Artikel
“Back to normality!” - Psychosocial distress of cancer survivors
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Veröffentlicht: | 20. März 2006 |
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Gliederung
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Background: With improved cancer therapies and a growing number of cancer survivors cancer becomes for an increasing number of patients a chronic disease they have to live with. From the literature we know that the majority of these patients do very well after the initial adjustment and studies show a good quality of life among cancer survivors. However, from our clinical experience we know that there is a subset of patients who have problems in integrating their cancer experience which is built on the life-threatening character of cancer, with its treatments, many of which are highly toxic, often resulting in permanent physical impairments. Another very unique aspect of the experience of survivorhood is the fear of disease recurrence, the “sword of Damocles” that hangs over a survivor’s head and threatening to fall at any time. In addition patients having finished treatment and are regarded as cured are faced with their own and others’ expectations to “go back to normality” and work and function in their various roles in spite of physical and/or psychological limitations. Studies comparing survivor cohorts with healthy comparison groups show clear evidence for high levels of psychological distress in cancer survivors involving symptoms of anxiety, depression and posttraumatic stress disorder that remain often untreated.
Methodology: Based on 10 case reports of cancer survivors having been seen in our psychooncology unit we document their emotional experience and describe the core issues of their psychological distress and the resulting needs of psychooncological interventions.
Conclusions: Cancer survivors have to cope with specific issues following their experience with the disease and its treatment: feelings of loss - in the body, in the self and in the security of life, fear of disease recurrence andproblems in communication and emotional support. Psychooncological interventions are targeted to help patients in regaining trust, re-negotiating their social relationships and integrating their emotional cancer experience in their actual and future life. Patients’ psychological distress can easily be overlooked due to survivors’ underreporting their emotional distress to health care professionals and doctors not recognizing it. Health care professionals have to be aware of the signs and symptoms of patients’ distress and the necessity of psychosocial interventions.