The effect on oncology of the doctrine of Cartesian dualism is examined. It is argued that (1) this doctrine continues to exert a baneful (though unacknowledged) influence on the practice of oncology, (2) Descartes's doctrine of a mind/ body split is mistaken, and (3) mind and body (brain) are inextricably interwoven. A biopsychosocial model of disease is advocated. The role of psychooncology in healing the mind/ body split by focusing research attention on the patient is outlined.
Fox BHProblems of the patient confronting the diagnosis of cancer. In: Cullen JW, Fox BH , Isom RN, eds. Cancer: The Behavioural Dimensions. New York, NY: Raven;1976:286.
2.
Lewis A.Agents of cultural advance. In: The State of Psychiatry. London, England: Routledge Kegan Paul; 1967:235-252.
3.
Kenny A.Descartes to Kant. In: Kenney A, ed. The Oxford History of Western Philosophy. Oxford , England: Oxford University Press; 1994;107-192.
4.
Greenfield S.The Human Brain. London, England: Phoenix;1997.
5.
Descartes, R.Meditations VI In: Martin P., ed. The Sickening Mind. London, England: Flamingo;1998.
6.
Bynum WFPsychiatry in its historical context. In: Shepherd M, Zangwill OL, eds. Handbook of Psychiatry. Cambridge, England: Cambridge University Press;1983:11-38.
7.
Martin P., ed. The Sickening Mind. London, England: Flamingo;1998.
8.
Ryle G.The Concept of Mind. London, England: Hutchinson;1949.
9.
Hippocrates.Ancient Medicine and Other Treatises. Adams F, trans. Chicago, Ill: Henry Regnery; 1949.
10.
Damasio A.Descartes' Error. New York, NY: Putnam; 1994.
11.
Pert CBMolecules of Emotion. New York, NY: Scribner; 1961.
Engel GLThe need for a new medical model: a challenge for biomedicine. Science. 1977;196:129-136.
14.
Foss L.The biomedical paradigm, psychoneuroimmunology and the black four of hearts . Adv Mind Body Med. 1994;10:32-44.
15.
Foss L.Animal brain vs. human mind-brain: the dilemma of mind-body medicine. Adv Mind Body Med.1995;11:57-69.
16.
Foss L.The necessary subjectivity of bodymind medicine: Candace Pert's molecules of emotions. Adv Mind Body Med. 1999;15:122-134.
17.
Foss L.Advancing psychosocial health education: a review of the Pew-Fetzer report . Adv Mind Body Med. 1996;12:43-50.
18.
Watson TACancer of the breast. The Janeway Lecture-1965. Am J Roentgenol Radium Ther Nucl Med.1966;96:547-559.
19.
Cohn KHChemotherapy from an insider's perspective. Lancet. 1982;1:1006-1009.
20.
Cooper A.Hodgkin's disease. Lancet. 1982;I:612-613.
21.
Boyes D.Wanted: less treatment, more care. World Medicine. October 18, 1980.
22.
Devlin HB, Plant JA, Griffin M.Aftermath of surgery for anorectal cancer. Br Med J. 1971;3:413-418.
23.
Oken D.What to tell cancer patients: a study of medical attitudes. JAMA. 1961;175:1120-1128.
24.
Lipowski ZJWhat does the word "psychosomatic" really mean? A historical and semantic inquiry. Psychosom Med. 1984;46:153-171.
25.
Fox BHPremorbid psychological factors as related to cancer incidence. J Behav Med. 1978;1:45-133.
26.
Cullen JW, Fox BH, Isom RNCancer: The Behavioural Dimensions. New York, NY: Raven; 1976.
27.
Cullen JW, Seites NS, Massey MMLifestyle and cancer prevention. Psychiatr Med. 1987;5:361-373.
28.
Sateia MJBehavioral modification in the treatment of smoking. Psychiatr Med. 1987;5:375-387.
29.
Hill M.Nutrition and the prevention of cancer. In: Heller T, Bailey L, Pottinson S, eds. Preventing Cancers. Buckingham, England: Open University Press;1992;59-67.
30.
Cinciripini PM, Gritz ER, Tsho JY, Skaar KLSmoking cessation and cancer prevention. In: Holland JC, ed. Psycho-Oncology. New York, NY: Oxford University Press;1998;27-44.
31.
