Current approaches to psycho-oncology

Psychooncology has today an accepted role within the Oncology community and Liaison Psychiatry. Increasing knowledge about the psychosocial and psychobiological dimensions of cancer, deriving from clinical work and research, has broadened its interests and at the same time served as the ground for more effective interventions concerning the psychosocial problems that arise in the course of the cancer patients' treatment. In addition, it provides new insights regarding the psychological processes or behaviours that may influence cancer morbidity and mortality. Clinical experience and research concerning quality of life, psychoneuroimmunology, meta-analysis of psychotherapeutic interventions etc, have redirected psychooncology towards new fields. The recognition of the genetic basis of increasingly more tumours prompted Liaison psychiatry to study cases with high genetic risk and studies have sought the impact of this factor on the emotional condition and quality of life of these individuals. Furthermore, the impact of bilateral prophylactic mastectomy or prophylactic oophorectomy on the adjustment of these patients and on the awareness of their bodies has been evaluated. Finally, the establishment of the importance of the immune system which not only functions as a surveillance mechanism but also is involved later in the disease progress revived hopes concerning the role of psychotherapeutic interventions. Numerous kinds of psychotherapy interventions, such as brief crisis counseling, individual or group psychotherapy, psychoeducational interventions, cognitive–behavioral interventions, art psychotherapy etc, are now available for patients and some of these have a positive impact in survival. Psychooncology was the first from all Liaison Psychiatry subspecialties, who changed the traditional way of assessment by using rapid screening tools such as the Distress Thermometer proposed by the National Cancer Centers Network.