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P1:TIX/XYZ P2:ABC JWST159-fm JWST159-Grassi April20,2012 9:53 Trim:246mmX189mm PrinterName:YettoCome Clinical Psycho-Oncology P1:TIX/XYZ P2:ABC JWST159-fm JWST159-Grassi April20,2012 9:53 Trim:246mmX189mm PrinterName:YettoCome 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 P1:TIX/XYZ P2:ABC JWST159-fm JWST159-Grassi April20,2012 9:53 Trim:246mmX189mm PrinterName:YettoCome Thiseditionfirstpublished2012 ©2012byJohnWiley&Sons,Ltd Wiley-BlackwellisanimprintofJohnWiley&Sons,formedbythemergerofWiley’sglobalScientific, TechnicalandMedicalbusinesswithBlackwellPublishing. Registeredoffice: JohnWiley&Sons,Ltd,TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK Editorialoffices: 9600GarsingtonRoad,Oxford,OX42DQ,UK TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK 111RiverStreet,Hoboken,NJ07030-5774,USA Fordetailsofourglobaleditorialoffices,forcustomerservicesandforinformationabouthowtoapplyfor permissiontoreusethecopyrightmaterialinthisbookpleaseseeourwebsiteat www.wiley.com/wiley-blackwell TherightoftheauthortobeidentifiedastheauthorofthisworkhasbeenassertedinaccordancewiththeUK Copyright,DesignsandPatentsAct1988. Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,ortransmitted, inanyformorbyanymeans,electronic,mechanical,photocopying,recordingorotherwise,exceptas permittedbytheUKCopyright,DesignsandPatentsAct1988,withoutthepriorpermissionofthepublisher. Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedastrademarks.Allbrandnames andproductnamesusedinthisbookaretradenames,servicemarks,trademarksorregisteredtrademarksof theirrespectiveowners.Thepublisherisnotassociatedwithanyproductorvendormentionedinthisbook. Thispublicationisdesignedtoprovideaccurateandauthoritativeinformationinregardtothesubjectmatter covered.Itissoldontheunderstandingthatthepublisherisnotengagedinrenderingprofessionalservices.If professionaladviceorotherexpertassistanceisrequired,theservicesofacompetentprofessionalshouldbe sought. Thecontentsofthisworkareintendedtofurthergeneralscientificresearch,understanding,anddiscussiononly andarenotintendedandshouldnotberelieduponasrecommendingorpromotingaspecificmethod, diagnosis,ortreatmentbyphysiciansforanyparticularpatient.Thepublisherandtheauthormakeno representationsorwarrantieswithrespecttotheaccuracyorcompletenessofthecontentsofthisworkand specificallydisclaimallwarranties,includingwithoutlimitationanyimpliedwarrantiesoffitnessforaparticular purpose.Inviewofongoingresearch,equipmentmodifications,changesingovernmentalregulations,andthe constantflowofinformationrelatingtotheuseofmedicines,equipment,anddevices,thereaderisurgedto reviewandevaluatetheinformationprovidedinthepackageinsertorinstructionsforeachmedicine, equipment,ordevicefor,amongotherthings,anychangesintheinstructionsorindicationofusageandfor addedwarningsandprecautions.Readersshouldconsultwithaspecialistwhereappropriate.Thefactthatan organizationorWebsiteisreferredtointhisworkasacitationand/orapotentialsourceoffurtherinformation doesnotmeanthattheauthororthepublisherendorsestheinformationtheorganizationorWebsitemay provideorrecommendationsitmaymake.Further,readersshouldbeawarethatInternetWebsiteslistedinthis workmayhavechangedordisappearedbetweenwhenthisworkwaswrittenandwhenitisread.Nowarranty maybecreatedorextendedbyanypromotionalstatementsforthiswork.Neitherthepublishernortheauthor shallbeliableforanydamagesarisingherefrom. 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 availableinelectronicbooks. Setin9/12ptMeridienbyAptaraInc.,NewDelhi,India FirstImpression2012 P1:TIX/XYZ P2:ABC JWST159-fm JWST159-Grassi April20,2012 9:53 Trim:246mmX189mm PrinterName:YettoCome 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 v P1:TIX/XYZ P2:ABC JWST159-fm JWST159-Grassi April20,2012 9:53 Trim:246mmX189mm PrinterName:YettoCome 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 P1:TIX/XYZ P2:ABC JWST159-loc JWST159-Grassi April10,2012 13:9 Trim:246mmX189mm PrinterName:YettoCome 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 vii P1:TIX/XYZ P2:ABC JWST159-loc JWST159-Grassi April10,2012 13:9 Trim:246mmX189mm PrinterName:YettoCome 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 P1:TIX/XYZ P2:ABC JWST159-loc JWST159-Grassi April10,2012 13:9 Trim:246mmX189mm PrinterName:YettoCome 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 P1:TIX/XYZ P2:ABC JWST159-bforeword JWST159-Grassi April11,2012 15:7 Trim:246mmX189mm PrinterName:YettoCome 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 P1:TIX/XYZ P2:ABC JWST159-bforeword JWST159-Grassi April11,2012 15:7 Trim:246mmX189mm PrinterName:YettoCome 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

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Most books are stored in the elastic cloud where traffic is expensive. For this reason, we have a limit on daily download.