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Lynne Eldridge MD

Lung Cancer - A Little Denial Might Be Just What the Doctor Ordered

By May 11, 2009

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”Aunt Sally says her husband Jim just doesn’t get it. He has stage 4 lung cancer and he's pretending he isn’t sick. He needs to get out of the denial stage.” It might be that Aunt Sally that needs an attitude adjustment – not her husband.

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We know that denial is common after a diagnosis of lung cancer, but until now we haven’t really understood its effect on treatment. We often think of denial as something that needs to be worked through – a stage – and something that is unhealthy. Despite the negative connotations of the word “denial” it appears that a reasonable degree of denial may help people adapt to lung cancer, and actually improve their overall health.

A new study looked at denial and its relationship to physical outcomes in those with lung cancer. Moderate or increasing levels of denial were consistently related to better outcomes when contrasted with low levels of denial. The patients with the most denial functioned better physically, and were less bothered by fatigue, nausea and vomiting, loss of appetite, difficulty swallowing (dysphagia), and pain in the arms and shoulder.

Certainly a level of denial that would result in skipping lung cancer treatments would not be beneficial. Even though Jim’s lung cancer is not curable at this stage, treatment can improve survival and lessen the symptoms of cancer. But a moderate amount of denial may be just what the doctor ordered.

The author’s conclusion - that health care professionals need to respect denial as a way in which lung cancer survivors can adapt to their disease – is a good reminder to all of us that have not lived with lung cancer. Unless we have walked a mile in those shoes, we might not know the best way to walk the path.

Photo: istockphoto.com

Sources:

Vos, M. et al. Denial and physical outcomes in lung cancer patients, a longitudinal study. Lung Cancer. 2009 May 5. (Epub ahead of print).

Vox, M. et al. Denial in lung cancer patients: a longitudinal study. Psychooncology. 2008. 17(12):1163-71.

Vox, M. and J. deHaes. Denial in cancer patients, an explorative review. Psychooncology. 2007. 16(1):12-25.

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