Departments

Medical Departments

Psycho Oncology Unit

Mission

Psychological aspects related to cancer

 

Over the past twenty years, the significant progress made in cancer treatment have had big impacts on the caretaking of patients suffering from such pathologies. First of all, the extension of patients' lifetime converted cancer into a chronic disease, the development of which is no longer systematically linked to death. In that way, some previously neglected aspects appeared to be essential in a good caretaking of patients. Particularly, quality of life became a factor more important in the mind of the nursing as well as researchers.

The concept of quality of life covers many factors that do not only take into account medical data (recovery percentage, duration of survival, efficiency of new anti-tumorous treatments…), but also and especially parametres regarding physical, emotional and social well-being of patients and their relatives. In the same way, it is even more clear that the idea (which was dominant until recently) according to which emotional distress caused by cancer is "normal" and "understandable" can be no longer justified. Indeed, this idea makes patients passively accepting a painful but inescapable reality; in other words, accepting that the medical staff can't do anything when they are faced with one of the most current and testing aspect of cancer.

A rigorous study led in the United States and published in 1983 showed that about one in two patients suffering from cancer has psychological disorders, 80% of which are due to anxiety and/or depression ! In the face of such reality that was finally acknowledged, a new science was developed : psycho-oncology.
Its has two aims :
- on the one hand, it consists in studying and treating the psycho-social consequences of cancer in patients and their relatives.
- on the other hand, the eventual impacts of psychological factors on the development of cancer arouse a growing interest and are subjected to deep studies.
But we will not dwell on this very interesting aspect because it does not belong to the subject of this short discussion.

To give an overall picture, the knowledge in this field can be summed up this way :
1) we did not manage to show that there is a link between psychological factors such as stress, anxiety or depression and a bad development of cancer.
2) some studies suggested that patients who had received psychosocial support lived longer. But people must interprete these data with caution because there were not repeat. In other words, the results were maybe discovered by pure coincidence, by mistakes made during the study or they come from independent factors of the study which have not been identified yet.
3) It is clear that psychological support improves patients' lifestyle and maybe their relatives' lifestyle.

In one word, it is very important to take into account the different factors that may have caused emotional reactions in the context of cancerology. Indeed, the study starts even before a patient is diagnosed, during screening. The new data relating to risk factors that we have at our disposal (coming from the recent progress in genetics) increase the duration of this pre-cancer stage.
There are specific profiles of psychological reactions which correspond to each stage of the disease (diagnosis, treatment(s), relapse(s), advanced stage), and these profiles must enable patients to receive an appropriate caretaking.
Moreover, in addition to the consequences of cancer and its treatment, other factors may also have an impact on the patient's psychological state of mind such as patient's history, environment (family, profession, social contacts, financial state…) as well as the complex interactions between these different factors.
In other words, everybody has had a different history when one is diagnosed with a cancer, and this will have an effect on the way one will react against different sources of stress.
In that way, one will be more or less supported by one's husband or wife, friends and colleagues, by one's financial state or one's social relationships which will help one to live more or less better.
In such a context, the psycho-social interventions aim to gather as most internal and external resources available as possible in order to allow the patient and the relatives to adapt themselves to a new reality caused by cancer.

Given the big number of different and complex factors, it is clear that the use of various therapeutic methods which are appropriate to the needs of each patient is required to provide them with the best caretaking. In that way, sometimes, it is required to complement the prescription of tranquillisers and antidepressants with psychotherapeutic consultations.
The emotional, cognitive, behavioural and systemic (family) approaches are the most effective psychotherapeutic techniques.

Regardless of which kind of approach the doctor will make use in a deep examination, the caretaking of patients suffering from cancer requires the help of specialists in psycho-oncology who deeply know the array of psychological reactions, the symptoms and the most recent progress in the oncology field.

In Bordet Institute, the Psycho-oncology unit belongs to the Supportive and Palliative Care Departement and Rehabilitation, and tries to respond to the needs of patients and their families as best as possible, by an appropriate, pluridisciplinary approach. It also invests in scientific research in order to continuously develop a better knowledge of the subject and improve the different treatments.

 

Person in charge : Dr Razavi