I have cancer. Psychological support for cancer patients. Cancer is not a death sentence

• May 22, 2019
• Psychotherapy
• Ekaterina Kirillova

Cancer is a devastating disease. In addition to the direct threat to life, it causes significant psychological problems in patients and their families. Screening methods for the psychological effects of cancer, including distress, depression, anxiety, post-traumatic stress, and demoralization, have been increasingly introduced and disseminated over the past few decades. In addition, a number of scientific cancer associations have developed and endorsed recommendations for the prevention and treatment of psychological disorders. This material addresses some of the most important related issues and focuses on recent advances in psychosocial and psychopharmacological interventions aimed at psychological support for cancer patients.

Cancer "epidemic"

The World Health Organization (WHO) projects that the number of cancer cases will increase exponentially by 2030, with the number of new cases per year increasing from 14.1 million in 2012 to 21.6 million in 2030, and the number of deaths from cancer cases will increase from 8.8 million worldwide in 2015 to more than 12 million in 2030. At the same time, some advances in oncology have also led to increased survival rates, and the number of people surviving cancer, a disease that is strongly associated in our minds with death, has increased by more than 300 million people worldwide in recent years.

Psychological assistance to cancer patients

Recommendations for the patient

You have learned that you or a person close to you has been diagnosed with cancer and a diagnosis has been made that disrupts your plans, instills anxiety and uncertainty... Do not give in to these feelings, because now you especially need all your mental strength, a clear mind and the will to combat the emerging danger.

Rule #1. In the beginning there was a word

First of all, think about who to discuss, with whom to share this problem. You cannot carry this information to yourself. By repeatedly thinking and weighing alarming facts, a person always involuntarily aggravates his reaction to them, “intimidates” himself. In the old days they said: “What is said is gone.” This is a very accurate psychological observation. Therefore, first of all, you need an interlocutor ( psychological help telephone number - 8–800–100–0191 . Calls within Russia are free, consultation is available around the clock).

Rule #2. Selecting an interlocutor

Choose it carefully. Beware of those who like to make fun of other people’s difficulties, and even add fuel to the fire by starting to tell you many sad examples that, as you understand, do not apply to you at all! You need a reasonable and active interlocutor, who, first of all, can be your doctor or psychologist.

Close people.

You also need interlocutors among your close people. And here, first of all, it is not knowledge or even organizational skills that are important (although later, perhaps, it will be important for you to have a mobile, active person in your inner circle, ready to practically help in solving current issues). First of all, talk to those who really care about you, who are attached to you. Feel how they worry about you, because our loved ones often worry about even a common cold, and you know that their fear is not a characteristic of the danger of the disease, but simply an expression of their love and care. It is important for you to understand that they need you. Let this be an incentive to forget about work and household chores for a while and strictly follow the doctor’s instructions.

Doctor.

Ask your doctor carefully what steps you need to take. Perhaps he will give you real statistics on your type of disease - but in fact, no matter what the “grandmothers on the bench” sometimes say, oncology today has several dozen diagnoses that are recognized all over the world (and in Russia too) 100% curable. It is possible that we are not yet talking about a diagnosis, but only about the first suspicion, which requires additional tests and verification.

Rule #3. Time factor

In oncology, as in any field of medicine, time is an important factor, and here it is important not to procrastinate or torment yourself with doubts - do I really need this? – take all additional actions quickly, clearly and in a timely manner. Doctors often rush you not because everything is already bad, but precisely because right now they see good prospects for treatment. In addition, scientists are developing diagnostic and treatment standards solely to achieve a positive outcome. An oncological diagnosis does not always mean a path to a chronic, recurrent disease; often you just need to spend a certain amount of time on treatment. But this time is usually quite significant, we can talk about several months, and from here...

Rule #4. You are a full and active participant in the treatment process

First of all, you need to gather strength and analyze your resources. We are talking primarily about psychological resources. In A.I. Solzhenitsyn’s book “Cancer Ward,” the main character, whose prototype was the author himself, during treatment inspires each cancer cell that they are destroyed, that they will no longer exist. It may be worth listening to the writer’s experience: having been hospitalized with the most severe diagnosis, not being able to undergo full treatment, he, among other things, with the power of his conviction, overcame the disease so much that it did not relapse throughout his life - but A.I. Solzhenitsyn is far from 80 years old.

Rule #5. Learn to control yourself

Psychologists believe that it is very dangerous to accept illness as an integral part of yourself, to “let” it into your life. If we take into account the nature of cancer, our body has already made the mistake of mistaking cells that are subject to dying for new and valuable elements of its structure, which it actively nourishes and grows (it is on this “failure” that the spread of tumor cells is built). Therefore, our psyche must be actively tuned to reject the disease, reject the tumor. Do not consider this problem to be part of your life forever. Think about what will happen after the treatment stage - believe that such a time will come - think about what you want to achieve, what you want to achieve. The believer wins - this must be remembered always and everywhere, and not only in illness.

Rule #6. Control of the situation

Another important resource is organizational. Be businesslike about your treatment plans. Determine at which medical institution you will be undergoing treatment, find out what additional opportunities and social benefits you have (a lot of reference information is contained directly on our website). And, of course, seek advice from who can help you practically.

Rule #7. I act, I fight, I live

It may happen that at first you will not have enough information about future prospects and opportunities. Therefore, your actions are additional consultations and diagnostics. Often the first words about suspected cancer can be told to you by a general practitioner or an ultrasound specialist, and not all doctors in these specialties are fully familiar with complex cases when the reason for doubt they notice may look like a tumor, but is not one at all. Do not rush to psychics, astrologers and traditional healers, etc. - You will most likely be deceived.

Find a qualified doctor, preferably in a specialized oncology institution, and take the time and effort to thoroughly check all doubts. Our site also provides recommendations on which hospitals and cancer clinics in your city are the best experts on these issues. Find out new information from them, think through all aspects of next steps. Trust your oncologist; qualified specialists work in oncology departments and hospitals. This specialization requires scientific thinking, extensive experience and compassion. Every year, the latest treatment technologies appear in the world, for which our oncologists undergo special training courses, so their knowledge is now an important resource for you! Fight together with doctors.

Life. Sometimes during an illness it seems to us that it has separated us from the usual circle of people, worries, interests, and thereby made us lonely. Life seems to be divided into a time “before” and “after” the diagnosis. But often we make ourselves so lonely. Look for those who can help you, and you will see that there are many such people. Keep a “clear head”, do not entrust your destiny to either vague fears or annoying “wizards”. After all, this is your life, you have it, it continues, and although next to you is a whole army of doctors, whole batteries of medicines, whole legions of inventions of modern science - the commander of this army is you.

Find answers

And it is possible to find all these resources: our website was created for this. Ask your questions here, get acquainted with examples of successful treatment, positive statistics, and learn more about medical achievements. Your “neighbors” on this site are doctors, and their active participation in our project is proof of how much domestic doctors care about the problems of oncology, how great their desire is to treat every person affected by this disease more effectively and successfully.

