Skip to main content
SpringerLink
Log in

Psychiatric and Psychological Issues

  • Chapter
  • First Online:
Breast Surgical Techniques and Interdisciplinary Management

  • 2488 Accesses

Abstract

Breast cancer is inherently stressful. Every person diagnosed with the disease immediately experiences understandable fear of dying of cancer, despite the fact that half of all breast cancer patients will live to die of something else. They also fear disfigurement, despite the increasing prevalence of breast-sparing treatments such as lumpectomy and radiation. These concerns tend to isolate them from social support, since such fundamental concerns arouse anxiety in others as well, and may lead to avoidance on both sides. Cancer treatments can induce nausea, fatigue, burns, lymphedema, disfigurement, and pain. The illness and its treatment cause acute disruption of educational, vocational, and social roles. Thus, it is natural that breast cancer patients experience stress, distress, anxiety, and depression. Few people are well prepared by life for the multiple existential problems that come with a diagnosis of breast cancer. Recognizing that these issues are always part of returning a patient to a well-state allows the clinician to better support patients and enables the astute clinician to recognize the potential need for consultation from a psychologist or psychiatrist.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Newport DJ, Nemeroff CB. Assessment and treatment of depression in the cancer patient. J Psychosom Res. 1998;45(3):215–37.

    Article  PubMed  CAS  Google Scholar 

  2. Rodin G, Voshart K. Depression in the medically ill: an overview. Am J Psychiatry. 1986;143(6): 696–705.

    PubMed  CAS  Google Scholar 

  3. Spiegel D. Cancer and depression. Br J Psychiatry. 1996;168 Suppl 30:109–16.

    Google Scholar 

  4. McDaniel JS, Musselman DL, et al. Depression in patients with cancer. Diagnosis, biology, and treatment. Arch Gen Psychiatry. 1995;52(2):89–99.

    Article  PubMed  CAS  Google Scholar 

  5. Koopman C, Butler LD, et al. Traumatic stress symptoms among women with recently ­diagnosed primary breast cancer. J Trauma Stress. 2002;15(4):277–87.

    Article  PubMed  Google Scholar 

  6. Derogatis LR, Morrow GR, et al. The prevalence of psychiatric disorders among cancer patients. JAMA. 1983;249(6):751–7.

    Article  PubMed  CAS  Google Scholar 

  7. Katon W, Sullivan M. Depression and chronic medical illness. J Behav Med. 1990;2010:3–2010.

    Google Scholar 

  8. Weitzner MA, Meyers CA, et al. Relationship between quality of life and mood in long-term survivors of breast cancer treated with mastectomy. Support Care Cancer. 1997;5(3):241–8.

    Article  PubMed  CAS  Google Scholar 

  9. Cohen L, de Moor C, et al. The association between treatment-specific optimism and depressive symptomatology in patients enrolled in a Phase I cancer clinical trial. Cancer. 2001; 91(10):1949–55.

    Article  PubMed  CAS  Google Scholar 

  10. Spiegel D, Bloom JR, et al. Group support for patients with metastatic cancer. A randomized outcome study. Arch Gen Psychiatry. 1981;38(5):527–33.

    Article  PubMed  CAS  Google Scholar 

  11. Bukberg J, Penman D, et al. Depression in hospitalized cancer patients. Psychosom Med. 1984;46:199–212.

    PubMed  CAS  Google Scholar 

  12. Spiegel D, Sands S, et al. Pain and depression in patients with cancer. Cancer. 1994;74(9): 2570–8.

    Article  PubMed  CAS  Google Scholar 

  13. van’t Spijker A, Trijsburg RW, et al. Psychological sequelae of cancer diagnosis: a meta-analytical review of 58 studies after 1980. Psychosom Med. 1997;59(3):280–93.

    PubMed  Google Scholar 

  14. Wellisch D, Carr C. Psychosocial outcomes of breast cancer therapies: lumpectomy vs mastectomy. Psychosomatics. 1991;32(2):177–86.

    Article  PubMed  Google Scholar 

  15. Pozo C, Carver CS, et al. Effects of mastectomy versus lumpectomy on emotional adjustment to breast cancer: a prospective study of the first year postsurgery. J Clin Oncol. 1992;10(8): 1292–8.

    PubMed  CAS  Google Scholar 

  16. Levy SM, Haynes LT, et al. Mastectomy versus breast conservation surgery: mental health effects at long-term follow-up [see comments]. Health Psychol. 1992;2010(6):349–54.

