Psychosocial issues in cancer

摘要

There are many dimensions to psychosocial, issues in cancer; two of which are focused here and relate to (i) the question of whether psychological factors play any role in cancer prognosis, and (ii) the quality of triage for serious psychological morbidity. These two may be inter-linked. If seriously depressed patients have a poorer outlook in relation to their length of survival then it is important to know whether depression gets diagnosed and treated. The view that psychological responses, such as depression, may be linked to disease course in cancer has always been controversial and never more so, than at the present time when medicine strives to be evidence based. That psyche or the 'mind' can influence somatic disorders such as cancer is perceived sometimes as a step back into the past when 'healers' or quacks practiced treatments that called upon the strengths of the 'mind' to effect a cure. So, what evidence is there that psychological variables impact upon cancer? What evidence is there that serious depression is accurately diagnosed? What is the best way to treat diagnosed depression in people with cancer? The evidence will be summarily reviewed.