Psychological help phone number 8–800–100–0191 Calls within Russia are free, consultation is available around the clock.

Psychological factor

It is a fact that cancer is not only a group of very different diseases requiring complex and interdisciplinary treatment, but also a highly stressful event with significant psychosocial consequences related to physical, emotional, spiritual and interpersonal factors.

In recent years, scientists have studied the psychological consequences of cancer in detail, showing that at a physical level, tumor treatment has clear consequences for body image, with distinctions between “visible cancers” (eg breast) and “less visible types” (eg leukemia). The type of treatment, including surgery, chemotherapy, immunotherapy, hormone therapy, and radiation therapy, is also important because of the possible physical changes that may occur (such as amputations, ostomies, and hair loss) and symptoms (such as pain, nausea, and vomiting) .

Decreased performance and functional activity, problems with carrying out daily activities, poor concentration, memory loss or changes in sexuality have a strong impact on the mental state of patients. Therefore, psychological support for cancer patients is extremely important.

Loss of confidence, instability of one's own emotional state (such as fears, worries, anxiety and sadness), the need to depend on others, decreased self-esteem, changes in outlook on the future, and the threat of possible death are some examples of the many emotional effects. In spiritual terms, the entire set of personal values, the meaning attached to one's life and existence, and changes in one's perception of time and existence are important contributory factors to cancer. The social and interpersonal dimension is also affected by cancer and its treatment. The sense of belonging (being with someone) and communication (having a commonality with someone) in the family, in the microcosm of close relationships and in the macrocosm of existence in the outside world, social and community involvement are also influenced by the disease. Feelings of loneliness and abandonment, problems returning to work, marginalization or even stigmatization are the most common problems that cancer patients complain about.

Home care

The first thing you need to do after diagnosing cancer is to provide your loved one with attention and not leave him alone with his problems. If there is no free time, it is better to find a decent hospice with suitable conditions of stay.

Many people mistakenly believe that a person with cancer will be much better at home. Home care is significantly different from professional medical care. Most relatives do not have special skills and time to provide quality care for cancer patients at home.

There are several rules for helping patients diagnosed with cancer:

1. The very first thing is to ensure a positive mood and create a warm atmosphere. A person should not feel powerless and terminally ill. Professional psychological assistance to cancer patients and their support from loved ones is important.
2. A comfortable bed with an orthopedic mattress and additional functions is required.
3. If necessary, hygiene procedures are carried out. It is difficult for bedridden patients to take care of themselves, so shaving, taking a shower or bath, brushing teeth and cutting nails should be supervised and done with care.
4. The person is regularly turned over and given massages to avoid the appearance of bedsores. Special products are provided for treating problem areas.
5. For people diagnosed with cancer, a separate menu is created in accordance with the disease. The diet is prepared by the attending physician.

Care and nutrition are an important component of the treatment and rehabilitation of older people with cancer. Before making any decision, consultation with a specialist is required. The right approach always improves the patient's condition and saves him from many inconveniences and suffering.

Communication with your doctor

Before visiting your doctor, prepare a list of several important questions. This will help you get your bearings, find out important details and create the right treatment or rehabilitation plan. The standard list of questions includes several:

1. Determining the type of cancer and its stage of development.
2. The need for additional examinations in addition to basic procedures.
3. Important points in the process of treatment or rehabilitation of an elderly person.
4. What you need can be obtained through compulsory medical insurance.
5. Duration of one course of treatment.
6. Side effects from taking potent drugs.
7. Acceptable ways to alleviate the patient’s general condition, permitted pain medications.

Difficulties in caring for cancer patients

Your loved ones may be faced with unusual responsibilities, so it’s better to prepare for them in advance:

• Nausea or vomiting after taking medications, eating, or in other cases;
• Use of specialized medical equipment;
• Bathing, cutting nails, and other hygiene procedures that require regular implementation;
• Treating bedsores, stitches, changing bandages, using special products.

It is not always possible to provide acceptable conditions at home due to various difficulties. You can make the task easier using certain measures:

1. Always make lists of things to do. It is better to do this together with a person with cancer, if his condition allows it. Let him know that he can still make important decisions.
2. Provide the person with the opportunity to perform some small household tasks, find a feasible activity.
3. Contact relatives or friends for help.
4. Medicines, medical equipment and other supplies should be stored in one place so that they are always at hand.
5. Provide the elderly person with safe movement around the apartment or room. There should be free space for walking without obstacles. The bathroom is usually equipped with handrails, wash chairs, and anti-slip mats.
6. If you have any doubts about any measures, do not hesitate to consult your doctor.

Not every relative is able to provide proper care for obvious reasons. Often people do not have enough time to constantly be with their loved ones. If you feel like you're not up to the task, consider working with a caregiver or staying in a cancer hospice.

Institutional care

Specialized organizations provide high-quality medical care for cancer patients, regardless of the patient’s condition. The staff of the institutions have the necessary qualifications to provide professional palliative care.

The main services include:

• Social adaptation and psychological support, including for relatives;
• Emergency assistance in critical situations;
• Relief of pain;
• Improving the general condition of the patient;
• Hygiene procedures;
• Organization of leisure time, walks in the fresh air;
• Monitoring medication intake;
• Elimination of intoxication of the body after taking medications;
• Diet food.

All programs are compiled individually. This takes into account the patient’s general condition, age, previous surgeries and other factors. It is allowed to involve specialized specialists and carry out important medical procedures.

When communicating with a person suffering from cancer, you need to consider the psychological burden. Procedures must be performed carefully, without negative consequences. A favorable environment is one of the important components of cancer treatment and the rehabilitation period. If your loved one is in hospice care, be sure to visit and support them regularly.

Problems and risks

Symptoms of distress and psychological distress secondary to cancer have also been shown to have significant negative consequences for both the patient and family. Maladaptive coping and abnormal illness behavior are associated with temporary mental distress, which negatively impacted treatment adherence, health behavior, and quality of life. In addition, people with such problems have to further increase their hospital stay and/or rehabilitation time.

There is evidence of decreased response to chemotherapy in patients with depression due to breast cancer, suggesting a possible association between psychological distress and a higher risk of relapse and decreased overall survival. An increased risk of suicide is also associated with psychological distress in cancer. Therefore, palliative care for cancer patients is extremely important.

Emotional problems such as depression and anxiety may also reverberate within the family, increasing emotional distress among caregivers and, if the patient dies, increasing the risk of depressed mood among relatives.

The world is collapsing and the course of time is changing

Photo from alsfund.ru

Olga Plyushcheva, leading psychologist-supervisor of the “Clear Morning” hotline:

— Who informs a patient of an oncological diagnosis, how does this news affect his ability to think and act further?

— Our diagnosis is traditionally given by a doctor. There are cases of the “Soviet legacy” when the doctor does not dare to communicate the diagnosis to the patient himself, and the relatives are the first to find out. If the patients are young children, elderly people or people with psychiatric disorders, relatives become the main intermediaries in communication with doctors.

