The overall principle behind all psychological and social treatment of cancer is that it is a bio-psycho-existential-social disease, which afflicts all aspects of life. The psychosocial aspects of cancer are treated by a range of clinical approaches, which vary according to the socioeconomic status of the region or country in which such treatment is given. Thus, an oncology nurse in a country with scarce resources and a low gross national product will concentrate on palliation or treating the immediate side-effects of cancer that arise from insufficient capacity to manage cancer in general and its complications. Cultural and general belief systems affect the interpretation of cancer as an illness, influence the expectations of patients and relatives and alter the treatment approach. Access to basic treatment options, such as specialists, X-ray equipment, chemotherapy, and opioids, is an important determinant of psychosocial reactions to cancer. The availability of sickness leave, the social security system in the country, access to treatment with or without a health insurance, the prices of the drugs required, access to outpatient follow-up clinics and to psychologists and other persons who can address the psychological problems of cancer patients also affect treatment. Most psychosocial support systems, clinical research, guidelines, and training of specialists in psychosocial oncology are found in affluent countries, reflecting not advances in the discipline but the global distribution of wealth. The international spread of psychological and social treatment of cancer is discussed below in the framework of scientific benchmarks and by reviewing advances in clinical practice and access to psychosocial support. This chapter starts with a brief history of psychosocial support in cancer treatment; then, we highlight some of the major scientific achievements and examine the growth in international collaboration. In a further section, examples are given of guidelines for providing psychosocial care in overall cancer treatment. In the last section, international organization and future aspects of international collaboration are described to support our vision of psychosocial clinical care and research.
International Psycho-oncology: Present and Future
GRASSI, Luigi
2010
Abstract
The overall principle behind all psychological and social treatment of cancer is that it is a bio-psycho-existential-social disease, which afflicts all aspects of life. The psychosocial aspects of cancer are treated by a range of clinical approaches, which vary according to the socioeconomic status of the region or country in which such treatment is given. Thus, an oncology nurse in a country with scarce resources and a low gross national product will concentrate on palliation or treating the immediate side-effects of cancer that arise from insufficient capacity to manage cancer in general and its complications. Cultural and general belief systems affect the interpretation of cancer as an illness, influence the expectations of patients and relatives and alter the treatment approach. Access to basic treatment options, such as specialists, X-ray equipment, chemotherapy, and opioids, is an important determinant of psychosocial reactions to cancer. The availability of sickness leave, the social security system in the country, access to treatment with or without a health insurance, the prices of the drugs required, access to outpatient follow-up clinics and to psychologists and other persons who can address the psychological problems of cancer patients also affect treatment. Most psychosocial support systems, clinical research, guidelines, and training of specialists in psychosocial oncology are found in affluent countries, reflecting not advances in the discipline but the global distribution of wealth. The international spread of psychological and social treatment of cancer is discussed below in the framework of scientific benchmarks and by reviewing advances in clinical practice and access to psychosocial support. This chapter starts with a brief history of psychosocial support in cancer treatment; then, we highlight some of the major scientific achievements and examine the growth in international collaboration. In a further section, examples are given of guidelines for providing psychosocial care in overall cancer treatment. In the last section, international organization and future aspects of international collaboration are described to support our vision of psychosocial clinical care and research.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
