[Subjective attitudes of laryngectomized patients of the cause of the tumor disease. Correlation with psychosocial adjustment and pre- and postoperative alcohol and tobacco consumption].

One or two days before operation 62 male patients with laryngeal or pharyngeal malignancies were questioned about their subjective beliefs concerning the causes of their cancer. Additionally they were asked about their current and past tobacco and alcohol consumption. Six months after the operation 51 of the 62 patients were interviewed about their psychosocial adjustment and their postoperative tobacco and alcohol consumption. Before the operation most of the patients (81%) reported that they already had been thinking about the possible causes of their malignant disease. Four out of five patients were smokers and consumed alcohol daily, at least until disease onset. According to psychiatric criteria more than 50% of the daily alcohol consumers were diagnosed as alcoholics. As was expected, "smoking" was rated as the most important causal factor in tumor etiology. Furthermore, "air pollution", "unhealthy working conditions" and "fate" were rated as important pathogenic factors of the individual cancer. Surprisingly "alcohol" was only rated as an important causal factor by a few patients. The causal factor "smoking" was correlated neither with actual pre- and postoperative smoking behavior, nor with postoperative psychosocial adjustment. "Alcohol" was positively associated with a postoperative reduction of alcohol consumption, on the one hand, and with increased postoperative psychological distress, on the other. Significant positive relationships were also found between "fate" and postoperative psychological distress and rejection of altered voice (e.g. laryngectomy). In conclusion, medical information about the possible causes of cancer should try to focus the attention of the patients on current and future stress factors and not on past risk behavior (e.g. alcohol and tobacco consumption), which cannot be altered retrospectively.(ABSTRACT TRUNCATED AT 250 WORDS)