‘We should be developing psychological care for people affected by cancer beyond a reactive model’

Dr Mike Rennoldson, Chair of the DCP Faculty for Oncology and Palliative Care, told us about the main priorities and challenges for psychological research and practice around cancer.

'The international psycho-oncology community began the last decade with a striking claim. Distress should become the sixth 'vital sign' of cancer care. Progress has been mixed. Looking ahead, we need to complete this unfinished business. But we cannot afford to neglect the twin challenges of inequality and prevention in psychological care in cancer.

In both research and practice psycho-oncology has steadily developed a presence and voice for the psychological care of people with cancer and their families. Effective psychological therapies have been developed and tested. The complex psychological burden borne by all affected by cancer has been laid bare, and the poorer survival outcomes of distressed cancer patients demonstrated. Services in the UK and internationally have expanded and found more effective ways of delivering psychological care within the vast industry of cancer care.

In the UK at least, there is much left to do. Access to quality psychological care is highly unequal. Too often it is determined by the hospital you happened to be treated in, and the type of cancer you have, not what your psychological need is. This has to change. No other 'vital sign' in cancer would be allowed to go untreated in this way.

However, we should be developing psychological care for people affected by cancer beyond a reactive model. Our traditional model of waiting for people to become significantly distressed, and for this to be picked up by the cancer care team and referred to us, risks entrenching health inequality, and missing the bigger goal of preventing distress in the first place. 

The priority for researchers and clinicians must be to identify the groups of people affected by cancer most at risk of becoming significantly distressed, and developing programmes that reduce the incidence of distress. Psycho-oncology focussed upon prevention will reduce unnecessary suffering and more quickly address inequality of access to psychological help, and inequality of psychological outcomes.

Cancer may be unpredictable, but the stressors of treatment and living with cancer are predictable. This certain knowledge allows a window of opportunity to prevent distress in a vulnerable group that few psychological specialties have. As a community of researchers and practitioners it's our job to take this opportunity.'

Dr Mike Rennoldson is Principal Lecturer in Psychology at Nottingham Trent University

Here are our articles from the archive on the psychological impact of cancer…

'You should be over cancer by now'
Cordelia Galgut on living with the long-term effects of cancer.

'Filtering down psychological thinking into cancer care: that's how we make a difference'
Sahil Suleman is a consultant clinical psychologist and lead for Macmillan Cancer Psychological Support team at St George's Hospital in London. Our editor Jon Sutton caught up with him from lockdown…

We're all fighting the same battle, with different journeys'
Kate Fulton and Rachel Trimmer on cross-sector working in cancer care.

'Your efforts can improve outcomes for people affected by cancer'
Kate Hamilton-West is a Chartered Psychologist and Head of Social and Behavioural Research for Cancer Research UK.

Living and dying with oesophageal cancer
Cara Ghiglieri, a post-doc research fellow at the University of Aberdeen, on a research journey shaped by personal experience.

'Cancer wasn't the end for me'
When Liam J. Williams received a devastating diagnosis as a teenager, he could never have imagined that a few years later he would be on a pathway to a fulfilling career as a psychologist…

'I can't remove every obstacle that myeloma patients will face… but I can provide support'
Sarah Dempsey

'Things were now differently different'
A new animated short film considers the psychological impact of breast cancer. We heard from Dr Becky Coles-Gale, who helped to develop the script.

'It's a scary place for a man to go, into a breast cancer clinic'
Chartered Psychologist Dr Kerry Quincey (DeMontfort University) speaks with breast cancer 'thrivers' Doug Harper and Dave Talbot about the Virtual Meet-Up (VMU).

'Cognitive control can improve the quality of life of women with breast cancer'
Nazanin Derakhshan is a Professor of Experimental Psychopathology at Birkbeck, University of London and founder of the Birkbeck Integrative Centre for Building Resilience in Breast Cancer. Delia Ciobotaru met her.

'I kept thinking that I will feel better soon'
Claire Foster is Professor of Psychosocial Oncology, Director of the Centre for Psychosocial Research in Cancer (CentRIC) in Health Sciences, University of Southampton. She told us about this work.

From the other side of the zipline
Clinical Psychologist 'Dr Roni Pea' with reflections on life-threatening illness

Keep on taking the medicine?
Parastou Donyai considers strategies for understanding and tackling medication non-adherence

The sibling spotlight
Rachel Batchelor on the challenges facing the 'forgotten' brothers and sisters of seriously ill children, including those with cancer

Personal reflections on coping and loss
Professor Adrian Furnham writes about the reactions of others to his wife's cancer

'You seldom heal… you live with cancer'
Ian Florance meets Cordelia Galgut to discuss how diagnosis and treatment has affected her work as a counselling psychologist 

Experiences of hallucinogen treatment
We hear from a researcher, participant and clinician on the use of psilocybin to alleviate cancer anxiety

Psychology, men and cancer
Peter Branney, Karl Witty and Ian Eardley call for a consideration of masculinity in understanding and treating the disease

Can reassurance hurt?
Yuefang Zhou and Gerry Humphris have their own worries about the 'don't worry' message in medical procedures

The 'late effects' of paediatric brain tumours
Helen Stocks, Kate Ablett and Matthew Morrall on the contribution of neuropsychological assessment to paediatric oncology services

Breast cancer - a voyage into hearts and minds
A voyage of discovery with survivors of breast cancer with Caroline Muttitt

There are many more mentions of cancer in our archive.

And find psychological studies relating to cancer digested on our Research Digest:

15-year study: Stress did not increase risk of breast cancer among women with a genetic susceptibility to the disease – Emma Young

When tears turn into pearls: Post-traumatic growth following childhood and adolescent cancer – Tomasz Witkowski

A new study sheds light on 'chemobrain' – Christian Jarrett

New meta-analysis undermines the myth that negative emotions can cause cancer – Tomasz Witkowski

Can psychosocial interventions extend the lives of cancer patients? – Christian Jarrett

Psychologists asked these skin cancer patients to draw their melanomas – Christian Jarrett

What's it like to be a child and your sibling is diagnosed with cancer? – Christian Jarrett