictory. In some studies the prevalence of pain may actually be lower than in a control group, and may differ between studies. There are a number of possible explanations. Recruitment strategies may be different, leading to different populations studied. As many pain syndromes can...

Chest Radiation

Chest irradiation can damage any of the structures in the chest. For example, breast irradiation can in some cases interfere with lactation.31 Acute radiation pneumonitis can progress to long-term focal pulmonary fibrosis and decreased lung capacity in a minority of patients. Its risk is related to both the total dose delivered and the volume of lung treated.32 Dyspnea and cough are the most common symptoms, and imaging shows interstitial fibrosis which can be progressive. It can eventually...

Info

Avedis Donabedian who might be considered the father of quality, described a model of understanding quality in health services incorporating the structure, process, and outcomes of the service2 where (a) Structure encompasses the characteristics of medical care that are relatively unchanging i.e., the materials and manpower available for care. (b) Process addresses the content of that care, i.e., how the patient was moved through and out of the health care system and the services that were...

Intervention Research

Several approaches intended to reduce stress primarily through emotion-focused coping have been investigated. Emotion-focused coping refers to dealing directly with the emotional concomitants of life events, such as distress and existential angst, rather than trying to solve the problem directly it is useful in circumstances when one has little or no control over the specific situation, such as fears of cancer recurrence or death and dying.68 Our experience is predominantly in the application...

Socioeconomic Status

Socioeconomic status (SES) remains the most widely studied variable in the area of health disparity. In many instances it is the most notable difference between Caucasians and minorities. SES is difficult to assess because income level, the most direct assessment of SES, is not routinely obtained when treating cancer patients. As a result SES is a value that must be estimated based on census tract data, patient location, or some other indirect assessment. The significance of SES as a...

Impact Of Problem Solving

Others have also looked to problem-solving training as a potentially important intervention strategy to help cancer patients and their families. For example, Fawzy et al. developed a multicomponent treatment package that included PST and focused on patients who were newly diagnosed with malignant melanoma.60 Cancer patients were randomly assigned to one of two conditions a 6-week structured group intervention that included PST, stress management training, group support, and health education,...

Problem Solving for Caregivers of Cancer Patients

Family members who are responsible for the day-to-day care of cancer patients can also experience high levels of distress and frequent problems. As such, we have also hypothesized that training such individuals themselves in problem-solving skills may be a particularly useful approach in helping family caregivers to cope more effectively in this role.55,56The Prepared Family Caregiver Course adapted the D'Zurilla and Nezu57 PST model as a means of providing the following types of information to...

Correlates Of Adjustment

As described briefly in the section on medical adaptive tasks, physical symptomatology and health status are often found to be strongly correlated with depression and QOL.3,31,32,34 Pain and fatigue in particular are associated with higher levels of distress.3,15 In women with metastatic breast cancer, both pain intensity and frequency have been correlated with depression and mood disturbance.43 However, as many of these studies are cross-sectional, it is not...

Patient Related Barriers to Smoking Cessation

There are several patient level barriers for smoking cessation in cancer survivors including high nicotine dependency, urgency of cessation advice, cancer-specific health beliefs, psychological distress, disease and treatment variables, social network influences and misreporting of smoking status. Table 3. Smoking Cessation in Cancer Survivors Improved survival rate Fewer treatment complications Improved treatment efficacy Reduced risk of disease recurrence and 2nd primary tumor Improved...

Surgery

(i) Post surgical pain syndromes are now recognized as a distinct clinical entity with an overall incidence of 1-2 .32 In addition to the syndromes mentioned in this chapter, these include syndromes of post-Coronary Artery Bypass Graft pain, post-sternotomy pain,33 and post-herniorrhaphy pain.34 During surgery, nociceptive stimulation leads to a barrage of C fiber impulses that activate spinal cord receptors and result in the development of central sensitization and a clinical hyperalgesic...

Existential and Spiritual Outcomes

Our more recent work has evolved to investigate the effects of MBSR on the types of existential outcomes described in the introduction. One way of examining these personally meaningful outcomes is through patient self-assessment using questionnaires developed to measure constructs such as benefit-finding and spirituality. We assessed posttraumatic growth using the Post-Traumatic Growth Inventory (PTGI) and Spirituality using the Functional Assessment of Chronic Illness Therapy-Spiritual Well...

Two Views of Well Being

At this point, I should clarify what I mean by emotional well-being. Ryan and Deci7 noted that the study of well-being in psychology emerged from two relatively distinct, though overlapping, philosophical perspectives (a) the hedonicposition, which views well-being in terms of the experience of personal happiness or the balance between positive and negative affect and (b) the eudaimonic position, which holds that well-being involves the quest to achieve growth, purpose, and meaning in one's...

The Quantitative Burden Based On Cancer Statistics

Understanding the burden of cancer survivorship also requires a quantitative appreciation of the incidence of cancer, the mortality of the disease, and the resulting number of accumulating survivors. The American Cancer Society publishes an annual summary of cancer statistics.14 Based on data from the National Cancer Institute and mortality data from the National Center for Health Statistics, it is estimated that in the United States for 2005, a total of 1,372,910 new cancer cases and 570,280...

Jos Verbeek and Evelien Spelten

The situation of cancer patients returning to work has taken a turn for the better. Where early research reported profound job discrimination of cancer patients (e.g. Feldman1), recent literature suggests that breast cancer patients are only slightly less frequently unemployed than their healthy controls.1 Maunsell et al. found a statistically significant 7 difference in risk of being unemployed between breast cancer survivors and healthy controls 3 years after diagnosis and concludes that job...