There are terrible cases when the diagnosis is “blurted out” in the office over the phone. For example, a person has undergone a mammogram, and the nurse calls him for examination with the phrase: “Your tests are bad!”

And this is already a very stressful situation.

The most typical reactions to an oncological diagnosis are shock, misunderstanding, denial, and stupor. The world and plans for life collapse, the course of time changes, the sense of space may change, landmarks are lost, everything floats, horror appears. And this is a normal reaction, it’s just that, depending on their psychotype, people go through these stages in different ways.

Then they enter the next stage - a violent emotional reaction, often - misunderstanding, mistrust. There are manifestations of aggression towards those who are nearby. Sometimes aggression spills out on doctors, on the entire medical system - this is what we often receive on our hotline.

It happens that people call with the attitude: “Everyone is an enemy.” Indeed, they often encounter the medical system, when they have to stand in line and the doctors “football.” That is, this stage is connected with objective moments. As a result, the person calls us: “You don’t understand me either and are acting to my detriment!” Aggression is simply transferred to whoever is nearby at that moment.

— An oncological diagnosis is preceded by a certain period when the diagnosis is in question, and this is already exciting. What type of person should we “insure” at this moment and pay closer attention to?

— First of all, these are uncommunicative people who experience strong emotions, withdrawing into themselves. Outwardly, they are weak and slightly asthenic - the psychotype is called “psychasthenic.” These are people who, having received the first emotional shock, perceive it as a disaster.

At this moment, it is really necessary for someone close to the person to support him. He didn’t counter-react violently: “It’s okay!”, but was simply there, for people of this psychotype this is important. Often, when informing them of the diagnosis, doctors immediately invite someone close to them. A person cannot be left alone.

— That is, a person needs to work as a lightning rod for the reaction to come out?

- No. A person should know that when his old world collapses, there remains someone stable in him whom he can cling to.

Attempts to solve problems

Despite these findings and their implications for clinical care, psychosocial issues in cancer continue to be minimized and underestimated. Cancer care professionals tend to confuse clinical depression (feelings of hopelessness, helplessness, worthlessness, or suicide) or anxiety disorders (avoidance phobia, arousal, persistent worry) with normal sadness and worry, with the mistaken belief that it is normal to feel sad or worried because of cancer . As a result, the psychological problems experienced by 30-40% of cancer patients are not diagnosed by their treating physicians, and therefore these patients are not referred to psychiatric or psycho-oncological services for specialized assessment and therapy.

Psychological aspects in oncology

Psychological consultations for oncologists, anonymity is maintained Telephone: 8-800 100-0191 (call within Russia is free, consultation around the clock)

Dear visitors!

Today, a system of free psychological assistance is gradually developing in our country. In many large cities of Russia, city and district Centers for psychological assistance to the population are opening, providing face-to-face consultations. As the First All-Russian Congress on the problems of providing psychiatric care to cancer patients, held in September of this year, once again confirmed, psychological problems arise in almost every cancer patient.

Our portal provides a unique professional service in domestic oncology. By calling the 24-hour toll-free psychological help line for cancer patients and their loved ones at 8-800-100-0191 or sending a message to , , an oncology patient can get advice from a specialist psychologist.

The success of treatment of any disease is directly related to the psychological state of a person. This is especially important when it comes to a serious and long-term illness that forces one to undergo complex and sometimes difficult to tolerate treatment that requires enormous mental and physical strength. In these difficult times, a person needs help and support from others. As a rule, our family and friends are ready to provide such help, but, unfortunately, the severity of the disease is sometimes great and even their energy may not be enough. Moreover, sometimes relatives also need outside support. The way out of such a situation may be to seek psychological help from a professional psychologist.

The goal of our project is to provide psychological assistance to cancer patients to improve the quality of life, reduce the frequency and quality of induced mental disorders.

The ability to call a hotline, which provides psychological support for patients and their families, relieves the attending physician of many problems. He is no longer faced with panic and psychosomatic reactions of the patient, but sees in the patient an active attitude towards treatment and a positive attitude towards the doctor’s recommendations. The phone works around the clock, free of charge for all regions of Russia, which guarantees the opportunity to reassure and support patients in any region.

We have set ourselves the task of providing not only correspondence, but also face-to-face psychological assistance to patients suffering from cancer, and we are currently training several groups of specialists who want to improve their competence in the field of oncology psychology.

Our specialists can also consult a doctor and provide psychological support to oncologists - specialists who work with the most complex category of patients with an increased risk of mortality. All requests are anonymous.

How to communicate with a person with cancer: advice from a psychologist

The first step to meeting patient needs is to review psychosocial aspects of cancer as a common practice in clinical care. Routine use of brief clinical instruments may help improve the identification of maladjustment and psychosocial or psychological morbidity for referral of patients in need of psychological services.

The phrase “I have cancer” itself sounds scary. However, the psychological literature also indicates that you should never attempt to self-diagnose depression, anxiety, or distress in cancer patients. The tools used by clinical psychologists appear to be more adequate. They include some pretty simple things like the Depression and Anxiety Scale and the Short List of Mental Health Symptoms. They have been shown to be useful as a practical system for monitoring psychological states throughout the disease course. Again, it should be said that the screening performance of some of these scales is limited compared to standard psychiatric diagnostic interviews, which in turn are limited by the failure to identify other psychosocial aspects of cancer, such as demoralization and excessive worry about one's health (hypochondriasis).

If there is no competent oncologist nearby, and you do not have the appropriate education, listen to the advice below:

• Do not talk to the patient about his illness. On the contrary, try to discuss as irrelevant things as possible that do not relate to his illness.
• Maintain a stable emotional state. Tears and an overly tense appearance can confuse the patient, because no matter how much you love him, it is his life that is under threat, and he worries much more than you. Don't let these feelings develop into depression or hysteria.
• Don't deny him anything.
• Make jokes more often. Pre-subscribe to some public pages or web pages with memes and jokes (depending on the patient’s preferences) and try to keep him in a cheerful, playful state.
• Never talk about death! If the patient himself begins to bring up this topic, convince him that he is not in danger of death.
• If the stage of cancer does not leave a person any chance and he knows this, behave calmly, bring up religious topics more often, lead him to the idea that some very interesting adventure awaits him and you even envy him a little, since you are incredibly interested in what is happening on the other side. This can calm the patient and even inspire him.
• Don't be fake! Work on yourself first. Your emotions should appear sincere, and not as if you are trying to console the patient.

Psychological assistance to cancer patients

Psychology Tags:

Anastasia Udilova:

Good evening, dear viewers and listeners. The program “Medicine of the Future” is on air. Today we are talking about psychotherapeutic assistance to cancer patients. Our guest today is Sergey Vladimirovich Kurenkov, a psychotherapist, psychologist, who provides psychological assistance to cancer patients and works at the Loginov Moscow Scientific Research Center. How long ago did such a narrow field arose in our country, as I understand it, this is an unofficial field, oncopsychology, because I myself worked for quite a long time in the oncology department of one of the leading institutions in the country, but no one even thought of having a such a specialist as an oncopsychologist. How long ago have we had specialists like you in Russia?

