Psychological problems of patients with head and neck cancer

Abstract

<h2>Summary</h2> Cancer of the head and neck affects the psyche as well as the soma and, as such, calls for a comprehensive approach to treatment. Physicians and dentists should be aware that patients normally react to the phenomenon of cancer as a grievous event and experience emotions such as denial, depression, anxiety, guilt, and fear. Patients also react to changes concomitant with disability, the treatment process, and surgery—changes that often affect their social roles and life-styles and vary in their degree of acceptance of the dependent role. Located in a highly visible and personally identifying place, head and neck cancer has serious social consequences and evokes symbolic sexual conflicts. Two factors that distinguish healthy reactions from pathologic reactions are the intensity and the duration of symptoms. Severe clinical depression, paranoid psychosis, acute brain syndrome, and delirium tremens are possible pathologic reactions. Milder reactions such as clinging dependency or uncooperativeness are more common. Patients at high risk for experiencing maladaptive response are those with so-called narcissistic personalities, those who have a history of disorganization and vulnerability to stress, and those who have recently experienced other forms of loss. Whether such persons are referred to a psychiatrist or not, the consideration of emotional factors is intrinsic to successful patient management.