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Therapeutic Approaches for Cancer Patients

  • Kyung Bong Koh
Chapter

Abstract

To live with cancer is much more than adapting to the treatments and their side effects. In the assessment and treatment of cancer patients, the importance of psychosocial factors is emphasized. The necessity for psychiatric treatment and assessment of therapies is increased in order to improve side effects of treatment and enhance quality of life. Treatment team members need to be careful of the possibility that psychiatric problems may occur regardless of the progress of illness. In case such problems occur, psychiatric consultation should be considered. The therapeutic approaches used in cancer patients are a combination of psychotherapeutic, behavioral, and psychopharmacologic techniques. Psychotherapeutic approaches include cognitive therapy, family therapy, group therapy, and self-help treatment. Behavioral approaches, such as relaxation, biofeedback, systematic desensitization, hypnosis, and guided imagery, are helpful for pain and anxiety during procedures, nausea and vomiting, and cancer-related eating disorders. Psychopharmacologic approach is effective for anxiety, depression, delirium, pain, nausea, vomiting, and insomnia. An integrated approach including those therapeutic techniques tailored to each individual’s need is strongly suggested.

Keywords

Cancer Psychosocial factors Quality of life Psychiatric consultation Psychotherapeutic techniques Behavioral techniques Psychopharmacologic techniques Integrated approach 

