“The application of psychology to understanding and treating cancer: achievements and prospects”
by Emeritus Professor Leslie G. Walker, MA (Hons), PhD, DipClinPsychol, CClinPsychol, CBiol, CSci, FSB, FBPsS
Professor of Cancer Rehabilitation at the University of Hull, United Kingdom
Cancer is a leading cause of mortality and morbidity worldwide. In 2012, an estimated 8.2 million deaths were due to cancer. In the USA, the lifetime risk of developing any type of cancer is currently 42% for men and 38% in women, and the risk of dying from cancer is 23% for men and 19% for women. Fortunately, cancer survival is improving and has doubled in the last 40 years in the UK, although there are wide variations in survival across cancer types and countries.
Although interest in psychosocial aspects of cancer goes back at least as far as Galen the revered Greek physician, it was not until the early 1980s that there was a burgeoning of interest in this field. A simple PubMed literature search using the terms “psychology and cancer” shows that whereas only 319 articles were published during the year 1980, this had risen to 1,502 during the year 2000, and as many as 4,606 during the year 2015, with a cumulative overall total of 62,655 publications up to the end of 2015.
Psychologists have made useful contributions in a number of areas. These include an understanding of behavioural and other psychological aspects that contribute to the onset and progression of cancer; an appreciation of psychosocial factors influencing the uptake of cancer screening and its psychosocial sequelae; how best to provide information to patients (including how and when to communicate ‘bad news’); psychological interventions to ameliorate cancer treatment side effects (chemotherapy, radiotherapy and surgery); how to prevent and manage cancer-related psychosocial morbidity, and psychosocial and complimentary interventions to optimise quality of life before, during and after cancer treatment. These contributions will be reviewed, with particular reference to our own clinical and research studies (see www.lgwalker.com).
Undoubtedly, significant progress has been made in the last 35 years. The application of the methods and findings of psychology in particular, and the social sciences more generally, have led to major advances in understanding various aspects of cancer and improving the quality of life of patients and their families. However, a great deal remains to be done in terms of applying the knowledge already gained, particularly in terms of preventing distress; improving quality of life before, during and after treatment; supporting the cancer workforce, and integrating psychosocial science conceptually and organisationally with other aspects of cancer.
Leslie G. Walker is Emeritus Professor of Cancer Rehabilitation at the University of Hull, Kingston upon Hull, United Kingdom. Since retiring from the NHS in 2009, he continues to carry out research and give invited lectures.
Until November 2009, in addition to holding the Foundation Chair of Cancer Rehabilitation, he was the Clinical Lead for the Division of Cancer in the Postgraduate Medical Institute, University of Hull. He was also Director of the Institute of Rehabilitation, and a member of the Faculty of the Hull York Medical School (HYMS).
In 1999, he founded a unique Oncology Health Service and he directed the service until 2009 when he retired from the NHS. Each year, more than 2,500 people with cancer access the Service for the first time, and each week some 375 people with cancer and their relatives attend the custom built, fully integrated Oncology Health Centre. The service has won a number of awards, and the approach is known internationally as the “Hull model”.
Current research includes psychosocial aspects of Li Fraumeni syndrome; the effects on quality of life of vaccination with human telomerase reverse transcriptase (hTERT) peptides, and psychosocial aspects of cancer screening.
Previous research has focussed on the psychoneuroimmunology of breast, brain and colorectal cancers; relaxation, hypnotherapy and guided imagery to alleviate the side effects of various cancer treatments; the evaluation of different models of providing psychosocial care, and the development and evaluation of psychological and complementary interventions for people with cancer. Over the years, he has received funding from a wide range of sources, including the Medical Research Council, the Wellcome Trust, Cancer Research UK, the HTA Programme, and the NHS R&D Programme (Cancer).
Professor Walker currently serves on a number of committees, including the The National Institute of Health Research Evaluation, Trials and Studies Coordinating Centre College of Experts; the Tenovus Research Committee; the Clinical Reference Group of Breast Cancer Care, and the Clinical Experts Reference Group of Breakthrough Breast Cancer.
He is a former Co-Chair of the Nominating Committee of the International Psychosocial Oncology Society, and he has served two terms of Office as Chairman of the British Psychosocial Oncology Society. He was Chairman of the Research Committee of Breast Cancer Care and was also a Member of the Population and Behavioural Sciences Committee of Cancer Research UK; the Council of the British Society of Experimental and Clinical Hypnosis; the Research Committee of the National Cancer Survivorship Initiative (Department of Health); the National Cancer Research Institute Complementary Therapies Clinical Studies Development Group; and three Medical Research Council Multicentre Trial Steering Committees.
He is a Fellow of the British Psychological Society, an Honorary Life Member of the British Association for Clinical and Academic Hypnosis, and a former Fellow of the Royal Statistical Society, the Society of Biology and the Royal Society of Medicine.
Further information, including publications and contact details, can be obtained from http://www.lgwalker.com .