Section 10 PSiC
by P Henry
An individual faced with existence-threatening cancer may be unaware of their many care[1] needs. Yet without these, their outcome worsens[2].
Inputs are basic, complex and subtle. All types should be accessible, trustworthy, agreeable, without cost, applicable and of practical use. The individual-different biases[3] and variations in perception of threat and coping skills[4] need to be accounted for.
SOCIAL
Family and friends play an essential role providing positive, affirmative caring which helps ward off isolation and loneliness. These trusted supporters can help stabilise the patients’ basic living and finances needs. They can use charities and social services for help. All aspects of their complex vulnerability [5] should be addressed. The supporters also can help their friend/family avoid receiving negative inputs (both short and long-term), from other relationships or environments. These toxic activities will tax precious energy and hurt your health[6]. The person transformed into a patient becomes more vulnerable and powerless.
MEDICAL
Getting an early diagnosis offers the best chance of positive treatments for cancer. Avoiding it because of work requirements or fears[7] increases problems.
Standard care oncology (SCO)[8], while good at eliminating existing cancer cell growth, does not deal with causes or preventions. Its services are limited by its restrictive routines[9] and due to using costs benefit analysis[10]. Comparing services is difficult[11]. Even with standardisation attempts[12], different teams and regions vary.
The divisions[13] between Public Health Care – attempting comprehensive low-cost services[14] –and that of private medicine plans, are glaring.
Public systems services are limited, particularly in the current financial recession. Increased unemployment and stressors produce poorer outcomes and mortality[15]. The over-inflationary medication costs and technology for SCO[16] increase costs[17] and reduce treatments. Yet SCO stands fast, while its dominant treatment model tests the integrity of medical science[18].
The rich[19] can purchase whatever they want, getting it quicker. They use mainly SCOs, having complementary therapies as add-ons which, unintegrated, reduce their efficiency. The more deprived continue to have higher incidence and death[20] with little choice of useful complementary therapies.
Needs and expectations for all remain unfilled[21].
Considering increased SCO costs and adverse effects from biomedical treatments[22], other possibilities should be considered.
Having more personalised care[23] with an integration of lower-cost evidence based complementary therapies[24]– these ignored priorities of patients[25] – could be implemented effectively. Not to try will reduce QoL and exacerbate cancers.
Patients and their support need full information and choice. This affects hope or hopelessness which strongly affect QoL, outcomes and longevity[26].
Inclusivity with comprehensive cancer care needs to be affordable and accessible to all.
[1] This illness carries threats of serious deterioration, isolation, and death. Pertinent issues include:
A. Compassion and Understanding from others: Understanding compassionate care from the patient
perspective…. (1Jan23) M Habib et al. Can Oncol Nurs J 33(1).
B. Basics about Cancer: Understanding Cancer. (2007) Nat Inst of Hea.
C. Feeling normal: Application of normalisation process theory in understanding implementation
processes …. (16Mar20) L. Huddlestone et al. BMC Family Practice 21
D. Understanding the threat of death can promote need to act: Mans Search for Meaning (1957) V Frankl.
His concept about when unable to change a situation we are challenged to change ourselves. AlsoThe
Doctor and Soul (1946)
E. Fear, anxiety, panic and cancer | Coping with cancer | Cancer Research UK. How To Stop the Fear of Cancer | Memorial Sloan Kettering Cancer Center, How To Stop the Fear of Cancer | Memorial Sloan Kettering Cancer Center,
[2] Mental Health Challenges in Cancer Patients: … Depression and Anxiety. (12Aug24) W Shalata et al. Cancers (Basel) 6(16). Cognitive–behavioural therapy effectiveness for fear of cancer …. (2025) Fangxin Wei et al. BMJ Supportive and Palliative Care 15(1). The Impact of Cancer on Mental Health and the Importance of Supportive Services. (26Feb24) Z Fereidouni et al. Galen Med J.13.
[3] Is there a universal positivity bias in attributions? A meta-analytic review of individual, developmental, and cultural differences in the self-serving attributional bias. (Sept04) A H Mezulis el al. Psychol Bull 130 (5).
[4] Early threat perception is independent of later cognitive and behavioral control.… (17May23) Juanzhi Lu et al. Cereb Cortex 33(13). Analysis of the components of cancer risk perception and links with intention and behaviour …. (13Jan22) C Riedinger et al. PLoS One. 17(1). Perceptions of threat. (2020) K Bredemeier, et al. In A. L. Gerlach et al eds., Generalized anxiety disorder and worrying….
