MIND AND EMOTIONS IN CANCER: STUDIES FROM DEVELOPING COUNTRIES
This special issue focuses on mind and emotions in cancer in five articles from Romania, a developing country regarding psycho-oncology.
Psycho-oncology is one of the specialties pertaining to oncology which has recently undergone a spectacular evolution. Main focus areas of psycho-oncology include cancer prevention, cancer distress screening and management, and cancer patients’ psychosocial treatment and rehabilitation, while also keeping in view the continuous improvement of their quality of life. The aim of this special issue was to provide a platform for researchers and clinicians to share their recent findings and knowledge on the psychosocial impact of cancer. We invited articles that address mind and emotions in cancer in the widest sense.
For start, we need to take into consideration the fact that both in the USA and Western Europe the movement of psychosocial care targeting cancer patients started to emerge in the late 1960s, whereas these services were initiated in the former communist bloc only in the 1990s (Clark & Centeno, 2006). Our introductory article entitled “Cancer and psychosocial care in Romania: what do we know?” presents a research overview of unmet psychosocial needs in a large national sample of Romanian cancer inpatients. It highlights that, in 2016, the status of psychosocial oncology within the Romanian healthcare system is just in its initial stages and focus on the psychosocial aspects of patient-related needs is still insufficient. Psychosocial distress is reaching high values and burden symptoms remained relatively unchanged in the last decade, especially with depression and anxiety in focus.
Cancer distress, the 6th vital sign is a universal cancer-related experience and a human rights issue. It is a multifaceted reality with the undisputable advantage of ‘reminding us that people with cancer are human beings’ (Greer, 2002). People-centered value of supportive and cognitive behavioral psychological interventions throughout the cancer trajectory is evidenced in the case report written by Pop, Iancu, and Lisencu. They registered posttraumatic growth in their intervention with a cancer patient which shows that for some affected persons cancer might have a positive psychological and social outcome, including survivorship, when tailored psychosocial care is available.
In fact, cancer can easily become emotional and charged with prejudices due to guilt, punishment, atonement and the image of death associated with its malignant nature. For some, the cancer experience has a significantly negative impact not just on mental health and well-being, but on sexuality and intimate life. Dr. Faludi and Dégi, upon examining the influence of a set of socio-demographic, cancer specific, and psychological characteristics of Romanian cancer patients on their intimate life, set out from the interaction of medical, psychological and social factors. They draw attention to the importance of including assessment of quality of sexual life in the overall evaluation of cancer patients’ psychosocial needs.
Cancer remains an unregulated form of life, which launches attack on the body, but from the very moment the affected or at-risk person becomes aware of it, or the perspective of it, the devastating effects of cancer might start working in the person’s psychological and social living as well. Information needs are high when cancer odds are present, like in the case of L.S., a 30 years old women diagnosed with a pathogenic R1203X (3726C>T) mutation in BRCA1. Genetic counselling session offered to her, a patient with a BRCA1 mutation-associated breast cancer, is described by authors Peca, Pop, and Farcaș in a case study report.
One of the most important tasks of psycho-oncology was set to reduce the gap between empirical knowledge and actual clinical services (Burg et al., 2010; Greer, 2002). In this regard, our closing article, written by Pop, Postolica, Lupău and Dégi, proposes a first clinical practice guide in psycho-oncology for Romanian helping professionals. This guide corroborates clinical experience from within the Romanian oncology system, psychosocial resources available to Romanian professionals in cancer care and best practice recommendations from the psycho-oncology literature. Our current level of knowledge indicates that psychosocial interventions and oncological rehabilitation can reduce cancer distress, cancer-related suffering, vulnerability, and psychosocial risks, thus improving cancer patients’ quality of life (Edelman, Craig, & Kidman, 2000), their minds and emotions.
I would like to take this opportunity to thank current editorial board members, peer reviewers and contributing authors from different oncology and research centers for making this special issue on psycho-oncology possible.