抄録
The problems of 3 oral cancer patients who committed suicide were investigated from a medicosocial standpoints.
The first patient was a 58-year old male with cancer of the tongue (T3NOMO). The tumor responded well to induction chemoradiotherapy and conservative surgery with selective neck dissection was performed. After that, the patient had been free from the tumor, living together with his wife, son and daughter without worrying about financial matters. However, he complained of a severe pain in his neck and shoulder, and he killed himself by hanging in his house 2 years and 9 months after the operation.
The second patient was a 68-year old female with malignant lymphoma (B cell type) in the submandibular node. She received CHOP therapy. Originally, her mental condition was normal, but depressive tendencies became noticeable at the end of the second course and her depression progressed along with negative effects such as oral mucositis and pneumonia. Four months after the initiation of chemotherapy, the patient's mental dystress appeared to improve in parallel with improvement in her physical condition. She wished for a short stay in her home, and we agreed to her request as a trial for permanent discharge. That night, she committed suicide by hanging herself in her home.
The third patient was a 71-year-old female with oral squamous carcinoma which transformed from oral floride papillomatosis, which had been treated with large doses of external irradiation. Due to the irradiation, severe fibrous degeneration of the oral mucosa and submucosal tissues was induced and severe jaw trismus was resulted. Considering the initial therapy, chemotherapy with peplomycin and 5-Fu was performed. Fortunately, the tumor responded well and only limited excision of the remaining tumor was performed. After remission, she was living by herself in a lonely village, relying on national social security. Although she was free of tumor, shd had been suffering dysphagia, and she killed herself by jumping into the Inland Sea 4 years after remission. These cases suggest that the mental condition of cancer patients should be cared for by establishing close human relationships between each patient and the medical staff and by considering the social enviroment of the patient.