Berwick M.Sun exposure and cancer risk. In: Holland JC, ed. Psycho-Oncology. New York, NY : Oxford University Press;1998:58-66.
32.
Block KIPsychooncology and total survivorship. Adv Mind Body Med. 1999;15:244-251.
33.
Greer S.Mind-body research in psychooncology. Adv Mind Body Med. 1999;15:236-244.
34.
Greer S.Psycho-oncology: its aims, achievements and future tasks. Psychooncology. 1994;3:87-101.
35.
Kune S., Kune GA, Watson LF, Rahe RHRecent life change and large bowel cancer. Data from the Melbourne Colorectal Cancer Study. J Clin Epidemiol.1991;44:57-68.
36.
Fox BHDepressive symptoms and risk of cancer. JAMA1989;262:1231.
37.
Neale AV, Tilley BC, Vernon SWMarital status, delay in seeking treatment and survival from breast cancer . Soc Sci Med. 1986;23:305-312.
38.
Goodwin JS, Hunt WC, Key CR, Samet JMThe effect of marital status on stage, treatment, and survival of cancer patients . JAMA. 1987;258:3125-3130.
39.
Waxler-Morrison N., Hislop TG, Mears B., Kan L.Effects of social relationships on survival for women with breast cancer: a prospective study. Soc Sci Med. 1991;33:177-183.
40.
Priestman TJ , Priestman SG, Bradshaw C.Stress and breast cancer. Br J Cancer. 1985;51:493-498.
41.
Graham J., Ramirez A., Love S., Richards M., Burgess C.Stressful life experiences and risk of relapse of breast cancer: observational cohort study. BMJ. 2002;324:1420-1422.
42.
Barraclough J., Pinder P., Cruddas M., Osmond C., Taylor I., Perry M.Life events and breast cancer prognosis. BMJ. 1992;304:1078-1081.
43.
Goodkin K., Antoni MH, Blaney PHStress and hopelessness in the promotion of cervical intraepithelial neoplasia to invasive squamous cell carcinoma of the cervix. J Psychosom Res. 1986;30:67-76.
44.
Greer S.Psychological intervention-the gap between research and practice. Acta Oncol. 2002;41:238-243.
45.
Bieliauskas LADepression, stress and cancer. In: Cooper CL, ed. Psychosocial Stress and Cancer. Chichester, England: Wiley;1985:37-48.
46.
Temoshok L., Dreher H. The Type C Connection: The Behavioural Links to Cancer and Your Health. New York, NY: Random House ; 1992.
47.
Gross J.Emotional expression in cancer onset and progression. Soc Sci Med. 1989;28:1239-1248.
48.
Temoshok L. , Heller BW, Sagebiel RW, et al. The relationship of psychosocial factors to prognostic indicators in cutaneous malignant melanoma. J Psychosom Res. 1985;29:139-153.
49.
Temoshok L.Biopsychosocial studies on cutaneous malignant melanoma: psychosocial factors associated with prognostic indicators, progression, psychophysiology and tumor-host response. Soc Sci Med. 1985;20:833-840.
50.
Schleifer SJ , Keller SE, Camerino M., Thornton JC, Stein M.Suppression of lymphocyte stimulation following bereavement. JAMA. 1983;250:374-377.
51.
Kiecolt-Glaser JK, Dura JR, Speicher CE, Trask OJ, Glaser R.Spousal caregivers of dementia victims: longitudinal changes in immunity and health. Psychosom Med. 1991;53:345-362.
52.
Herbert TB, Cohen S.Stress and immunity in humans: a meta-analytic review. Psychosom Med. 1993;55:364-379.
53.
Jung W., Irwin M.Reduction of natural killer cytotoxic activity in major depression: interaction between depression and cigarette smoking. Psychosom Med. 1999;61:263-270.
54.
Fawzy FI, Kemeny ME, Fawzy NW, et al. A structured psychiatric intervention for cancer patients. II. Changes over time in immunological measures. Arch Gen Psychiatry . 1990;47:729-735.
55.
Walker LG, Heys SD, Ogston K., et al. Psychological factors predict response to neo-adjuvant chemotherapy in women with locally advanced breast cancer. Psychooncology . 1997; 6:242-243.
56.
Walker LG, Walker MB, Simpson E., et al. Guided imagery and relaxation therapy can modify host defenses in women receiving treatment for locally advanced breast cancer. Br J Surg.1997;84(suppl 1):31.
