Despite emerging evidence that distress and adversity can contribute to negative health outcomes in cancer, little is known about the brain networks, regions, or circuits that can contribute to individual differences in affect/distress states and health outcomes in treated cancer patients. To understand the state-of-the-science in this regard, we reviewed neuroimaging studies with cancer patients that examined the associations between negative affect (distress) and changes in the metabolism or structure of brain regions. Cancer patients showed changes in function and/or structure of key brain regions such as the prefrontal cortex, thalamus, amygdala, hippocampus, cingulate cortex (mainly subgenual area), hypothalamus, basal ganglia (striatum and caudate), and insula, which are associated with greater anxiety, depression, posttraumatic stress disorder (PTSD) symptoms, and distress. These results provide insights for understanding the effects of these psychological and emotional factors on peripheral stress-related biobehavioral pathways known to contribute to cancer progression and long-term health outcomes. This line of work provides leads for understanding the brain-mediated mechanisms that may explain the health effects of psychosocial interventions in cancer patients and survivors. A multilevel and integrated model for distress management intervention effects on psychological adaptation, biobehavioral processes, cancer pathogenesis, and clinical outcomes is proposed for future research.

Background: Cancer is a complex health problem requiring multidisciplinary care. There are clinical guidelines available in order to improve the process and outcomes of cancer care within Europe. However, strategic action is still needed in many European Union (EU) Member States to develop or improve national cancer control plans (NCCPs), which play a key role in cancer control and care. The current study clarifies the extent of implementation of psychosocial oncology care (PSOC) in the EU.Method: A survey methodology was used to cover four dimensions: (1) inclusion of PSOC in NCCPs; (2) structure and resources of PSOC delivery; (3) use of NCCP clinical guidelines; and (4) education and training resources available along with determination of training needs in PSOC.Results: Twenty‐seven (90%) countries returned questionnaires of which 21 (78%) include PSOC in their NCCP. However, only 10 (37%) reported having specific budgets for PSOC, 8 (30%) having nationally recommended PSOC clinical guidelines, and 6 countries (22%) reported having an official certification for PSOC education.Conclusion: Although many countries seem to have integrated PSOC into their NCCP, there is still much to do in terms of allocating resources and delivering psychosocial care equitably. Also, there is a need for improving training and certification in PSOC. The findings indicate the need to develop national policies concerning PSOC with clear targets for deliverables in an appropriate timetable in order that psychosocial services and existing clinical guidelines are implemented and fully integrated into EU NCCPs. Copyright © 2015 John Wiley & Sons, Ltd.

Background: According to Europe’s Beating Cancer Plan, the number of cancer survivors is growing every year and is now estimated at over 12 million in Europe. A main objective of the European Commission is to ensure that cancer survivors can enjoy a high quality of life, underlining the role of digital technology and eHealth apps and tools to achieve this. Objective: The main objective of this study is the development of a user-centered artificial intelligence system to facilitate the input and integration of patient-related biopsychosocial data to improve posttreatment quality of life, well-being, and health outcomes and examine the feasibility of this digitally assisted workflow in a real-life setting in patients with colorectal cancer and acute myeloid leukemia. Methods: A total of 60 patients with colorectal cancer and 30 patients with acute myeloid leukemia will be recruited from 2 clinical centers: Universitätsmedizin der Johannes Gutenberg-Universität Mainz (Mainz, Germany) and IRCCS Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori” (IRST, Italy). Psychosocial data (eg, emotional distress, fatigue, quality of life, subjective well-being, sleep problems, and appetite loss) will be collected by questionnaires via a smartphone app, and physiological data (eg, heart rate, skin temperature, and movement through step count) will be collected by a customizable smart wrist-worn sensor device. Each patient will be assessed every 2 weeks over their 3-month participation in the ONCORELIEF study. Inclusion criteria include patients with the diagnosis of acute myeloid leukemia or colorectal cancer, adult patients aged 18 years and older, life expectancy greater than 12 months, Eastern Cooperative Oncology Group performance status ≤2, and patients who have a smartphone and agree to use it for the purpose of the study. Exclusion criteria include patients with a reduced cognitive function (such as dementia) or technological illiteracy and other known active malignant neoplastic diseases (patients with a medical history of treated neoplastic disease are included). Results: The pilot study started on September 1, 2022. As of January 2023, we enrolled 33 patients with colorectal cancer and 7 patients with acute myeloid leukemia. As of January 2023, we have not yet started the data analysis. We expect to get all data in June 2023 and expect the results to be published in the second semester of 2023. Conclusions: Web-based and mobile apps use methods from mathematical decision support and artificial intelligence through a closed-loop workflow that connects health professionals and patients. The ONCORELIEF system has the potential of continuously identifying, collecting, and processing data from diverse patient dimensions to offer health care recommendations, support patients with cancer to address their unmet needs, and optimize survivorship care. Trial Registration: German Clinical Trials Register (DRKS) 00027808; https://drks.de/search/en/trial/DRKS00027808 International Registered Report Identifier (IRRID): DERR1-10.2196/45475

