Cancer patients receiving chemotherapeutic treatments routinely experience a wide range of distressing side effects, including nausea, vomiting, and dysphoria. Such symptoms often compromise patients 1 quality of life and may lead to the decision to postpone or even reject future, potentially life-saving, treatments. In this article, we discuss the hypotheses that have been offered to explain the development of such symptoms. We also review, in greater detail, the research evidence for the efficacy of five treatments for such symptoms: hypnosis, progressive muscle relaxation training with guided imagery, systematic desensitization, attentional diversion or redirection, and biofeedback. We discuss the implications of this treatment research, paying particular attention to factors associated with treatment outcome, mechanisms of treatment effectiveness, and issues associated with clinical application.
Chemotherapy is the treatment of choice for hundreds of thousands of cancer patients diagnosed each year in the UnitedStates (Silverberg & Lubera, 1986). Its frequent use with cancer patients is the result of recent advances in antineoplastic medication; new and more effective medications have increased the life expectancy for many patients and, in some cases, have resulted in remission and cure. Unfortunately, such long-term gain can come at considerable short-term cost to the cancer patient in the form of aversive and debilitating side effects. Among the more common drug-induced side effects are alopecia, stomatitis, immunosuppression, anorexia, nausea, and vomiting.In addition to these pharmacological side effects, chemotherapy patients also experience psychological side effects.Psychological side effects, which should not necessarily be regarded as abnormal or indicative of psychopathology, are those that cannot be attributed directly to the antineoplastic medications; instead, such symptoms are believed to result from psychological processes (e.g., learning) that occur in the chemotherapy context. These symptoms can occur before chemotherapy (in which case they are referred to as anticipatory side effects) as well as during and after the actual chemotherapy infusion. When they occur after chemotherapy has been administered (and while the drugs remain pharmacologically active within the system), it is practically impossible to distinguishWe wish to thank Kate B. Carey and the anonymous reviewers for their many helpful suggestions on an earlier draft of this review.