Despite many advances in the palliation and management of the symptoms of advanced cancer, the assessment and management of psychological and psychiatric symptoms are still poor.
A common misapprehension is to assume that depression and anxiety represent understandable reactions to incurable illness. When cure is not possible, the analytical approach we adopt to physical and psychological signs and symptoms is often forgotten. This error of approach and the lack of diagnostic importance given to major and minor symptoms of depression result in underdiagnosis and undertreatment of psychiatric disorder.
Psychological adjustment reactions after diagnosis or relapse often include fear, sadness, perplexity, and anger. These usually resolve within a few weeks with the help of the patient's own personal resources, family support, and professional care. However, 10-20% of patients will develop formal psychiatric disorders that require specific evaluation and management in addition to general support.
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