The main worries of a cancer patient can be summarised as a fear of death, a fear of being dependent on others, inadequacy, and disruption of social relationships.
The defence mechanism developed by the patients in response to their disease depends on their medical and psychological state but also on the relationships they establish with people around them. Amongst medical factors are the symptoms the patient experiences, the localization of the cancer, and the expected prognosis. As psychological factors we could list the patient’s past personality traits, ability to deal with problems, ego power, psychological development stage, the impact of the cancer at its location and what this means. The most important relationship is the relationship of the patient with his family, and with people from other social support and health service providers.
Emotional responses vary between intense anxiety, unhappiness, guilt, fear, anger and complete apathy. Patients are in great need of cognitive information. They may experience difficulties concentrating. We may meet patients that are confused and mentally almost paralysed.
We see an increase in somatic complaints, everyday activities get disrupted, sleep and appetite often deteriorate.
All these symptoms represent acute generalised stress disorder. However the period of acute stress usually ends quickly and we see the patient return to the important functions in his life.
We can list the vital actions of the cancer patient as follows:
– deciding to receive treatment,
– compliance with treatment,
– maintaining important relationships,
– maintaining family related, social and professional functions.
If the state of acute stress symptoms and dysfunction lasts longer than two weeks it is regarded as a psychiatric disorder.