Psycho-science: Where do we go from here?

Abstract

The last 25 years have seen a burgeoning of research and publications in the field of psychosocial oncology. For example, in 1998, the frequency of publication of Psycho Oncology (the official organ of the International Psycho Oncology Society) was increased from four issues per year to six issues per year, and by 2004 the frequency had increased to 12 issues per year (currently over 1200 pages per annum). There have been a number of significant achievements during this time, notably (a) the universal realisation that the diagnosis and treatment of cancer commonly cause significant psychosocial and psychiatric morbidity, (b) the increasing recognition of the importance of good communication between health care professionals and their patients (and other family members) as well as the importance of providing appropriate information and support, and (c) the acceptance of the need to include measures of quality of life and related psychosocial parameters as outcomes in clinical trials of new oncological interventions. There has also been increasing recognition of the need for specialist palliative care services [1]. Unfortunately, too much recent research, both qualitative and quantitative, has been devoted to describing and quantifying ad nauseam the nature and prevalence of cancer-related distress, at the expense of developing and evaluating ways of preventing and treating such distress. Despite this, a number of well-designed randomised controlled trials (RCTs) have shown that psychosocial interventions can be effective in reducing treatmentrelated distress (for example, treatment-related nausea and anxiety treated to medical investigations and procedures) as well as in treating clinically significant anxiety and depression [2]. Other RCTs have shown that various psychosocial interventions, for example, relaxation and guided imagery, can improve quality of life more generally following the diagnosis as well as during and after treatment [3]. Quo vadis