Psychological Trends and Adaption Towards Social Environment of the Patients with the End-stage of Cencer Who Can Stand Superior to Life or Death(Care of the Dying)

Abstract

In patients who are sentenced to have cancers in general, the period of 'shock' primarily appears and then comes the period of 'denial', in which patients dare to deny the presence of cancer. Subsequently, the period of 'agony' with anger and depression, the period of 'acceptance' in which patients accept the presence of cancer, and death in peace and dignity follow them. Medical doctors have to know and keep in mind such psychological transitions of the patients.We studied the psychological trends and adaptation towards social environment of the patients, who knew themselves to have cancer, with spontaneous regression of cancer (SRC) and those with the end-stage of cancer who showed long survival.We could collect 45 cases of SRC according to the definition by Everson and Cole, with the aid of several universities and their related hospitals. The SRC cases are mainly composed of digestive tract and respiratory tract cancers and metastasis was identified in 73% of them; histologically adenocarcinoma and squamous cell carcinoma were frequently observed. Cancer patients in general are emotionally repressed, overly adaptive, conservative and adherent to social customs. In other words, despite their sharp temperament, they make good social adjustment; though they look warm on the surface, they are unable to express what they actually are, thus completely unadaptive in their inner life. However, psychological evaluation in the patients who show SRC revealed that after they know they have cancer, their conditions take a favorite turn when an existential shift takes place and they overcome fear and anxiety of cancer and live a meaningful life afterwards. They also show active adaptation towards social environment. It appears that the way which stands superior to life or death and recovery of a life worthwhile to live may lead a profitable host reaction. These tendencies were observed not only in SRC cases but also in cancer patients with long survival. In management of such patients with the end-stage of cancer, doctors should keep in mind that it is necessary to cure and care the patients both from physical and psychological aspect.