    Article  Google Scholar 

  17. Peto R, Boreham J, et al. UK and USA breast cancer deaths down 25% in year 2000 at ages 20-69 years. Lancet. 2000;355(9217):1822.

    Article  PubMed  CAS  Google Scholar 

  18. Spiegel D. Mind matters – group therapy and survival in breast cancer. [letter; comment.]. N Engl J Med. 2001;345(24):1767–8.

    Article  PubMed  CAS  Google Scholar 

  19. Han WT, Collie K, et al. Breast cancer and problems with medical interactions: relationships with traumatic stress, emotional self-efficacy, and social support. Psychooncology. 2005;14(4): 318–30.

    Article  PubMed  Google Scholar 

  20. Pirl WF, Roth AJ. Oncology (Huntingt). 1999;13(9):1293–301. discussion 1301-2, 1305-6.

    CAS  Google Scholar 

  21. Lerman C, Kash K, et al. Younger women at increased risk for breast cancer: perceived risk, psychological well-being, and surveillance behavior. J Natl Cancer Inst Monogr. 1994;16: 171–6.

    PubMed  Google Scholar 

  22. Richardson JL, Shelton DR, et al. The effect of compliance with treatment on survival among patients with hematologic malignancies. J Clin Oncol. 1990;8(2):356–64.

    PubMed  CAS  Google Scholar 

  23. Ayres A, Hoon PW, et al. Influence of mood and adjustment to cancer on compliance with chemotherapy among breast cancer patients. J Psychosom Res. 1994;38(5):393–402.

    Article  PubMed  CAS  Google Scholar 

  24. Eisenberg D, Davis R, et al. Trends in alternative medicine use in the United States, 1990–1997. JAMA. 1997;280:1569–75.

    Article  Google Scholar 

  25. Kao GD, Devine P. Use of complementary health practices by prostate carcinoma patients undergoing radiation therapy. Cancer. 2000;88(3):615–9.

    Article  PubMed  CAS  Google Scholar 

  26. Sollner W, Zingg-Schir M, et al. Attitude toward alternative therapy, compliance with standard treatment, and need for emotional support in patients with melanoma [see comments]. Arch Dermatol. 1997;133(3):316–21.

    Article  PubMed  CAS  Google Scholar 

  27. Spiegel D, Giese-Davis J. Depression and cancer: mechanisms and disease progression. Biol Psychiatry. 2003;54(3):269–82.

    Article  PubMed  Google Scholar 

  28. Sephton S, Spiegel D. Circadian disruption in cancer: a neuroendocrine-immune pathway from stress to disease? Brain Behav Immun. 2003;17(5):321–8.

    Article  PubMed  CAS  Google Scholar 

  29. Sephton SE, Sapolsky RM, et al. Diurnal cortisol rhythm as a predictor of breast cancer survival. J Natl Cancer Inst. 2000;92:994–1000.

    Article  PubMed  CAS  Google Scholar 

  30. Editorial. Hypnosis may lower costs of breast surgery. CA Cancer J Clin. 2008;58:3–4.

    Google Scholar 

  31. Lang EV, Berbaum KS, et al. Adjunctive self-hypnotic relaxation for outpatient medical ­procedures: a prospective randomized trial with women undergoing large core breast biopsy. Pain. 2006;126(1–3):155–64.

    Article  PubMed  Google Scholar 

  32. Montgomery GH, Bovbjerg DH, et al. A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients. J Natl Cancer Inst. 2007;99(17): 1304–12.

    Article  PubMed  Google Scholar 

  33. Spiegel H, Spiegel D. Trance and treatment: clinical uses of hypnosis. Washington D.C.: American Psychiatric Publishing; 2004.

    Google Scholar 

  34. Faymonville ME, Laureys S, et al. Neural mechanisms of antinociceptive effects of hypnosis. Anesthesiology. 2000;92(5):1257–67.

    Article  PubMed  CAS  Google Scholar 

  35. Rainville P, Duncan GH, et al. Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science. 1997;277:968–71.

    Article  PubMed  CAS  Google Scholar 

  36. Rainville P, Hofbauer RK, et al. Hypnosis modulates activity in brain structures involved in the regulation of consciousness. J Cogn Neurosci. 2002;14(6):887–901.

    Article  PubMed  Google Scholar 

  37. Spiegel D, Bierre P, et al. Hypnotic alteration of somatosensory perception. Am J Psychiatry. 1989;146(6):749–54.

    PubMed  CAS  Google Scholar 

  38. Kosslyn SM, Thompson WL, et al. Hypnotic visual illusion alters color processing in the brain. Am J Psychiatry. 2000;157(8):1279–84.

