Clinical Psycho-Oncology E-Book

Luigi Grassi

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 876

Veröffentlichungsjahr: 2012

Beschreibung

The level of psychological distress and the ability to adjust to a diagnosis of cancer are highly variable. Medical factors, psychological factors prior to diagnosis and social factors account for this variability. By understanding these variables, the clinician can better assess and manage the distress caused by the diagnosis and provide the most appropriate medical treatment or psychological intervention. This practical handbook will address the principal behavioural and psychological problems associated with cancer. Where appropriate, it adopts a broader, multicultural perspective, in line with the aim of the World Psychiatric Association and the Federation of Psycho-Oncology societies.

The main aims of the book are:

• to present the significant and challenging clinical problems encountered when caring for cancer patients and their families, including assessment, diagnosis and treatment
• to describe the best responses to these challenges, summarizing the evidence base and digesting clinical experience where evidence from clinical trials is lacking
• to discuss the emerging themes in psycho-oncology, such as genetic counselling, bioethics, cultural issues and cultural diversity
• to provide practical suggestions for dealing with special populations, such as children, the elderly, long-term survivors or mentally ill patients.

The book is designed to be easy to read and to reference, with information clearly displayed in concise tables and boxes accompanied by further detail within the text.

Chapters feature

• clinical vignettes, including management algorithms
• Key Points
• Suggested further reading

The editors aim to provide an indispensable tool for junior doctors in training in either psychiatry, psychology or oncology, general practitioners, community psychiatric nurses, palliative care physicians and other members of the multidisciplinary team.

With a Foreword by the pioneer in psycho-oncology, Professor Jimmie Holland.

Leseprobe

Contents

Cover

Title Page

Copyright

List of Contributors

Foreword

Acknowledgements

Part 1: Clinical Issues

Chapter 1: Introducing Multicultural Psycho-oncology

Chapter 2: Communication in Cancer Care: A Cultural Perspective

Introduction

Why is communication important?

Relevance of medical communication to psycho-oncology

What are the critical tasks in communication?

Cultural issues in communication

Communication skills training

Conclusions

Chapter 3: Psychosocial Assessment and Screening in Psycho-oncology

Introduction

Major issues and available evidence

Summary and conclusions

Chapter 4: Sexuality and Gender: Psychosocial Implications in Cancer Patients: A Multicultural Perspective

Introduction

Sexuality, gender and cancer: common aspects and cultural variables

Sexuality and prostate cancer

Sexuality and gynaecological tumours and breast cancer

Sexuality and gastrointestinal and bladder cancer: stoma patients

Cancer, infertility and sociocultural aspects

Health disparities in infertility and cancer: a global perspective

What are the causes of infertility in cancer patients?

What are the options?

Tissue banking and fertility preservation

Improved IVF technology as a therapy for infertility among cancer patients

Alternative fertility treatment

Pregnancy and cancer

Infertility and the impact on patient and family quality of life

Suggestions for clinicians in addressing sexuality and fertility concerns

Conclusion and future directions

Chapter 5: Psychosocial and Psychiatric Disorders

Introduction and background

Common psychiatric disorders

Psychiatric emergencies

Role of cultural factors and cultural implications

Chapter 6: Neurocognitive Effects of Anticancer Treatments

Introduction

Background

Normal pre-treatment cognitive function

Chemotherapy is the major cause of cognitive change

Pattern of cognitive change

Cognitive changes are subtle

Psychological factors do not impact cognitive decline

Risk factors for post-treatment cognitive decline

Inconsistencies in the pattern of results

Impact of chemotherapy on brain structure and function

Interventions

The International Cancer and Cognition Task Force

Cultural implications

Conclusions

Chapter 7: Screening for Distress, the 6th Vital Sign, as the Connective Tissue of Health Care Systems: A Roadmap to Integrated Interdisciplinary Person-centred Care

Introduction: Integrated interdisciplinary patient-centred care

Background

Major issues

Summary and conclusion

Acknowledgements

Chapter 8: Psychological Intervention

Introduction

Background

Major issues

Conclusions and summary

Clinical case

Clinical case (continued)

