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Clinical Psycho-Oncology
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Clinical
Psycho-Oncology
An International Perspective
Luigi Grassi, MD
ProfessorandChairofPsychiatry
ChairmanDepartmentofBiomedicalandSpecialistSurgicalSciences
UniversityofFerrara;
Director,Clinical&EmergencyPsychiatryUnit,DepartmentofMentalHealth&DrugAbuse,
Ferrara,Italy
Michelle Riba, MD, MS
ProfessorandAssociateChair,IntegratedMedicineandPsychiatricServices
DepartmentofPsychiatry
UniversityofMichiganMedicalSchool;
Director,PsychOncology
UniversityofMichiganComprehensiveCancerCenter,MI,USA
A John Wiley & Sons, Ltd., Publication
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LibraryofCongressCataloging-in-PublicationData
Clinicalpsycho-oncology:aninternationalperspective/[editedby]LuigiGrassiandMichelleRiba.
p.;cm.
Includesbibliographicalreferencesandindex.
Summary:“Thisinternationalprimeronpsycho-oncologyspanssettingsofcareaswellasregional
boundaries.Designedtobeeasytoread,withinformatonclearlydisplayedinconcisetablesandboxes
accompaniedbyclinicalvignettes,thebookprovidesclear,practicalguidanceonallaspectsofthepsychological
careofpatientswithcancer.Bothtraineesandpractitionerswillfinditusefulintheclinicaswellasaresource
forcontinuedprofessionaldevelopment”–Providedbypublisher.
ISBN978-0-470-97432-2(hardback)
I.Grassi,Luigi. II.Riba,MichelleB.
[DNLM:1.Neoplasms–psychology. 2.Family–psychology. 3.NeedsAssessment. 4.Psychology,
Medical. 5.Psychotherapy. 6.SocialSupport. QZ200]
616.99(cid:2)40651–dc23
2012009770
AcataloguerecordforthisbookisavailablefromtheBritishLibrary.
Wileyalsopublishesitsbooksinavarietyofelectronicformats.Somecontentthatappearsinprintmaynotbe
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FirstImpression2012
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Contents
ListofContributors, vii
Foreword, xi
Acknowledgements,xiii
Part 1 Clinical Issues
1 IntroducingMulticulturalPsycho-oncology, 3
LuigiGrassiandMichelleRiba
2 CommunicationinCancerCare:ACulturalPerspective, 11
PhyllisButowandWalterF.Baile
3 PsychosocialAssessmentandScreeninginPsycho-oncology, 21
PaulB.JacobsenandKristineA.Donovan
4 SexualityandGender:PsychosocialImplicationsinCancerPatients:A
MulticulturalPerspective, 39
AnnaCostantini,ChiaraM.Navarra,KimlinTamAshing-GiwaandSophiaYeung
5 PsychosocialandPsychiatricDisorders, 55
SantoshK.ChaturvediandYosukeUchitomi
6 NeurocognitiveEffectsofAnticancerTreatments, 71
TimAhles,SanneSchagenandJanetteVardy
7 ScreeningforDistress,the6thVitalSign,astheConnectiveTissueofHealth
CareSystems:ARoadmaptoIntegratedInterdisciplinaryPerson-centredCare, 83
BarryD.Bultz,MatthewJ.LoscalzoandKarenL.Clark
8 PsychologicalIntervention, 97
MaggieWatson
9 PsychopharmacologicalInterventions,109
SeemaM.Thekdi,Mar´ıaElisaIrarra´zavalandLauraB.Dunn
10 Rehabilitation,127
AnjaMehnertandUweKoch
Part 2 Special Populations
11 PediatricPsycho-oncology,139
MargaretL.StuberandElizabethM.Strom
12 ALife-stageApproachtoPsycho-oncology,155
PeterFitzgerald,RinatNissimandGaryRodin
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vi Contents
13 Psycho-oncologyinUnderservedandMinorityPopulations,165
RichardFieldingandWendyW.T.Lam
Part 3 Other Topics
14 ExplorationofFamilyCare:AMulticulturalApproach,187
LeaBaiderandGilGoldzweig
15 BioethicalChallenges:UnderstandingCulturalDifferencesandReducing
HealthDisparities,199
AntonellaSurbone
16 Post-traumaticGrowthinCancerPatientsAcrossCultures,211
MichaelDiaz,MatthewCordovaandDavidSpiegel
17 TheNeedforPsychosocialSupportinGeneticCounsellingandGeneticTesting,223
MaryJaneEsplen,JonathanHunterandKathrynM.Kash
