Week3:endocrine

tumors

Done By: Reem Alyahya

212522156

complain

• 35 years old women

• Fatigue, wt increase, HT, stria, brusing

diagnosis

• Cushing’s syndrome

• Laparoscopic adrenalectomy

• Family history

3 years later

• Lump in her breast, malignant

• Lumpectomy, chemotherapy, hormone therapy

Introduction

Objectives:

• The psychology of grieving process

• Is it relevant in this case?

Why is it important?

• Cancer has far-reaching consequences for the patient and their family.

• Not only the disease itself, but also the various tests and examination, treatments and also hospital admission. It all represent a heavy physical, mental and social burden.

• At the cognitive level, the effects manifest themselves in the form of uncertainty and accompanying strong desire for information.

• Emotionally, the patient experiences anxiety and a feeling of hopelessness, perhaps accompanied by grief, anger and loneliness.

Although these are normal, healthy reactions, the grieving process can

become pathological

Psychology of grieving

Grieving

• Grief can be described as the intense emotional and physical reaction that an individual experiences following catastrophic personal loss.

• The Kübler-Ross model, or the five stages of grief, is a series of emotional stages experienced when faced with impending death or death of someone.

• The five stages are: denial, anger, bargaining, depression and acceptance.

Grieving

• kübler-Ross originally developed this model based on her observations of people suffering from terminal illness.

• She later expanded her theory to apply to any form of catastrophic personal loss, such as the death of a loved one,  drug addiction, the onset of a disease (and even minor losses).

Grieving stages

1- Denial 

The person is trying to shut out the reality or magnitude of his/her situation, and begins to develop a false, preferable reality.

Grieving stages

2-Anger

 Once in the second stage, the individual recognizes that denial cannot continue. Because of anger, the person is very difficult to care for due to misplaced feelings of rage and envy.

• The person can be angry with himself, or with others.

• "Why me? It's not fair!"; "Why would God let this happen?"

Grieving stages

3- Bargaining  

The third stage involves the hope that the individual can somehow undo or

avoid a cause of grief. The patient can become lost in a maze of "If only..." statements, blaming himself for this

situation. It rarely provides a sustainable solution, especially if it is a

matter of life or death.

Grieving stages

4- Depression

During the fourth stage, the grieving person begins to understand the certainty of death.  the idea of living becomes pointless. Things begin to

lose their importance. Because of this, the individual may become silent, refuse visitors and

spend much of the time crying.

• "I'm so sad, why bother with anything?"; "I'm going to die soon so what's the point?"

Grieving stages

5- Acceptance

In this last stage, individuals begin to come to terms with tragic event. This stage varies

according to the person's situation. This typically comes with a calm, retrospective

view for the individual, and a stable mindset.

it is important to note that not everyone will go through all of these stages. also, they might not happen in order. Some people have described a “roller coaster effect,” with lots of wild swings between stages.

Is it relevant in this case?

•Yes, it is.

Why?

• After someone has been diagnosed with cancer, current or anticipated losses such as control over daily living, health, and even life itself can contribute to grieving.

• In our case, the patient have been through 2 painful experiences with tumor management, investigations, hospital admission.

So,

Recurrent experience of tumors.

Two major surgeries (laparoscopic adrenalectomy , breast lumpectomy)

Chemotherapy and radiation and its side effects.

Family history of adrenal adenoma.

All of theses factors can contribute to cause grieving, and it should be taken into account when dealing and taking care of any cancer patient.

Conclusion

Cancer has far-reaching

consequences that represent a heavy physical,

mental and social burden.

Grief is an intense emotional and physical

reaction that an individual experiences following catastrophic

personal loss.

The five stages of The Kübler-Ross

model are: denial, anger,

bargaining, depression and acceptance.

Our patient had many factors that could contribute to

cause grieving, and it should be taken into

account when dealing with her

References

• Oncologie voor de algemene praktijk.

• Grief – Stages of dealing with your cancer diagnosis, cancerclenick.com

• Australian psychological society