Approaches to Specific Cancers

  • Kyung Bong Koh


Breast cancer, prostate cancer, and childhood cancer have unique characteristics not seen in other cancers with regard to assessment and treatment. Breast cancer patients with persistent concerns about body image, sexual desire, and sexual function should be referred to professionals. Quality of life in prostate cancer patients needs to be emphasized because treatments not only provide a good survival rate but also cause adverse side effects. Prostate cancer patients also need support in psychological, informational, and daily living domains. Open communication between parents, physicians, and teachers is crucial for children with cancer who have difficulty in adapting to their school life. Psychosocial treatment for childhood cancer patients focuses on helping their family and treatment team provide emotional support to them and promoting development at maximum level by encouraging normal activities. Team approach is recommended for treatment of these children in which pediatricians, child psychiatrists, nurses, social workers, teachers, and pastors are involved. A variety of antidepressants can be used in depressed patients with breast cancer, prostate cancer, and childhood cancer. However, clinicians should be careful of the possibility that antidepressant efficacy will be lower in women taking an estrogen antagonist, such as tamoxifen.


Breast cancer Prostate cancer Childhood cancer Quality of life Open communication Team approach Antidepressants 


  1. 1.
    Walker LG, Eremin O. Psychological assessment and intervention: future prospects for women with breast cancer. Semin Surg Oncol. 1996;12:76–83.CrossRefGoogle Scholar
  2. 2.
    Kissane DW, Clarke DM, Ikin J, et al. Psychological morbidity and quality of life in Australian women with early-stage breast cancer: a cross-sectional survey. Med J Aust. 1998;169:192–6.PubMedGoogle Scholar
  3. 3.
    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
  4. 4.
    Pendlebury SC, Snars J. Role of a psychiatry liaison clinic in the management of breast cancer. Australas Radiol. 1996;40:283–6.CrossRefGoogle Scholar
  5. 5.
    Daune F. Psychological aspects of breast cancer. Rev Med Brux. 1995;16:245–7.PubMedGoogle Scholar
  6. 6.
    Blomberg BB, Alvarez JP, Diaz A, et al. Psychosocial adaptation and cellular immunity in breast cancer patients in the weeks after surgery: an exploratory study. J Psychosom Res. 2009;67:369–76.CrossRefGoogle Scholar
  7. 7.
    Peck A. Emotional reactions to having cancer. Radium Ther Nucl Med. 1972;114:591–9.CrossRefGoogle Scholar
  8. 8.
    McGregor BA, Antoni MH. Psychological intervention and health outcomes among women treated for breast cancer: a review of stress pathways and biological mediators. Brain Behav Immun. 2009;23:159–66.CrossRefGoogle Scholar
  9. 9.
    Andersen BL, Yang HC, Farrar WB, et al. Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial. Cancer. 2008;113:3450–8.CrossRefGoogle Scholar
  10. 10.
    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
  11. 11.
    Koh KB. Psychosocial aspects of breast cancer: focus on interventions. In: Koh KB, editor. Somatization and psychosomatic symptoms. New York: Springer; 2013.CrossRefGoogle Scholar
  12. 12.
    Mamelock AE. Psychiatry and surgery. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry. Baltimore: Williams & Wilkins; 1995.Google Scholar
  13. 13.
    Spiegel D. Cancer and depression. Br J Psychiatry. 1996;30(Suppl):109–16.CrossRefGoogle Scholar
  14. 14.
    Lesko LM, Massie MJ, Holland JC. Oncology. In: Stoudemire A, Fogel BS, editors. Principles of medical psychiatry. Orlando: Grune & Stratton; 1987.Google Scholar
  15. 15.
    Nunes DF, Rodriguez AL, da Silva Hoffmann F, et al. Relaxation and guided imagery program in patients with breast cancer undergoing radiotherapy is not associated with neuroimmunomodulatory effects. J Psychosom Res. 2007;63:647–55.CrossRefGoogle Scholar
  16. 16.
    Antoni MH, Lechner S, Diaz A, et al. Cognitive behavioral stress management effects on psychosocial and physiological adaptation in women undergoing treatment for breast cancer. Brain Behav Immun. 2009;23:580–91.CrossRefGoogle Scholar
  17. 17.
