There is some controversy regarding the effects that psychi­atric/psychological factors play in the incidence and course of these and other cancers. Large epidemiologic studies found that depression was associated with double the risk of death from cancer up to 17 years post diag­nosis. However, other prospec­tive large cohort studies found no depressive symptom effects on cancer risk. In breast cancer as a protypical example, 50% of the patients experienced serious degrees of anxiety, depression and other psychiatric symptoms/illnesses during the course of their illness. Depression which may be reactionary, biologically mitigated or the result of treat­ment, can affect the course of the illness, recurrence or mortality according to some but not all studies. Issues such as adequate pain relief, adherence of recom­mended treatments/interven­tions, diminished desire to sustain life and rageful despair have all been implicated and observed in gyn and other cancer patients with co-morbid psychiatric issues.

Studies have also shown that any given patients psychiat­ric/psychological response to a diagnosis and course of cancer is influenced by many factors. These may include: the specific aspects of the type and stage of cancer itself, an individuals abil­ity to manage the diagnosis and treatment of cancer- especially pain issues, preeminent factors of medical, social and psychological stability, the type and effects of various treatment modalities and their complications, pre-exist­ing traumatic experiences and coping styles/skills, personality strengths or limitations, overall mental health, social support, age and stage of life, stability financially, meaning of their lives, etc., cultural and religious beliefs.

The most serious psychiatric issue associated with gyn and other cancers is suicide. Passive suicidal thoughts are much more likely than active suicidal intent. There is still however an increased risk of suicide espe­cially with advanced disease and poor prognosis, intense pain, delirium, substance abuse, selec­tive solitude, social isolation, helpless – hopeless feelings, depression and previous suicid­ality. This serious risk must be adequately screened and profes­sionally evaluated during the course of the disease.

In conclusion, gyn cancers present with a range of physical and psychological symptoms throughout the various stages of the disease, i.e., initial diagnosis, treatment, survival or recurrence. Multiple stressors of surgical menopause, various medications, pain and radiation potentials are some of the most physically demanding aspects. These all may lead to more severe psychiatric sequel as well. Screening for psychological distress may be useful to help identify women who would benefit from psychiatric or psy­chological care. They should be referred to a mental health professional with psycho oncol­ogy knowledge and experience. When possible, psychiatric treatment should be where they receive their oncology services.

The battle of mankind against cancer has been an ongoing one. Even with several cutting edge technological breakthroughs we have not yet been able to completely cure this deadly disease. However, there is hope yet, because recent research findings show a positive trend of declining death rates due tocancer. The death rate is seen to drop steadily; the rate of decrease has almost doubled in 2002-2004 from the figure in 1993-2002. The overall death rate still remains higher for men than women. But the death rate decreased for the top 15 cancers in both men and women. Most cancer related deaths in men are due to prostrate, lung and colorectal cancers. Breast, lung and colorectal cancer related deaths in women have also seen a dip.

The reason for this decline in death rate could be because of progress that has been achieved in anti-smoking drives, regular screening and commencement of treatment as soon as the disease is detected. Surprising news is that evencancer detection rates have reduced which means that we are slowly but surely overtaking this killer disease. The reason for the drop in breast cancer rate in 2001-2004 is believed to be increased mammography screening and decrease in the usage of hormone replacement therapy. Lung cancer also shows similar decreasing trend in both men and women. Experts say that the fight against cancer could show even better results if everyone in the US had access to essential healthcare facilities. Most important are the screening, prevention services and the primary healthcare. What seems to be working is the greater awareness among people about the disease itself, prevention, early detection and prompt treatment. The awareness on healthy lifestyle and diet also contributes significantly to this positive trend. If we can just keep up this healthy trend, the day that we overcome cancer is not too far.