[5] Social vulnerability among cancer patients and changes in vulnerability during their trajectories…. (Aug23) Jens-Jakob Kjer Møller et al. Cancer Epidemiol 85
[6] Positive and negative psychosocial impacts on cancer survivors. (2023) G Yao et al. Scientific Reports 13 (14749). Cancer and Stress: Understanding the Connections and Interventions. (6Dec24) S D D’Andre et al. Am J Lifestyle Med. 19(8). Mind over Medicine. (2020) L Rankin. Radical Remissions. (2014) K Turner. Affective reactivity to daily stressors and long-term risk of reporting a chronic physical health condition. (Feb13 ) J R Piazza et al. Ann Behav Med 45(1). When the Body Says No: The Cost of Hidden Stress. (2003) G Maté. The Negative Side of Interaction (Maty84) K S Rook. J of Pers and Soc Psych, 46(5).
[7] Hospitals seen as where people die: Culture, Health and Illness. (2007) C Helman. Often self-employed, like farmers, lorry drivers, can’t extricate themselves from what they see as the demanding responsibilities their work.
[8] Advancing psychosocial care in cancer patients. (4Dec17) L Grassi et al. PMC F1000Res.6(2083) BUT this changes with regions, professional skills, available resources, whether public or private provision, and what who is in control our services perceive as efficient.
[9] Standard oncological care (SCO) is mainly directed to cancer cell growth. Basically the right drug at the right time. These services are usually limited by cancer type, stage and progression aggressivity, individuals general health & age, comorbidity and medical treatment goals. Challenging Standard-of-Care Paradigms in the Precision Oncology Era. (12Jan18) V Subbiah et al. Trends Cancer 4(2).
[10] An Introduction to the Main Types of Economic Evaluations Used for Informing Priority Setting and Resource Allocation in Healthcare…. (25Aug21) H C Turner et al. Front Public Health 9.
[11] Comparing Cancer Care, Outcomes, and Costs Across Health Systems…. (16Aug13) J Lipscomb et al. J Natl Cancer Inst Monogr (46).
[12] An improvement with the creation of integrated care pathways (ICP) which delineate care pathways and timing.Implementing Personalized Pathways for Cancer …. (8Mar19 ) C M Alfano et al. CA Cancer J Clin 69(3). How has the impact of ‘care pathway technologies …. (Mar2008) D Allen et al. Int J Evod Based Healthc 6(1).
[13] International models of health systems financing. (2014) R Kulesher et al. J of Hosp Admin 3(4).
Public and private healthcare services …. (Jun20) M Meleddu et al. Socio-Econ Plan Sci 70
[14] Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries…. (13Aug16) M Maruthappu et al. Lancet 388 (10045). Expanding Access to Essential Quality Services for Cancer Patients as Part of Universal Health Coverage…. (26Mar20) S E Johnson et al. JCO Glob Oncol.
[15] Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries …. (13Aug16) M Maruthappu et al. Lancet 388 (10045)
[16] Economic downturns, universal health coverage, and cancer mortality in high-income and middle-income countries …. (13Aug16) M Maruthappu et al. Lancet 388 (10045)
[17] Estimates and Projections of the Global Economic Cost …. (1Apr23) S Chen et al. JAMA Oncol9(4)
[18] The Erosion of Healthcare and Scientific Integrity…. (21Feb25) L D Björn et al. J Healthc Leadersh.17.
[19] The USA despite its wealth is a health underperformer. U.S. Health in International Perspective: Shorter Lives, Poorer Health. S H Woolf, L Aron, eds. National Research Council (US)
[20] Cancer in the UK 2025: Socioeconomic deprivation. Can Research UK.
[21] Attempts to equalise care and provide patients’ rights, e.g. The European Code of Cancer Practice. (Jun21) M Lawler et al. J of Can Pol 28. Details: https://www.europeancancer.org/content/european-code-of-cancer-practice.html
[22] Problems of treatment access, side effects, damaged immune system, comorbid illnesses, reoccurrence. Management Interventions to Facilitate Psychological and Physiological Adaptation …. (Aug22) Michael H Antoni et al. Annu Rev Psychol.74.
[23] Improving the oncology care pathway through the experience …. (12Jul25) S Gentile et al. BMC Palliat Care 24(196). The relationship between integrated care and cancer patient experience…. (Jan16) S Foglino et al. Health Policy 120(1). Preferences of Cancer Patients Regarding Communication …. (Apr09) Maiko Fujimori et al. JJCO 39(4).
[24] Integrative oncology…. (2022) J J Mao et al. Ca Cancer J Clin 72. Integrative oncology.… (Aug08) SM Sagar, et al. Curr Oncol. 15(2).
[25] Systematic Review of Psychological Therapies for Cancer Patients…. (17Apr2002) S A Newell et al. J Nat Can Inst 94(8). The clinically evidenced physical exercises, mindfulness, PNI, nature therapy, Tai chi mentioned in previous chapters are rarely mentioned.
[26] The Impact of Cancer on Mental Health and the Importance of Supportive Services. (26Feb24) Z Fereidouni et al. Galen Med J.13. Hope and cancer. (Feb23) D B Feldman et al. Cur Opin in Psych 49.
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