The missing piece: cancer prevention within psycho‐oncology — a commentary

Abstract

In this commentary, we review the place of prevention within the field of Psycho-Oncology. The thrust of Psycho-Oncology's clinical and research efforts have historically focused on behavioral and social factors implicated in the cancer patients' experience from detection and diagnosis, to treatment, survivorship and end of life along the cancer trajectory. This conceptualization has raised the standards for research, leading to a better understanding of the patient experience and the delivery of highly effective interventions to improve quality of life. Emerging data on the role of potential prevention behaviors (e.g., diet and exercise, smoking cessation, screening, etc.) suggests that Psycho-Oncology has a significant role to play in understanding and intervening on a population level to reduce cancer incidence. We present and describe an expanded model of research in Psycho-Oncology which incorporates psychosocial variables in prevention research to complement Holland et al. 's (1998, 2010) original model. The implications of this model are discussed in relation to research, clinical work and training within the discipline of Psycho-Oncology.

Developing a preventive psycho‐oncology for a global context. The International Psycho‐Oncology Society 2018 Sutherland Award Lecture

“…The case for more prevention in psycho‐oncology has already been outlined . Prevention is hierarchical: primary prevention, preventing/modifying known causes of disease (smoking, inactivity, viruses); secondary prevention, ensuring appropriate detection in those at risk; tertiary prevention, management of early and late effects (in psycho‐oncology, this is predominantly psychosocial distress); and quaternary prevention, ensuring what remains does not deteriorate.…”

A fertility needs assessment survey of male cancer patients

“…It would therefore be of great value for HCPs to address these points, particularly as some patients may avoid FP because they falsely believe that they can pass on cancer to their child. We know that the hereditary link of cancer is overestimated by the general public, when in fact it is quite low (~5%‐10% of all cancer) and that most cancers are due to lifestyle choices and viruses . Informing patients of the extremely rare likelihood that their cancer can be transmitted via genetics to their unborn child may help relieve unfounded stress and anxiety.…”

Mitigating negative emotions through virtual reality and embodiment

“…Our paradigm will offer a gradual experience of embodiment that will be implemented before oncological treatments (i.e., surgery, chemotherapy, radiotherapy) start. Despite the well-recognized impact of oncological treatments on patients’ psychological well-being (e.g., Kam et al, 2015 ; Moschopoulou et al, 2018 ; Pitman et al, 2018 ), in fact, interventions in psycho-oncology mostly focus on tertiary prevention, with the main goal of improving outcomes, and lessen the negative effects of the disease on patients’ life (e.g., symptom management, minimization of treatment-related complications; Rosberger et al, 2015 ). However, if cancer patients have a high chance to experience such difficulties, why do psycho-oncological interventions not focus on preventing mental health problems from happening?…”

“…The possibility to propose this training before the beginning of cancer treatments places, indeed, our paradigm in the position of filling the gap that Rosberger and colleagues identified in 2015, therefore moving psycho-oncology from tertiary to primary prevention. By doing that, psycho-oncology will finally avoid treatment-related psychological difficulties from happening (e.g., anxiety, body image, and social concerns), instead of buffering them once already occurred (Rosberger et al, 2015 ).…”