Denial in Cancer Patients

Abstract

Denial is a basic mechanism for coping with stressful themes, common in healthy and sick individuals. This article deals with the role and functions of denial in cancer, reviewing empirical studies about the effects of denial on cancer prevention, screening, undergoing tests for early detection, delay in seeking medical attention and getting treatment, complying with medical instructions, and coping with the disease in different stages. Special sections are devoted to the possible role of denial as a risk factor for cancer, the effects of denial on disease course and survival, and the relation of denial to immunocompetence. Major conclusions are that denial may have a positive effect when applied in the first phase of coping, after diagnosis, because it reduces anxiety. This holds also for the terminal stage. The negative effects of denial are that it may interfere with getting treatment (e.g., delay in going to the doctor, not showing up for follow-ups, noncompliance), may disrupt the process of assimilating the stressful event, may affect adversely interpersonal relations, and constitutes a cumulative stressor depressing even immunocompetence. The use of denial varies with the severity of the situation, the patient's personality, and his or her familial and cultural background. A large body of research examined the hypothesis that a tendency toward denial could be one of the risk factors for cancer. Despite evidence supporting the occurrence of denial as a correlate of cancer, a lot of research is necessary to clarify the role of denial in general and of anger specifically as a factor affecting the occurrence of cancer and the course of disease and survival.

Understanding Barriers to Malaysian Women with Breast Cancer Seeking Help

“…Denial also results in disruption of the assimilation process with reality. The usage of denial as a coping mechanism depends upon the severity of the situation, individual personalities and family and cultural background (Kreitler, 1999). Some of the respondents in this study did not believe that they had breast cancer and needed time to accept diagnosis and treatment.…”

The six emotional stages of organizational change

“…First, Kübler-Ross (1969) indicates that sometimes the five stages of grief can be superimposed, and individuals can experience more than one stage at a time. Second, Dueñas et al (2010) related anxiety, one of the elements that can appear during denial (Kreitler, 1999), with anger. Because both stages always appeared concurrently in our participants, they were combined into a single emotional stage, termed denial and anger.…”

El significado psicológico de las cinco fases del duelo propuestas por Kübler-Ross mediante las redes semánticas naturales

“…Por lo tanto, la propuesta final de la escala de fases del duelo tras la modificación de su redacción desde la valoración y las sugerencias de los expertos, quedó conformada por 66 ítems, 15 ítems para la fase de negación (1,6,15,20,25,30,35,40, 45, 50, 55, 60, 62, 64 y 66), 12 ítems para la fase de ira (2,7,11,16,21,26,31,36,41,46, 51 y 56), 12 ítems para la fase pacto o negociación (3,8,12,17,22,27,32,37,42, 47, 52 y 57), 12 ítems para la fase depresión (4, 9, 13, 18, 23, 28, 33, 38, 43, 48, 53 y 58), y 15 ítems para la fase de aceptación de la enfermedad (5,10,14,19,24,29,34,39,44,49,54,59, 61, 63 y 65) (véase Anexo 1).…”

“…Asimismo, varios investigadores señalan que la negación es una estrategia adaptativa para proteger a la persona de eventos, pensamientos, sentimientos o de información dolorosa o amenazante (5,29) , permitiéndole un mayor tiempo para procesar la situación, lo cual disminuye la ansiedad (30) . No obstante, también se encontraron definidoras que hacen énfasis en una negación desadaptativa, la cual se manifiesta en el retraso de la búsqueda de tratamiento médico, en la falta de adherencia al tratamiento y en la ausencia de obtención de información sobre la enfermedad.…”