Even the word "cancer" in daily life evokes negativity. It is almost inevitable for patients who are likely or have been diagnosed with cancer to develop negative emotions and thoughts. Cancer is perceived as a destruction and, in the most dramatic sense, causes a crisis in the person's psychological balance. Crisis; It is experienced in a process ranging from a healthy life to adaptation to the threat of disease and death.
People show many different reactions to the diagnosis of cancer. The most common initial reaction is shock and disbelief. Immediate denial of the truth is often a defense against the feelings of anxiety, panic, and helplessness that the truth creates that are so difficult, and for some impossible, to bear. In a sense, by denying the reality and accepting it as never happening, the patient protects himself from unbearable anxiety.
Psychological reactions to the cancer diagnosis and psychosocial adaptation to cancer
Behavioral reactions that occur in cancer reactions are described in 5 stages: denial, anger, bargaining, depression and acceptance. The most common initial reaction is shock and denial. Denial of a cancer diagnosis is a common reaction during this period. Denial is when the patient underestimates the importance of his or her illness or ignores his or her illness. Denial of the diagnosis is a defense mechanism against the feelings of anxiety and helplessness created by the reality that is difficult to bear. Over time, rejection and panic disappear and the person begins to perceive this situation more clearly. Then comes the second period, defined as the anger period, in which the feeling of "why me" is experienced. During this period, the person tries to find reasons for his illness. The anger experienced during this period may be directed towards others or the person himself. Following this period, the patient enters the bargaining period. After this, anxiety, depression, anger, sleep, appetite and concentration disorders, inability to achieve daily activities and fear of the future may develop. This period can last for weeks or even months, with anxiety and depression gradually increasing. Over time, the adaptation process begins when the patient accepts the truth and directs his energy and spiritual power towards his new life.
There are a number of medical, psychic and psychosocial factors that play a role in the adaptation of the cancer patient. The disease itself, the organ it affects, its type, symptoms symptoms and findings, the patient's age, personality structure, experiences and thoughts about diseases, cultural and social attitudes, coping processes, the level of threat posed by the disease to their goals and projects, and environmental support systems are factors that play a role in adaptation. All these factors are elements that should be taken into consideration by healthcare professionals in psychosocial adaptation to cancer.
Psychological support and treatment in cancer patients
In psychological treatment, reducing psychological anxiety and pain. , to ensure harmony, to improve the quality of life, to help express emotions, to increase the strength to fight and live, to help cope healthily with the multifaceted crisis created by the disease, to correct existing misperceptions, to correct all-or-nothing behavior and thoughts, to strengthen social support and communication.
Illness causes a crisis in the family as well as in the individual. Difficulties arise in the relationships between the patient and the family. The patient's adaptation is best in families where relationships are balanced, allow the free expression of emotions, have fewer conflicts and more cooperation. The family's attitude should be caring but not overly anxious. Unclear family roles, family environments dominated by overprotectiveness, rigidity, and ignoring conflicts make the patient's adaptation difficult. Denying possible conflicts makes conflict resolution even more difficult. In addition to the cancer patient, families often need psychological support and treatment.
In the psychiatric treatment of cancer, biological psychiatric treatments (drug treatments), medical psychotherapy (cognitive-behavioral therapy, supportive techniques, relaxation techniques), psychosocial support and Group psychotherapies form a whole when necessary.
The expert therapist working in this field must first of all know the medical condition of the patient, evaluate its course, and understand the complications and side effects related to the medical disease and its treatment. Psychotherapy begins with understanding the patient and the disease, and how the patient perceives his own situation and disease. Informing, realistic acceptance without destroying hope, explaining treatment possibilities and options, wrong attitudes and information Correction and relief are essential. Treatment, course and side effects, and understanding of the disease should be ensured. Possible catastrophic comments in the patient should be corrected. Medical psychiatrist; about the patient's disease, examinations, results and general course of the disease; Provides information in consultation with the oncologist. By examining the psychological dynamics of the patient, he interprets the defense mechanisms and helps the development of more effective positive defense mechanisms. It encourages the patient to express normal psychological and emotional reactions. It applies crisis intervention treatment during periods when feelings of anxiety and helplessness are most intense, such as diagnosis, new treatment, relapse, and treatment failure. All these interventions and treatments are carried out in cooperation with the oncologist and other specialists who follow the patient and aim to increase the success of the patient's treatment.
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