Psychosocial oncology research. Where we have been, where we are going, and why we will not get there

Quality of life, symptom management, and social support are the traditional foci for the practice of psychosocial oncology and clinical research into the behavioral and psychologic aspects of cancer. The current paradigm for research in this area primarily assesses patient responses to cancer related stressors and the means of ameliorating the negative aspects of those responses. However, clinically meaningful interventions have been the exception, rather than the rule. The authors think that the central event initiating a stressful response is the interaction between the patient and physician conveying the diagnosis, prognosis, or treatment plan. The authors think addressing the initial event in a cascade of responses is an important prerequisite for progress in this area.