57.
Greer S., Moorey S., Baruch JD, et al. Adjuvant psychological therapy for patients with cancer: a prospective randomised trial. BMJ. 1992;304:675-680.
58.
Derogatis LR , Morrow GR, Fetting J., et al. The prevalence of psychiatric disorders among cancer patients. JAMA. 1983;249:751-777.
59.
Zabora J., BrintzenhofeSzoc K., Curbow B., Hooker C., Piantadosi S.The prevalence of psychological distress by cancer site. Psychooncology. 2001;10:19-28.
60.
Fobair P., Hoppe RT, Bloom J., Cox R., Varghese A., Spiegel D.Psychosocial problems among survivors of Hodgkin's disease. J Clin Oncol. 1986;4:805-814.
61.
Kornblith AB , Anderson J., Cella DF, et al. Hodgkin disease survivors at increased risk for problems in psychosocial adaptation. The Cancer and Leukemia Group B. Cancer. 1992; 70:2214-2224.
62.
Baider L., Cooper CL, De Nour AKCancer and the family. Chichester, England: Wiley;1996.
63.
Ravais VH, Karus D., Pretter S.Correlates of anxiety among adult daughter caregivers to a parent with cancer . J Psychosoc Oncol. 1999;17:1-26.
64.
Matthews AK , Aikens JE, Helmrich SP, Anderson DD, Herbst AL, Waggoner SESexual functioning and mood among long-term survivors of clear-cell adenocarcinoma of the vagina or cervix. J Psychosoc Oncol. 1999;17:27-45.
65.
Northouse PG , Northouse LLCommunication and cancer: issues confronting patients, health professionals and family members. J Psychosoc Oncol. 1987;5:17-46.
66.
Mackillop WJ , Stewart WE, Ginsburg AD, Stewart SSCancer patients' perceptions of their disease and its treatment. Br J Cancer. 1988;58:355-358.
67.
Fallowfield L.Giving sad and bad news. Lancet. 1993;341:476-478.
68.
Fallowfield L., Ford S., Lewis S.No news is not good news: information preferences of patients with cancer. Psychooncology. 1995 ;4:197-202.
69.
Maguire P., Booth K., Elliott C., Jones B.Helping health professionals involved in cancer care acquire key interviewing skills-the impact of workshops. Eur J Cancer. 1996;32A:1486-1489.
70.
Fallowfield L., Lipkin M., Hall A.Teaching senior oncologists communication skills: results from phase I of a comprehensive longitudinal program in the United Kingdom. J Clin Oncol. 1998;16:1961-1968.
71.
Cunningham AJ, Tocco EKA randomised trial of group psychoeducational therapy for cancer patients. Patient Educ Counsel. 1989;14:101-114.
72.
Spiegel D., Spira J.Supportive-Expressive Group Therapy: A Treatment Manual for Women With Recurrent Breast Cancer. Stanford, Calif: Stanford University School of Medicine; 1991.
73.
Meyer TJ, Mark MMEffects of psychosocial interventions with adult cancer patients: a meta-analysis of randomized experiments. Health Psychol. 1995;14:101-108.
74.
Moorey S., Greer S.Cognitive Behaviour Therapy for People With Cancer. Oxford , England: Oxford University Press;2002.
75.
Spiegel D., Bloom JR, Kraemer HC, Gottheil E.Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet. 1989;2:888-891.
76.
Linn MW, Linn BS, Harris R.Effects of counseling for late stage cancer patients. Cancer . 1982;49:1048-1055.
77.
Cunningham AJ, Edmonds CV, Jenkins GP, Pollack H., Lock-wood GA, Warr D.A randomized controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer. Psychooncology. 1998;7:508-517.
78.
Edelman S., Bell DR, Kidman ADA group cognitive behaviour therapy programme with metastatic breast cancer patients. Psychooncology. 1999;8:295-305.
79.
Goodwin PJ, Leszcz M., Ennis M., et al. The effect of group psychosocial support on survival in metastatic breast cancer. N Engl J Med. 2001;345:1719-1726.
80.
Cunningham AJ, Phillips C., Stephen J., Edmons C.Fighting for life: a qualitative analysis of the process of psychotherapy-assisted self-help in patients with metastatic cancer. Int Cancer Ther. 2002;41:146-161.