Acknowledgements

Chapter 9: Psychopharmacological Interventions

Introduction

Background

Major issues

Analysis of the evidence

Anticonvulsants and mood stabilizers: use in the oncology setting

Cultural implications

Conclusions

Summary

Chapter 10: Rehabilitation

Cancer survivorship

The International Classification of Functioning, Disability and Health (ICF)

Objectives and the concept of cancer rehabilitation

Psychological aspects of rehabilitation

Indication and rehabilitation motivation

Psychological interventions during rehabilitation

Health promotion, patient education and psychoeducation

The multiprofessional rehabilitation team

Rehabilitation research

Part 2: Special Populations

Chapter 11: Pediatric Psycho-oncology

Introduction

Background

Developmental issues

Psychiatric disorders

Long-term issues for adult survivors

Families of paediatric patients and survivors

Therapeutic interventions

Acknowledgements

Chapter 12: A Life-stage Approach to Psycho-oncology

Introduction and background

The psychological impact of cancer in old age

Access to cancer care and psychosocial oncology services

Assessment considerations

Cognitive assessment and capacity

Assessment of depression

Social support and attachment security

Psychosocial interventions

Contextual factors

Spiritual well-being

Caregiving

Summary and conclusions

Chapter 13: Psycho-oncology in Underserved and Minority Populations

Introduction

Definitions

Psycho-oncology across cancer trajectories

Background

Major issues

Recovery and rehabilitation

Acknowledgements

Part 3: Other Topics

Chapter 14: Exploration of Family Care: A Multicultural Approach

Introduction

Family illness: a private universe

Family culture: quandaries of care

Families in the Middle East: a protective fortress

Israel population statistics (Table 14.2)

Family care: an inconclusive exploration …

Chapter 15: Bioethical Challenges: Understanding Cultural Differences and Reducing Health Disparities

Introduction: culture as a bioethical challenge

Culture and oncology

Culture, health and illness

Cross-cultural communication and its impact on decision-making: a global challenge

The ethical challenge of cultural differences in palliative and end-of-life care

The ethical challenge to understand cultural differences in survivorship care

The ethical challenge of cultural differences includes family caregiving

The ethical challenge includes overcoming language and cultural barriers

The ethical duty to acquire cultural competence in oncology

Practical suggestions are needed for an ethical psycho-oncology practice in a global perspective

Conclusion

Chapter 16: Post-traumatic Growth in Cancer Patients Across Cultures

Introduction

Background

Major issues relative to the theme of the chapter

Analysis of the evidence

Cultural implications

Conclusions

Summary

Chapter 17: The Need for Psychosocial Support in Genetic Counselling and Genetic Testing

Background

Genetic testing and counselling

Psychosocial issues in genetic testing

Psychological approaches that support the impact of genetic testing

Summary

Chapter 18: Psychosocial and Physical Health in Post-treatment and Extended Cancer Survivorship

Introduction and background

Trajectory of recovery after treatment ends: Major issues and analysis of the evidence

Sociocultural and developmental factors influencing psychosocial and physical recovery

Organizing the survivorship care team

Conclusions

Chapter 19: End-of-life Care

Introduction

Palliative care

Palliative care programmes/models of care delivery

Definition of a ‘good’ death

Assessment and management of commonly encountered psychiatric disorders in the palliative care setting

Suicide, assisted suicide, and desire for hastened death

Psychotherapy interventions in palliative care

Emerging psychotherapeutic interventions in the terminally ill

Conclusion

Chapter 20: Grief and Bereavement

Introduction

Background

Major issues

Cultural guidelines

Self-care for clinicians

Conclusion

Chapter 21: Spiritual and Religious Coping with Cancer

Introduction

Religious coping and the world's major religions

Religious prayer, spirituality and meaning

Clinical issues in spiritually-directed patient care

Therapeutic approaches to spiritually directed care

Challenges in delivering spiritually informed clinical care

Chapter 22: Psycho-oncology and Advocacy in Cancer Care: An International Perspective

