Psychosocial Management of Patients with Cutaneous Cancers. A Preliminary Report

Abstract

Based on 50 interviews with patients attending the New York University Skin and Cancer Clinic for cutaneous malignancies, an impression was gained of the psychosocial impact of cutaneous cancer upon those afflicted. On the basis of this impression, guidelines for physicians in psychological management of such patients are offered.

Psychosocial factors in sunbathing and sunscreen use.

“…Anecdotal accounts indicate that it is difficult for some people to stop sunbathing even after they have had lesions removed. Freidenbergs (1981) found denial, depression, and other negative psychological processes in people who have had skin cancer. It would be interesting to see whether the same psychological factors that contribute to sunbathing behavior are relevant to how a person copes with skin cancer.…”

Delayed treatment and continued growth of nonmelanoma skin cancer

“…Early diagnosis and treatment will usually result in cure and in markedly reduced functional loss and disfigurement. Further research is likely to improve understanding of delayed presentation for NMSC [26][27][28] and melanoma skin cancer. [29][30][31][32][33][34][35][36][37] Summary and conclusions Delayed treatment of NMSC may result in tumor enlargement, functional loss, and the need for larger excisions that may impact cosmetic and motor function.…”

“…[26][27][28] In this cohort, younger patients, patients with a skin cancer history, patients with major life problems, and those with a family history of any cancer waited longer for diagnosis and treatment of their skin cancers. Most prominent among the underlying reasons for delay appeared to be the patients' psychologic unwillingness to accept the need for care (ie, denial) rather than physical impediments such as difficulty in scheduling or major concurrent life or health problems.…”

A Psychosocial Assessment of Patients with Basal Cell Carcinoma

“…BCCs occur most frequently on the face, which has important social and esthetic values. In a study of cutaneous cancer patients, Frie‐denbergs 16 tells of a 68‐year‐old widow who, when told that her nose would have to be removed in an attempt to cure her BCC, stated that she would rather commit suicide than tolerate such extensive facial disfigurement. Taylor et al, 3 in their study on breast cancer patients, found that the effect of the type of surgery on adjustment appeared to be mediated more by a sense of disfigurement than by prognosis or disability produced by radical surgeries.…”