Abstract :
After the diagnosis of cancer and acceptance of it by patient and his/her family, treatment course will
be started. All aspects of the treatment have their specific psycho oncology response with some general
reaction based on the main disease and its reaction. The general issues are due to loss of physical strength
and well being, loss of body and /or organ, dependency, loss of role, loss of interpersonal relationship,
loss of sexual function, loss of life expectancy, fear of the recurrence, and loss of mental integrity. It is
clear that two patients with similar malignant disease will not have the same response. Response depends
on the individual perception of the threat of cancer, as determined by the characteristics of the person
concerned.
Surgery as the main therapeutic procedure for malignancy has the specific psychological side effects
before and after surgery. Preoperative anxiety may become out of control and the patients become panic
or unable to sleep and refuse going to operating room. Post operative reactions will differ from even
relief and euphoria if there is good news and operation is safely over to severe depression when there is
bad news after operation; there are some easy adjustment ways to accept the surgical procedure(s).
Preoperative counseling will make sure the patient understands the proposed procedure. Some time their
quality of life may be better with less radical treatment even if the prognosis of their cancer is
consequently less good. Preoperative training in anxiety management even with drug prescription can help
reduction of distress and pain after surgery. Post operative counseling is also supportive for adjusting the
surgical outcome, all of these jobs will be managed by trained nurse(s) who are educated for emotional
management of surgery, and they are able to refer the patient to a psychologist in the proper time. Peer
counseling with similar involved patients and survivors will help and have a tonic effect. Chemotherapy as the second way of treatment of malignant cases is the worse and unacceptable
approaches by the patient that may have scientific support for doing it. This is because of the complication
of chemotherapy and reduction of quality of life. The prolonged nature of the treatment with pulses
administered every three or two weeks and some times weekly for several months, means that patients are
continually being reminded about their disease. Their lifestyle is disrupted because of the time and money
spent on repeated visit to hospital, with burden to care giver and consequent absences from home and
work. Also many other complication such as nausea and vomiting, hair loss, depression, acute organic
mental disorder, infertility, premature menopause, pulmonary fibrosis, cardiomyopathy and induction of
second malignancy are the main complaint after chemotherapy which should be under more consideration
by oenological staff. Some patients continue to feel fatigue and lack of energy for months after treatment
has ended; these may be due to anxiety and/or depression or even some genomic changes.
Radiation therapy, hormone therapy and immune therapy are also accompanied with psychosocial
disorder based on their acute and chronic complications. It is approved that some psychosocial support will
help patients to better acceptance and tolerates the chemo radiation therapy such as: minimizing waiting
time before treatment to reduce the bad expectation, minimizing patient’s bad expectation by not talking
about the complications and not hear from the cases who are suffering from therapeutic complications.
Supportive counseling and a chance to ventilate anxieties, distraction from cues: praying the God, notice to
him and thinking about supportive believes, hearing from holy books and music or relaxant music, or
sucking flavored chewing gum or mints to mask hospital smell will be effective during such kind of
treatment. These are some clinical psychosocial aspect of treatment period for cancer patients which
unfortunately are not standardized and practical by oncologist staff and oncologic wards.
