Testicular cancer: the psychosocial problems of patients and their relatives.

The idea that cancer may be associated with emotional states or personality structure is not a new one. However, psychosocial research has fallen in and out of favour with the medical profession, but is currently experiencing a massive upsurge of popularity as a focus for investigation. In this paper I examine longstanding individualistic assumptions and the contradictory and sometimes similar findings of research in this field despite the differing and ever increasing sophistication of measurement techniques and study design. I have also attempted to formulate a theory that may explain why individualistic traits continue to take precedence over social factors and why psychosocial research has been elevated into a position of medical importance in recent years. At the Royal Marsden Hospital, Sutton, we studied 102 men with testicular cancer and 77 of their relatives in an attempt to establish the extent of psychosocial morbidity in these two groups. Despite an excellent prognosis we found high levels of psychological morbidity in both the patients and their relatives, even five years after their diagnosis. 'Extrinsic' social variables such as unemployment experience of patients and childlessness among partners may explain psychiatric symptoms. 'Extrinsic' social variables, however, should be examined in conjunction with individualistic 'intrinsic' factors emotional states may be but symptoms of the social context of the subject.