    Andersen BL, Farrar WB, Golden-Krreutz DM, et al. Psychological, behavioral, and immune changes after a psychological intervention: a clinical trial. J Clin Onclo. 2004;22:3570–80.CrossRefGoogle Scholar
  18. 18.
    van der Pompe G, Duivenvoorden HJ, Antoni MH, et al. Effectiveness of a short-term group psychotherapy program on endocrine and immune function in breast cancer patients: an exploratory study. J Psychosom Res. 1997;42:453–66.CrossRefGoogle Scholar
  19. 19.
    Andersen BL, Golden-Kreutz D, Emery CF, et al. Distress reduction from a psychological intervention contributes to improved health for cancer patients. Brain Behav Immun. 2007;21:953–61.CrossRefGoogle Scholar
  20. 20.
    Spiegel D, Butler LD, Giese-Davis J, et al. Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer: a randomized prospective trial. Cancer. 2007;110:1130–8.CrossRefGoogle Scholar
  21. 21.
    Visser A, van Andel G. Psychosocial and educational aspects in prostate cancer patients. Patient Educ Couns. 2003;49:203–6.CrossRefGoogle Scholar
  22. 22.
    Parahoo K, McDonough S, McCaughan E, et al. Psychosocial interventions for men with prostate cancer. Cochrane Database Syst Rev. 2013;12:CD008529. Scholar
  23. 23.
    Facts and Figures of the Integraal Kankercentrum Nederland n.d.. Accessed 1 Nov 2011.
  24. 24.
    Voerman B, Fischer M, Visser A, et al. Prostate cancer: a review of the literature on psychosocial problems and psychosocial interventions. Gedrag en Gezondh: Tijdschr Psychol Gezondh. 2004;32:251–70.Google Scholar
  25. 25.
    van Andel G, Bottemley A, Fossa SD, et al. An international field study of the EORTC QLQ-PR25: a questionnaire for assessing the health-related quality of life of patients with prostate cancer. Eur J Cancer. 2008;44:2418–24.CrossRefGoogle Scholar
  26. 26.
    Sanson-Fisher R, Girgis A, Boyes A, et al. The unmet supportive care needs of patients with cancer. Cancer. 2000;88:226–37.CrossRefGoogle Scholar
  27. 27.
    Steginga SK, Occhipinti S, Gardiner RA, et al. Prospective study of men’s psychological and decision-related adjustment after treatment for localized prostate cancer. Urology. 2004;63:751–6.CrossRefGoogle Scholar
  28. 28.
    Lederberg MS, Holland JC. Psycho-oncology. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry. 5th ed. Baltimore: Williams & Wilkins; 1989.Google Scholar
  29. 29.
    Howarth RV. The psychiatry of terminal illness in children. Proc R Soc Med. 1972;65:1039–40.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Lansky SB, Gendel M. Symbiotic regressive behavior patterns in childhood malignancy. Clin Pediatr. 1978;17:133–8.CrossRefGoogle Scholar
  31. 31.
    Spinetta JJ, Deasy-Spinetta P. Living with childhood cancer. St. Louis: CV Mosby; 1981.Google Scholar
  32. 32.
    Kellerman J, Varni JW. Psychosocial aspects of pediatric hematology-oncology. In: Willoughby M, Siegel SE, editors. Hematology and oncology. London: Butterworth Scientific; 1982.Google Scholar
  33. 33.
    Kashani J, Hakami N. Depression in children and adolescents with malignancy. Can J Psychiatr. 1982;27:474–7.CrossRefGoogle Scholar
  34. 34.
    van Dongen-Melman JEWM, Sanders-Woudstra JAR. Psychosocial aspects of childhood cancer: a review of the literature. J Child Psychol Psychiatry. 1986;29:145–80.CrossRefGoogle Scholar
  35. 35.
    Bach SR. Spontaneous picture of leukemic children as an expression of the total personality, mind and body. Acta Paedopsychiatr. 1975;41:86–104.PubMedGoogle Scholar
  36. 36.
    Kagen-Goodheart L. Reentry: living with childhood cancer. Am J Orthop. 1977;47:651–8.CrossRefGoogle Scholar
  37. 37.
    Bozeman MF, Orbach CE, Sutherland AM. Psychological impact of cancer and its treatment:III. The adaptation of mothers to the threatened loss of their children through leukemia. Cancer. 1955;8:1–19.CrossRefGoogle Scholar
  38. 38.