References

  1. 1.
    Fallowfield LJ, Hall A, Maguire GP, et al. Psychological outcomes of different treatment policies in women with early breast cancer outside a clinical trial. Br Med J. 1990;301:575–80.CrossRefGoogle Scholar
  2. 2.
    Lesko LM, Massie MJ, Holland JC. Oncology. In: Stoudemire A, Fogel BS, editors. Principles of medical psychiatry. Orlando: Grune & Stratton; 1987.Google Scholar
  3. 3.
    Holland JC, Rowland J, Lebovits A. Reactions to cancer treatment: assessment of emotional response to adjunct radiotherapy. Psychiatr Clin N Am. 1979;2:347–58.CrossRefGoogle Scholar
  4. 4.
    Holland JC. Psychological issues in the care of the terminally ill. In: Flach F, editor. Directions in psychiatry. New York: Hatherleigh; 1982.Google Scholar
  5. 5.
    Wellisch D. Psychosocial problems of cancer. In: Haskell CM, editor. Cancer treatment. Philadelphia: WB Saunders; 1980.Google Scholar
  6. 6.
    Worden JW. Cognitive therapy with cancer patients. In: Freeman A, Greenwood V, editors. Cognitive therapy: applications in psychiatric and medical settings. New York: Human Science Press; 1987.Google Scholar
  7. 7.
    Peck A. Emotional reactions to having cancer. Radium Ther Nucl Med. 1972;114:591–9.CrossRefGoogle Scholar
  8. 8.
    Plumb MM, Holland J. Comparative studies of psychological functions in patients with advanced cases of self-reported depressive symptoms. J Psychosom Med. 1979;39:264–76.CrossRefGoogle Scholar
  9. 9.
    Kaufman E, Micha VG. A model for psychotherapy with the good-prognosis cancer patient. Psychosomatics. 1987;28:540–7.CrossRefGoogle Scholar
  10. 10.
    Abrams RD. The patient with cancer: his changing pattern of communication. N Engl J Med. 1966;274:317–22.CrossRefGoogle Scholar
  11. 11.
    Singer BA. Psychosocial trauma, defense strategies and treatment consideration in cancer patients and their families. Am J Fam Ther. 1983;11:15–21.CrossRefGoogle Scholar
  12. 12.
    Koh KB, Kim KW. A comparison of psychopathology between cancer patients on radiotherapy and noncancer patients. J Korean Neuropsychiatr Assoc. 1990;29:662–8.Google Scholar
  13. 13.
    Koh KB, Kim ST. Coping strategy of cancer patients. J Korean Neuropsychiatr Assoc. 1988;27:140–50.Google Scholar
  14. 14.
    Koh KB. Stress and coping strategy in family members of cancer patients. J Korean Neuropsychiatr Assoc. 1988;27:693–702.Google Scholar
  15. 15.
    Kaplan HI, Sadock BJ. Synopsis of psychiatry. 5th ed. Baltimore: Williams & Wilkins; 1988. p. 100.Google Scholar
  16. 16.
    Moos RH, Tsu VD. The crisis of physical illness: an overview. In: Moos R, editor. Coping with physical illness. New York: Plenum; 1977.CrossRefGoogle Scholar
  17. 17.
    Campell PC. Suicide among cancer patients. Community Health Bull. 1966;80:207–12.Google Scholar
  18. 18.
    Hackett TP, Cassem NH, Wishnie H. Detection and treatment of anxiety in the coronary care unit. Am Hosp J. 1969;78:729–36.Google Scholar
  19. 19.
    LeShan L. Cancer mortality rates: some statistical evidence of the effect of psychological factors. Arch Gen Psychiatry. 1962;63:333–5.CrossRefGoogle Scholar
  20. 20.
    Kubler-Ross E. On death and dying. New York: Macmillan; 1969.Google Scholar
  21. 21.
    Lederberg MS, Holland JC. Psychooncology. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry. Baltimore: Williams & Wilkins; 1995.Google Scholar
  22. 22.
    Daune F. Psychological aspects of breast cancer. Rev Med Brux. 1995;16:245–7.PubMedGoogle Scholar
  23. 23.
    Goldfarb C, Driesen J, Cole D. Psychophysiologic aspects of malignancy. Am J Psychiatry. 1967;123:1545–52.CrossRefGoogle Scholar
  24. 24.
    Greer S, Morris T. Psychological attributes of women who develop breast cancer: a controlled study. J Psychosom Res. 1975;19:147–53.CrossRefGoogle Scholar
  25. 25.
    Abse DW, Wilkins MM, Van de Castle RL. Personality and behavioral characteristics of lung cancer patients. J Psychosom Res. 1974;18:101–13.CrossRefGoogle Scholar
  26. 26.
    Joffe RT, Rubinow DR, Denicoff KD, et al. Depression and carcinoma of the pancreas. Gen Hosp Psychiatry. 1986;8:241–5.CrossRefGoogle Scholar
  27. 27.
    Koh KB. A comparison of illness behavior between cancer and noncancer patients. J Korean Neuropsychiatr Assoc. 1991;30:739–51.Google Scholar
