Distress in Cancer Patients

By Kállay, Éva; Dégi, Csaba L. | Cognitie, Creier, Comportament, March 2014 | Go to article overview

Distress in Cancer Patients


Kállay, Éva, Dégi, Csaba L., Cognitie, Creier, Comportament


Cancer is one of the leading causes of death worldwide (National Center for Health Statistics, 2006). Of all deaths, one in four cases is attributable to different forms of oncological diseases (Massie & Greenberg, 2005), lung, stomach, liver, colon, and breast cancer causing the most cancer-related deaths each year (WHO, 2013). According to the WHO (2008a; 2008b), the next decade will record a substantial, over 50% increase in cancer related illnesses, leading to the diagnosis of 16 million new cases, and 10.3 million cancer-related deaths worldwide. Because of the advances in the efficiency of detection and treatment methods, more than two thirds of the adult patients diagnosed with cancer may be expected to survive more than five years (Ries, Harkins, Krapcho, Mariotto, Miller, Feuer, et al., 2006 as cited in Costanzo, Stawski, Ryff, Coe, & Almeida, 2012). Thus, as the population ages, and death rates decrease, the number of persons living with cancer-related diseases will continue to increase (Massie & Greenberg, 2005). Research has repeatedly evidenced that the diagnosis with cancer has a tremendous psychological impact on patients and their families, inducing high levels of distress, significantly impairing psychological functioning (NCCN, 2009). In this context, the investigation of factors affecting the quality of cancer patients' physical and psychological functioning, and their interaction becomes imperative (Bradley, Rose, Lutgendorf, Costanzo, & Anderson, 2006; Helgeson & Tomich, 2005; Hewitt, Greenfield, & Stovall, 2005).

The relationship between distress and oncological diseases has kindled several trajectories of research. One area started investigating the effect different psychological factors have on the onset of cancer (Massie & Greenberg, 2005). This far, empirical research has not clarified this relationship (Levenson & McDonald, 2002), though lay people continue to believe that psychological factors may cause cancer-related illness (Massie & Greenberg, 2005; Ross, Boesen, & Johansen, 2005).

The second direction of research focused on investigating the effect of distress on the progress of illness. Research documented that different forms of emotional distress may have a significant impact on the course of illness via poorer pain control (Glover, Dibble, Dood, & Miaskowski, 1995), lower levels of compliance to treatment (Ayres, Hoon, Franzoni, Matheni, Cotanch, & Takayanagi, 1994), decreased desire for implication in different forms of therapy that would sustain recovery and enhance the patients' quality of life (Lee & Ganzini, 1992).

The diagnosis with cancer is typically thought of as a highly adverse, traumatic encounter (Costanzo, Ryff, & Singer, 2009; Kangas, Henry, & Bryant, 2002). Its prolonged treatment and physical side effects can have a profound impact on almost all aspects of the patients' functioning (CPAC, 2009). Besides the multiple physical sequelae, cancer patients may also experience a wide variety of emotional, social, professional, spiritual problems as a result of the cancer-experience (Aspinwall & MacNamara, 2005; Costanzo, Ryff, & Singer, 2009; Coughlin, 2008; Stanton, Revenson, & Tennen, 2007). The confrontation with a life-threatening disease and its treatment can induce high levels of uncertainty, hopelessness, anxiety, depression (Moos & Schaefer, 1984). A plethora of large population-based studies indicate that patients diagnosed with cancer present significantly more mental health problems than the healthy population (Arndt, Merx, Stegmaier, Ziegler, & Brenner, 2005; Baker, Haffer, & Denniston, 2003; Rabin, Rogers, Pinto, Nash, Frierson, & Trask, 2007). The physical and psychological effects simultaneously influence the dynamic of their social life, their social activities and interpersonal relationships (with partner, children, other family members, friends, work, etc.) (e. …

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