Cancer

Health Psychology
Contents
 Introduction
 Psycho-oncology
 Incidence of cancer
 Types of cancer
 Stages of cancer
 Etiological factors
 Psychological factors
 Role of psychology
 Consequences of cancer
 Psychological work with stage 1 to end
 References
Cancer
 The term cancer covers well over 100 different medical
conditions all involving the abnormal and excessive division
of cells (Barraclough, 2000).
 Also called Tumour
Psycho-oncology
 “Psycho” comes from the Greek word psyche which means
the mind or soul. ‘Oncology’ from the Greek word onkos
means the study of cancer (Barraclough, 2000).
 Psycho-oncology is concerned with relationships between
cancer and the mind. Psychosocial oncology is a similar term
with the broader implication that cancer concerns not just
individual patients but their families, friends and colleagues
and the society in which they live (Barraclough, 2000).
Incidence of cancer
 According to the estimates, in Pakistan, in the year 2012, the
total number of cancer cases and deaths recorded in both
genders combined was 148,041 and 101,113;
 Among men it was 63,451 and 48,449;
 Among women, it was 84,590 and 52,664, respectively.
Types of Cancer
 Benign tumours
 Malignant tumours

(Ogden,2004).
Cancers can be grouped according to
the type of cell they start in. There
are 5 main categories
 Carcinomas
 Sarcomas
 Leukaemias – cancer of blood cells
 Lymphomas and myeloma – lymphatic system cancers
 Brain and spinal cord cancers
(National Cancer Institute, 2015).
 Breast cancer Pancreatic cancer Prostate Cancer
Colon cancer

Lung cancer Endometrial Cancer

Skin cancer

Cervical cancer
Leukemia Cancer Oral cancer

Thyroid Cancer Liver cancer Bladder cancer

Kidney cancer Rectal Cancer
Cancer biology
 Cancer biology is extremely complex but the basic principles
may be summarized as follows. Cancer is initiated when
genetic material e.g DNA within a cell body is damaged and
mutates. The next stage promotion involves expression of
these damaged genes, leading to uncontrolled proliferation of
abnormal cells. These may or may not be recognized and
destroyed by the person’s own immune defenses
(Barraclough, 2000).
 Cancer is not the name of a single medical condition.
 Both the rate of growth and the pattern of spread vary greatly
from case to case, depending on the type of cancer
concerned, the patience’s resistance and treatment given
(Ogden,2004).
 Stages of cancer
 Stage 1 usually means that a cancer is relatively small and contained within
the organ it started in.
 Stage 2 usually means the cancer has not started to spread into surrounding
tissue but the tumour is larger than in stage 1. Sometimes stage 2 means that
cancer cells have spread into lymph nodes close to the tumour. This depends
on the particular type of cancer.
 Stage 3 usually means the cancer is larger. It may have started to spread into
surrounding tissues and there are cancer cells in the lymph nodes in the area.
 Stage 4 means the cancer has spread from where it started to another body
organ. This is also called secondary or metastatic cancer.
Sometimes doctors use the letters A, B or C to further divide the number
categories – for example, stage 3B cervical cancer.

Cancer research UK, 2014

Symptoms of Cancer
A broad spectrum of non-specific cancer symptoms may include:
Persistent Fatigue: Fatigue is one of the most commonly experienced cancer symptoms. It is usually more common when the
cancer is advanced, but still occurs in the early stages of some cancers. Anemia is commonly the culprit -- a condition that is
associated with many types of cancer, especially types affecting the bowel. Fatigue is a symptom of both malignant and non-malignant
conditions and should be evaluated by a physician.
Unintentional Weight Loss: While it may be a welcome surprise to lose weight without trying, it can be a red flag for many
illnesses, including cancer. Losing 10 pounds or more unintentionally definitely warrants a visit to the doctor. This type of weight loss
can occur with or without loss of appetite. Remember, weight loss can be a symptom of cancer, but is also a symptom of many other
illnesses, too.

 Pain Typically, pain is not an early symptom of cancer, except in some cancer types like those that spread to the bone. Pain generally
occurs when cancer spreads and begins to affect other organs and nerves.
- Lower pack pain is cancer symptom that is associated with ovarian cancer and colon cancer. Shoulder pain can also be a symptom of
lung cancer. Pain in the form of headaches can be associated with brain tumors (malignant and benign).
- Stomach pains can be related to types of cancer, like stomach cancer, pancreatic cancer, and many others. Stomach pain can be a
very vague symptom because so many illnesses can cause stomach pain.

 Fever: A fever is a very non-specific symptom of many mild to severe conditions, including cancer. In relation to cancer, a fever that
is persistent or one that comes and goes frequently can signal stress on the immune system. Fevers are commonly associated with
types of cancer that affects the blood, like leukemia and lymphoma, but are also common in people whose cancer has spread.
Bowel Changes: If you experience constipation, diarrhea, blood in the stools, gas, thinner stools, or just a general overall change in
bowel habits, see your doctor. These symptoms are most commonly associated with colon cancer, but are also related to other cancer
types.
Chronic Cough: A persistent, new cough or a cough that won't go away or becomes worse needs to be evaluated by a doctor. Blood
and/or mucus may accompany the cough and can be caused many conditions. In relation to cancer, a chronic cough with blood or
mucus can be symptom of lung cancer.
Etiological factors
A variety of factors including
 genetic make-up,
 diet,
 smoking,
 virus infection,
 exposure to certain chemical,
 hormones,
 Irradiation and excessive sunlight are all known to contribute
to some form of cancer (Barraclough, 2000).
 Factors related to psychological
response due to cancer
 Medical prognosis as understand by the patient: guidelines
can be given depending on the type of cancer and its stage of
advancement when diagnosed.
 Age, sex and social group of the patient: The psychosocial
issues for a retired male manual worker who is suffering
from lung cancer, for example, will probably be rather
different from those affecting a young professional woman
with breast cancer.