18 PsychosocialandPhysicalHealthinPost-treatmentandExtendedCancer
Survivorship,237
PatriciaA.GanzandAnnetteL.Stanton
19 End-of-lifeCare,249
WilliamBreitbart,HarveyMaxChochinovandYesneAlici
20 GriefandBereavement,271
SueMorrisandSusanBlock
21 SpiritualandReligiousCopingwithCancer,281
DavidW.Kissane,CarrieE.LethborgandBrianKelly
22 Psycho-oncologyandAdvocacyinCancerCare:AnInternationalPerspective,297
LuziaTravado,JanGeissler,KimThiboldeaux,JeffDunn,RanjitKaurandAnneMerriman
Index, 311
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List of Contributors
TimAhles,PhD BarryD.Bultz,PhD
Director,NeurocognitiveResearchLaboratory,Department Director,DepartmentofPsychosocialResources;Program
ofPsychiatryandBehavioralSciences,Memorial Leader:PsychosocialOncology,Supportive,Painand
Sloan-KetteringCancerCenter,NewYork,NY, PalliativeCare,TomBakerCancerCentre;AdjunctProfessor
USA andChair,DivisionofPsychosocialOncology,Facultyof
Medicine,UniversityofCalgary,Alberta,Canada
YesneAlici,MD
PhyllisButow,BA(Hons)DipEd,MClinPsych,MPH,PhD
AttendingPsychiatrist,GeriatricPsychiatryTreatmentUnit,
ChairinPsychology,Co-directorCentreforMedical
CentralRegionalHospital,Butner,NC,USA
PsychologyandEvidence-basedMedicine(CeMPED)and
Chair,Psycho-OncologyCo-operativeResearchGroup,
KimlinTamAshing-Giwa,PhD UniversityofSydney,NSW,Australia.
Professor&FoundingDirector,CenterofCommunity
AllianceforResearch&Education(CCARE),Divisionof SantoshK.Chaturvedi,MD,FRCPsych
PopulationSciences,CityofHopeNationalMedicalCenter, ProfessorofPsychiatry,DepartmentofPsychiatry,National
Duarte,CA,USA InstituteofMentalHealthandNeurosciences,Bangalore,
India
LeaBaider,PhD
HarveyMaxChochinov,MD,PhD,FRCPC
FullProfessorofMedicalPsychology,FacultyofMedicine,
DirectorandCanadaResearchChairinPalliativeMedicine,
HebrewUniversityMedicalSchool,HadassahUniversity
ManitobaPalliativeCareResearchUnit,CancerCare
Hospital,Jerusalem;Director,Psycho-OncologyUnit,Sharett
Manitoba;ProfessorofPsychiatryandFamilyMedicine,
InstituteofOncology,DepartmentofRadiationandClinical
DepartmentsofPsychiatryandFamilyMedicine,University
Oncology,HadassahUniversityHospital,Jerusalem,Israel
ofManitoba,Winnipeg,Manitoba,Canada
WalterF.Baile,MD KarenL.Clark,MS
Professor,DepartmentsofBehavioralScienceandFaculty ProgramManager,Sheri&LesBillerPatientandFamily
Development;Director,ProgramonInterpersonal ResourceCenter;DepartmentofSupportiveCareMedicine
CommunicationandRelationshipEnhancement(I*CARE), andDepartmentofPopulationSciences,CityofHope,
TheUniversityofTexasMDAndersonCancerCenter, Duarte,CA,USA
Houston,TX,USA
AnnaCostantini,PhD
DirectorofPsychooncologyUnit,Professorof
SusanD.Block,MD
Psychooncology,Sant’AndreaHospital,FacultyofMedicine
Chair,DepartmentofPsychosocialOncologyandPalliative
andPsychology,SapienzaUniversityofRome;Certified
Care;Co-Director,HMSCenterforPalliativeCare,Professor
GroupPsychotherapistandMemberoftheAmericanGroup
ofPsychiatryandMedicine,HarvardMedicalSchool;
PsychotherapyAssociation,PresidentofItalianSocietyof
Dana-FarberCancerInstituteandBrighamandWomen’s
Psychooncology,Italy
Hospital,Boston,MA,USA
MatthewCordova,PhD
WilliamBreitbart,MD AssistantProfessor,PaloAltoUniversity,PaloAlto,California
Chief,PsychiatryService,DepartmentofPsychiatryand StaffPsychologist,VANorthernCaliforniaHealthCare
BehavioralSciences,andAttendingPsychiatrist,Painand System,Martinez,CA
PalliativeCareService,DepartmentofMedicine,Memorial
Sloan-KetteringCancerCenter;ProfessorofClinical MichaelDiaz
Psychiatry,DepartmentofPsychiatry,WeillMedicalCollege Undergraduatestudent,HumanBiology,Stanford
ofCornellUniversity,NewYork,NY,USA University,PaloAlto,CA,USA
