Breitbart W, Holland J
Department of Psychiatry Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Semin Oncol. 1988 Feb;15(1):61-9.
The major psychosocial issues in managing the patient with a head and neck tumor are dealing with the emotional reactions to structural and functional deficits, recognizing and treating preexisting personality problems, especially those related to alcohol and tobacco abuse, which frequently complicate their treatment course. These factors influence the rehabilitation process which should begin in the preoperative period with careful attention to psychologic and social assessment and psychiatric evaluation; if an alcoholic history is elicited. Important continuity in rehabilitation can be accomplished by contact with the rehabilitative team members before surgery, preoperative chemotherapy or radiation. Attention to appropriate adaptation to facial prostheses and dealing early with communication disorders requires a specialized staff and a rehabilitative team which can call on a range of skills including a psychiatric consultant. While the ordeal of the head and neck cancer patient is psychologically difficult and challenging, most patients are able, with the proper help, to resume full and productive lives.
对头颈部肿瘤患者进行管理时，主要的心理社会问题包括应对因结构和功能缺陷产生的情绪反应、识别并治疗既有的人格问题，尤其是那些与酗酒和吸烟相关的问题，这些问题常常使治疗过程复杂化。这些因素会影响康复进程，康复进程应在术前阶段就开始，要仔细关注心理和社会评估以及精神科评估；如果发现有酗酒史。术前与康复团队成员取得联系，在手术、术前化疗或放疗之前，就可以实现康复过程中的重要连续性。关注对面部假体的适当适应以及尽早处理沟通障碍，需要专业的工作人员和康复团队，他们可以调用一系列技能，包括精神科顾问。虽然头颈部癌症患者所经历的折磨在心理上是困难且具有挑战性的，但大多数患者在得到适当帮助后，能够重新过上充实而有意义的生活。
