The psychologic support of the cancer patient: a medical oncologist's viewpoint

The cancer patient should not be treated differently from other patients. He has the right to good medical care and, especially, sympathetic and constructive psychologic support during all phases of diagnosis, surgery, radiotherapy, and chemotherapy, independent of disease extent or therapeutic response. After the physician has reevaluated his own concepts about cancer and death, he can effectively begin to treat and support his cancer patients. By understanding the individual psychologic problems of cancer patients and their families, a physician can develop an effective psychologic, as well as antineoplastic, treatment program. The family physician has the central role of introducing the cancer patient to his illness and to his oncologic physicians. The surgeon should discuss preoperatively the nature of a patient's problem and the proposed surgical treatment with its possible alterations of bodily function. Postoperatively, he and the family physician should develop a treatment program after appropriate consultation with oncologic subspecialists. If the radiotherapist is consulted and feels radiation therapy is indicated, he should outline his objectives and the possible side effects of therapy. Likewise, the medical oncologist should discuss the potential benefits and possible side effects of anticancer drugs if he feels they should be administered. No one way of supporting the cancer patient is superior. Each patient and his doctors have to develop individual relationships based on honesty, trust, and close communication. A continued commitment to the care of the patient with nurturing of hope and realistic goals is necessary, even when all antineoplastic treatment plans have failed. A satisfactory adjustment of the patient, his family, and the physician as he approaches death can be a natural and beneficial outgrowth of the doctor-patient relationship. Although much attention has been recently focused on the problems of the terminal patient, it is also important to realize that even cured cancer patients may need active psychologic support long after successful antineoplastic therapy has been terminated.