Difficulty: Intermediate | Prerequisites: Biopsychosocial model, basics of immune function
This unit examines cancer through the health psychology lens: how psychological and cultural factors influence cancer risk, screening, coping, and progression. It is not a biology-of-cancer unit, though you need to know the basic types. The emphasis is on how stress, personality, social support, and health behaviours interact with cancer outcomes, and how cultural disparities affect who gets screened, diagnosed, and treated. You should already know the biopsychosocial model and the basics of immune function (especially NK cells).
Psychological factors do not clearly cause cancer, but they matter enormously for coping, progression, and survival. Stress weakens the immune system, health behaviours like smoking and diet affect risk directly, and cultural disparities mean minorities are diagnosed later and die more often. Social support is one of the strongest protective factors.
Neoplasm
Cells showing abnormal growth. In simple terms, a mass of cells that are growing in a way they should not be.
Benign
Not cancerous. The growth does not invade surrounding tissue or spread to other parts of the body.
Malignant
Cancerous. The growth can invade nearby tissue and metastasise (spread).
Carcinoma
Cancer that starts in skin cells or cells lining internal organs.
Lymphoma
Cancer of the lymphatic system. Includes Hodgkin's and non-Hodgkin's types.
Sarcoma
Cancer of muscles, bones, or cartilage.
Leukemia
Cancer of the blood or bone marrow.
Fatalism
The belief that cancer is a punishment or that outcomes are predetermined. In simple terms, the view that getting cancer is fate and nothing can be done about it. More common in some cultural groups and linked to lower screening rates.
NK cells (natural killer cells)
Immune cells that target and destroy abnormal cells, including cancer cells. Stress has a direct impact on NK cell activity.
Health belief model (as applied to screening)
A framework predicting health behaviour. For cancer screening: patients who believe they are susceptible to cancer and believe screening is effective are more likely to get screened.
Carcinoma: starts in skin cells or cells lining organs
Lymphoma: lymphatic system (Hodgkin's or non-Hodgkin's)
Sarcoma: muscles, bones, cartilage
Leukemia: blood or bone marrow
Black men have the highest rates of cancer
Minority groups are more likely to get cancer because they are disproportionately poor and medically underserved
Minorities are less likely to get cancer screening tests
Rural women are 2x more likely to die from cervical cancer
Minorities are diagnosed later, often at more advanced stages
Puerto Rican culture has higher smoking rates, which increases cancer risk
Fatalism (seeing cancer as a punishment) reduces screening behaviour
There is little proof that psychological factors directly cause cancer. However, three possible pathways link psychology to cancer development:
Direct effects of psychological processes on bodily systems (e.g. stress suppressing immune function)
Unhealthy behaviours (e.g. smoking, poor diet)
Poor screening behaviours and low adherence
Key findings:
Higher cancer incidence and poorer survival occur in people with stress-related psychological factors
Women who experience 4-6 major life stressors are 5x more likely to develop breast cancer
Half of cancer patients meet criteria for a psychological disorder
Avoidant, repressive, or unexpressive personalities have poorer outcomes
Optimism predicts better adjustment to cancer
Social support is strongly protective: low levels of support consistently relate to faster cancer progression
53% of women report positive life changes since their diagnosis (finding meaning)
Stress has a direct impact on NK cells, which are crucial for fighting cancer
Stress can also increase unhealthy coping behaviours (drinking, smoking, poor diet)
Smoking: smokers have 9x the risk of getting cancer, and not only lung cancer. African Americans have a particularly notable history with smoking.
Diet and exercise: the next most important factor after smoking. Too much fat and not enough fibre can increase cancer risk. High animal fat intake is linked with breast and colon cancer.
Sun exposure: a risk factor, though less emphasised in this set of notes
The health belief model is a useful framework for understanding screening behaviour:
Patients who believe they are susceptible to cancer (e.g. believe they will get breast cancer) are more likely to get screened
They also have to believe that screening is effective for it to drive behaviour
Two conditions: perceived susceptibility + perceived effectiveness of screening = action
The link between stress and NK cell function helps explain why cancer patients benefit from stress management programmes. The cultural disparities in screening rates have direct public health implications: targeting screening outreach to rural women and minority communities, and addressing fatalistic beliefs, can catch cancers earlier. The health belief model is used in practice to design screening campaigns (making people aware of their susceptibility and the effectiveness of early detection).
Students often think psychological factors directly cause cancer. The evidence for this is weak. Where psychology matters is in coping, progression, and survival, not in causation.
Fatalism is sometimes confused with general pessimism. It is a specific cultural belief that cancer is a form of punishment or predetermined fate.
Students sometimes assume social support helps only with mood. It is linked to slower disease progression and better survival, not just emotional wellbeing.
Optimism is protective for adjustment to cancer, but it does not prevent cancer from developing.
Know the three pathways linking psychology to cancer development (direct physiological effects, unhealthy behaviours, screening/adherence)
The "5x more likely" statistic for women with 4-6 major life stressors and breast cancer is exam-ready
Be able to explain how the health belief model applies to cancer screening (perceived susceptibility + perceived effectiveness)
Half of cancer patients meeting criteria for a psychological disorder is a key statistic
Cultural variations: who has the highest rates (Black men), who gets diagnosed late, why minorities are underserved
True or False: Psychological factors are the primary cause of cancer. (False. There is little proof of direct causation; they matter for coping and progression.)
Fill in the blank: Smokers have ___x the risk of getting cancer, and it is not limited to lung cancer. (9x)
True or False: Fatalism refers to a general sense of pessimism about health outcomes. (False. It is a specific cultural belief that cancer is a punishment or predetermined.)
Fill in the blank: Women who experience 4-6 major life stressors are ___x more likely to develop breast cancer. (5x)
True or False: The health belief model predicts that screening will increase if patients believe they are susceptible to cancer. (True, but they also need to believe screening is effective.)
Q: Name the three pathways through which psychological factors may contribute to cancer development.
A: (1) Direct effects of psychological processes on bodily systems, such as stress suppressing immune function. (2) Unhealthy behaviours like smoking and poor diet. (3) Poor screening behaviours and low treatment adherence.
Q: How does social support relate to cancer outcomes?
A: Low levels of social support consistently relate to faster cancer progression. Social support is one of the strongest protective factors for cancer patients, linked to better survival and adjustment.
Q: Why do minority groups have higher cancer mortality rates?
A: They are disproportionately poor and medically underserved, less likely to receive screening tests, and more often diagnosed at later stages. Cultural factors like fatalism can also reduce screening behaviour.
Q: Explain how the health belief model applies to cancer screening decisions.
A: For someone to get screened, they need to believe two things: that they are personally susceptible to cancer, and that the screening procedure is effective at detecting it. Both perceived susceptibility and perceived effectiveness must be present to drive action.
Q: What personality traits predict poorer versus better adjustment to cancer?
A: Avoidant, repressive, or unexpressive personalities predict poorer outcomes. Optimism predicts better adjustment to cancer.
Stress and immune function connect directly to the HIV/AIDS unit, where psychoneuroimmunology covers the same mechanisms. Adherence and the health belief model reappear in the patient-provider communication notes. The cultural disparities discussed here mirror those in heart disease (African Americans, underserved populations). Social support as a protective factor is a recurring theme across every disease unit in this course.
Cancer, neoplasm, benign, malignant, carcinoma, lymphoma, sarcoma, leukemia, fatalism, NK cells, natural killer cells, psychoneuroimmunology, health belief model, cancer screening, perceived susceptibility, social support, stress, immune function, cultural disparities, health behaviours, smoking, diet, cancer risk, cancer progression, health psychology, PSY 320, Michigan State University