    Kellerman J, Rigler D, Siegel SE. The psychological effects of isolation in protected environments. Am J Psychiatry. 1977;134:563–5.CrossRefGoogle Scholar
  39. 39.
    Brunnquell C, Hall MD. Issues in the psychological care of pediatric oncology patients. Am J Orthop. 1982;52:32–44.CrossRefGoogle Scholar
  40. 40.
    Frienman SB, Chodoff P, Mason JW, et al. Behavioral observations on parents anticipating the death of a child. Pediatrics. 1963;32:610–25.Google Scholar
  41. 41.
    Deasy-Spinetta P. The school and the child with cancer. In: Spinetta JJ, Deasy-Spinetta P, editors. Living with childhood cancer. St. Louis: CV Mosby; 1981.Google Scholar
  42. 42.
    Slavin LA, O’Malley JE, Koocher GP, et al. Communication of the cancer diagnosis to pediatric patients: impact on long-term adjustment. Am J Psychiatry. 1982;139:179–83.CrossRefGoogle Scholar
  43. 43.
    Beisser AR. Denial and affirmation in illness and health. Am J Psychiatry. 1979;136:1026–30.CrossRefGoogle Scholar
  44. 44.
    Katz ER. Illness impact and social reintegration. In: Kellerman J, editor. Psychological aspects of childhood cancer. Springfield: Charles Thomas; 1980.Google Scholar
  45. 45.
    Massimo L, Zarri D, Caprino D. Psychosocial aspects of survivors of childhood cancer or leukemia. Minerva Pediatr. 2005;57:389–97.PubMedGoogle Scholar
  46. 46.
    Adams MA. A hospital play program: helping children with serious illness. Am J Orthop. 1976;46:416–24.CrossRefGoogle Scholar
  47. 47.
    Maunsell E, Jacques B, Deschenes L. Social support, a survival among women with breast cancer. Presented at the annual Psycho-oncology meeting, Memorial-Sloan Ketteri Cancer Center. 1993.Google Scholar
  48. 48.
    Spiegel D, Kato PM. Psychosocial influences on cancer incidence and progression. Harvard Rev Psychiatry. 1996;4:10–26.CrossRefGoogle Scholar
  49. 49.
    Levy SM, Herberman RB, Whiteside T, et al. Perceived social support and tumor- estrogen/progesterone receptor status as predictors of natural killer cell activity in breast cancer patients. Psychosom Med. 1990;52:73–85.CrossRefGoogle Scholar
  50. 50.
    Visser A, Breed W, Geluk W, et al. The value of open walking-in houses for cancer patients and their proxies: history, use, needs and evaluation. Nederl Tijdschr Oncol. 2009;6:248–55.Google Scholar
  51. 51.
    Thewes B, Butow P, Girgis A, et al. The psychosocial needs of breast cancer survivors; a qualitative study of the shared and unique needs of younger versus older survivors. Psycho-Oncology. 2004;13:177–89.CrossRefGoogle Scholar
  52. 52.
    Soothill K, Morris SM, Harman J, et al. The significant unmet needs of cancer patients: probing psychosocial concerns. Support Care Cancer. 2001;9:597–605.CrossRefGoogle Scholar
  53. 53.
    Daeter L Visser A, Van der Hooft-Lemans T. Determinants of seeking psychosocial care in Dutch men with prostate cancer. Master thesis. Report De Vruchtenburg, Rotterdam; 2012.Google Scholar
  54. 54.
    Visser A. Cancer in a psychosomatic perspective. In: Koh KB, editor. Somatization and psychosomatic symptoms. New York: Springer; 2013.Google Scholar
  55. 55.
    Steele AC, Mullins LL, Mullins AJ, et al. Psychosocial interventions and therapeutic support as a standard of care in pediatric oncology. Pediatr Blood Cancer. 2015;62(Suppl 5):S585–618.CrossRefGoogle Scholar
  56. 56.
    Weaver MS, Heinze KE, Bell CJ, et al. Establishing psychosocial palliative care standards for children and adolescents with cancer and their families: an integrative review. Palliat Med. 2016;30:212–23.CrossRefGoogle Scholar
  57. 57.
    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
  58. 58.
