Psychological issues in cancer and non-cancer conditions

The mechanism whereby incoming noxious stimuli result in emotional and behavioural changes is centred within cognitive processes. The mechanism is activated for all forms of pain but variations in the emotions generated and coping styles and strategies adopted occur. They are related to each individual's appraisal of their pain and the condition giving rise to it--major differences in appraisal relate to the presence or absence of malignancy with its potential threat to life. The psychological treatments of cognitive behavioural therapy have a role in the management of all chronic pain but historically have been employed more in non-cancer pain conditions than in patients with cancer pain. In the United Kingdom, the facilities for the treatment of pain by cognitive behavioural therapy are very limited and for that reason counselling, long used in aiding cancer patients, is likely to remain the main form of psychological treatment in that group.