Introduction

The European perspective

The US experience

The Australian experience

The experience of ‘Reach to Recovery’ in Asia

The African perspective

Final comments

Index

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Library of Congress Cataloging-in-Publication Data Clinical psycho-oncology : an international perspective / [edited by] Luigi Grassi and Michelle Riba. p. ; cm. Includes bibliographical references and index. Summary: “This international primer on psycho-oncology spans settings of care as well as regional boundaries. Designed to be easy to read, with informaton clearly displayed in concise tables and boxes accompanied by clinical vignettes, the book provides clear, practical guidance on all aspects of the psychological care of patients with cancer. Both trainees and practitioners will find it useful in the clinic as well as a resource for continued professional development”–Provided by publisher. ISBN 978-0-470-97432-2 (hardback) I. Grassi, Luigi. II. Riba, Michelle B. [DNLM: 1. Neoplasms–psychology. 2. Family–psychology. 3. Needs Assessment. 4. Psychology, Medical. 5. Psychotherapy. 6. Social Support. QZ 200] 616.99′40651–dc23 2012009770

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

First Impression 2012

List of Contributors

Tim Ahles, PhD Director, Neurocognitive Research Laboratory, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA Yesne Alici, MD Attending Psychiatrist, Geriatric Psychiatry Treatment Unit, Central Regional Hospital, Butner, NC, USA Kimlin Tam Ashing-Giwa, PhD Professor & Founding Director, Center of Community Alliance for Research & Education (CCARE), Division of Population Sciences, City of Hope National Medical Center, Duarte, CA, USA Lea Baider, PhD Full Professor of Medical Psychology, Faculty of Medicine, Hebrew University Medical School, Hadassah University Hospital, Jerusalem; Director, Psycho-Oncology Unit, Sharett Institute of Oncology, Department of Radiation and Clinical Oncology, Hadassah University Hospital, Jerusalem, Israel Walter F. Baile, MD Professor, Departments of Behavioral Science and Faculty Development; Director, Program on Interpersonal Communication and Relationship Enhancement (I*CARE), The University of Texas MD Anderson Cancer Center, Houston, TX, USA Susan D. Block, MD Chair, Department of Psychosocial Oncology and Palliative Care; Co-Director, HMS Center for Palliative Care, Professor of Psychiatry and Medicine, Harvard Medical School; Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA, USA William Breitbart, MD Chief, Psychiatry Service, Department of Psychiatry and Behavioral Sciences, and Attending Psychiatrist, Pain and Palliative Care Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center; Professor of Clinical Psychiatry, Department of Psychiatry, Weill Medical College of Cornell University, New York, NY, USA Barry D. Bultz, PhD Director, Department of Psychosocial Resources; Program Leader: Psychosocial Oncology, Supportive, Pain and Palliative Care, Tom Baker Cancer Centre; Adjunct Professor and Chair, Division of Psychosocial Oncology, Faculty of Medicine, University of Calgary, Alberta, Canada Phyllis Butow, BA(Hons)Dip Ed, MClinPsych, MPH, PhD Chair in Psychology, Co-director Centre for Medical Psychology and Evidence-based Medicine (CeMPED) and Chair, Psycho-Oncology Co-operative Research Group, University of Sydney, NSW, Australia. Santosh K. Chaturvedi, MD, FRCPsych Professor of Psychiatry, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India Harvey Max Chochinov, MD, PhD, FRCPC Director and Canada Research Chair in Palliative Medicine, Manitoba Palliative Care Research Unit, Cancer Care Manitoba; Professor of Psychiatry and Family Medicine, Departments of Psychiatry and Family Medicine, University of Manitoba, Winnipeg, Manitoba, Canada Karen L. Clark, MS Program Manager, Sheri & Les Biller Patient and