Most children cope with the emotions related to cancer and not only adjust well, but show positive emotional growth and development. A small number of children, however, develop psychological problems including depression, anxiety, sleeping problems, relationship problems, and are uncooperative about treatment. A mental health specialist should treat these children.
Children with severe late effects of cancer have more symptoms of depression. Anxiety usually occurs in younger patients, while depression is more common in older children. Most cancer survivors are generally able to adapt and adjust successfully to cancer and its treatment; however, a small number of cancer survivors have difficulty adjusting.
Patients with unresectable extrahepatic bile duct cancer have cancer that cannot be completely removed by the surgeon. These patients represent the majority of cases of bile duct cancer. Often a proximal bile duct cancer invades directly into the adjacent liver or into the hepatic artery or portal vein. Portal hypertension may result. Spread to distant parts of the body is uncommon, though transperitoneal and hematogenous hepatic metastases do occur with bile duct cancers of all sites. Invasion...
The term depression refers to a symptom or a set of symptoms or conditions that occur together and suggest the presence of depression, or an illness. A diagnosis of depression as an illness depends on how severe the symptoms are and how long they last. For example, a child may be sad in response to trauma, and the sadness usually lasts a short time. Depression, however, is marked by a response that lasts a long time, and is associated with sleeplessness, irritability, changes in eating habits, and problems at school and with friends. Depression should be considered whenever any behavior problem continues. Depression does not refer to temporary moments of sadness, but rather to a disorder that affects development and interferes with the child's progress.
Some signs of depression in the school-aged child include the following:
Fear of death.
Feelings of sadness or hopelessness.
Refusing to go to school.
Showing anger towards parents and teachers.
Loss of interest in activities that were previously enjoyed.
Some of these signs can occur in response to normal developmental stages; therefore, it is important to determine whether they are related to depression or a developmental stage.
Determining a diagnosis of depression includes evaluating the child's family situation, as well as his or her level of emotional maturity and ability to cope with illness and treatment; the child's age and state of development; and the child's self esteem and prior experience with illness.
A comprehensive assessment for childhood depression is necessary for effective diagnosis and treatment. Evaluation of the child and family situation focuses on the child's health history; observations of the behavior of the child by parents, teachers, or healthcare workers; interviews with the child; and use of psychological tests.
Childhood depression and adult depression are different illnesses due to the developmental issues involved in childhood. The following criteria may also be used for diagnosing depression in children:
A sad mood (and a sad facial expression in children younger than 6) with at least 4 of the following signs or symptoms present every day for a period of at least 2 weeks:
Either not sleeping or sleeping too much.
Being either too active or not active enough.
Loss of interest or pleasure in usual activities.
Signs of not caring about anything (in children younger than 6).