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Extra resources for Clinical Practice Guidelines for the Psychosocial Care of Adults with Cancer

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323 In the spiritual domain, the basic human need for transcendence,‘to step back and move beyond what is’, may manifest as a search for meaning in the illness. 1). 337 Those who offer informal care also appear vulnerable. 6 S U RV I VA L I S S U E S Medicine has traditionally focused on the diagnosis and management of illness, or its prevention. Earlier detection and improved treatments are now leading to increasing proportions of patients surviving cancer. The precise emotional needs of patients who are cured have been less clearly defined.

197 There is a paucity of literature relating to cancer types other than breast cancer. Where only one leg is affected, loss of balance is also a problem. 239 For some patients, in addition to the physical limitations it poses, lymphoedema may be highly visible of one’s status as a ‘cancer patient’ and a constant reminder of the diagnosis. 242 Disfigurement Despite improvements in cosmetic results, disfigurement is still an issue for many people with cancer. Thickened or keloid scars may also be disfiguring, regardless of where they are located on the body.

181 A number of risk factors for PTSD have been identified in cancer patient. 178,180 Among patients with colorectal cancer, the reported rate of PTSD is twice as high in women as in men. 183 Traumatic symptomatology may persist long-term. In women with breast cancer, traumatic symptomatology does not appear to diminish with time. 186 These include nausea and vomiting,187 acute and chronic pain,188-190 fatigue,191,192 lymphoedema,193-197 disfigurement,109,111,198 odour,199,200 incontinence,201 cognitive problems,202-204 difficulties in communication,205 swallowing difficulties,205 respiratory symptoms,203,206 loss of appetite and nutritional deficiencies,207,208 and fertility problems,209-211 as well as a decline in general health.

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