A Case of Patient with Advanced Tongue Cancer and Depression who Became Operable by Treatment with ECT

Abstract

A woman in her seventies with a history of depression and who also had progressive tongue cancer developed depression again during chemotherapy and radiotherapy. She refused to undergo an operation because of psychiatric symptoms such as suicidal tendencies and rejection although she was administered psychiatric pharmacotherapy such as sertraline and clomipramine. Because electroconvulsive therapy (ECT) was administered for her psychiatric symptoms, she dramatically improved and decided to have the operation. Therefore, the refusal of the operation was thought to be a decision-making disturbance due to depression. This case indicates the possibility of a cancer patient making a normal judgment via treatment with ECT when the patient is affected by drug-resistant depression and has a decision-making disturbance. Further, during a course of treatment, the psychiatrist in attendance expressed impatience and discomfort with this critical situation because psychiatric treatment was involved in the life progress of the cancer. The negative feelings of the psychiatrist may be "counter transference" in the broad sense of the term. Therefore, it is important for psychiatrists to appropriately manage their own feelings with progressive cancer patients.