    Thompson DS. Mirtazapine for the treatment of depression and nausea in breast and gynecological oncology. Psychosomatics. 2000;41:356–9.CrossRefGoogle Scholar
  59. 59.
    Loprinzi CL, Kugler JW, Sloan JA, et al. Venlafaxine in management of hot flashes in survivors of breast cancer: a randomized controlled trial. Lancet. 2000;356:2059–63.CrossRefGoogle Scholar
  60. 60.
    Loprinzi CL, Sloan JA, Perez EA, et al. Phase III evaluation of fluoxetine for treatment of hot flashes. J Clin Oncol. 2002;20:1578–83.CrossRefGoogle Scholar
  61. 61.
    Stearns V, Issacs C, Rowland J, et al. A pilot trial assessing the efficacy of paroxetine hydrochloride (Paxil) in controlling hot flashes in breast cancer survivors. Ann Oncol. 2000;11:17–22.CrossRefGoogle Scholar
  62. 62.
    Soares CN, Poitras JR, Prouty J, et al. Efficacy of citalopram as a monotherapy or as an adjunctive treatment to estrogen therapy for perimenopausal and postmenopausal women with depression and vasomotor symptoms. J Clin Psychiatry. 2003;64:473–9.CrossRefGoogle Scholar
  63. 63.
    Kimmick GG, Lovato J, McQuellon R, et al. Randomized, double-blind, placebo-controlled, crossover study of sertraline (Zoloft) for the treatment of hot flashes in women with early stage breast cancer taking tamoxifen. Breast J. 2006;12:114–22.CrossRefGoogle Scholar
  64. 64.
    Stearns V, Beebe KL, Iyengar M, et al. Paroxetine controlled release in the treatment of menopausal hot flashes: a randomized controlled trial. JAMA. 2003;289:2827–34.CrossRefGoogle Scholar
  65. 65.
    Gordon PR, Kerwin JP, Boesen KG, et al. Sertraline to treat hot flashes: a randomized controlled, double-blind, crossover trial in a general population. Menopause. 2006;13:568–75.CrossRefGoogle Scholar
  66. 66.
    Grassi L, Biancosino B, Marmai L, et al. Effect of reboxetine on major depressive disorder in breast cancer patients: an open-label study. J Clin Psychiatry. 2004;65:515–20.CrossRefGoogle Scholar
  67. 67.
    Mathias C, Cardeal Mendes CM, Ponde de Sena E, et al. An open-label, fixed-dose study of bupropion effect on sexual function scores in women treated for breast cancer. Ann Oncol. 2006;17:1792–6.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.
    Schneider LS, Small GW, Clary CM. Estrogen replacement therapy and antidepressant response to sertraline in older depressed women. Am J Geriatr Psychiatry. 2001;9:393–9.CrossRefGoogle Scholar
  70. 70.
    Schneider LS, Small GW, Hamilton SH, et al. Estrogen replacement and response to fluoxetine in a multicenter geriatric depression trial. Fluoxetine Collaborative Study Group. Am J Geriatr Psychiatry. 1997;5:97–106.CrossRefGoogle Scholar
  71. 71.
    Irani J, Salomon L, Oba R, et al. Efficacy of venlafaxine, medroxyprogesterone acetate, and cyproterone acetate for the treatment of vasomotor hot flushes in men taking gonadotropin-releasing hormone analogues for prostate cancer: a double-blind, randomized trial. Lancet Oncol. 2010;11:147–54.CrossRefGoogle Scholar
  72. 72.
    Naoe M, Ogawa Y, Shichijo T, et al. Pilot evaluation of serotonin reuptake inhibitor antidepressants in hot flash patients under androgen-deprivation therapy for prostate cancer. Prostate Cancer Prostatic Dis. 2006;9:275–8.CrossRefGoogle Scholar
  73. 73.
    Scahill L, Hamrin V, Pachler ME. The use of selective serotonin reuptake inhibitors in children and adolescents with major depression. J Child Adolesc Psychiatr Nurs. 2005;18:86–9.CrossRefGoogle Scholar
  74. 74.
    Moreno C, Roche AM, Greenhill LL. Pharmacotherapy of child and adolescent depression. Child Adolesc Psychiatr Clin N Am. 2006;15:977–98.CrossRefGoogle 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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