World Cancer Day:Psychology and the Alleviation of Cancer Symptoms
Are you aware that in human papillomavirus and hepatitis B and C viruses significantly contribute to the burden of cervical and liver cancer in the African? Today is World Cancer Day which is held every year on 4 February. It was established by the Paris Charter adopted at the World Summit against Cancer for the New Millennium in 2000.
Despite recent scientific progress in finding treatments and improving patients' care, 8.2 million people still die each year from cancer, nearly half of them between the age of 30 and 69. This figure is expected to rise to 11.5 million by 2025 and 13 million by 2030.Low- and middle-income countries are more affected than high income countries – two thirds of global cancer deaths occur in these places – and this trend is predicted to continue in the next decade.
Policy direction, prioritization &implementation, funding of health care systems in Africa, especially Nigeria, cost of treatment and access to cancer treatment facilities are some major factors contributing to management and survival of patients. There is an urgent need for policy-makers and programme managers in low resource settings to facilitate timely diagnosis and improve access to cancer treatment for all.
Medical researchers have advocated the biopsychosocial model (physical, mental and social indicators) as a holistic view for the diagnosis, treatment, management and prevention of cancer. Many lives can be saved if appropriate investment is made in raising public awareness on the early signs and symptoms of common cancers. In addition people should adopt healthy lifestyles that reduce the risk of cancers.
Stress: The presence of symptoms meeting the criteria for post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms (PTSS) in adults and children with cancer, as well as in the parents of children diagnosed with the illness have been documented by Kangas et al., 2002; Bruce, 2006. Indeed, experiencing a life-threatening medical illness or observing it in another to whom one is close can be a qualifying event for PTSD according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (APA, 2000).
Stress is particularly great for parents of children with cancer. Studies consistently have shown that parents have higher rates of PTSD and PTSS than either their children or adult cancer survivors, suggesting that the experience of parenting a child with cancer may be more traumatic than actually having the illness (Bruce, 2006). Children of cancer patients also are a vulnerable group, with frequent psychological problems, acting-out behaviors, and problems in school (Lederberg, 1998). Moreover, siblings of pediatric cancer patients may experience their own fears and anxieties, and may receive less attention from parents while their brother or sister is in treatment.
Life events; families who had a cancer victim had higher numbers who had moved house, change in health status other than the cancer person, and higher numbers of divorces indicating that life events may well be a factor contributing to the onset of cancer (Jacobs& Charles, 1980).
Coping styles: If an individual is subjected to stress, then the methods they use to cope with this stress may well be related to the onset of cancer. For example, maladaptive, disengagement coping strategies, such as smoking and alcohol, may have a relationship with an increase in cancer
Hardiness: Kobasa et al. (1982) described a coping style called ‘hardiness’, which has three components: control, commitment and challenge. Low control suggests a tendency to show feelings of helplessness in the face of stress. Commitment is defined as the opposite of alienation: individuals high in commitment find meaning in their work, values and personal relationships. Individuals high in challenge regard potentially stressful events as a challenge to be met with expected success. Hardiness may be protective in developing cancer.
Emotional responses: Up to 20 per cent of cancer patients may show severe depression, grief, lack of control, personality change, anger and anxiety, Pinder et al. (1993).
Developmental Problems; The effects of cancer and its treatment can interrupt and delay the activities in which individuals typically engage to develop these skills, or can require temporarily or permanently giving up the skills and activities. Cancer-induced inability to perform normative activities can occur at any age. As a result, individuals can experience a range of problems manifested as developmental delays, regression, or inability to perform social roles resulting in significant loss of independence and disruption of their social relationships at a time when they should be developing social and relationship skills critical to successful functioning in adulthood (NCI, 2004).
Social Problems; The physical and psychological problems described above can be exacerbated by or produce significant new social problems. Financial stress resulting from low income, the cost of health care, or a lack of health insurance, as well as reduced employment and income, can result in substantial stress. While the fundamental resolution of such social problems is beyond the abilities of health care providers, evidence shows why attention to these problems is an integral part of good-quality health care and how they can be addressed within the constraints of clinical practices (Boberg et al 2003)
Health psychologists and other health providers have used psychosocial interventions in an attempt to alleviate some of the symptoms of the cancer sufferer (such as distressing pain difficulties, vomiting, sleeplessness, loss of bowel and bladder control, loss of appetite, and mental confusion) and to improve their quality of life, (Simonton and Simonton (1975).
