[Anxiety and coping with anxiety in patients with head and neck cancers]

In addition to their oncological symptoms, 82% of head and neck cancer patients showed anxiety. A high level of anxiety was found in 14% of the patients before surgery and 16% of the patients after surgery. In order to achieve a comprehensive treatment, it is very important to have some basic knowledge of conditions causing anxiety, reaction to anxiety, coping with anxiety, and anxiety-reinforcing conditions. In a longitudinal study of 50 men undergoing surgery for head and neck carcinoma, the subjective level of anxiety before and after surgery and the coping strategies were evaluated by a valid and reliable psychological method. The coping strategies "giving up" and "intake of medication, alcohol and nicotine" were positively correlated with higher levels of anxiety and anxiety reinforcement. The objective level of threat of surgery, such as the extent of impairment imposed by the operation or the individual prognosis, was not correlated with the subjective level of anxiety. It is possible for even minor diagnostic procedures to induce high anxiety. Talking to the patient about the outcome of investigations and the treatment is not enough to reduce anxiety. It is necessary to enhance the patient's feeling of personal control through continual contact with the doctor. A therapeutic approach for anxiety intervention which can be used by the physician is recommended. This intervention strengthens the level of the individual's self-control and reduces his anxiety-reinforcing behaviour, such as compulsive thinking, alcohol and nicotine use and social withdrawal.