Psychological preparation of the patient and family

Psychological preparation is crucial, for it will contribute importantly to the patient's and family's ability to adapt to a diagnosis of urologic cancer and to manage the stresses of treatment. Psychological preparation is an intrinsic component of early doctor-patient interactions, whether or not the physician and patient perceive it as such. Guidelines for the pivotal discussion concerning diagnosis and treatment plan are provided. The results of a survey of psychosocial adaptation among 39 patients treated for seminomatous testicular cancer and 39 controls are presented. Patients were found to exhibit typical or average emotional status. They were significantly more satisfied than controls with spouse/partner relationships. Despite important sexual and reproductive limitations reported by others, patients treated for testicular cancer adapt well, and most attain average or better degrees of satisfaction with interpersonal and sexual relationships. Newly diagnosed patients, beginning their adjustment to what often appears to be an overwhelming set of problems and potential limitations, should benefit from the knowledge that psychosocial adaptation is an eventual reality. Physicians' management of early discussions, as well as their openness to ongoing communication, contribute importantly to the perspective that will guide patients and families through this process.