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viii ListofContributors
KristineA.Donovan,PhD,MBA Mar´ıaElisaIrarra´zaval,MD
AssistantMember,PsychosocialandPalliativeCareProgram, Chief,MentalHealthUnit,Fundacio´nArturoLo´pezPe´rez
DepartmentofHealthOutcomesandBehavior,Moffitt OncologicCenter,Santiago,Chile
CancerCenter,Tampa,FL,USA
PaulB.Jacobsen,PhD
JeffDunn,PhD Chair,DepartmentofHealthOutcomesandBehavior,
GriffithHealthInstitute,GriffithUniversity,Australia;School MoffittCancerCenter,Tampa,FL,USA
ofSocialScience,UniversityofQueensland,Australia;
ViertelCentreforResearchinCancerControl,Cancer KathrynM.Kash,RN,BS,MPhil,PhD
CouncilQueensland,Australia AssociateProfessor,ProgramDirector,MastersinChronic
CareManagement,JeffersonSchoolofPopulationHealth,
LauraB.Dunn,MD
ThomasJeffersonUniversity,PA,USA
AssociateProfessorandDirectorofPsycho-Oncology,
DepartmentofPsychiatry,UniversityofCalifornia,San
BrianKelly,BMed,PhD,FRANZCP,FAChPM
Francisco,SanFrancisco,CA,USA
ProfessorofPsychiatryandHead,DisciplineofPsychiatry,
UniversityofNewcastle,NSW,Australia
MaryJaneEsplen,RN,PhD
Professor,DepartmentofPsychiatry,FacultyofMedicine,
DavidW.Kissane,MD,MPM,FRANZCP,FAChPM
UniversityofToronto;Director,deSouzaInstitute;Head,
ProgramofPsychosocial&PsychotherapyResearchin JimmieC.HollandChairofPsycho-Oncology,Attending
CancerGenetics,UniversityHealthNetwork,Toronto, PsychiatristandChairman,DepartmentofPsychiatryand
Canada BehavioralSciences,MemorialSloan-KetteringCancer
Center;ProfessorofPsychiatry,WeillMedicalCollegeof
RichardFielding,PhD,CPsychol,FFPH CornellUniversity,NewYork,NY,USA
Director,CentreforPsycho-OncologyResearch&Training,
ProfessorofMedicalPsychologyinPublicHealth,Schoolof UweKoch,PhD,MD
PublicHealth,TheUniversityofHongKong,HongKong, ProfessorofMedicalPsychology;Dean,MedicalFaculty,
China HamburgUniversity,UniversityMedicalCenterHamburg
Eppendorf,Hamburg,Germany
PeterFitzgerald,MDMRCPysch(UK)
FellowinPsychosocialOncology,PrincessMargaretHospital, WendyW.T.Lam,RN,PhD
Toronto,Canada AssistantProfessor;DeputyDirector,Centrefor
Psycho-OncologyResearch&Training,SchoolofPublic
PatriciaA.Ganz,MD Health,UniversityofHongKong,HongKong,China
Professor,UCLASchoolsofMedicine&PublicHealth;
Director,DivisionofCancerPrevention&ControlResearch, CarrieLethborg,PhD
JonssonComprehensiveCancerCenter, SeniorSocialWorker,DepartmentofOncology,StVincent’s
LosAngeles(UCLA),CA,USA Hospital,UniversityofMelbourne,Victoria,Australia
JanGeissler
MatthewJ.Loscalzo,LCSW
FounderandCEO,Patvocates;Co-founder,CMLAdvocates
LilianeElkinsProfessorinSupportiveCarePrograms;
Network;Chair,LeukaNET
AdministrativeDirector,Sheri&LesBillerPatientand
FamilyResourceCenter;ExecutiveDirector,Departmentof
GilGoldzweig,PhD
SupportiveCareMedicine;Professor,Departmentof
MedicalandClinicalPsychologist;SeniorLecturer,The
PopulationSciences,CityofHope,Duarte,CA,USA
AcademicCollegeofTel-Aviv–Yaffo,TelAviv,Israel
LuigiGrassi,MD AnjaMehnert,PhD
ProfessorandChairofPsychiatry,ChairmanDepartmentof Head,Psycho-OncologyandPalliativeCareResearchGroup,
BiomedicalandSpecialistSurgicalSciences,Universityof DepartmentofMedicalPsychology,UniversityMedical
Ferrara;Director,Clinical&EmergencyPsychiatryUnit, CenterHamburgEppendorf,Hamburg,Germany
DepartmentofMentalHealth&DrugAbuse,Ferrara,Italy
AnneMerrimanPhD,FRCP,MCommH
JonathanHunter,MD,FRCPC DirectorofPolicyandInternationalProgrammes,Hospice
AssociateProfessor;Head,Consultation/LiaisonDivision, AfricainUganda;HonoraryProfessorofPalliativeMedicine,
UniversityofTorontoDepartmentofPsychiatry;Mount DepartmentofInternalMedicine,MakerereUniversity,
SinaiHospital,Toronto,Canada Uganda
