Progress and challenges in psychosocial and behavioral research in cancer in the twentieth century

Article Abstract:

Prior to 1850, there was nothing that could be done to treat cancer, therefore a diagnosis of cancer was synonymous with death. Even after the development of anesthesia and aseptic technique, the use of surgery in the treatment of cancer was ineffective and the prognosis for cancer remained uniformly grim. In fact, it is not until the 20th century that some success could be achieved with any regularity in the surgical treatment of cancer. In the 1920s, improvements in instrumentation permitted the precise delivery of controlled doses of radiation to a tumor, and the first successful radiotherapeutic treatment of a laryngeal cancer opened a new era for cancer treatment. The development of chemotherapy did not begin until after the second world war, and it was not until 1951 that the first cancer was cured entirely by chemotherapeutic treatment; it was a choriocarcinoma treated with methotrexate. The author provides a historical description of the treatment of cancer, and he includes observations on the prevailing social and psychological attitudes towards cancer, cancer research and "establishment" medicine. There has always been some belief that psychological factors play a role in the development of cancer; indeed, the development of mouth cancer by Ulysses S. Grant, prior to the Civil War, was attributed to depression and distress of the mind, in addition to cigar smoking. However, it has only been relatively recently that the psychological and psychosocial issues involved in cancer have been attacked in an organized and scientific manner. From December 5 through 8, 1989 the American Cancer Society hosted a workshop on methodology in behavioral and psychosocial cancer research; the reports that came out of this workshop have been published as a supplement to the February 1, 1991 issue of the scientific journal Cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Forecasts and trends, History, Medical research, Psychosomatic research, American Cancer Society, United States. National Cancer Institute

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Changes in the prescription patterns of psychotropic drugs for cancer patients during a 10-year period

Article Abstract:

The charts of 200 consecutive patients admitted for cancer treatment were reviewed for the prescription of psychotropic drugs. The prescription practices were then compared with studies of psychotropic drug prescriptions performed in 1977 and 1984. There was an overall 30 percent increase in the use of psychotropic drugs, but the ratios of drugs prescribed from different categories has remained relatively constant. In 1987, 43 percent of the prescriptions were for hypnotics; in 1977, hypnotics comprised 48 percent of psychotropics prescribed. In 1987, antipsychotics accounted for 28 percent of the prescriptions, anxiolytics about 27 percent, and antidepressants represented about three percent of prescriptions. Although the categories have remained relatively constant, the drugs prescribed within the categories have changed, reflecting the greater choice of agents presently available. The drugs were prescribed for anxiety, difficulty falling asleep, and for medical procedures such as chemotherapeutic infusion. Many of the prescriptions are to counteract the effects of chemotherapy. Antipsychotic drugs also have antiemetic effect (prevents or relieves nausea and vomiting), and their use among cancer patients reflects this fact. Antidepressant prescriptions were given least frequently, despite the fact that the prevalence of major depression among cancer patients has been estimated at six percent, and may be as high as 20 percent among hospitalized patients. This low rate of prescribing antidepressant drugs may reflect either a general unfamiliarity on the part of the oncologist, or a failure to perceive the seriousness of the psychiatric condition in an environment where life-threatening cancer is the primary target. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Tranquilizing drugs, Tranquilizing agents, Antidepressants, Hypnotics and sedatives, Antipsychotic drugs, Antipsychotic agents, Hypnotics

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Psychosocial factors, curative therapies, and behavioral outcomes: a comparison of testis cancer survivors and a control group of healthy men

Article Abstract:

The survival rates of Hodgkin's disease, leukemia and testis cancer have been significantly improved. However, it has been recognized that these curative treatments produce lasting mental and physical changes which influence the patient's quality of life. The effects of cancer treatment on the long-term sexual functioning, relationships, employment and overall mental outlook of patients with testicular cancer were studied. The 223 testis cancer survivors answered questionnaires regarding long-term outcomes. The unemployment rate was 4.5 percent and the divorce rate was 6.8 percent. The patients reported more infertility and distress regarding sexual performance. Fertility stress was related to the inability to have children and lack of education. Sexual performance distress was related to level of education and lower occupational status. Men who received chemotherapy and retroperitoneal lymph node dissection, surgical removal of lymph nodes in the abdominal cavity, reported more infertility and performance distress. Men with sexual impairment were more likely to have a poor outlook on life and strained relationships. The results of this study can be used to identify patients who may be at risk for psychosocial problems and to make treatment decisions. Patients at risk can be directed towards counseling and sexual therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surveys, Cancer patients, Testicular cancer

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