On December 24, 2017, the cancer research community lost an internationally acclaimed pioneer of psycho-oncology, Jimmie C. Holland. She had served on the AACR's Program Committee for many years, was Chair of the AACR Task Force on Survivorship Research, and was honored with the AACR-Joseph H. Burchenal Clinical Research Award in 2005. Founder of the American Psychosocial Oncology Society (APOS) and cofounder of the International Psycho-Oncology Society (IPOS), Jimmie C. Holland was a guiding force in promoting understanding and recognition of the psychologic aspects of cancer. She was the first Chair of the Department of Psychiatry and Behavioral Sciences at Memorial Sloan-Kettering Cancer Center (MSKCC) in New York and Professor of Psychiatry at the Weill Cornell Medical College. Holland was an extraordinary mentor to many of the current leaders of psycho-oncology research programs and clinical services across the country.
Her early research observed the patient's experience of cancer from a psychological perspective. Holland described the common fears associated with cancer and its treatment—death, disfigurement, disability, discomfort, dependency, and disruption of relationships. Working with her husband, medical oncologist, James F. Holland, MD, they helped introduce quality-of-life assessments into the clinical trials conducted by Cancer and Leukemia Group B, thus making routine such quality of life assessments for the years that followed.
In 1981, Holland first introduced the notion of the “humanistic” side of cancer in the title of a research article (“The Humanistic Side of Cancer Care: Changing Issues and Challenges”), as she described the impact of cancer across the life cycle of the illness and its impact on families, couples, mothers, and children. She would later write her book for patients, The Human Side of Cancer: Living with Hope, Coping with Uncertainty. In further studies, she offered an explanation for why patients seek unproven cancer remedies. Her observational studies covered every perspective, from the prevalence of depression in hospitalized patients with cancer to impacts such as neuropsychologic or psychosexual functioning. She differentiated the consequences of specific tumor types and was there at the start of the AIDS epidemic, with papers on Kaposi's sarcoma and the mental health challenges of AIDS. She wrote several articles on burnout and compassion fatigue.
A graduate of the Baylor School of Medicine in Texas in 1952, Holland trained in St. Louis and Boston (Massachusetts General Hospital) before working in psychiatry at the State University of New York, Buffalo, and then the Albert Einstein College and Montefiore Hospital in New York. In 1977, she was recruited as Chief of the Psychiatry Service at MSKCC. There began forty generative years of leadership and service. She immediately identified the need for psychosocial research in cancer care. In 1984, she won for MSKCC its initial “Psychosocial and Pain Research in Cancer Training Grant” from the National Cancer Institute, which has trained multiple cohorts of six psychology postdoctoral scholars per term, with continuous funding to this day. Similar funding from the National Institute of Mental Health trained psychosocial AIDS researchers during that epidemic. She also developed a parallel program that trained six psychiatry fellows annually. Her enthusiasm for the development of the discipline of psycho-oncology and her mentorship of extraordinary numbers of MSK fellows helped cement the discipline's status across the country and, indeed, the world.
With distinguished colleague, Julia Rowland, she edited the first Handbook of Psycho-Oncology in 1989, which later matured into the Oxford University Press textbook, Psycho-Oncology, now in its third edition. In 1992, Holland launched with Maggie Watson, coeditor from the Royal Marsden Hospital in the United Kingdom, Psycho-Oncology: The Journal of the Psychological, Social and Behavioral Dimensions of Cancer. In the first issue, she wrote, “Worldwide, psychological, and social issues in cancer were not the subject of scientific inquiry until the past two decades. Since then, a new subspecialty of oncology has evolved, Psycho-oncology.” Over the subsequent two and a half decades, great progress has been made in consolidating this young specialty, and the 25-year partnership that Holland and Watson came to enjoy as coeditors of their journal has supported the publication of great research. Holland herself came to write 8 books, 110 chapters or monographs, and 278 peer-reviewed publications, and delivered 30 media presentations, personally establishing a truly solid foundation of scholarship for the discipline with her own hand.
As the 1990s went by, Holland contributed to a number of studies of the use of psychotropic medication in cancer care. In 1997, she published her first article on “distress” (“Preliminary Guidelines for the Treatment of Distress”), which became one key focus of her endeavors over the subsequent two decades. Rather than the stigma of psychiatric diagnoses like “major depression,” Holland believed that when a ship or airplane put out a “distress call,” they created a worthwhile warning signal that deserved attention. With her MSKCC colleague Andrew. J. Roth, she published in 1998 the first validation study of distress screening in cancer care. With the National Comprehensive Cancer Network (NCCN), she published guidelines for distress screening in 1999 and consolidated these in 2003. Distress screening has been adopted in many parts of the world to aid in the recognition of unmet psychosocial needs and has been discipline changing in its impact on improving care provision. Distress has subsequently been called the sixth vital sign.
During her final decade, Holland's research focus turned to the challenges and opportunities for older people who develop cancer. She became an active advocate against ageism in medical practice, and examined the impact of reading and support groups in fostering wisdom and integrity for octogenarians and nonagenarians with cancer.
Jimmie Holland's marriage to James F. Holland, Distinguished Professor of Neoplastic Diseases at the Icahn School of Medicine at Mt. Sinai in New York has been a truly great medical partnership. Their mutual support of each other's scholarship and joint attendance at cancer research meetings is well exemplified by their nurturance of AORTIC, the African Organization for Research and Training in Cancer. As they did with AACR Annual Meetings, IPOS, APOS, and the American Society of Clinical Oncology (ASCO), their regular attendance at AORTIC meetings fostered research in other parts of the world.
Jimmie was awarded the American Cancer Society's Medal of Honor for Clinical Research in 1994. She was elected to both the Institute of Medicine and the National Academy of Sciences in 1995. She was honored by the American Psychiatric Association with their Presidential Commendation in 2000. The International Psycho-Oncology Society gave her their “Arthur Sutherland Award for Lifetime Achievement in Psycho-oncology” in 2004, thus linking her to Sutherland, the first psychiatrist to work at MSKCC in 1950.
Despite their advancing years and health challenges, James Holland dropped his wife Jimmie off at MSKCC each morning on his way to work, before returning 12 hours later to collect her for their evening meal together. Always adventurous, the Hollands once took a year out of the United States (1972) as they took their six children to Russia to foster scientific exchange for the NIH with scholars from that country. They sustained close family bonds and leave a wonderful legacy for their six children and nine grandchildren. Who might have thought in 1928, when this baby girl was born to cotton farmers in Nevada, Texas, that she would develop such an extraordinary legacy for the world of oncology, the care of the whole person and their family, the development and nurturance of Psycho-oncology, this new specialty? We salute you and thank you, Dr. Jimmie Holland, a generous and wonderful friend of cancer physicians and psychosocial health care providers the world over.