Psychosocial adaptation to cancer involves interactions among emotional, cognitive, and biological processes. Although the efficacy of psychological interventions is well documented, the mechanisms linking psychological adaptation to physiological outcomes remain fragmented across disciplines. The Special Issue of the International Journal of Clinical and Health Psychology, "Advancing Health Psychology Research in Oncology: Biobehavioral Models, Stress Pathways, and Stress-Management Interventions for Cancer Patients" addresses this gap and this paper serves as an overview. As an overview for the Special Issue, this paper proposes an integrative biobehavioral model that synthesizes findings on brain function, stress-response systems, and psychosocial variables to explain how stress management interventions- including those delivered via digital platforms-may influence health trajectories in cancer care. Using a targeted narrative approach, we draw upon recent empirical findings and prior integrative reviews conducted by the authors to examine: (a) the impact of perceived stress and inflammation across the cancer continuum; (b) brain-body stress response pathways linking affective, neuroendocrine, and immune function; (c) the evidence for psychological interventions to modulate these systems and improve behavioral and health outcomes; (d) future challenges for this line of research and cancer care. Evidence suggests that cancer-related distress is associated with neural and immune dysregulation, with inflammation emerging as a central pathway. Stress management interventions, based on cognitive-behavioral theory and using digital delivery modalities, show promise in altering these biobehavioral mechanisms, thereby enhancing resilience, quality of life, and potentially long-term health outcomes in cancer survivors.

Purpose: Emotional distress and adversity can contribute to negative health outcomes in women with breast cancer. Individual differences in perceived stress management skills such as cognitive reframing and relaxation for coping with adversity have been shown to predict less distress and better psychological and physiological adaptation. Prior work shows that more distressed breast cancer patients reveal less metabolic activity in brain regions such as the insula, thalamus, ventromedial and lateral prefrontal cortices. This led us to pose the hypothesis that breast cancer patients with greater stress management skills (e.g., ability to reframe stressors and use relaxation) may conversely show greater activation in these brain regions and thereby identify brain activity that may be modifiable through stress management interventions. The main objective of this study was to examine the association of perceived stress management skill efficacy with the metabolism of 9 key stress-implicated brain regions in women diagnosed with metastatic breast cancer. Methods: Sixty women (mean age 59.86 ± 10.04) with a diagnosis of mBC underwent ¹⁸F-fluorodeoxyglucose positron emission tomography. Perceived stress management skill efficacy was assessed with the Measure of Current Status Scale. Results: Greater perceived stress management skill efficacy related significantly to higher metabolic activity in the insula, thalamus, ventromedial and lateral prefrontal cortices, and basal ganglia; this network of regions overlaps with those previously shown to be under-activated with greater level of distress in this same sample of metastatic breast cancer patients. Conclusion: This is the first study to demonstrate in metastatic cancer patients that greater perceptions of stress management skill efficacy are associated with metabolic activity in key brain regions and paves the way for future studies tracking neural mechanisms sensitive to change following stress management interventions for this population.