Five questions for assessing psychological problems in pediatric patients cured of neoplastic disease

Pediatric patients who have been cured of cancer may have particular unexpressed needs and psychopathological consequences. The authors describe their experience with an apparently well-adjusted 20-year-old girl previously cured of rhabdomyosarcoma, who developed severe psychological distress with serious difficulty in controlling her emotions due to defense mechanisms and massive rationalization. The trauma of tumor and its treatment can be associated with psychopathological disorders that may significantly affect the future life of a person cured of cancer. Doctors must learn to notice telltale signs and take the time to investigate the patient's social life and identify any psychopathological disorders. Experience drawn from pediatric oncology might suggest an approach based on a physician-patient relationship that could provide the means for identifying patients' psychological needs and problems.