On 2015 Oct 15, Radboudumc Psycho-Oncology Journal Club commented:

This interesting commentary, which has important implications for the field of psycho-oncology, was discussed by our Journal Club members on 14th of October, 2015 and generated a lively discussion and the following comments and questions:

• 1) After reading your commentary, we concluded that it would be worthwhile to incorporate lifestyle variables in psychosocial intervention programmes on tertiary prevention, to further explore the relationship between psychological outcomes and health behaviours. Our group is based within an academic medical centre and there was debate within our group about the role of psycho-oncologists should take. Some members of our journal club believed that psycho-oncology as a discipline should focus more on collaboration with public health, health psychology and other disciplines working in the area of primary and secondary cancer prevention.. However, other members believed health behaviour change is the area of expertise of health psychologists not psycho-oncologists. Furthermore, in light of resource constraints, psycho-oncology professionals should focus on the core business of providing care to those affected by disease and ill-health in medical settings.<br>
• 2) We welcomed the proposal of The Expanded Model of Research in Psycho-Oncology and congratulate the authors for stimulating debate over the role of psycho-oncology. As for a suggestion, we would have liked it if the new conceptional model had an additional box with factors relevant to secondary prevention after cancer diagnosis. For example, psycho-oncologists are well placed to conduct activities that focus on the secondary prevention of psychological problems (e.g. depression, anxiety) or which might prevent a new disease recurrence following a diagnosis of cancer (e.g via lifestyle change programmes for cancer survivors). We also believed that psychological screening within oncology settings can be conceptualised as a secondary prevention activity.
• 3) We believe that psycho-oncology as a discipline, if it is to be involved with primary and secondary prevention at all, might focus on the three non-tumor specific health behavior changes with the biggest impact smoking, diet and exercise.
• 4) When it comes to medical psychologists working in psycho-oncology, essentially it comes down to the question whether a hospital is a “health valley” or a place in which we treat those affected by disease. Primary and secondary prevention implies the “health valley” model, which needs a much larger paradigm shift of medicine in general rather than in psycho-oncology alone. It will also require increased funding for hospitals to enable this to occur.<br>
• 5) We identified systemic barriers such as the organisational separation of hospitals and public health programmes in many jurisdictions. We concur with the authors that further investment is needed in the training of psycho-oncologists to ensure they learn how to apply their skills to preventive health and have more opportunities to gain work experience in preventive health care settings.

On 2015 Oct 15, Radboudumc Psycho-Oncology Journal Club commented:

This interesting commentary, which has important implications for the field of psycho-oncology, was discussed by our Journal Club members on 14th of October, 2015 and generated a lively discussion and the following comments and questions:

• 1) After reading your commentary, we concluded that it would be worthwhile to incorporate lifestyle variables in psychosocial intervention programmes on tertiary prevention, to further explore the relationship between psychological outcomes and health behaviours. Our group is based within an academic medical centre and there was debate within our group about the role of psycho-oncologists should take. Some members of our journal club believed that psycho-oncology as a discipline should focus more on collaboration with public health, health psychology and other disciplines working in the area of primary and secondary cancer prevention.. However, other members believed health behaviour change is the area of expertise of health psychologists not psycho-oncologists. Furthermore, in light of resource constraints, psycho-oncology professionals should focus on the core business of providing care to those affected by disease and ill-health in medical settings.<br>
• 2) We welcomed the proposal of The Expanded Model of Research in Psycho-Oncology and congratulate the authors for stimulating debate over the role of psycho-oncology. As for a suggestion, we would have liked it if the new conceptional model had an additional box with factors relevant to secondary prevention after cancer diagnosis. For example, psycho-oncologists are well placed to conduct activities that focus on the secondary prevention of psychological problems (e.g. depression, anxiety) or which might prevent a new disease recurrence following a diagnosis of cancer (e.g via lifestyle change programmes for cancer survivors). We also believed that psychological screening within oncology settings can be conceptualised as a secondary prevention activity.
• 3) We believe that psycho-oncology as a discipline, if it is to be involved with primary and secondary prevention at all, might focus on the three non-tumor specific health behavior changes with the biggest impact smoking, diet and exercise.
• 4) When it comes to medical psychologists working in psycho-oncology, essentially it comes down to the question whether a hospital is a “health valley” or a place in which we treat those affected by disease. Primary and secondary prevention implies the “health valley” model, which needs a much larger paradigm shift of medicine in general rather than in psycho-oncology alone. It will also require increased funding for hospitals to enable this to occur.<br>
• 5) We identified systemic barriers such as the organisational separation of hospitals and public health programmes in many jurisdictions. We concur with the authors that further investment is needed in the training of psycho-oncologists to ensure they learn how to apply their skills to preventive health and have more opportunities to gain work experience in preventive health care settings.