| "To be
successful, doctors have to know more about the sick person than
just the name of the disease and its pathophysiology."
Eric J Cassell, The Nature of Suffering and the Goals of Medicine,
1991.
Psychological distress is often described
as anxiety or depression but patients with advanced cancer suffer
a range of other emotional problems. These are not necessarily
psychopathological. Some like denial, are actually coping
mechanisms. Most patients with advanced cancer will manifest some
features of coping mechanism. In most cases, these coping
mechanisms should be regarded as normal defence mechanism and not
pathological. Used to excess, they are considered maladaptive and
pathological.
Denial is the most frequently seen coping
mechanism. It is not necessarily abnormal. Denial allows patients
time to become realistic and accept the real situation. Denial
does not necessarily indicate that patients are unaware of their
situation. It is common for patients exhibiting denial to to the
doctor and nurses to simultaneously confide in someone else that
they have a realistic view of the condition. Every patient with
advanced cancer is different. Each must find their level between
denial and acceptance.
The age-related meaning of the disease to
the patient is an important determinant of psychological suffering
and is different for patients in the various age groups. These
factors are detailed in Holland and Rowland's Handbook of
Psycho-oncology. The Handbook explains the effects on
interpersonal relationships, independence, goals, body image, and
existential concerns. Patients with religious beliefs or those
with stable value belief systems are likely to cope better.
Cultural attitudes to serious disease vary greatly, and is an
important factor influencing patient's ability to cope with the
disease.
Another major cause of emotional distress
is the need to complete unfinished business, which may be
religious or spiritual in nature, mending personal or family
relationships or concluding family or worldly affairs.
The effective treatment of psychological
distress in patients with advanced cancer may greatly improve the
quality of life. Management of psychological distress has to be
tailored to the needs of each individual patient.
If you have questions related to this article you may e-mail me
at doctor@soontongkiong.com quoting the contents of the article.
About the author
DR SOON is a medical practitioner. He holds four degrees. MBBS
(University of Malaya), MBA (University of East Asia), LLB (Hons)
(University of Wolverhampton), Master of Medicine (Edith Cowan
University
:
Dr SOON is the owner of AskMyVisitor.com and MyScriptDoctor.com
where you can find the most up-to-date advice and information
on
many medical, health and lifestyle topics. |
