In Meeting Psychosocial Needs of Women with Breast Cancer, the National Cancer Policy Board of the Institute of Medicine examines the psychosocial consequences of the cancer experience. The book focuses specifically on breast cancer in women because this group has the largest survivor population (over 2 million) and this disease is the most extensively studied cancer from the standpoint of psychosocial effects. The book characterizes the psychosocial consequences of a diagnosis of breast cancer, describes psychosocial services and how they are delivered, and evaluates their effectiveness. It assesses the status of professional education and training and applied clinical and health services research and proposes policies to improve the quality of care and quality of life for women with breast cancer and their families. Because cancer of the breast is likely a good model for cancer at other sites, recommendations for this cancer should be applicable to the psychosocial care provided generally to individuals with cancer. For breast cancer, and indeed probably for any cancer, the report finds that psychosocial services can provide significant benefits in quality of life and success in coping with serious and life-threatening disease for patients and their families.

Contents

• THE NATIONAL ACADEMIES
• NATIONAL CANCER POLICY BOARD
• Reviewers
• Executive Summary
• 1. Introduction
  • ROLE OF THE NATIONAL CANCER POLICY BOARD
  • FRAMEWORK OF THE REPORT
  • REFERENCES
• 2. Epidemiology of Breast Cancer
  • INCIDENCE AND MORTALITY
  • PREVALENCE
  • STAGE AT DIAGNOSIS
  • SOME RISK FACTORS ASSOCIATED WITH BREAST CANCER
  • SUMMARY
  • REFERENCES
• 3. Psychosocial Needs of Women with Breast Cancer
  • PSYCHOSOCIAL NEEDS OF WOMEN BY PHASE OF CARE
  • PREVALENCE OF PSYCHOSOCIAL DISTRESS
  • RISK FACTORS ASSOCIATED WITH PSYCHOSOCIAL DISTRESS
  • SUMMARY
  • REFERENCES
• 4. Psychosocial Services and Providers
  • PSYCHOSOCIAL SERVICES
  • PROVIDERS OF PSYCHOSOCIAL CARE
  • SUMMARY
  • REFERENCES
• 5. The Effectiveness of Psychosocial Interventions for Women with Breast Cancer
  • HISTORY OF PSYCHOSOCIAL INTERVENTION RESEARCH
  • METHODOLOGICAL ISSUES
  • REVIEW OF THE LITERATURE
  • SUMMARY
  • REFERENCES
• 6. Delivering Psychosocial Services
  • THE EVOLUTION OF BREAST CANCER CARE AND ITS IMPLICATIONS FOR THE PROVISION OF PSYCHOSOCIAL SERVICES
  • THE STRUCTURE AND DELIVERY OF PSYCHOSOCIAL SERVICES TO WOMEN WITH BREAST CANCER
  • PSYCHOSOCIAL SERVICE USE
  • SUMMARY
  • REFERENCES
• 7. Barriers to Appropriate Use of Psychosocial Services
  • ACCESS TO CARE
  • SUMMARY AND RECOMMENDATIONS
  • REFERENCES
• 8. Research
  • STATUS OF BREAST CANCER-RELATED RESEARCH
  • SUGGESTIONS FOR FUTURE RESEARCH PRIORITIES
  • FINDINGS AND RECOMMENDATIONS
  • REFERENCES
• Appendix A Meeting Psychosocial Needs of Women with Breast Cancer
• Appendix B Tables and Boxes Summarizing Evidence from Clinical Trials

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by Contract/Grant No. N02-CO-01029 between the National Academy of Sciences and the National Cancer Institute, and a grant from the Longaberger Company through the American Cancer Society. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project.