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Guidance Counselor Examination information: the psychological problems of cance
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First, the development of cancer in the psychological and social factors (A) personality factors and cancer Since ancient times, some people took note of cancer and personality. As early as the second century AD, Galen on the observed depression than women who cheerful easy to get breast cancer. Many studies in the future the psychological characteristics of cancer patients referred to a "slow response, do not show emotion, feeling more distant from their parents"; "Smoking increases depression easy to get lung cancer"; "anger is often difficult to breast cancer patients who were self-made suppressed ";" loneliness, helplessness and despair and other emotions in the grief of leukemia and Hodgkin's disease can develop. " Mainly the digestive tract of the malignant tumor, gastric cancer is most common. According to 1980 data, gastric cancer mortality accounted for 23.03% of total mortality, recent studies have shown that dietary factors and mental factors (psychosocial factors) is a risk factor for gastric cancer. According to a national comprehensive survey of gastric cancer epidemiology group (1981) pointed out that closely related to gastric cancer of social and psychological factors: ① character traits: social introversion, depression, not flexibility; ② life events: adolescence or early trauma. Zhang Wei, Guo Yanrong (1986) with self-scale epidemiological study of tumor measured, depression and inflexible personality in the incidence of gastric cancer has some significance (as compared with healthy control group), but with other cancer control group There was no significant difference compared to illustrate psychological and social factors in cancer of universal significance. Beijing city survey showed that "good sulk," various types of risk factors for gastric cancer ranks first. (B) life events and cancer Miller (1977) in a review that: ① in more than 200 articles related to personality, mood, stress on cancer in the literature, conclusions are positive, the connection between; ② clinical experience shows that those who believe their cancer diagnosis, often poor prognosis, and the diagnosis of skeptics often better; ③ Some clinical long-term survival (15 to 20 years) after the sudden relapse, recurrence of the reasons are in the first 6 to 18 months suffer from emotional stress ; ④ tragedy of breast cancer and can not be resolved on; ⑤ of 1,400 for the spouse survey of cancer incidence, cancer or died of cancer in a spouse's psychological stress can cause cancer in the other (of course, should also be considered "common environment" factors involved). Comparison of blood chemistry and the relationship between psychological variables showed that blood chemistry can provide information on recent disease, and psychological variables related to the prognosis of cancer (Achterberg, etc., 1977). Sisters of breast cancer was higher than other women (other parts of the cancer was no significant difference), consistent with single women, married women, breast cancer was higher than in fact. The age of 40-year-old sister played, the incidence of breast cancer even more than the single control group. Sisters of breast cancer incidence is earlier than the control group. During the 45 to 49 years in a "mutation" of the increase, compared with gastrointestinal cancer, "Mutation" as early as 5 years. Different disease groups was similar in personality, as a general factor (G factor); In addition, there is a defined location and type of cancer-specific psychological factors that God will, called specificity factor (S factor). The results show that the S factor for breast cancer patients: ① less or no children; ② hostility and are difficult to vent anger containment; ③ orthodox religion or social provisions; ④ hesitant; ⑤ early life is characterized by the loss of childhood, parents cool image or because the parents leaving less protection of childhood and love, so often in a mood of depression and despair. Again with the Social Adjustment Scale for comparison, before the onset of cancer patients within one year experience higher rates of major life events. In the psychological treatment group, 72% of cancer patients to eight months before the onset of the period are subject to the impact of the deaths of close relatives, while other reasons for the psychological treatment (control group) only 10%. For cancer incidence and relationship of psychosocial factors have major difficulties in the interpretation of this is due to experimental design methodology and the diversity caused by the other, depression and cancer are closely related to the emotional state, whether it is before the causative disease factors or the physical and psychological reactions after cancer, or both, we need evidence. Second, the psychological mechanism of carcinogenic Psychological and social factors to promote cancer occurrence and development is clearly achieved by means of psychological physiology, this approach is psychological - neuro - endocrine - immune axis. Large number of experiments show that shock, trauma, malignant stimulation, repeated and concentrated conditioned reflex experiments of the nervous system can cause excessive or general stress and promote "spontaneous" tumor growth. Or use the central cortical inhibitory drugs (such as pentobarbital sodium) may promote tumor development and the transplanted animals die prematurely; and small doses of caffeine and significant delays or disabilities would prefer to block tumors. Destruction of the hypothalamic paraventricular nucleus and dorsomedial nucleus to the thyroid gland adenoids degradation; destruction of transplanted dorsal hypothalamic tumor can prolong survival; band anterior hypothalamic damage can lead to lower antibody titers and inhibition of allergic reactions or delay. These experimental data suggest that the hypothalamus in the mediation of psychosocial factors on the impact of the tumor plays an important role, between the hypothalamus and the immune response may be through the autonomic nervous system and neuroendocrine effects of other common processes. Relevant information, including: 1. Inner anger (anger-in) accompanied by increased secretion of adrenaline; explicit anger (anger-out) with the increase in norepinephrine (Funkenstein, etc., 1957). 2. Different types of stress can cause blood and urine in the apparent specificity of hormone changes, stress can cause the majority of 17 - hydroxy corticosteroids, catecholamines, thyroid hormone and growth hormone increase (Mason, 1968,1972.) . 3. Family bereavement (parents, spouse), the defense should fail Erzhi depression, there are 17 - hydroxy corticosteroids increase or reduce the number of T cells. Increased cortisol levels in breast cancer patients with poor prognosis; respond better or flexible person, cortisol levels low, and the prognosis is good (Stenback, etc., 1965; Katz, etc., 1969). 4. Neuroendocrine system is mainly concentrated in the hypothalamic arcuate nucleus and the medullary solitary tract nucleus of the opioid - melanin - cortisol system (opiomelanocortin, the ACTH / endorphin), and is widely distributed in the central nervous system ACTH releasing factor (CRF) neurons in nuclei. These two systems are the product of the feedback effect of the immune response to the target tissue (Joseph, etc., 1985; Blalock and Smith, 1985) Psychological and social factors start of the neuroendocrine system and immune system loop, thus affecting the occurrence and development of cancer (see Figure 5-2). Third, the psychological response to cancer treatment Drugs, radiation or surgery side effects that accompany cancer can often constitute a temporary or lasting psychological impact. Treatment of the patient's reaction depends on the body of stress and the impact on the complex interactions between self-esteem. Chemotherapy and radiotherapy induced nausea and vomiting is a temporary side effects, usually disappear within 24 to 48 hours. However, the duration of the reaction is very serious and individual differences. If the patient's anxiety can enhance or extend the reaction; in expectations or reminiscence therapy can also cause nausea, vomiting are often the patients adhere to treatment adherence (compliance) are the main reasons. Alopecia is also a lot of side effects caused by chemotherapy drugs, often to continue throughout the treatment period. Although many patients wear a wig can solve the problem. However, the fact that hair loss would upset the patient whom, but also harm the patient "denial" coping mechanisms of cancer. Results of surgery are permanent changes. Or amputation involving facial, visceral ostomy, such as organ removal can constitute a psychological trauma. It was found that maladaptive after mastectomy were about 20%, patients received cosmetic breast after reduction of depression after surgery, more confident (грасименко, 1979) breast cancer patients after about 1 / 3 more than moderate anxiety and depression need psychological help, also, colon cancer surgery or amputation due to disfigurement or loss of functionality at the expense of self-esteem.