Creagan E T
Division of Medical Oncology, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1993 Feb;68(2):161-7. doi: 10.1016/s0025-6196(12)60164-5.
Impressive gains in the survival of some patients with malignant diseases have primarily reflected the availability of multimodality programs for selected pediatric neoplasms and germ cell tumors and for subsets of patients with regional breast cancer, colorectal cancer, and small-cell lung cancer. Most patients with advanced solid tumors, however, will die of their disease. Sophisticated psychosocial investigations of patients with advanced cancer have targeted several areas in which clinicians can positively influence quality of life. Families often "cascade through an avalanche" of emotional upheavals as patients struggle with the sequelae of their illness. After a patient dies, clinicians should be familiar with some generally recognized patterns of behavior that are indicative of a normal mourning process. This knowledge may help clinicians be aware of situations that might necessitate intervention of other professionals, either medical or pastoral. Attention to psychosocial events is an integral part of a comprehensive oncologic program to facilitate patients and families to live in an atmosphere of peace and dignity.
一些恶性疾病患者生存率的显著提高，主要反映了针对特定儿童肿瘤、生殖细胞肿瘤以及局部乳腺癌、结直肠癌和小细胞肺癌患者亚组的多模式治疗方案的可用性。然而，大多数晚期实体瘤患者最终会死于疾病。针对晚期癌症患者的复杂社会心理调查聚焦于几个领域，临床医生可在这些领域对患者的生活质量产生积极影响。当患者与疾病后遗症作斗争时，其家人常常会“在情感剧变的‘雪崩’中随波逐流”。患者去世后，临床医生应熟悉一些普遍认可的行为模式，这些模式表明处于正常的哀悼过程。这些知识可能有助于临床医生意识到可能需要其他专业人员（无论是医学还是神职人员）介入的情况。关注社会心理事件是全面肿瘤治疗方案的一个组成部分，以帮助患者和家人在和平与尊严的氛围中生活。