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ListofContributors ix
SueE.Morris,MPsychol(Clinical)Hons ElizabethM.Strom
DirectorofBereavementServices,Dana-Farber/Brighamand Medicalstudent,UniversityofIllinoisatChicagoCollegeof
Women’sCancerCenter;DepartmentofPsychosocial Medicine,Dixon,IL,USA
OncologyandPalliativeCare,Dana-FarberCancerInstitute,
Boston,MA,USA MargaretL.Stuber,MD
JaneandMarcNathansonProfessor,DavidGeffenSchoolof
ChiaraM.Navarra,PhD Medicine,UniversityofCalifornia,LosAngels,CA,USA
PsychooncologyUnit,Sant’AndreaHospital,Facultyof
MedicineandPsychology,SapienzaUniversityofRome; AntonellaSurboneMD,PhD,FACP
CertifiedPsychotherapist,MemberofItalianSocietyof
ProfessorofMedicine,DepartmentofMedicine,NewYork
Psychooncology,Italy
UniversityMedicalSchool,NewYork,NY,USA;Faculty,
InterpersonalCommunication&RelationshipEnhancement
RinatNissim,PhD
Program(I*CARE),M.D.AndersonCancerCenter,Houston,
DepartmentofPsychosocialOncologyandPalliativeCare,
TX,USA;LecturerinClinicalBioethicsandPalliative
PrincessMargaretHospital,UniversityHealthNetwork,
Care,Italy
Toronto,Canada
MichelleRiba,MD,MS SeemaM.Thekdi,MD
ProfessorandAssociateChair,IntegratedMedicineand AssistantProfessor,DepartmentofPsychiatry,MDAnderson
PsychiatricServices,DepartmentofPsychiatry,Universityof CancerCenter,Houston,TX,USA
MichiganMedicalSchool;Director,PsychOncology,
UniversityofMichiganComprehensiveCancerCenter, KimThiboldeaux
MI,USA President&CEO,CancerSupportCommunity,UnitingThe
WellnessCommunityandGilda’sClubWorldwide,Washington
GaryRodin,MDFRCPC DC,USA
ProfessorofPsychiatry,UniversityofToronto;Head,
DepartmentofPsychosocialOncologyandPalliativeCare, LuziaTravado,D.ClinPsych,MSc
PrincessMargaretHospital;UniversityofToronto/University ClinicalPsychologyUnit,CentralLisbonHospitalCentre–
HealthNetworkChairinPsychosocialOncologyand HospitaldeS.Jose´,Lisbon,Portugal
PalliativeCare;SeniorScientist,OntarioCancerInstitute,
Canada YosukeUchitomi,MD,PhD
ProfessorandChairman,DepartmentofNeuropsychiatry,
SanneSchagen,PhD
OkayamaUniversityGraduateSchoolofMedicine,Dentistry
DepartmentofPsychosocialResearchandEpidemiology, andPharmaceuticalSciences,Okayama,Japan
NetherlandsCancerInstitute,AntonivanLeeuwenhoek
Hospital,Amsterdam,theNetherlands
JanetteVardy,MD,PhD
SydneyCancerCentre,UniversityofSydney,Concord
RanjitKaurPritamSingh,AMP,MSc
RepatriationGeneralHospital,Concord,NSW,Australia
ChiefExecutiveOfficer,BreastCancerWelfareAssociation
Malaysia,PetalingJaya,Selangor,Malaysia
MaggieWatson,BSc,PhD,DipClinPsych,AFBPS
DavidSpiegel,MD Head,PsychologyResearchGroup,InstituteofCancer
WillsonProfessorintheSchoolofMedicine,AssociateChair, Research;ConsultantClinicalPsychologist,RoyalMarsden
DepartmentofPsychiatry&BehavioralSciences,Director, Hospital;HonoraryProfessor,ResearchDepartmentof
CenteronStressandHealth,StanfordUniversitySchoolof Clinical,HealthandEducationalPsychology,University
Medicine,Stanford,CA,USA CollegeLondon,UK
AnnetteL.Stanton,PhD SophiaYeung,RN
Professor,Psychology&Psychiatry/BiobehavioralSciences; CommunityInterventionist,CenterofCommunityAlliance
Member,JonssonComprehensiveCancerCenter;Senior forResearch&Education(CCARE),DivisionofPopulation
ResearchScientist,CousinsCenterfor Sciences,CityofHopeNationalMedicalCenter,Duarte,
Psychoneuroimmunology,LosAngeles,CA,USA CA,USA
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Foreword
It is an honour and a privilege to write the Fore- of pride for me since I served as its Founding
word for this book, which establishes a bench- Chair.Theco-editorsofthisbook,LuigiGrassiand
mark in the emerging field of psycho-oncology. MichelleRiba,havecarriedtheworkoftheSection