  28. 28.
    Perrin GM, Pierce IR. Psychosomatic aspects of cancer; a review. Psychosom Med. 1959;21:397–421.CrossRefGoogle Scholar
  29. 29.
    Locke SE, Gorman JR. Behavior and immunity. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry. Baltimore: Williams & Wilkins; 1989.Google Scholar
  30. 30.
    Heim E, Augustiny KF, Schaffner L, et al. Coping with breast cancer over time and situation. J Psychosom Res. 1993;37:523–42.CrossRefGoogle Scholar
  31. 31.
    Derogatis LR, Morrow GR, Fetting J. The prevalence of psychiatric disorders among cancer patients. JAMA. 1983;249:751–7.CrossRefGoogle Scholar
  32. 32.
    Buckberg JB, Penman DT, Holland JC. Depression in hospitalized cancer patients. Psychosom Med. 1984;46:199–212.CrossRefGoogle Scholar
  33. 33.
    Fox BH, Stanek EJ, Boldy SC, et al. Suicide rates among cancer patients in Connecticut. Chron Dis. 1982;35:85–100.CrossRefGoogle Scholar
  34. 34.
    Bolund C. Suicide and cancer: 1. Demographic and social characteristics of cancer patients who committed suicide in Sweden 1973–1976. J Psychosoc Oncol. 1985;3:17–30.CrossRefGoogle Scholar
  35. 35.
    Greer S, Morris T, Pettingale KW. Psychological response to breast cancer: effect on outcome. Lancet. 1979;2:785–7.CrossRefGoogle Scholar
  36. 36.
    Chen CC, David A, Thompson K, et al. Coping strategies and psychiatric morbidity in women attending breast assessment clinics. J Psychosom Res. 1996;40:265–70.CrossRefGoogle Scholar
  37. 37.
    Janis E, Mann L. Decision-making. New York: Free Press; 1997.Google Scholar
  38. 38.
    Spivack G, Platt J, Schure M. The problem-solving approach to adjustment. San Francisco: Jossey-Bass; 1976.Google Scholar
  39. 39.
    Billings AG, Moos RH. The role of coping responses in attenuating the stress of life events. J Behav. 1981;4:139–57.CrossRefGoogle Scholar
  40. 40.
    Smith LW, Patterson TL, Grant I. Avoidant coping predicts psychological disturbance in the elderly. J Nerv Ment Dis. 1990;178:525–30.CrossRefGoogle Scholar
  41. 41.
    Cassem NH. The dying patient. In: Cassem, editor. MGH handbook of general hospital psychiatry. St. Louis: Mosby Year Book; 1991.Google Scholar
  42. 42.
    Bleeker JAC. Brief psychotherapy with lung cancer patients. Psychosom Med. 1978;29:282–7.Google Scholar
  43. 43.
    Renneker RE. Countertransference reactions to cancer. Psychosom Med. 1957;19:409–18.CrossRefGoogle Scholar
  44. 44.
    Druss RG. Psychotherapy of patients with serious intercurrent medical illness. Bull Assoc Psychoanal Med. 1984;23:163–8.Google Scholar
  45. 45.
    Marmor J. Short-term dynamic psychotherapy. Am J Psychiatry. 1979;136:149–55.CrossRefGoogle Scholar
  46. 46.
    Fiore N. Fighting cancer: one patient’s perspective. N Engl J Med. 1979;300:284–9.CrossRefGoogle Scholar
  47. 47.
    Bloom JR, Ross RD, Burnell G. The effect of social support on patient adjustment after breast surgery. Patient Couns Health Educ. 1978;1:50–9.CrossRefGoogle Scholar
  48. 48.
    La Barba RC. Experimental and environmental factors in cancer. Psychosom Med 1970;32:259–269.Google Scholar
  49. 49.
    Jerse MA, Whitman HH, Gustafson JP. Cancer in adults. In: Roback HB, editor. Helping patients and their families cope with medical problems. San Francisco: Jossey-Bass; 1984.Google Scholar
  50. 50.
    Benson H. The relaxation response. New York: Morrow; 1975.Google Scholar
  51. 51.
    Burish TG, Lyles JN. Effectiveness of relaxation training in reducing adverse reactions to cancer chemotherapy. J Behav Med. 1981;4:65–78.CrossRefGoogle Scholar
  52. 52.
    Morrow GR, Morrell BS. Behavioral treatment for the anticipatory nausea and vomiting induced by cancer chemotherapy. N Engl J Med. 1982;306:1476–80.CrossRefGoogle Scholar
  53. 53.
    Redd WH, Andresen GV, Minagawa Y. Hypnotic control of anticipatory emesis in patients receiving cancer chemotherapy. J Consult Clin Psychol. 1982;50:14–9.CrossRefGoogle Scholar
  54. 54.
    Mishra SI, Scherer RW, Snyder C, et al. Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev. 2012;8:CD008465.  https://doi.org/10.1002/14651858.CD008465.pub2.CrossRefGoogle Scholar
  55. 55.