Detecting cancer early can effectively reduce the mortality associated with cancer. In resource-poor settings, cancer is often diagnosed at a late-stage of disease resulting in lower survival and potentially greater morbidity and higher costs of treatment. Even in countries with strong health systems and services, many cancer cases are diagnosed at a late-stage. Addressing delays in cancer diagnosis and inaccessible treatment is therefore critical in all settings for cancer control.
Early diagnosis strategies improve cancer outcomes by providing care at the earliest possible stage and are therefore an important public health strategy in all settings. The barriers that delay cancer diagnosis must first be identified and assessed, and these factors may originate from patients to carers to health systems. Effective programmes can then be implemented at various levels that include community engagement to address patient behaviour, improving diagnostic and referral capacity and ensuring access to timely, high-quality treatment.
Early diagnosis; Early diagnosis is the identification of symptomatic (indicative) cancer cases in the very early stages of the disease..
Additional References
Despite recent scientific progress in finding treatments and improving patients' care, 8.2 million people still die each year from cancer, nearly half of them between the age of 30 and 69. This figure is expected to rise to 11.5 million by 2025 and 13 million by 2030.Low- and middle-income countries are more affected than high income countries – two thirds of global cancer deaths occur in these places – and this trend is predicted to continue in the next decade.
Policy direction, prioritization &implementation, funding of health care systems in Africa, especially Nigeria, cost of treatment and access to cancer treatment facilities are some major factors contributing to management and survival of patients. There is an urgent need for policy-makers and programme managers in low resource settings to facilitate timely diagnosis and improve access to cancer treatment for all.
Medical researchers have advocated the biopsychosocial model (physical, mental and social indicators) as a holistic view for the diagnosis, treatment, management and prevention of cancer. Many lives can be saved if appropriate investment is made in raising public awareness on the early signs and symptoms of common cancers. In addition people should adopt healthy lifestyles that reduce the risk of cancers.
The Most Common Cancers in the African Region
- Cancers of the cervix( 14,089 new cervical cancer cases were diagnosed annually in Nigeria. Ranked as the second leading cause of female cancer in Nigeria and most common in women aged 15 to 44 years in Nigeria, (World Health Organization, WHO).
- Others are; Breast , Liver, Prostate , Kaposi's sarcoma, Non-Hodgkin's lymphoma
Psychosocial Factors in the Initiation and Promotion of Cancer
Psychosocial factors are a term used to describe the relationship or interrelation of social factors (elements from the social environment) and individual thought and behavior. For a concept to be psychosocial means it relates to one's psychological development in, and interaction with, a social environment. Research has proved that psychological factors also have association between mind and cancer.Stress: The presence of symptoms meeting the criteria for post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms (PTSS) in adults and children with cancer, as well as in the parents of children diagnosed with the illness have been documented by Kangas et al., 2002; Bruce, 2006. Indeed, experiencing a life-threatening medical illness or observing it in another to whom one is close can be a qualifying event for PTSD according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (APA, 2000).
Stress is particularly great for parents of children with cancer. Studies consistently have shown that parents have higher rates of PTSD and PTSS than either their children or adult cancer survivors, suggesting that the experience of parenting a child with cancer may be more traumatic than actually having the illness (Bruce, 2006). Children of cancer patients also are a vulnerable group, with frequent psychological problems, acting-out behaviors, and problems in school (Lederberg, 1998). Moreover, siblings of pediatric cancer patients may experience their own fears and anxieties, and may receive less attention from parents while their brother or sister is in treatment.
Read Also; Behavioral Factors Promoting Cancer
Anxieties: Patients who do not develop clinical syndromes may experience worries, fears, and other forms of psychological stress that cause them significant distress.- Chronic illness can bring about such as guilt, feelings of loss of control, anger, sadness, confusion, and fear (Charmaz, 2000; Stanton et al., 2001).
- Anxiety, mood disturbance, fear of recurrence, concerns about body image, and communication and other problems with family members are common in cancer patients as well (Kornblith, 1998).
- Generalized worry; fear for the future; inability to make plans; uncertainty and a heightened sense of vulnerability; and other worries, such as about the possible development of a second cancer, changes in sexual function and reproductive ability, and changes in one’s role within the family and other relationships (IOM and NRC, 2006).