Sergey Kurenkov:

From the very beginning, this arose on the basis of the First Hospice in St. Petersburg, which was created by Andrei Vladimirovich, a man who devoted his entire life to this. This is the first chief physician of the Perovoy Hospice in Russia. Then the following hospices appeared. This is approximately the 90s, the time of the Russian Federation. Then both practice and theory arose, because it already existed in the world, but it existed in such a name as psycho-oncology; in our country it acquired the name oncopsychology. And when they actively began to work with this topic, namely psychotherapeutic support for cancer patients, we became convinced that it works very effectively in supporting patients, in pulling them out of depressive states, with the possibility of high-quality psychotherapeutic support, which ultimately resulted in the mobilization of all strength and energy person to fight cancer. This began to develop with the First Hospice, which is now named after Vera Millionshchikova.

Anastasia Udilova:

I worked with cancer patients and often spent more time talking with relatives. Sometimes there have even been situations where the patient does not always understand what is happening, the severity of his condition, and there are relatives standing at the door who do not know what to do with themselves and what next. Your scale of work with both patients and relatives, maybe also medical personnel, who do you focus on in your work?

Sergey Kurenkov:

First of all, we focus on patients, and we focus almost from the first stage, from the moment of diagnosis of the disease, when an understanding, therapeutic tactics, regimen and further chemotherapy, if necessary, operating room, preoperative preparation and postoperative work with the patient are already formed. But in this case, there is also a second category of people with whom we also actively work - relatives, because much depends on their support in the fate of the patient, in his ability to mobilize and effectively accept treatment. And the third category is our colleagues, we also need to work with them in this direction, we also prepare them from the point of view that medical workers, our colleagues, worry about the patient, cannot help but worry, so the issue of emotional burnout arises, with which need to work. We create conditions so that our colleagues do not burn out and can equally effectively treat our patients.

Anastasia Udilova:

Who is more difficult to work with – relatives or the patient?

Sergey Kurenkov:

I would not place such an emphasis, because everything depends on the specific individual situation. There are difficult situations with patients, there are difficult situations with relatives, so everything here is individual.

Anastasia Udilova:

Do you have any tasks? After all, doctors used to have a dilemma - to tell the patient or not to tell the diagnosis. If I tell you how, because I personally wasn’t taught this at the institute. We had the subject “oncology”, but we were not taught how to communicate with patients, how to convey to the patient that he has an incurable or curable disease, but it is unknown how long the patient will live. That is, your task is to help the doctor tell the patient the diagnosis, what awaits him, what should he prepare for? Not just to get you out of a depressed state?

Sergey Kurenkov:

We help the patient find out the diagnosis in the least emotionally traumatic way, we give certain techniques and recommendations, certain trainings to our colleagues in order to convey all this in the least traumatic way. The same goes for working with relatives; this is also included in the program. Moreover, now it is already at the residency level. For example, I give lectures that have some success; residents and doctors are interested.

Anastasia Udilova:

That is, you give lectures to doctors in different areas, not to future psychologists?

Sergey Kurenkov:

No, we need to train our colleagues so that they are as ready as possible to work with patients, with relatives, and this means that they need to pass on the psychotherapeutic techniques that we know, so communicating the diagnosis is one of the important factors in how to convey this to the least traumatic way.

Oleg Druzhbinsky:

Should you say straight to your face: “You have cancer,” or should you beat around the bush: “Sit down, drink some water, relax”?

Sergey Kurenkov:

Let's start with the fact that the patient, especially an adult, has the right to know the truth. It is important that he knows this truth completely, but there are certain nuances, namely the psychological state of the patient. It is very important for us that he does not end up in a depressed state. A depressive state will lead to a deterioration of immunity, and he absolutely needs immunity in order to fight the disease. Therefore, the patient should know about this, and we inform him about it. But we still look at the severity of the patient’s condition and see to what extent to give him this information.

Oleg Druzhbinsky:

That is, you start from the psychological state of the patient himself. If he is an optimist, you can tell him: “You know, you have a nonsense disease, it is now being treated almost everywhere.”

Sergey Kurenkov:

You can not do it this way. Here it already turns out that we are deceiving him a little. We still must tell him, within the limits of what we know and understand, we must not give him false information. He must understand that this is oncology, but at the same time he must understand perfectly well that oncology 20 years ago and oncology today are two incredibly different things. I know a colossal number of examples of people actually being treated, they are achieving a great goal in this regard, they are reaching a wonderful finish line called “long-term high-quality remission” - this is possible.

Anastasia Udilova:

That is, when after treatment, after surgery, the tumor does not return for a long time.

Oleg Druzhbinsky:

Even the diagnosis is removed. If after 5 years there is no reappearance, the diagnosis is simply removed.

Sergey Kurenkov:

Yes, but first they conduct long-term studies, because they must be on the safe side.

Oleg Druzhbinsky:

There is no need to deceive - I agree with you here, but first of all you start from the person himself, from his psychological state. How to say?

Sergey Kurenkov:

We should not delay the answer, we should not weigh it in this regard. But we must prepare him for this news, soften him up.

Anastasia Udilova:

How? You work with a patient for 1.5 hours, carefully feeling the ground, the patient’s condition?

Sergey Kurenkov:

Absolutely right, because we study a person’s psychotype, in what state he acquired this disease, we must know the anamnesis, the history of how he came to this. Maybe before this he had a severe depressive period, which does not improve the prognosis, treatment, or our contact in this regard. Therefore, we need to study all this in detail, in advance, and only after that come into contact and communicate with the patient as much as possible. Moreover, we should not dumbfound him.

Oleg Druzhbinsky:

To what extent does the stress of learning about an oncological diagnosis negatively affect the patient psychosomatically?

Sergey Kurenkov:

Of course, it has a negative impact, because some people still call it the terrible word “sentence.” It's just hard for me to pronounce this word. Many often perceive this way when they find out their diagnosis. But here we must include an objective point of view, logic, we must convey to the patient what the real state of affairs is. The human psyche reacts in such a way that it defends itself, the person begins to fence himself off from this: “No, this has nothing to do with me.” And then there is a certain negative in this, it can take a week, two - time will be wasted that we could make the most of for the benefit of the patient. And there are times when there is a hypertrophy of the patient’s perception that he has been given such a diagnosis, when he is simply in a state of panic. We shouldn't allow this to happen either.

Oleg Druzhbinsky:

Is suicide possible in this state of panic?

Sergey Kurenkov:

Unfortunately, yes, there is still a risk, so we must explain to the patient in time the situation that it is not critical. We know what to do with this, because it is difficult for a psychological patient to endure waiting, misunderstanding, and ignorance, so it is important for the doctor to clearly understand, verify the disease, know a clear diagnosis, understand the therapeutic line and explain this to the patient.

