SURVIVING CANCERSURVIVING CANCER

IMPACT 0f cancer on :IMPACT 0f cancer on :

Psychological functioning – quality of Psychological functioning – quality of lifelife

Role of psychological variables in Role of psychological variables in cancer risk & survivalcancer risk & survival

GoalsGoals

GOAL of psycho-oncology is an GOAL of psycho-oncology is an attempt to influence the course of attempt to influence the course of illness in cancer patientsillness in cancer patients

PSYCHOLOGICAL status & immune PSYCHOLOGICAL status & immune system effects on illnesses…. Cancer, system effects on illnesses…. Cancer, hypertension, diabetes, asthma…. hypertension, diabetes, asthma…. Poor control, poorer outcomePoor control, poorer outcome

Studies on cancer patientsStudies on cancer patients18 months longer survival of metastatic 18 months longer survival of metastatic breast cancer female patients receiving breast cancer female patients receiving weekly group psycotherapyweekly group psycotherapyMalignant melanoma pts on group therapy- Malignant melanoma pts on group therapy- – lower recurrance rates lower recurrance rates – lower mortality rates. lower mortality rates. – large granular lymph & natural killer cellslarge granular lymph & natural killer cells(NK), increased NK cell activity suggesting (NK), increased NK cell activity suggesting increased immune responseincreased immune responseHigher NK cell activity & lymphocyte mitogen Higher NK cell activity & lymphocyte mitogen response in female breast cancer pts response in female breast cancer pts receiving rlaxation/biofeedbackreceiving rlaxation/biofeedback

ReasonsReasons

Newer cancer treatment protocols Newer cancer treatment protocols results in now often to a frquently results in now often to a frquently chronic and often curable diseasechronic and often curable disease

Therefore the psychiatric aspects, Therefore the psychiatric aspects, both in the diagnostic and both in the diagnostic and managment phase are becoming managment phase are becoming more & more important as 5 yr more & more important as 5 yr survival rate is increasingsurvival rate is increasing

THE FACTSTHE FACTS

More than 50% of all cancer pts have More than 50% of all cancer pts have diagnosable psychiatric Disorders :diagnosable psychiatric Disorders :

adjustment disorder 60%adjustment disorder 60%

MDD 20%MDD 20%

delirium 8%delirium 8%

(Most common diagnoses)(Most common diagnoses)

CAUSESCAUSESMostly related to the knowledge of Mostly related to the knowledge of having cancerhaving cancerOther causes :Other causes : drugs known to cause depression.. drugs known to cause depression.. Antiparkisonian, antihypertensiveAntiparkisonian, antihypertensive tumor effects..hormone secreting, tumor effects..hormone secreting, CNS tumorsCNS tumors others..uremia, encephalitis, others..uremia, encephalitis, electrolyte imbalance electrolyte imbalance

MY THREE STAGESMY THREE STAGES

On being diagnosedOn being diagnosed

- fear of death, disfigurement, - fear of death, disfigurement, disabilitydisability

- abandonement, loss of - abandonement, loss of independeceindependece

- role functioning, financial standing- role functioning, financial standing

OthersOthers

The treatment processThe treatment process : :

-side effects of therapies-side effects of therapies

-physical & psychological-physical & psychological

Remission/incurablity Remission/incurablity

-quality of life-quality of life

Suicidal risk assessmentSuicidal risk assessment

CARE OF THE CAREGIVERSCARE OF THE CAREGIVERS

Concept of family exhaustionConcept of family exhaustion

Care available for schizophrenia, Care available for schizophrenia, drug dependence..al anondrug dependence..al anon