Beyond the psychotherapy and survival debate: the challenge of social disparity, depression and treatment adherence in psychosocial cancer care.
The psychotherapy and cancer survival debate generated great interest in the psychoneuroimmunological and bio-behavioral mechanisms that might mediate any gain in survival. Recent methodologically-improved cognitive-existential, supportive-expressive and psycho-educational group interventions for patients with breast cancer and melanoma have not extended survival times. Shorter survival has been associated with social disparity and untreated clinical depression, potentially mediated by poorer adherence to anti-cancer treatments. Group therapy both prevents and treats depression. Future research could address these bio-behavioral mechanisms.
Kissane
David
D
Department of Psychiatry and Behavioral Sciences, MSKCC, New York, NY, USA. kissaned@mskcc.org
D003866:Depressive Disorder / Q000517:prevention & control*; D054624:Health Status Disparities; D006801:Humans; D055118:Medication Adherence / Q000523:psychology; D009369:Neoplasms / Q000401:mortality* / Q000523:psychology*; D011613:Psychotherapy; D013315:Stress, Psychological / Q000517:prevention & control*; D015996:Survival Rate