Oleg Druzhbinsky:

Simply put, give the patient as much information as possible so that he is busy studying his disease rather than fantasizing about how he will now fall into pieces, or who to bequeath the apartment to, or how to say goodbye to his family and friends. From the point of view of physics, I will now say such a banal, common phrase: atoms came together, atoms separated. In general, there is no death, there is work on mistakes. But let's talk about the positive.

Anastasia Udilova:

The psychological state of the patient affects his immune system. After all, this is very important so that the patient recovers in the postoperative period, after chemotherapy, and does not give up. Nowadays the word “positive”, “positive person”, “let’s live positively” is used very often, this is good, there will be no diseases or problems. You said that depression worsens treatment results. How does depression affect the immune system, reducing it?

Sergey Kurenkov:

From the point of view of practical medicine, you see this almost every day. That is, when a person goes into a depressed state, we take the rehabilitation period, the postoperative period, you go to your colleagues and ask: “How are the clinical indicators?” - “They are going down.” Moreover, when a person has support, when he has hope, when he has optimism, an understanding that he has not just a chance, but the opportunity to fight and win, then even clinical indicators change. This is objective, and you come across this quite often. Because when you enter the rehabilitation department in order to accompany a psychotherapeutic patient, you ask your colleagues a question: “How are the clinical indicators, have they gone down or up?” – your tactics depend on this. When working with the same relatives who are also in support, it is necessary to set up the relatives in a certain way, because if a relative comes to visit the patient and his tears flow without stopping, this should not happen, because there are certain moments that themselves patients, having gone through this path, clearly express in a certain way, including this look of farewell should not be - this is not support, it is rather the opposite, because here we start from what they want, what they say.

Anastasia Udilova:

Any doctor has his own statistics that a patient who has the task of surviving after an operation in order to plant potatoes, his cat is not fed - these are the patients who recover faster. How is this explained on a physiological level?

Sergey Kurenkov:

Research was carried out long before oncology psychology appeared. Moreover, this became a definite basis for this discipline to appear in the world at all, because more than a decade ago our colleagues noticed that patients who are supported psychotherapeutically and supported by relatives most often go into good remission. They are optimistic and respond effectively to the therapy, unlike patients who do not. There were even groups that were accompanied by psychotherapists and psychologists, and long-term studies gave certain figures: from 60 to 80% of patients who were accompanied received long-term remission. 60-80% is a colossal percentage in medicine, so there’s nothing to add here in terms of numbers, how important it is, how much it works.

Oleg Druzhbinsky:

But the psychosomatic sphere, the impact of a person’s mood on the actions of his immune system is still terra incognita, where a button is pressed, thanks to which leukocytes run somewhere, nothing is clear, as always.

Sergey Kurenkov:

Today, one of the fundamental statements of neurophysiologists is that about 80% of our mind deceives us. The second point is that a very large number of world-famous neurophysiologists offered to work on the model and abandon the old model of explaining what happens to our brain. This suggests that we no longer fit certain things into the existing model, that is, we need a different explanation.

Oleg Druzhbinsky:

No answers yet.

Sergey Kurenkov:

Unfortunately, there are no global explanations for everything down to the details. There are certain points that are explained, but not all. This will be studied, studied, and now very large amounts of money are being invested in this, because there is a need for it.

Oleg Druzhbinsky:

You act empirically, you tried that it is good, if the patient is positive, it means he recovers better. Some kind of story?

Sergey Kurenkov:

This is practice. And when a practice is confirmed by thousands, tens of thousands, millions of people, it is already science.

Oleg Druzhbinsky:

Relatives are different. I had to communicate with doctors and get information; some relatives even want the patient to die. For various mercantile reasons, in general, it is more or less clear, they are waiting for an inheritance. How much can you control the attitude of relatives towards the patient? You can instruct them and say, “Stay positive,” and they will do the opposite, what can be done in this situation?

Sergey Kurenkov:

Relatives have access to the patient, we are obliged to know the patient’s opinion, and it will be the first and foremost for us. If the patient does not want to communicate with relatives, then this is his right, this is the law.

Anastasia Udilova:

What are the legal limitations that prevent you from practicing with this type of patient?

Sergey Kurenkov:

I have not encountered the practice of having negatively-minded relatives. Firstly, it was always possible to establish contact with them, and if some issues arose, then the relatives understood perfectly well with whom they could carry out some negative things. Such questions have never arisen for me, positive ones - yes, we discussed how best to support, what should be said, what should not be said, because we not only must be quite soft and adaptive in relation to the patient. One of the patients' requests is that this should not be too exaggerated.

Oleg Druzhbinsky:

That is, there was no exaggerated emphasis on their illness?

Sergey Kurenkov:

There should be no pity. Pity has no positive effect on the patient. Moreover, most patients say: “We don’t need pity, we need a real feeling of support.” And they want this desire to be not artificial, real, from the heart.

Anastasia Udilova:

And even seeing relatives, their sincere smile, that is, the person came to the relative in a good mood, despite the fact that the husband, son, brother has oncology, but you are in a good mood, because the sun is today, and perhaps this smile is sincere will charge the patient. There is no need to be ashamed of your emotions and enjoy life.

Sergey Kurenkov:

True emotions give support to the patient. There should be nothing artificial, no theatrical production, this is not necessary. But on the other hand, if a relative comes, he is very worried, then, as a rule, people are very reasonable, they wait for this wave of panic to pass, so as not to pass it on to the patient.

Oleg Druzhbinsky:

People themselves felt that it was better not to go now.

Sergey Kurenkov:

Recently, relatives of patients have begun to read the Internet and become interested; many are sympathetic to this, so this makes it easier to work with them. The only thing is that it often happens that relatives worry so much that their condition becomes no less serious.

Oleg Druzhbinsky:

And relatives may find themselves in a depressed state.

Sergey Kurenkov:

Therefore, you also need to work with them, because when you explain to them that you are the patient’s resource, it is you who help him get out, fight, go to victory, this stimulates many.

Anastasia Udilova:

You work closely with surgeons because you work at the preoperative stage, preparing the patient, so that later it will be easier for surgeons to work. You somehow divide the responsibilities, for example, you say: “Ivan Ivanovich, don’t tell me the stage of prevalence, I will say it, this is my responsibility,” or the surgeon says: “Sergey, tomorrow I have 5 operations in a row before this patient, I don’t know.” , how to say this, can you say”?

Sergey Kurenkov:

During this time, all our doctors coped with this task, they conveyed the diagnosis.

Anastasia Udilova:

Did you do it yourself or did you help?

