Adjustment or psychosocial adaptation to cancer has been defined [1,2,3,4,5] as an ongoing process in which the individual patient tries to manage emotional distress, solve specific cancer-related problems, and gain mastery or control over cancer-related life events. Adjustment to cancer is not a unitary, single event but rather a series of ongoing coping responses to the multiple tasks associated with living with cancer. Patients are faced with multiple challenges that vary with the clinical course of the disease. Common periods of crisis and significant challenge include the following:
Palliative care helps relieve symptoms that bother the patient and helps improve the patient's quality of life.
The goal of palliative care is to improve the quality of life of patients who have a serious or life-threatening disease. Palliative care is meant to prevent or treat symptoms, side effects, and psychological, social, and spiritual problems caused by a disease or its treatment.
Palliative care for patients with advanced cancer includes nutrition therapy (see the Treatment of Symptoms...
Normal or successful adjustment is indicated in patients who are able to minimize disruptions to life roles, regulate emotional distress, and remain actively involved in aspects of life that continue to hold meaning and importance.
Coping refers to the specific thoughts and behaviors a person uses in his or her efforts to adjust. Coping style refers to the most common, more frequent, and longer-term style of coping that an individual tends to use across a variety of life situations. One's coping style is often closely related to one's overall disposition and personality (e.g., optimism, pessimism, introversion, extroversion).
Coping strategies refer to those less frequently used and more situation-specific coping efforts, such as readjusting one's daily routine or work schedule to adjust to the side effects of cancer treatment. Coping strategies are engaged in an effort to adjust. Although there are many successful coping strategies, three broad categories have been noted:[2,8,9,10]
Problem-focused strategies help patients manage specific problems by directly trying to alter problem situations. Emotion-focused strategies help a person regulate his or her degree of emotional distress, and meaning-focused strategies help patients understand why this has happened and what impact cancer will have on their life. In general, persons who adjust well typically remain committed and actively engaged in the process of coping with cancer and continue to find meaning and importance in their lives. Conversely, persons who do not adjust well often become disengaged, withdraw, and feel hopeless. Thus, assessing the degree of engagement versus giving up may be a way to distinguish between successful and unsuccessful adjustment.
For example, in a correlational study of adolescent cancer patients and their parents, engagement coping by the adolescent (including cognitive restructuring, seeking social support, expressing emotions, and problem solving) was associated with lower levels of distress. Conversely, disengagement coping by parents (including problem avoidance, wishful thinking, social withdrawal, and self-criticism) was associated with increased distress.