Psychologic Problems in the Management of Adolescents with Malignancy: Experiences with 182 Patients

Having a malignant disease and having to undergo long-term therapy is an additional stress to the normal physiologic and psychosocial stresses inherent in the adolescent's maturation. Such patients present complex problems in management. These problems are not the same as those encountered by the pediatrician when dealing with an infant or child who is too young to understand the meaning of malignancy or who has not yet developed a concept of self as it relates to death. Nor are these the same problems as those the internist meets when he treats adults who may have lived a full life or have developed effective ways of adjusting to the psychologic stress of having cancer. Though sufficiently mature to appreciate the implications of his diagnosis and prognosis, the adolescent has not yet completed the personality integration or fully evolved the adult defense mechanisms which might enable him to adjust successfully to the knowledge of his illness.