Sergey Kurenkov:

They themselves sometimes ask how this is best in this case, because it is difficult for a patient with a certain psychotype to do this, you need to tactically work out how best to convey this. Sometimes colleagues posed the question in such a way that let’s look at the situation after the operating room, because a number of more operations will be required. And imagine, the patient has undergone one operation, and he still has a dozen ahead, and I so easily say: “Ten.” This can be extremely difficult, because large-scale heavy operations, and a person just needs to survive, he cannot endure one heavy operation, so they do it in parts, gradually allowing the body to recover. This is where a person needs incredible emotional strength in order to find this line, to find optimism, and then surgeons actively begin to involve me and my colleagues in this field, because here we can really stretch the patient emotionally so that he finally prepares, so that he can see what we are going towards - this is our task, it works out. Surgeons are conservative people, this is good, in fact, that’s why they believe you when you start to produce results; for them you are a psychologist, a psychotherapist.

Anastasia Udilova:

It is difficult for surgeons to understand this; surgeons are focused on a specific result.

Sergey Kurenkov:

They just tried it once: come, here’s a patient for you. One person liked the result, another liked the result - and it became a system. And this is good, because your colleagues believe in this method, and this is very worth it.

Anastasia Udilova:

Do you communicate with every patient admitted to the hospital, or selectively?

Sergey Kurenkov:

No, those are the ones that our colleagues want to pay attention to first of all, because we have a large volume of patients undergoing treatment, a large number of operations are performed daily.

Oleg Druzhbinsky:

These are selective patients who need to be helped.

Sergey Kurenkov:

God forbid, those who have signs of suicidal tendencies. Maybe they are not expressed, but a depressive state can contribute to this, push it, so colleagues are determined to solve this problem in a timely manner.

Oleg Druzhbinsky:

You mentioned the conservatism of doctors, but medicine 50 years ago left patients blissfully unaware.

Anastasia Udilova:

This was literally 10 years ago. And extracts were given without a diagnosis.

Oleg Druzhbinsky:

And perhaps the patient felt better in this blissful ignorance?

Sergey Kurenkov:

Imagine, we say: “Everything will be great, we practically promise you this,” - we pull the patient to remission. After some time, he continues this story, and in that case, what happens? As a rule, the patient loses faith in the doctor. When we set up a patient for this or that therapy, for surgical care, we also set him up to trust the team of surgeons who will carry out this hard work, because we always forget that doctors also want they believed in them. We forget about this side of the issue, they need it.

Anastasia Udilova:

You started your practice in hospice. As you know, in hospice there are already terminal stage patients, that is, stage 4, who have nothing to help, that is, they die there. What is the task of a psychologist to work with this kind of patients, because already due to cancer intoxication, due to the fact that they are exhausted by the disease, their criticism of everything that happens is worsening. What was your task then?

Sergey Kurenkov:

The task is very global. The fact is that this is a task not only for patients who are in this condition, but for any person. The task is to change your priorities in life, to finally understand that there are many small, once unimportant things that are the most important and central in this life. Because often people run after global goals, and at some stage they suddenly realize that these are all false goals, this is something that should not have been done. A colossal amount of time, effort and energy was spent on this, and at some stage a person suddenly realizes that these little things: family values, relationships with people, your admiration for nature are much more important than everything that happened before.

Therefore, this task is still global, and when a patient finds himself in this position, it is very important for him to reassess this, and many overestimate it. They begin to appreciate, and along with them you, month, week, day, hour, that is, you understand that time is not sand, it is an incredibly valuable thing that can go away very quickly. And you yourself also overestimate this, you begin to relate to it, and you begin to value the time of patients who are in serious condition in a completely different way. Therefore, the possibility of round-the-clock visits by relatives, special treatment from medical staff, because how much time a person has is unknown.

But there is also a certain point here that causes optimism, despite such a difficult topic. I observed patients who were in a certain condition, not to say critical, not terminal, that is, something you can live with for quite a long time - from localizations, with a fairly aggressive form of the disease itself, but people come, but they are not there. Question: why? This is an appeal to our consciousness.

Anastasia Udilova:

It's his choice. The person himself decides to leave or look out the window.

Sergey Kurenkov:

And the body reacts to this incredibly quickly; there are examples of this not only in oncology, but in everyday life. An example that often happens among older people is when they start sitting on the couch, watching TV, going to the kitchen and back, and sending a signal to our body. The body is an incredibly smart thing that has its own intelligence. The person says: “Listen, I don’t need you,” and he begins to join this program. And when a person wakes up in the morning, exercises, active actions, he speaks in the opposite language - I need you, I need to continue living, I need to achieve some goals, I need to do something.

Oleg Druzhbinsky:

But is it possible to set some kind of goal for such a patient in the terminal stage, so that he has something to hold on to, or is it better for him not to hold on?

Sergey Kurenkov:

The price of time is already different, it is priceless, which means that being with a loved one is the most important and greatest goal, and how much time he spends with a loved one is priceless.

Anastasia Udilova:

If there were any omissions, grievances, before the person leaves, remove all this and understand that something a little different is valuable.

Sergey Kurenkov:

Let go of the problems that existed between them, the elements of misunderstanding.

Oleg Druzhbinsky:

When you just talked about this hopeless stage, I remembered one historical literary example about the writer Burgess, the author of the book “A Clockwork Orange.” He started writing this novel because he was diagnosed with cancer, brain cancer, and he decided to write it so that his family would have some means of subsistence. He was so passionate about the goal that he had to leave some money for his family, he wrote it and lived for quite a long time after that - this is an interesting fact, that is, thanks to the goal, a person can hold on and live much longer than if he had given up.

Sergey Kurenkov:

Another example is when the patient is in an extremely serious condition, when there was no explanation for why he was alive, when there was a large-scale disintegration, that is, everything is quite difficult to see, perceive, smell, imagine how conscious the desire to live was, how much he clung, how turned on he was volitional lever. Therefore, I really believe in human consciousness, as my teacher says: our consciousness can destroy us in a split second, but at the same time it can lift us to the highest peaks, if you want it.

Anastasia Udilova:

I remembered the words of my teacher, this is academician Alexander Fedorovich Chernousov, I was in residency with him, and he told us: “You can’t buy a year of life on the market.” When they asked him: “Why are you doing such extensive operations, the person may not live long?” – “It may not be for a long time, but a year, yes, but you can’t buy a year of life on the market,” so I understand perfectly well what you are talking about now.

Sergey Kurenkov:

I don’t want to say anything in this regard, but you have to live it to understand it.

Anastasia Udilova:

I would like to touch upon such a serious topic as professional burnout among doctors. I am one of those people who suffered professional burnout at one time. I worked with cancer patients, it was very difficult for me, because I am a very positive person, and it was very difficult for me when people in whom I invested myself, my soul, left. These were young, beautiful people who left anyway. What difficulties do you encounter when working with medical personnel, middle management, and doctors?

Sergey Kurenkov:

With the same ones as with other other patients.

Anastasia Udilova:

That is, a doctor is also a person.

Sergey Kurenkov:

Naturally, he is also a person. Some people believe in it, some don't believe in it. Working at the Loginov Moscow Scientific Research Center, we also have patients there who are similar to us, our colleagues, and psychologically they endure it much more difficult. Imagine being a god all your life, and suddenly finding yourself in the role of a patient, and a serious patient at that - it’s tragic, it’s more difficult emotionally.