Family Resource Center; Department of Supportive Care Medicine and Department of Population Sciences, City of Hope, Duarte, CA, USA Anna Costantini, PhD Director of Psychooncology Unit, Professor of Psychooncology, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome; Certified Group Psychotherapist and Member of the American Group Psychotherapy Association, President of Italian Society of Psychooncology, Italy Matthew Cordova, PhD Assistant Professor, Palo Alto University, Palo Alto, California Staff Psychologist, VA Northern California Health Care System, Martinez, CA Michael Diaz Undergraduate student, Human Biology, Stanford University, Palo Alto, CA, USA Kristine A. Donovan, PhD, MBA Assistant Member, Psychosocial and Palliative Care Program, Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA Jeff Dunn, PhD Griffith Health Institute, Griffith University, Australia; School of Social Science, University of Queensland, Australia; Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Australia Laura B. Dunn, MD Associate Professor and Director of Psycho-Oncology, Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA Mary Jane Esplen, RN, PhD Professor, Department of Psychiatry, Faculty of Medicine, University of Toronto; Director, de Souza Institute; Head, Program of Psychosocial & Psychotherapy Research in Cancer Genetics, University Health Network, Toronto, Canada Richard Fielding, PhD, CPsychol, FFPH Director, Centre for Psycho-Oncology Research & Training, Professor of Medical Psychology in Public Health, School of Public Health, The University of Hong Kong, Hong Kong, China Peter Fitzgerald, MD MRCPysch (UK) Fellow in Psychosocial Oncology, Princess Margaret Hospital, Toronto, Canada Patricia A. Ganz, MD Professor, UCLA Schools of Medicine & Public Health; Director, Division of Cancer Prevention & Control Research, Jonsson Comprehensive Cancer Center, Los Angeles (UCLA), CA, USA Jan Geissler Founder and CEO, Patvocates; Co-founder, CML Advocates Network; Chair, LeukaNET Gil Goldzweig, PhD Medical and Clinical Psychologist; Senior Lecturer, The Academic College of Tel-Aviv – Yaffo, Tel Aviv, Israel Luigi Grassi, MD Professor and Chair of Psychiatry, Chairman Department of Biomedical and Specialist Surgical Sciences, University of Ferrara; Director, Clinical & Emergency Psychiatry Unit, Department of Mental Health & Drug Abuse, Ferrara, Italy Jonathan Hunter, MD, FRCPC Associate Professor; Head, Consultation/Liaison Division, University of Toronto Department of Psychiatry; Mount Sinai Hospital, Toronto, Canada María Elisa Irarrázaval, MD Chief, Mental Health Unit, Fundación Arturo López Pérez Oncologic Center, Santiago, Chile Paul B. Jacobsen, PhD Chair, Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA Kathryn M. Kash, RN, BS, MPhil, PhD Associate Professor, Program Director, Masters in Chronic Care Management, Jefferson School of Population Health, Thomas Jefferson University, PA, USA Brian Kelly, BMed, PhD, FRANZCP, FAChPM Professor of Psychiatry and Head, Discipline of Psychiatry, University of Newcastle, NSW, Australia David W. Kissane, MD, MPM, FRANZCP, FAChPM Jimmie C. Holland Chair of Psycho-Oncology, Attending Psychiatrist and Chairman, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center; Professor of Psychiatry, Weill Medical College of Cornell University, New York, NY, USA Uwe Koch, PhD, MD Professor of Medical Psychology; Dean, Medical Faculty, Hamburg University, University Medical Center Hamburg Eppendorf, Hamburg, Germany Wendy W.T. Lam, RN, PhD Assistant Professor; Deputy Director, Centre for Psycho-Oncology Research & Training, School of Public Health, University of Hong Kong, Hong Kong, China Carrie Lethborg, PhD Senior Social Worker, Department of Oncology, St Vincent's Hospital, University of Melbourne, Victoria, Australia Matthew J. Loscalzo, LCSW Liliane Elkins Professor in Supportive Care