- Cancer patients can face spiritual and existential issues involving their faith, their perceived relationship with God, and the possibility and meaning of death. Some cancer survivors report feelings of anger, isolation, and diminished self-esteem in response to such stress (NCI, 2004).
- Family members’ psychological distress can be as severe as that of the patient. Studies of partners of women with breast cancer (predominantly husbands, but also “significant others,” daughters, friends, and others) find that partners’ mental health correlates positively with the anxiety, depression, fatigue, and symptom distress of women with breast cancer and that the effects are bidirectional (Segrin et al., 2005, 2007). Thus, helping family members to manage their distress may have a beneficial effect on the distress level of patients.
Life events; families who had a cancer victim had higher numbers who had moved house, change in health status other than the cancer person, and higher numbers of divorces indicating that life events may well be a factor contributing to the onset of cancer (Jacobs& Charles, 1980).
Coping styles: If an individual is subjected to stress, then the methods they use to cope with this stress may well be related to the onset of cancer. For example, maladaptive, disengagement coping strategies, such as smoking and alcohol, may have a relationship with an increase in cancer
Hardiness: Kobasa et al. (1982) described a coping style called ‘hardiness’, which has three components: control, commitment and challenge. Low control suggests a tendency to show feelings of helplessness in the face of stress. Commitment is defined as the opposite of alienation: individuals high in commitment find meaning in their work, values and personal relationships. Individuals high in challenge regard potentially stressful events as a challenge to be met with expected success. Hardiness may be protective in developing cancer.
Emotional responses: Up to 20 per cent of cancer patients may show severe depression, grief, lack of control, personality change, anger and anxiety, Pinder et al. (1993).
Developmental Problems; The effects of cancer and its treatment can interrupt and delay the activities in which individuals typically engage to develop these skills, or can require temporarily or permanently giving up the skills and activities. Cancer-induced inability to perform normative activities can occur at any age. As a result, individuals can experience a range of problems manifested as developmental delays, regression, or inability to perform social roles resulting in significant loss of independence and disruption of their social relationships at a time when they should be developing social and relationship skills critical to successful functioning in adulthood (NCI, 2004).
Social Problems; The physical and psychological problems described above can be exacerbated by or produce significant new social problems. Financial stress resulting from low income, the cost of health care, or a lack of health insurance, as well as reduced employment and income, can result in substantial stress. While the fundamental resolution of such social problems is beyond the abilities of health care providers, evidence shows why attention to these problems is an integral part of good-quality health care and how they can be addressed within the constraints of clinical practices (Boberg et al 2003)
Psychology and the Alleviation of Cancer Symptoms
- Pain management
- Social support interventions
- Treating nausea and vomiting
- Body image counselling
- Cognitive adaptation strategic
- Relaxation
- Mental imagery,
- Exercise programmes
Detecting cancer early can effectively reduce the mortality associated with cancer. In resource-poor settings, cancer is often diagnosed at a late-stage of disease resulting in lower survival and potentially greater morbidity and higher costs of treatment. Even in countries with strong health systems and services, many cancer cases are diagnosed at a late-stage. Addressing delays in cancer diagnosis and inaccessible treatment is therefore critical in all settings for cancer control.
Early diagnosis strategies improve cancer outcomes by providing care at the earliest possible stage and are therefore an important public health strategy in all settings. The barriers that delay cancer diagnosis must first be identified and assessed, and these factors may originate from patients to carers to health systems. Effective programmes can then be implemented at various levels that include community engagement to address patient behaviour, improving diagnostic and referral capacity and ensuring access to timely, high-quality treatment.
How to Improve Cancer Detection
Screening; Screening seeks out asymptomatic (non-indicative) cancers or precancerous lesions without symptoms in the population or in vulnerable groupsEarly diagnosis; Early diagnosis is the identification of symptomatic (indicative) cancer cases in the very early stages of the disease..
Policies and Cancer prevention
Do you know that between 30-50% of all cancer cases are preventable? Prevention offers the most cost-effective long-term strategy for the control of cancer. National policies and programs should be implemented to raise awareness, to reduce exposure to cancer risk factors and to ensure that people are provided with the information and support they need to adopt healthy lifestyles.Additional References
- Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs (NCBCI)
- Pubmed.
- World Health Organization
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