Oleg Druzhbinsky:

Your wonderful story and examples once again prompted the idea that human consciousness plays a huge role, and perhaps a person is consciousness. We always talk about human consciousness, no matter what we do, because our physical shell is good, but without our creation it is nothing. Little is said about human consciousness, but the most important thing is how much it influences the person himself, and how through this consciousness the body can be physically changed.

Sergey Kurenkov:

More than possible. Previously, we were always taught approximately this model: matter is primary, consciousness is secondary. But now I liked another phrase: consciousness is material.

Anastasia Udilova:

If we proceed from psychosomatics, then this is completely justified.

Sergey Kurenkov:

Here we see a complete reconciliation of the once irreconcilable idealist-materialists, and at the same time this is the essence of this problem. I work in this system now, and it gives me much more positive feelings and impressions than when I worked in the hospice system, because there you are fighting for hours of human life, worthy of living, here you are fighting for life, especially then when there is such a great team, when everything is subordinated to one single task. When you see that your colleagues are not in a hurry to run home at exactly the right time, they sit until eight, and until nine, and until ten. And when you go from building to building, sometimes you meet the director, who just goes to the building alone to see how work is going in the department.

At first, when I came there, I was somewhat surprised: a corresponding member, a world-famous professor, just walked out, without any retinue. We bump into each other, and every time he asks: “How’s it going?” Great. Well done. Therefore there is optimism. Moreover, there were different thoughts, but now you see a large number of young specialists who did not need to be forced to study, who wanted to study, who wanted to graduate, who knew what they wanted to do in their profession. And you understand that we have a good future, because this is a good, big element of colossal optimism.

Oleg Druzhbinsky:

I wanted to thank you for educating doctors. It is very important that young doctors already have the basic principles of psychological assistance. It is clear that there are spontaneous psychologists, and they are good doctors, they have remained in history, but we work across areas, we need all good doctors so that they are sufficiently psychologically prepared.

Sergey Kurenkov:

That's right, because when we chose this profession, no one forced us to go there. Therefore, this is our choice, which for most is forever. If we do something, we do it first and foremost not for ourselves, we do it for the patient, and each of us can be a patient.

Oleg Druzhbinsky:

Inner optimism and helping loved ones are the most important things from a psychological point of view. At any moment we need to support someone and expect the same support from others. Thank you very much, Sergey, for being with us today.

Psychologist's work with cancer patients

Knowledge of the treatment of psychological problems is imperative for cancer clinicians given the amount of research that has shown the effectiveness and efficiency of psychosocial interventions. Counseling, education, psychological support and other types of assistance, as well as more specific forms of psychotherapy (group, individual and family) and therapeutic orientation (cognitive-behavioral, supportive-expressive, existential and psychodynamic) have been developed for cancer patients to more effectively treat all painful conditions. The choice of specific psychological support is related to several variables, including the clinical psychological state, the type and phase of the disease, and the context and availability of psycho-oncological services with trained specialists who should be part of the interdisciplinary teams in any normal clinic. Hospices for cancer patients also employ entire staffs of psychologists.

In what cases should you seek help from a psychologist?

In a good way, a consultation with a psychologist will not harm anyone: neither the cancer patient nor his worried loved ones, who experience almost the same negative emotions and hide their sad feelings from the patient.

It is believed that a strong personality does not need soul-saving conversations, but you are sure that you belong to the strong ones, maybe you are mistaken? If you are a strong person, then a specialist will confirm your personality type, which will only add to your self-confidence and will be beneficial during a difficult period.

Unconfident cancer patients should definitely receive their share of moral support, resolve their mental doubts and develop new life goals.

Of course, you need to learn about the specifics of clinical events during surgery or chemotherapy from an oncologist; no one else knows the intricacies of medical procedures and, especially, possible complications. But not every oncologist is able to relieve and even recognize the patient’s anxiety before important treatment stages; with anxiety and uncertainty about the future, they go for a psychological consultation.

The patient's relatives should be wary of skipping an examination without an objective reason, and rather due to fear of unpleasant findings. Intentional failure to follow medical recommendations is an indicative symptom of denial of one’s disease. Wandering at night, a previously unusual appetite, or, conversely, refusal to eat are symptoms of anxiety. It will probably be possible to cope with all this without the help of a specialist, but it is better to get into mental balance earlier and help your recovery.

After completing cancer treatment, a person often cannot find his place in life, he does not know how his colleagues and bosses will accept his return to work, and when applying for disability or a pension, it is difficult not to fall into despair from the overwhelming loneliness and excess free time. A professional oncologist will help you accept your new life and make it full and joyful.

It is very important for us to provide you with the optimal and most modern treatment, but we know well that despair is no help in the fight against cancer, so we are always ready to offer our patients qualified psychological support and our sincere attention.

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Psychopharmacology: is medication necessary?

Psychopharmacological interventions have been shown to be effective in some disorders, where the use of certain medications that target the serotonergic and noradrenergic systems (eg, selective serotonin reuptake inhibitors) helps treat depression and anxiety, as well as other cancer-related symptoms such as frequent mood swings and depression. Therefore, it is important that clinicians, usually psychiatrists, as well as oncologists and primary care physicians, receive adequate training in the use of drugs and their interactions with other cancer treatments. Oncology psychologists are doing everything to ensure that the phrase “I have cancer” no longer frightens sick patients and they learn to live with this diagnosis.

Practical approaches in the field of psychotherapeutic counseling at different stages of cancer began to take shape in the middle of the last century. The main areas of work of psychosocial services in England, Germany, Japan, Poland have become the spiritual and existential needs of patients at different stages - from the prevention of cancer to death.

The effectiveness of psychotherapeutic counseling for cancer patients, proven in world practice, is confirmed in the practical work of Russian psychologists working with cancer cases. Equally important is the psychological support of relatives and loved ones of patients, as well as doctors and staff of institutions providing medical care to cancer patients.

There are three areas of work for a window psychologist: the patient, the patient’s family and medical workers.

Unfortunately, hiring a psychologist for a medical institution in our country is still perceived as a worthless luxury. This is how it happened historically. In addition, doctors, nurses and junior medical staff often reject the significance of the work of a psychologist. Integrating into the medical team, gaining trust, conveying the essence and capabilities of a psychologist’s work within the institution is the first stage of the professional activity of a medical psychologist working in a clinic. The second stage is the correction and prevention of professional burnout and secondary traumatization of employees.

Psychological support in oncology has its own characteristics and is eclectic in nature, including elements of existential, cognitive and supportive-expressive therapy. Psychodynamic and cognitive-behavioral models are effective in working with medical personnel. Elements of interpersonal psychotherapy can be used in group work with relatives of patients.

The forms of work of an oncopsychologist are based on generally accepted methods of correction and depend on the physical condition of the patient.

The goal of counseling in oncology psychology is to adapt to changes in the patient’s life associated with a serious illness, that is, to reconstruct the picture of life, search for resources and control mental trauma.