Programs; Administrative Director, Sheri & Les Biller Patient and Family Resource Center; Executive Director, Department of Supportive Care Medicine; Professor, Department of Population Sciences, City of Hope, Duarte, CA, USA Anja Mehnert, PhD Head, Psycho-Oncology and Palliative Care Research Group, Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Hamburg, Germany Anne Merriman PhD, FRCP, MCommH Director of Policy and International Programmes, Hospice Africa in Uganda; Honorary Professor of Palliative Medicine, Department of Internal Medicine, Makerere University, Uganda Sue E. Morris, MPsychol (Clinical) Hons Director of Bereavement Services, Dana-Farber/Brigham and Women's Cancer Center; Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA Chiara M. Navarra, PhD Psychooncology Unit, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome; Certified Psychotherapist, Member of Italian Society of Psychooncology, Italy Rinat Nissim, PhD Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, University Health Network, Toronto, Canada Michelle Riba, MD, MS Professor and Associate Chair, Integrated Medicine and Psychiatric Services, Department of Psychiatry, University of Michigan Medical School; Director, PsychOncology, University of Michigan Comprehensive Cancer Center, MI, USA Gary Rodin, MD FRCPC Professor of Psychiatry, University of Toronto; Head, Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital; University of Toronto/University Health Network Chair in Psychosocial Oncology and Palliative Care; Senior Scientist, Ontario Cancer Institute, Canada Sanne Schagen, PhD Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands Ranjit Kaur Pritam Singh, AMP, MSc Chief Executive Officer, Breast Cancer Welfare Association Malaysia, Petaling Jaya, Selangor, Malaysia David Spiegel, MD Willson Professor in the School of Medicine, Associate Chair, Department of Psychiatry & Behavioral Sciences, Director, Center on Stress and Health, Stanford University School of Medicine, Stanford, CA, USA Annette L. Stanton, PhD Professor, Psychology & Psychiatry/Biobehavioral Sciences; Member, Jonsson Comprehensive Cancer Center; Senior Research Scientist, Cousins Center for Psychoneuroimmunology, Los Angeles, CA, USA Elizabeth M. Strom Medical student, University of Illinois at Chicago College of Medicine, Dixon, IL, USA Margaret L. Stuber, MD Jane and Marc Nathanson Professor, David Geffen School of Medicine, University of California, Los Angels, CA, USA Antonella Surbone MD, PhD, FACP Professor of Medicine, Department of Medicine, New York University Medical School, New York, NY, USA; Faculty, Interpersonal Communication & Relationship Enhancement Program (I*CARE), M.D. Anderson Cancer Center, Houston, TX, USA; Lecturer in Clinical Bioethics and Palliative Care, Italy Seema M. Thekdi, MD Assistant Professor, Department of Psychiatry, MD Anderson Cancer Center, Houston, TX, USA Kim Thiboldeaux President & CEO, Cancer Support Community, Uniting The Wellness Community and Gilda's Club Worldwide, Washington DC, USA Luzia Travado, D. Clin Psych, MSc Clinical Psychology Unit, Central Lisbon Hospital Centre – Hospital de S. José, Lisbon, Portugal Yosuke Uchitomi, MD, PhD Professor and Chairman, Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan Janette Vardy, MD, PhD Sydney Cancer Centre, University of Sydney, Concord Repatriation General Hospital, Concord, NSW, Australia Maggie Watson, BSc, PhD, DipClinPsych, AFBPS Head, Psychology Research Group, Institute of Cancer Research; Consultant Clinical Psychologist, Royal Marsden Hospital; Honorary Professor, Research Department of Clinical, Health and Educational Psychology, University College London, UK Sophia Yeung, RN Community Interventionist, Center of Community Alliance for Research & Education (CCARE), Division of Population Sciences, City of Hope National Medical Center, Duarte, CA, USA

