This section examines what cancer is, looks at its prevalence and then assesses the role
of psychology in understanding cancer in terms of the initiation and promotion of
cancer, the psychological consequences of cancer, dealing with the symptoms of cancer,
longevity and the promotion of a disease-free interval.
What is cancer?
Cancer is defined as an uncontrolled growth of abnormalcells, which produces tumours
called neoplasms. There are two types of tumours: benign tumours, which do not spread
throughout the body, and malignant tumours, which show metastasis (the process
of cells breaking off from the tumour and moving elsewhere). There are three types of
cancer cells: carcinomas, which constitute 90 per cent of all cancer cells and which
originate in tissue cells;sarcomas, which originate in connective tissue; and leukaemias,
which originate in the blood.
The prevalence of cancer
In 1991, it was reported that there were 6 million new cases of cancer in the world
every year, and that one-tenth of all deaths in the world are caused by cancer. In 1989,
it was reported that cancers are the second leading cause of death in the UK and
accounted for 24 percent of all deaths in England and Wales in 1984 (Smith and
Jacobson 1989). The main causes of cancer mortality among men in England and Wales
are lung cancer (36 per cent), colorectal cancer (11 per cent), prostate cancer (9 per
cent); and among women are breast cancer (20 per cent), lung cancer (15 per cent),
colorectal cancer (14 per cent), ovarian cancer (6 per cent), cervical cancer (3 percent).
While the overall number of cancer deaths do not appear to be rising, the incidence of
lung cancer deaths in women has risen over the past few years.
The role of psychology in cancer
A role for psychology in cancer was first suggested by Galen in 200–300, who argued
for an association between melancholia and cancer, and also by Gedman in 1701, who
suggested that cancer might berelated to life disasters. Eighty-five per cent of cancers
are thought to be potentially avoidable. Psychology therefore plays a role in terms,
attitudes and beliefs about cancer and predicting behaviours, such as smoking, diet and
screening which are implicated in its initiation (details of these behaviours can be found
in Chapters 2, 5, 6, 7, 8 and 9). In addition, sufferers of cancer reportpsychological
consequences, which have implications for their quality of life. The role of psychology in
cancer is also illustrated by the following observations:
_ Cancer cells are present in most people but not everybody gets cancer; in addition
although research suggests a link between smoking and lung cancer, not all heavy
smokers get lung cancer. Perhaps psychology is involved in thesusceptibility to
_ All those who have cancer do not always show progression towards death at the same
rate. Perhaps psychology has a role to play in the progression of cancer.
_ Not all cancer sufferers die of cancer. Perhaps psychology has a role to play in
The potential role of psychology in understanding cancer is shown in Figure 14.2.
The role of psychology in cancerwill now be examined in terms of (1) the initiation
and promotion of cancer; (2) the psychological consequences of cancer; (3) dealing with
the symptoms of cancer; and (4) longevity and promoting a disease-free interval.
The psychosocial factors in the initiation and promotion
1 Behavioural factors. Behavioural factors have been shown to play a role in the
initiation and promotion ofcancer. Smith and Jacobson (1989) reported that 30 per
cent of cancers are related to tobacco use, 35 per cent are related to diet, 7 per cent
are due to reproductive and sexual behaviour and 3 per cent are due to alcohol. These
behaviours can be predicted by examining individual health beliefs (see Chapters 2, 5,
6 and 9).
2 Stress. Stress has also been shown to have a role to play in...