Clinical Briefs
With Comments from John La Puma, MD, FACP
Mind-Body Medicine in Cancer Treatment
November 1998; Volume 1: 131
Source: Simonton SS, Sherman AC. Psychological aspects of mind-body medicine: Promises and pitfalls from research with cancer patients. Altern Ther Health Med 1998;4(4):50-67.
Research in psychosocial oncology has grown considerably. In this article, psychological interventions for cancer patients are reviewed. The following four areas are examined: adjustment and quality of life; symptom control; immune function; and disease progression. In each area, psychosocial dimensions of risk and resilience, the efficacy of current interventions, and the trajectory of future developments are considered.
Comment
This is a state-of-the-art review from two professors of behavioral medicine and otolaryngology at the University of Arkansas. They list and analyze more than 250 references, most of which are longitudinal descriptive studies and controlled clinical trials published in peer-reviewed journals.
Among other areas, the authors look at the evidence base for identifying those patients most vulnerable to psychosocial difficulties, and for those interventions designed to control nausea, vomiting, pain, and fatigue. Evidence for specific coping strategies and personality traits is also examined.
Overall, the authors find good evidence for improved quality of life from many interventions, from spirituality to biofeedback. There is less persuasive evidence for improved immune functioning and survival, but there is some, especially among already immunocompromised patients, the elderly, and those with endocrine-influenced tumors.
Recommendation
Because of its rigor and comprehensiveness, this is an invaluable work for clinicians and clinical researchers who treat and study patients with cancer.
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