Foreword

It is an honour and a privilege to write the Foreword for this book, which establishes a benchmark in the emerging field of psycho-oncology. It reflects the fact that there is now international recognition of the importance – and even necessity – of the integration of the psychosocial domain into routine cancer care in this early part of the twenty-first century. There have been significant barriers to reaching this benchmark: the fact that patients were not told their diagnosis; that the stigma attached to cancer made it a word that could not be spoken; that the psychological burden of the patient with cancer was not acknowledged by others; and that the study of patient-reported (subjective) symptoms were regarded as not quantifiable by the scientific cancer community. Progress has been quite remarkable in the past 35 years as these barriers broke down and psychological issues became the topic of scientific study and research, particularly the validation of quantitative assessment tools to measure symptoms such as pain, anxiety and depression. With the development of reliable tools, the science could move forward which allowed us to measure changes in symptoms based on interventions to reduce distressing physical and psychological symptoms. Thus, this book contains the synthesis of global state of the art research which today constitutes what we now call the ‘science of care’ in cancer – attention to the humanistic, ethical, psychological, social, cultural, psychiatric and behavioural issues that contribute so substantially both to the outcome of the medical treatment and the quality of the experience of the patient with cancer and the family.

The fact that this book was developed out of the Psycho-Oncology and Palliative Care Section of the World Psychiatric Association is a source of pride for me since I served as its Founding Chair. The co-editors of this book, Luigi Grassi and Michelle Riba, have carried the work of the Section forward in an impressive way, collaborating with the International Psycho-Oncology Society (IPOS), the world's leading international multidisciplinary association which addresses the psychological and social issues in cancer. IPOS has taken a lead role in establishing standards for psychological care by engaging the major global cancer organizations. The IPOS International Standard of Quality Cancer Care states that

1. Quality cancer care must integrate the psychosocial domain into routine care;

2. Distress should be measured as the Sixth Vital Sign after temperature, blood pressure, pulse, respiration and pain.

The recent endorsement by the International Union Against Cancer (UICC) and the International Pediatric Society (SIOP) speaks to the synergy that comes from these collaborative international efforts. IPOS has proposed that the World Cancer Day 2013 should call for global action on supportive care, under the banner ‘Declare you care about cancer support’. These global initiatives have an immediate effect upon the potential of the national psycho-oncology societies to have an impact in their own countries, implementing the goals in ways that are culturally appropriate.

The authors of these chapters that follow are the scholars in psycho-oncology from around the globe. They have truly brought together the information that is most relevant and have synthesized it to provide an overview of the best research in the area. I am enormously proud of what our field has accomplished up to now. I am sure that the future will see major steps forward to ensure that the emotional suffering that has so long accompanied cancer will be further reduced. Francis Peabody, thoughtful physician, wrote in 1927 in the JAMA, ‘The secret of the care of the patient is in CARING FOR the PATIENT’. The clinicians and researchers in psycho-oncology contribute that ‘caring’ piece to cancer, through developing the ‘science of care’ combined with attention to the humanistic and compassionate aspects of care.

Jimmie C. Holland, MDWayne E. Chapman Chair in Psychiatric OncologyApril 2012

Acknowledgements

The idea of this book originated at the World Psychiatric Association (WPA) International Congress in Florence, Italy, in April 2009, where the activity and the work done by the Section on Psycho-Oncology and Palliative Care and the Section on Psychiatry, Medicine and Primary Care, which we respectively chair, were presented. On that occasion, we decided to take the challenge to edit a book exploring, from an international perspective, the cultural aspects underlying the several areas related to psychosocial care in cancer. A fundamental concept of the book was to promote and sustain the role of our sections within the WPA and to sensitize more mental health professionals and psychiatrists to the psychosocial concomitants of cancer. Further, we hoped these collaborative efforts would give possible insights to the well-established science and discipline of psycho-oncology by stressing the role of culture, with all its complex facets, as a basic variable to be taken into account when dealing with communication, ethical, spiritual, psychological and social aspects of cancer.

We are deeply grateful to all the authors from many different parts of the world and belonging to many different cultural backgrounds who accepted to speak, as one voice, the common language of clinical psycho-oncology care, and to generously share their experiences and commitment to participate in this task. Without their enthusiasm, expertise and contributions this book would not have been possible. Our deepest thanks to the board of the World Psychiatric Association (WPA), in particular Mario Maj, Miguel Jorge and Pedro Ruiz, and Helen Herrman, for their guidance; to Jimmie Holland, founding chair of the WPA Section on Psycho-Oncology and Rodolfo Fahrer, founding chair of the WPA Section on Psychiatry, Medicine and Primary Care, for their vision and encouragement to us to persist in our efforts and to maintain the aims of the sections; to the present and the past board of the International Psycho-Oncology Society (IPOS) with whom we have collaborated and worked in many different projects over the last years, namely Elisabeth Andritsch, Lea Baider, William Breitbart, Barry Bultz, Phyllis Butow, Santosh Chaturvedi, Vicente De Carvalho, Maria Die-Trill, Sylvie Dolbeault, Jeff Dunn, Fawzy Fawzy, Richard Fielding, Lise Fillion, Thomas Hack, Elizabeth Harvey, Jimmie Holland, Takashi Hosaka, Paul Jacobsen, Christoffer Johansen, David Kissane, Uwe Koch, Katalin Muszbek, Antonella Surbone, Luzia Travado, Yosuke Uchitomi, Kazuhiro Yoshiuchi, Maggie Watson, for their friendship and constant contribution in making psycho-oncology grow year after year. We also would like to express our appreciation and acknowledgement to all the representative persons and members, most of them friends for a long time, of the several National Societies of Psycho-Oncology of different countries throughout the world, belonging to the Federation of IPOS. Their commitment and enthusiasm in founding and sustaining the Federation has been the seed for the idea of this book.