Typically, the stages of the disease are divided into prevention, diagnosis, treatment, recovery, remission, relapse, palliative and terminal stages. Features of the work exist at each stage of the patient’s disease. Each stage deserves special consideration in a separate article.

Common to counseling cancer patients is the fact that they are aware of the proximity of their own death. The experience of such awareness depends on the patient’s personality and the stage of adaptation to the disease at which he is. Some replace, others displace, others resist. The fourth accept. In any case, the work of an oncopsychologist is associated with such an indispensable component of the life cycle as death. The ability to maintain effective work in an environment saturated with the experience of fear of death, pain and loss of loved ones requires special skills and special training of psychologists.

In preparation for the work of an oncopsychologist, it is necessary to work out one’s own attitude towards death, reinforce a humanistic attitude towards patients, develop stable skills of non-aggressive and non-accusatory behavior in a conflict situation, introspection, and effective utilization of one’s own negative experiences. Within this specialization, it is especially important to understand that preventing emotional burnout allows you to extend your own professional life. In addition to introspection, the oncologist is simply obliged to provide himself with the support of the professional community, request supervision, and attend Balint groups.

One of the features in the work of an oncopsychologist is a genuine relationship of sincerity and trust between the consultant and the patient, since physical and moral suffering usually sharply reduces the level of neuroticism of the individual. Communication with a person who truly accepts the inevitability of his own death, that is, a mature person, is the most valuable thing in the work for the personality of the psychologist himself. This is not common, but in oncology more often than anywhere else.

The work of an oncology psychologist can be described as a search for resources. Search for psychological resources of the patient, the patient’s relatives, staff and doctors, and the psychologist himself. The most popular tasks of our work are the utilization of negative experiences associated with the cancer situation (clear the internal space), as well as the recognition and use of the patient’s resources (fill the internal space) to maintain the quality of life, no matter how much of this life remains.

The motto of an oncopsychologist could be formulated as follows: “It’s not how long, but how exactly that matters.”

M.V. Vagaytseva - State Healthcare Institution "Hospice No. 1", ANO "CSPP "Second Wind", Department of Psychology of Crisis and Extreme Situations, Faculty of Psychology, St. Petersburg State University, leading the workshop "Oncopsychologist: motivation and features of work."

Help not only patients, but also families

Cancer and its treatment have a huge psychological and psychosocial impact on both patients and their families, and are accompanied by a number of dramatic changes affecting the physical, emotional, spiritual, interpersonal and social aspects of the patient. Recognizing that a high percentage of cancer patients suffer from emotional symptoms (eg, health anxiety, irritable mood, and demoralization) or psychopathological conditions (eg, major depression and post-traumatic stress disorder) is critical for cancer care professionals to provide comprehensive and comprehensive assistance. In fact, there is now scientific evidence of the benefits of providing psychosocial support to patients and their families as part of standard treatment. This is done to reduce distress and psychosocial morbidity associated with cancer and to improve quality of life during and after treatment and ultimately increase survival. A cancer patient who is not in a hospital, but at home, also needs regular visits to a psychologist.

What should you do if you recently found out you have cancer?

If you have already started treatment, then you don’t have to worry - you have overcome all five stages of stress and accepted your new condition.

If you are being treated and have begun to make plans for your future life, even if not for a year, but for months - you are a strong person, most likely the time for psychological help has not yet come.

If you are not sure about the correctness of antitumor therapy , talk to your treating oncologist, but prepare in advance a list of questions that are important to you. Often shock does not allow you to understand the essence of the information - words fly by, as soon as you realize that you missed something important, you need to return to the conversation, you need a little more time to understand and a detailed conversation with the oncologist will help relieve internal tension. It is possible that to gain confidence you need to get a “second opinion”, sign up for a consultation and do not forget to take a list of questions.

If, after a conversation with an oncologist, your soul is not in the right place, sign up for a consultation with a psychologist, and we will help you get it as quickly as possible.

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If you are worried about the lack of guarantees of treatment results, your will is paralyzed by the fear of waiting for chemotherapy or surgery - a medical psychologist will help you understand that nothing is eternal in this life, confidence in the future is not based on following the predictions of the “life line”, but on the feeling of the uniqueness of every moment life and carrying out an adequate amount of therapy.

If you are concerned not only about the result of therapy, but also about how you will look after treatment and how others will react to changes in your appearance, is it worth talking about the disease to strangers and how your disease will affect your career, if before each analysis you fall into horror - you need medical a psychologist is simply necessary. Do not be afraid to consult a specialist whose job is to help your soul find peace and confidence.

Benefit to society

Significant advances in psycho-oncology research have facilitated the development, implementation, and dissemination of psychosocial guidelines and evidence-based treatments for a range of mental health disorders in cancer, such as depression and anxiety.

Psychologists are also trained in advance to help children with cancer, because they especially need it. Soon such practices will be introduced in absolutely all hospitals in Russia.

there is hope

Cancer is not a death sentence! There was a time when this diagnosis automatically meant death, and doctors often told patients that they had little time left to live. There is also the tired stereotype of the doctor telling a patient, “I have bad news for you, you have a week to live.” Everyone knows perfectly well how long cancer patients live, and even today this period significantly exceeds one week. The five-year survival rate of patients with the first and second stages of cancer is 60-80%, the third - 50%, and the fourth - 5-10%. The life expectancy of cancer patients is determined by two main factors. This is the localization of the malignant neoplasm and the stage of its growth.

Breast cancer is the most common form of cancer among women, but advances in medicine have made it possible not to perceive this diagnosis as a death sentence. The survival rate for malignant breast tumors is high: every second patient, after receiving complete and correct treatment in the early stages of the disease, lives another 5 years, every third woman lives 10 years. For these women, the phrase “how I found out I had cancer” usually accompanies stories with a happy ending.

Oncolytic viruses

Very soon, the phrase “I have cancer” won’t ring a bell, and here’s why. A recent study published in Clinical Cancer Research, conducted at Cardiff University in Wales, reprogrammed viruses to kill ovarian cancer. Until now, the five-year survival rate for ovarian cancer is only 15% unless the disease is detected very early, and therefore available treatments have limited effectiveness.

The researchers took a very common, well-studied virus known as a respiratory adenovirus and modified it so that it could only enter a specific receptor unique to metastases but not present on normal cells. Once the virus enters a cancer cell, it multiplies and destroys the cellular machinery, thereby killing the cancer. This method has shown great effectiveness in experiments on mice, and researchers are now working on modifying the virus to treat tumors of the breast, pancreas, lungs and other organs. There is also speculation that specific anti-cancer antibodies and other human chemotherapeutic agents could be tagged with the virus, which would then only reach metastases. Apparently, soon it will be possible to say with greater confidence that cancer is not a death sentence. Human trials are expected to begin within the next five years. Therefore, if one day you have to tell your loved ones the terrible phrase “I have cancer,” it is quite possible that by this time you will have every reason to say it with a cheerful, unobtrusive intonation. Because by that time all forms of this disease will already be curable.