It reflects the fact that there is now international forward in an impressive way, collaborating with
recognition of the importance – and even neces- theInternationalPsycho-OncologySociety(IPOS),
sity–oftheintegrationofthepsychosocialdomain the world’s leading international multidisciplinary
into routine cancer care in this early part of the association which addresses the psychological and
twenty-first century. There have been significant social issues in cancer. IPOS has taken a lead role
barriers to reaching this benchmark: the fact that in establishing standards for psychological care by
patients were not told their diagnosis; that the engaging the major global cancer organizations.
stigmaattachedtocancermadeitawordthatcould TheIPOSInternationalStandardofQualityCancer
not be spoken; that the psychological burden of Carestatesthat
the patient with cancer was not acknowledged by 1 Qualitycancercaremustintegratethepsychoso-
others;andthatthestudyofpatient-reported(sub- cialdomainintoroutinecare;
jective) symptoms were regarded as not quantifi- 2 Distress should be measured as the Sixth Vital
able by the scientific cancer community. Progress Sign after temperature, blood pressure, pulse, res-
has been quite remarkable in the past 35 years as pirationandpain.
thesebarriersbrokedownandpsychologicalissues The recent endorsement by the International
became the topic of scientific study and research, UnionAgainstCancer(UICC)andtheInternational
particularly the validation of quantitative assess- Pediatric Society (SIOP) speaks to the synergy
ment tools to measure symptoms such as pain, that comes from these collaborative international
anxiety and depression. With the development efforts. IPOS has proposed that the World Cancer
of reliable tools, the science could move forward Day2013shouldcallforglobalactiononsupport-
which allowed us to measure changes in symp- ivecare,underthebanner‘Declareyoucareabout
toms based on interventions to reduce distressing cancer support’. These global initiatives have an
physical and psychological symptoms. Thus, this immediateeffectuponthepotentialofthenational
book contains the synthesis of global state of the psycho-oncology societies to have an impact in
artresearchwhichtodayconstituteswhatwenow their own countries, implementing the goals in
callthe‘scienceofcare’incancer–attentiontothe waysthatareculturallyappropriate.
humanistic, ethical, psychological, social, cultural, The authors of these chapters that follow are
psychiatric and behavioural issues that contribute the scholars in psycho-oncology from around the
sosubstantiallybothtotheoutcomeofthemedical globe.Theyhavetrulybroughttogethertheinfor-
treatmentandthequalityoftheexperienceofthe mationthatismostrelevantandhavesynthesized
patientwithcancerandthefamily. ittoprovideanoverviewofthebestresearchinthe
The fact that this book was developed out of area.Iamenormouslyproudofwhatourfieldhas
the Psycho-Oncology and Palliative Care Section accomplisheduptonow.Iamsurethatthefuture
of the World Psychiatric Association is a source will see major steps forward to ensure that the
xi
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xii Foreword
emotional suffering that has so long accompanied combined with attention to the humanistic and
cancer will be further reduced. Francis Peabody, compassionateaspectsofcare.
thoughtful physician, wrote in 1927 in the JAMA,
‘ThesecretofthecareofthepatientisinCARING
FOR the PATIENT’. The clinicians and researchers JimmieC.Holland,MD
in psycho-oncology contribute that ‘caring’ piece WayneE.ChapmanChairinPsychiatricOncology
tocancer,throughdevelopingthe‘scienceofcare’ April2012