We owe a special debt of gratitude to our teachers and mentors who advocated and supported our commitment to psychosomatic medicine and collaborative models during our professional and human journey; to our families who consistently supported and encouraged us; and to all the patients and families who taught us the sense of humanity and shared their underlying suffering and pain, in all their physical, psychological, interpersonal and spiritual dimensions.

We also would like to thank the editorial staff at Wiley-Blackwell, particularly Joan Marsh, Fiona Seymour and Robyn Lyons, for their wise suggestions, help and guidance for this project.

Luigi GrassiFerrara, Italy

Michelle RibaAnn Arbor, Michigan, USAMarch 2012

PART 1

Clinical Issues

CHAPTER 1

Introducing Multicultural Psycho-oncology

Luigi Grassi1 and Michelle Riba2

1Section of Psychiatry, Department of Medical and Surgical Disciplines of Communication and Behaviour, University of Ferrara, Italy

2Department of Psychiatry, University of Michigan and University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA

There is one short rule that should regulate human relationships. All that you see, both divine and human, is one. We are the parts of one great body. Nature created us from the same source and to the end. She imbued us with mutual affection and sociability, she taught us to be fair and just, to suffer injury rather than to inflict it. She bids us extend our hands to all in need of help. Let that well-known line be in our hearts and on our lips: I am a man: I deem nothing pertaining to man is foreign to me (Homo sum, humani nihil a me alienum puto).

Lucius Annaeus Seneca, Epistulae Morales ad Lucilium, Book XV, Letter 95:52–53 (62–65 AD)

According to the World Health Organization (WHO) projections, it is estimated that the incidence of cancer will increase by the year 2030, with new cases of cancer jumping from 13.3 million in 2010 to 21.3 million in 2030 and cancer deaths rising from 7.9 million to 13.1 million. At the same time, earlier diagnoses and improvement in cancer therapies have also noted an increase in survival for about 25 million people (long-term survivors) throughout the world.1

It is clear that this epidemiological data has a specific value if evaluated through a global perspective which takes into account the important issues of quality of life and psychosocial needs of cancer patients. In fact, cancer is not only a series of very different diseases needing complex treatments, from many professionals, but also a devastating and ‘traumatic’ event with physical, emotional, interpersonal and social implications that should be constantly monitored across the disease trajectory, and into survivorship. Being affected by cancer means an overall transformation of the sense of one's own self, in which the parameters of time (the past, the present, the future), of space (one's own individual space, one's own home, one's own world context) and of existence (Umwelt, the biological dimension, my body; Eigenwelt, the relationship with myself, my-being-in-the-world; Mitwelt, the relational dimension with others; Überwelt, the spiritual dimension, the meaningfulness) are altered by the diagnosis and treatment, recovery and recurrence or transition to palliative and end-of-life care.

Starting from the work of a small group of psychiatrists,2–6 interested in examining the psychophysiological and emotional factors implicated in cancer and cancer treatment, oncologists quickly started showing a specific need for more precise indications about the psychosocial, behavioural and rehabilitative issues in cancer care. This determined the rapid growth of the psycho-oncology discipline in the USA from the 1970s and subsequently, from the early 1980s, in many other countries, such as France, Germany, Italy, the Netherlands, the United Kingdom, to cite just a few.