1. SURVIVING CANCER

2. IMPACT 0f cancer on : Psychological functioning – quality of life Role of psychological variables in cancer risk & survival

3. Goals GOAL of psycho-oncology is an attempt to influence the course of illness in cancer patients PSYCHOLOGICAL status & immune system effects on illnesses…. Cancer, hypertension, diabetes, asthma…. Poor control, poorer outcome

4. Studies on cancer patients 18 months longer survival of metastatic breast cancer female patients receiving weekly group psycotherapy Malignant melanoma pts on group therapy- –lower recurrance rates –lower mortality rates. –large granular lymph & natural killer cells (NK), increased NK cell activity suggesting increased immune response Higher NK cell activity & lymphocyte mitogen response in female breast cancer pts receiving rlaxation/biofeedback

5. Reasons Newer cancer treatment protocols results in now often to a frquently chronic and often curable disease Therefore the psychiatric aspects, both in the diagnostic and managment phase are becoming more & more important as 5 yr survival rate is increasing

6. THE FACTS More than 50% of all cancer pts have diagnosable psychiatric Disorders : adjustment disorder 60% adjustment disorder 60% MDD 20% MDD 20% delirium 8% delirium 8% (Most common diagnoses)

7. CAUSES Mostly related to the knowledge of having cancer Other causes : drugs known to cause depression.. Antiparkisonian, antihypertensive drugs known to cause depression.. Antiparkisonian, antihypertensive tumor effects..hormone secreting, CNS tumors tumor effects..hormone secreting, CNS tumors others..uremia, encephalitis, electrolyte imbalance others..uremia, encephalitis, electrolyte imbalance

8. MY THREE STAGES On being diagnosed - fear of death, disfigurement, disability - fear of death, disfigurement, disability - abandonement, loss of independece - abandonement, loss of independece - role functioning, financial standing - role functioning, financial standing

9. Others The treatment process : -side effects of therapies -side effects of therapies -physical & psychological -physical & psychologicalRemission/incurablity -quality of life -quality of life

10. Suicidal risk assessment

11. CARE OF THE CAREGIVERS Concept of family exhaustion Care available for schizophrenia, drug dependence..al anon