Etiology and treatment of the psychological side effects associated with cancer chemotherapy: A critical review and discussion.

Cancer patients receiving chemotherapeutic treatments routinely experience a wide range of dis-tressing side effects, including nausea, vomiting, and dysphoria. Such symptoms often compromise patients1 quality of life and may lead to the decision to postpone or even reject future, potentially life-saving, treatments. In this article, we discuss the hypotheses that have been offered to explain the development of such symptoms. We also review, in greater detail, the research evidence for the efficacy of five treatments for such symptoms: hypnosis, progressive muscle relaxation training with guided imagery, systematic desensitization, attentional diversion or redirection, and biofeedback. We discuss the implications of this treatment research, paying particular attention to factors associ-ated with treatment outcome, mechanisms of treatment effectiveness, and issues associated with clinical application. Chemotherapy is the treatment of choice for hundreds of thousands of cancer patients diagnosed each year in the United States (Silverberg & Lubera, 1986). Its frequent use with cancer patients is the result of recent advances in antineoplastic medi-cation; new and more effective medications have increased the