    Article  PubMed  CAS  Google Scholar 

  39. Lang E, Benotsch E, et al. Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial. Lancet. 2000;355:1486–90.

    Article  PubMed  CAS  Google Scholar 

  40. Lang E, Joyce J. Self-hypnotic relaxation during interventional radiological procedures: effects on pain perception and intravenous drug use. Int J Clin Exp Hypn. 1996;XLIV(2):106–19.

    Article  Google Scholar 

  41. Lang EV, Rosen MP. Cost analysis of adjunct hypnosis with sedation during outpatient interventional radiologic procedures. Radiology. 2002;222(2):375–82.

    Article  PubMed  Google Scholar 

  42. Kabat-Zinn J, Massion AO, et al. Meditation. In: Holland JC, editor. Psychooncology. New York: Oxford University Press; 1998. p. 767–79.

    Google Scholar 

  43. Spiegel D. A 43-year-old woman coping with cancer [clinical conference] [see comments]. JAMA. 1999;282(4):371–8.

    Article  PubMed  CAS  Google Scholar 

  44. Spiegel D, Classen C. Group therapy for cancer patients: a research-based handbook of psychosocial care. New York: Basic Books; 2000.

    Google Scholar 

  45. Yalom ID. Existential psychotherapy. New York: Basic Books; 1980.

    Google Scholar 

  46. Spiegel D, Morrow GR, et al. Group psychotherapy for recently diagnosed breast cancer patients: a multicenter feasibility study. Psychooncology. 1999;8(6):482–93.

    Article  PubMed  CAS  Google Scholar 

  47. Spiegel D. Mind matters: effects of group support on cancer patients. J NIH Res. 1991;3:61–3.

    Google Scholar 

  48. Giese-Davis J, DiMiceli S, et al. Emotional expression and diurnal cortisol slope in women with metastatic breast cancer in supportive-expressive group therapy: a preliminary study. Biol Psychol. 2006;73(2):190–8.

    Article  PubMed  Google Scholar 

  49. Goodwin PJ et al. The effect of group psychosocial support on survival in metastatic breast cancer. N Engl J Med. 2001;345(24):1719–26.

    Article  PubMed  CAS  Google Scholar 

  50. Spiegel D, Bloom JR. Group therapy and hypnosis reduce metastatic breast carcinoma pain. Psychosom Med. 1983;45(4):333–9.

    PubMed  CAS  Google Scholar 

  51. Classen C, Butler LD, et al. Supportive-expressive group therapy reduces distress in metastatic breast cancer patients: a randomized clinical intervention trial. Arch Gen Psychiatry. 2001;58: 494–501.

    Article  PubMed  CAS  Google Scholar 

  52. Cain EN, Kohorn EI, et al. Psychosocial benefits of a cancer support group. Cancer. 1986; 57(1):183–9.

    Article  PubMed  CAS  Google Scholar 

  53. Spiegel D, Bloom JR. Pain in metastatic breast cancer. Cancer. 1983;52(2):341–5.

    Article  PubMed  Google Scholar 

  54. Giese-Davis J, Koopman C, et al. Change in emotion-regulation strategy for women with metastatic breast cancer following supportive-expressive group therapy. J Consult Clin Psychol. 2002;70(4):916–25.

    Article  PubMed  CAS  Google Scholar 

  55. Kelly CM, et al. Selective serotonin reuptake inhibitors and breast cancer mortality in women receiving tamoxifen: a population based cohort study. Bmj. 2010;340: p. c693.

    Google Scholar 

  56. Lash TL, et al, Tamoxifen’s protection against breast cancer recurrence is not reduced by concurrent use of the SSRI citalopram. Br J Cancer, 2008;99(4): p. 616–21.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Stanford Center for Integrative Medicine, Stanford University School of Medicine, Stanford, CA, USA

    David Spiegel

Authors
  1. David Spiegel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Spiegel .

Editor information

Editors and Affiliations

  1. Middle Ave. 1285, Menlo Park, 94025, California, USA

    Frederick Dirbas

  2. Iowa City, USA

    Carol Scott-Conner

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer New York

About this chapter

Cite this chapter

Spiegel, D. (2010). Psychiatric and Psychological Issues. In: Dirbas, F., Scott-Conner, C. (eds) Breast Surgical Techniques and Interdisciplinary Management. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-6076-4_29

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-6076-4_29

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-6075-7

  • Online ISBN: 978-1-4419-6076-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation