the presentation highlight the concept of psychology and grieving process of cancer patient. case-based approach

1. Week3:
endocrine tumors

2. 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

3. Objectives:
• The psychology of grieving process
• Is it relevant in this case?

4. 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.

5. • 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.

6. Although these are normal,
healthy reactions, the grieving
process can become
pathological

7. Psychology of grieving

8. 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.

9. 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).

10. 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.

11. 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?"

12. 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.

13. 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?"

14. 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.

15. 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.

16. Is it relevant in this case?
•Yes, it is.

17. 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.

18. So,
 Recurrent experience of tumors.
 Two major surgeries (laparoscopic
adrenalectomy , breast lumpectomy)
 Chemotherapy and radiation and its side
effects.
 Family history of adrenal adenoma.

19. 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.

20. 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

21. References
• Oncologie voor de algemene praktijk.
• Grief – Stages of dealing with your cancer
diagnosis, cancerclenick.com
• Australian psychological society