    Pfeffenbaum G, Pasnau R, Jamison K. A comprehensive program of psychosocial care for mastectomy patients. Int J Psychiatry Med. 1977;8:65–71.Google Scholar
  56. 56.
    Schain WS. Sexual problems of patients with cancer. In: Devita VT, Hellman S, Rosenberg SA, editors. Cancer: principles and practices of oncology. Philadelphia: JB Lippincott; 1982.Google Scholar
  57. 57.
    Fawzy FI, Fawzy NW. Group therapy in the cancer setting. J Psychosom Res. 1998;45:191–200.CrossRefGoogle Scholar
  58. 58.
    Fawzy FI, Fawzy NW. Psychoeducational interventions. In: Holland JC, editor. Textbook of psychooncology. London: Oxford University Press; 1998. p. 676–93.Google Scholar
  59. 59.
    Spiegel D, Stein SL, Earhart TZ, et al. Group psychotherapy and the terminally ill. In: Chochinov H, Breitbart W, editors. The handbook of psychiatry in palliative medicine. New York: Oxford Univ. Press; 2000. p. 241–51.Google Scholar
  60. 60.
    Breitbart W. Spirituality and meaning in supportive care: spirituality and meaning-centered group psychotherapy interventions in advanced cancer. Support Care Cancer. 2002;10:272–80.CrossRefGoogle Scholar
  61. 61.
    Kissane D, Block S, Miach P, et al. Cognitive existential group therapy for patients with primary breast cancer – techniques and themes. Psychooncology. 1997;6:25–33.CrossRefGoogle Scholar
  62. 62.
    Spiegel D, Spira J. Supportive-expressive group psychotherapy: a treatment manual of psychosocial intervention for women with recurrent breast cancer. Stanford: Psychosocial Treatment Lab, Stanford Univ. School of Medicine; 1991.Google Scholar
  63. 63.
    Spiegel D, Bloom JR, Yalom ID. Group support for patients with metastatic cancer: a randomized prospective outcome study. Arch Gen Psychiatry. 1981;38:527–33.CrossRefGoogle Scholar
  64. 64.
    Carlson LE, Ursuliak Z, Goodey E, et al. The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: 6-month follow-up. Support Care Cancer. 2001;9:112–23.CrossRefGoogle Scholar
  65. 65.
    Carlson LE, Speca M, Patel KD, et al. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosom Med. 2003;65:571–81.CrossRefGoogle Scholar
  66. 66.
    Galway K, Black A, Cantwell M, et al. Psychosocial interventions to improve quality of life and emotional wellbeing for recently diagnosed cancer patients. Cochrane Database Syst Rev. 2012;11:CD007064.  https://doi.org/10.1002/14651858.CD007064.pub2.CrossRefPubMedGoogle Scholar
  67. 67.
    Williams JW, Barrett J, Oxman T, et al. Treatment of dysthymia and minor depression in primary care: a randomized controlled trial in older adults. JAMA. 2000;284:1519–26.CrossRefGoogle Scholar
  68. 68.
    Fann JR, Thomas-rich AM, Katon WJ, et al. Major depression after breast cancer: a review of epidemiology and treatment. Gen Hosp Psychiatry. 2008;30:112–26.CrossRefGoogle Scholar
  69. 69.
    Maguire P, Hopwood P, Tarrier N, et al. Treatment of depression in cancer patients. Acta Psychiatr Scand Suppl. 1985;320:81–4.CrossRefGoogle Scholar
  70. 70.
    Cunningham LA, Borison RL, Carman JS. A comparison of venlafaxine, trazodone and placebo in major depression. J Clin Psychopharmacol. 1994;14:99–106.CrossRefGoogle Scholar
  71. 71.
    Koh KB. Stress and psychosomatic medicine. Seoul: Ilchokak; 2011.Google Scholar
  72. 72.
    Cunningham LA. Depression in the medically ill: choosing an antidepressant. J Clin Psychiatry. 1994;55(Suppl AJ):90–7.PubMedPubMedCentralGoogle Scholar
  73. 73.
    Morrow GR, Hickok JT, Roscoe JA, et al. Differential effects of paroxetine on fatigue and depression: a randomized, double-blind trail from the University of Rochester Cancer Center Community Clinical Oncology Program. J Clin Oncol. 2003;21:4635–41.CrossRefGoogle Scholar
  74. 74.
    Thompson DS. Mirtazapine for the treatment of depression and nausea in breast and gynecological oncology. Psychosomatics. 2000;41:356–9.CrossRefGoogle Scholar
  75. 75.
    Foley K. Pharmacologic management of pain. In: Massie MJ, Lesko LM, editors. Current concepts in psycho-oncology. New York: Gold Publishers; 1984.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Kyung Bong Koh
    • 1
  1. 1.Department of PsychiatryYonsei University College of MedicineSeoulKorea

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