Surviving cancer

Research trends on quality of life outcomes for cancer survivors are discussed. Epidemiologic data indicate that female cancer survivors, coming primarily from patient groups with gynecologic, breast, and colorectal cancers, will outnumber male survivors 3 to 1. Male survivors will come from the ranks of patient groups with colorectal and other digestive tumors (such as stomach cancer), prostate, and bladder cancers. With the exception of breast cancer, there have been few well controlled descriptive, longitudinal studies of cancer survivors, with data on men being notably absent. A strategy for identifying differential levels of risk for psychologic morbidity for cancer survivors is proposed. Other important psychologic individual difference variables were identified: control, optimism, and stable coping strategies may be useful in the prediction of mental health outcomes; conscientiousness in the prediction of health behaviors; and sexual self-schema in the prediction of sexual outcomes. Finally, data suggest that psychologic and behavioral outcomes can be improved with psychologic interventions, but it is likely that even greater gains could be achieved if health behavior components were added. New directions for research include study of individual differences, examination of active components of multifaceted interventions, and study of the health consequences of interventions. In the latter regard, a biobehavioral model of stress and cancer is offered to integrate psychologic, behavioral, biologic, and disease factors into testable new research directions.