Biopsychosocial Perspective On The Pain Experience Of Cancer Survivors

Pain symptoms in cancer survivors can arise from multiple causes including adverse effects of cancer treatment, infection, and musculoskeletal problems (see Chapter 9).7-10 Research suggests that 30-60 of individuals with cancer will continue to experience pain symptoms that will persist in the posttreatment period.2,11-17 Neuropathic pain and somatic pain conditions are the most common pain diagnoses in cancer survivors.18-20 Compared to other domains of pain research, the psychosocial...

Measures to Prevent Postmastectomy Pain

The effect of special attention to preserving the intercostobrachial nerve was studied in a group of 120 patients, who were randomized to either sacrifice or preservation of the nerve. The number of patients who experienced pain, numbness, and altered sensation was halved in the preservation group postoperatively but not at follow-up 3 months later.111 The role of axillary dissection is highlighted by a study comparing 85 patients who underwent axillary dissection to 65 patients who had...

Adaptive Tasks In Living With Advanced Cancer

To date the psychologically relevant issues receiving the greatest attention in this population have been pain, fatigue, and depression (see special issue no. 32 of JNCI, 2004). The ramifications of AC likely extend well beyond these important concerns into a number of other diverse domains. As treatment advances have prolonged and improved the QOL of many people with metastatic disease, increased clinical and empirical attention has been directed to their psychosocial concerns. Of note, much...

The Impact Of Cancer On Relationships

Understanding the impact of cancer on relationships is important because cancer occurs in an interpersonal context. The diagnosis and treatment of cancer affect not only the patient, but also their significant others, including family and friends. Partners of cancer patients may experience significant decrements in physical, emotional, and social functioning that appear to parallel the patient's own response to their cancer.6,14 Levels of adjustment in cancer patients and their partners also...

Biological Outcomes

We have also become interested in the effects of MBSR on some of the biological processes identified by researchers as affected by cancer treatments, which may have potential consequences in terms of future health and disease recurrence. In the study described above with breast and prostate survivors an average of 1.1 years post-treatment, we investigated immune function by looking at the counts of a number of lymphocyte subsets, including T cells (divided into helper and cytotoxic T cells) and...

Psychosocial Influences On Painrelated Limitations In Cancer Survivors

Many individuals either discontinue or avoid activities that are associated with pain.97,98 These might include activities of daily living, social and recreational activities, or occupational activities.23 Research suggests that 15-20 of individuals with chronic musculoskeletal pain conditions will become permanently occupation-ally disabled.99,100 Few research investigations have addressed the nature or severity of functional limitations due to pain in cancer survivors.17,23,101 It is possible...

Contributors

Ahles, PhD Director of the Neurocognitive Research Laboratory, Memorial Sloan-Kettering Cancer Center, New York, NY Carlynn A. Alt, PhD, PT, MS Assistant Professor, Exercise Science Program, Department of Physical Therapy Marquette University, Miluankee, WI Jane Alavi, MD Professor Emeritus, Department of Medicine, University of Pennsylvania Department of Medicine, Philadelphia, PA Tammy Beran, MA Graduate Student, Department of Psychology, University of California, Los Angeles, Los...

Clare Stevinson Kristin L Campbell Christopher M Sellar and Kerry S Courneya

Interest in the potential of exercise as a therapeutic intervention for a wide range of clinical populations is growing steadily. A body of research has established physical activity as having a role in the prevention and or management of several chronic medical conditions,1 including coronary heart disease,2 stroke,3 hypertension,4 non-insulin-dependent diabetes,5 obesity,6 musculoskeletal disorders,7 and mental health problems.8 Evidence of the effects of physical exercise in protecting...

Linda A Jacobs Jane Alavi Angela DeMichele Steven Palmer Carrie Stricker and David Vaughn

Cancer survivors experience a number of physiological and psychological sequelae, called late effects, as a consequence of their cancer treatment. In pediatric oncology, late effects of treatment have been studied for over two decades,1-2 and are therefore better understood than late effects as a result of cancer treatment during adulthood. However, identified late effects in adults include diverse phenomena such as decreased cognitive functioning in breast cancer survivors3 and increased...

Robert J Ferguson Raine Riggs Tim Ahles and Andrew J Saykin

Dysfunction in memory and attention associated with cancer treatment has gained increased attention over the past two decades. In 1999 the President's Cancer Panel1 and the National Coalition for Cancer Survivorship2 formally recognized the problem as a quality of life matter that deserved higher priority in clinical research. With nearly 1 million chemotherapy recipients annually in the United States alone, the problem is widespread. Over this same time span, research has clearly documented...

Common Measurement Characteristics of Quality of Life Scales

Three basic measurement characteristics found in a good assessment tool are reliability, validity, and responsiveness.47-49 Reliability is primarily concerned with the stability of items within a test and the uniformity between test scores over time. Two common forms of test reliability are internal consistency how well items hang together and test-retest reliability the stability of scores over repeated measurements . Test validity deals with the degree to which an instrument accurately...

Handbook of Cancer Survivorship

Michael Feuerstein, Ph.D, MPH, ABPP Uniformed Services University of the Health Science Department of Medical and Clinical Psychology and Preventive Medicine and Biometrics 4301 Jones Bridge Road Bethesda, MD 20814 USA Library of Congress Control Number 2006929207 ISBN-10 0-387-34561-2 e-ISBN-10 0-387-34562-0 ISBN-13 978-0-387-34561-1 e-ISBN-13 978-0-387-34562-8 2007 Springer Science Business Media, LLC All rights reserved. This work may not be translated or copied in whole or in part without...