Cancer diseases affect approximately 10 million people only in Europe. As a result of the demographic development, their prevalence is expected to double during the next 10 years. Cancer is a leading cause of death. It accounted for eight million deaths worldwide (around 15% of all deaths) in 2010 (38% more than in 1990) Meanwhile the number of survivors continues to grow, not just because of earlier detection and treatment, but because of revolutionary new therapies. About 9 million Americans of all ages are living with a current or past diagnosis of cancer. For many individuals, this changes the landscape from a terminal illness to more of a chronic illness with periods of remission and exacerbation of symptoms. This perspective on neoplasms has broadened the scope of care from treating the disease alone to managing cancer-related symptoms at different stages of the disease trajectory including mental disorders. Cancer-related distress was depicted as a “multifactorial unpleasant emotional experience of a psychological, social, and/or spiritual nature that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatment” by the National Comprehensive Cancer Network of the US. Distress is related to a lower quality of life, treatment compliance and efficacy, higher mortality, and a higher risk of suicide. Therefore, clinicians should make efforts to promote patients’ quality of life and decrease medical costs by alleviating patient distress. The NCCN clinical practice guidelines in oncology distress management have, since 1997, advocated routine screening for distress in cancer patients. Similar to the model of using pain for the 5th vital sign, the use of distress for the 6th vital sign was recommended in 2005. It was reaffirmed with International Federation of Psycho-oncology Societies. To begin, for adults diagnosed with cancer and other chronic illnesses, the “risk of psychological disability” is nearly six times higher than for adults not living with cancer. Given the prevalence of psychological disorders in cancer patients and their potential negative effects on outcomes, in the absence of adequate data, neither physicians nor patients can accurately predict the mental health impact of cancer diagnosis and treatment, thereby potentially limiting a patient’s autonomy. Comprehensive cancer care includes not only medical procedures but should also include psychosocial support if needed. Comprehensive patient-centered care in oncology has been emphasized in international guidelines and standards, implying cancer prevention and early detection as well as high quality evidence-based medical treatment, rehabilitation and palliative care.
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Alex John
Managing Editor
Epidemiology: Open Access