Editorial for International Journal of Behavioral Medicine: Special Issue on Cancer

Contributions of Behavioral Medicine to CancerPrevention and ControlOver the past several decades, behavioral medicine hascontributed in many significant ways to cancer preventionand control (CPC) research [1]. This includes primaryprevention theory development and behavioral interven-tions designed to modify cancer risk behaviors tied toexposure to high-fat diet, sexually transmitted viruses,tobacco, and excessive sunlight. This has led to markeddecreases in the incidence of lung, skin, colorectal, andcervical cancers. Other work in behavioral medicine hascontributed to efforts in secondary prevention by increasingour understanding of processes underlying decisions toundergo cancer screening (mammogram, Pap smears, fecaloccult blood testing (FOBT), skin cancer screening) as wellas the role of behavioral and psychosocial factors inpostscreening follow-up behaviors [1]. This secondaryprevention work is designed to reduce mortality as well aspsychosocial and physical morbidity [1] and has beenwidely responsible for the increased use of establishedscreening procedures for breast, cervical, and skin cancers,and is making some gains in increasing screening forprostate, lung, and colorectal cancer. Behavioral medicineresearch has also extended to examine factors underlyingthe choice to undergo testing for genetic risk factors such asBRCA 1 and 2, which connote surplus risk for breast andovarian cancers. This work has led to increased expertise ingenetic counseling to guide individuals in the decision-making challenges (e.g., prophylactic surgery, increasedscreening frequency) that follow a positive test result.A huge amount of behavioral medicine research in CPChas been done within the field of “psycho-oncology”mostly targeted to tertiary prevention, wherein behavioraland psychosocial models have been applied to helpdiagnosed cancer patients optimize psychosocial andphysiological adaptation to the stressors of diagnosis,treatment and reentry to their premorbid lives—a periodoften referred to as early survivorship. The ultimate goal ofthis work is to enhance quality of life in patients and thoseconnected to them (e.g., family caregivers) as they navigatethe cancer experience. This work has applied multiplepsychological theories (e.g., cognitive behavioral, existen-tial) to better understand how patients rally their intrapsy-chic, interpersonal, and spiritual resources to cope with andadapt to the mental and physical challenges of this 1–2-yearperiod. This has resulted in the completion of over 300randomized trials testing the effects of a wide range ofbehavioral and psychosocial interventions, which haveshown modest but reliable effects on improved quality oflife and mood, and reduced side effects (e.g., sleepdisruption, fatigue, pain). In a small subset of studies, thereis a suggestion that these interventions may help reducephysiologic effects of treatment (compromised immunefunction) [2]. Very recent work suggests that stressprocesses may contribute to cancer disease progression,which may help to explain the provocative but difficult toreplicate observation that some cancer patients whoparticipate in group-based psychosocial interventions showlonger survival times and disease-free intervals [3].Completing the ways in which behavioral medicinecontributes to CPC are quaternary prevention studies thatfocus on the role of behavioral and psychosocial processesin optimal long-term survivorship after curative and initial