(Barraclough, 2000).
 Cause of the disease: Is there any justification for self blaming
(smokers who develop lung cancer) or blaming others
(asbestos workers who develop mesothelioma) or as in so
many cases is the patient faced with the unanswerable
question “why me?”
 Manifestations of the disease: Different symptoms such as
pain or breathlessness, visual disfigurement, functional
disability or general malaise and fatigue may each have their
own psychological impact.
 Direct effects of the disease and its treatment on brain
function for example cerebral metastases, biochemical
disturbances, drug with an effective mood.
 The burden of the treatment a mutilating operation
(mastectomy, colostomy), nausea, vomiting and hair loss
(with some forms of radiotherapy and chemotherapy),
prolonged interference with work and social life through
repeated hospital attendance.
 The patient relationship with doctors and nurses: This may be
permanently influence by the way that news of the diagnosis
was conveyed at the beginning.
 Characteristics of the patience as a person: past life
experience, personality, family relationships, current social
circumstances and religious beliefs.
Psychological factors
 Behavioral factors
 Stress
 Life events
 Control
 Coping style
 Personality

Ogden, 2004
Consequence of cancer
 Emotional response
 Cognitive response
 Psychological and social problems created or exacerbated by cancer—
including depression and other emotional problems; lack of
information or skills needed to manage the illness; lack of
transportation or other resources; and disruptions in work, school,
and family life—cause additional suffering, weaken adherence to
prescribed treatments

Ogden, 2004
 Patients with major depression as compared with non-depressed
persons also have higher rates of unhealthy behaviors such as smoking,
a sedentary lifestyle, and overeating.
 Moreover, depression and other adverse psychological states thwart
behavior change and adherence to treatment regimens by impairing
cognition, weakening motivation, and decreasing coping abilities.
 Evidence emerging from the science of psychoneuroimmunology—
the study of the interactions among behavior, the brain, and the body’s
immune system—is beginning to show how psychosocial stressors
interfere with the working of the body’s neuro-endocrine, immune,
and other systems.

(National Academy of Sciences, 2008)

 Cancers Related to Diet
About one-third of cancer deaths in the United
States that occur annually are due to nutrition
and physical activity factors.

For people who do not use tobacco, diet, and

physical activity are the most important
modifiable determinants of cancer risk.
Ex. Colorectal (3rd most deadly cancer in U.S.)
 Breast Cancer
• Breast cancer occurs primarily in women.
• Signs and symptoms involve changes in breast tissue:
 Risk factors
 Family history
 Women with mothers, sisters, or daughters who have breast cancer
 Age
 Rare before age 20
 Risk increases throughout the 20s
 Rises dramatically during the 30s through mid-70s (majority or cases occur in
women 40 and over)
 Drops significantly after mid-70s
Skin Cancer
• Related to exposure to ultraviolet (UV) radiation
from the sun as well as tanning beds.
• Three types of UV radiation: UVA, UVB, and
UVC.
• All types are harmful and have potential to cause
skin cancer.
• UVA is associated with sunburn, skin cancer
formation, and premature aging effects.
Skin Cancer (continued)
– Artificial UV sources may also generate UVC rays
 UVC is potent cancer-causing radiation
 Earth’s atmosphere filters natural UVC
 Prevention
 Limit sun exposure
 Use sunscreens
 Where protective clothing when exposed to sunlight
 Avoid artificial sources of UV light (i.e., tanning beds).
Psychological work with cancer
patients

 Pain management
 Social support intervention
 Treating nausea and vomiting
 Body image counseling
 Cognitive adaptation strategies
 The work of the Simontons
 Unfinished business & Quality time
 Future apprehension
 Dealing with grief and bereavement
Ogden, 2004
 Reducing Cancer Risk
 Eat a diet low in fat and red meats, especially high-fat and
processed meats.
 Eat a variety of fruits and vegetables daily.
 Men should conduct monthly testicular self-examinations.
 Know warning signs of cancer and see your health care
provider immediately if you detect any.
 Reducing Cancer Risk (continued)
 Sexually active people should use condoms to avoid
contacting HPV.
 Maintain a healthy weight.
 Women should consult with their health care providers
about risks of using oral contraceptives or hormone
replacement therapy.
 Exercise most days of the week.
 When in the sun, takes steps to limit UV radiation
exposure.
References
 Barraclough, J. (2000). Cancer and emotion: a practical
guide to psycho-oncology. John Wiley & Sons, Ltd.
England.
 Ogden, J. (2004). Health psychology: a text book. McGraw
Hill Education, England.
 National Cancer Institute. (2015). What is cancer. Retrieved
from http://www.cancer.gov/about- cancer/what-is-
cancer
 Work stress reduction book