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Cancer as a chronic illness: On managing mental disorders

Boris M. Zaydiner

The diagnosis of delirium should be considered in such patients demonstrating an acute onset of agitation or uncooperative behavior, personality change, impaired cognitive functioning, altered attention span, and fluctuating level of consciousness. Many episodes of delirium are reversible, such reversal is consistent with the goals of care; standard management approach is to search for & treat the delirium’s reversible precipitants. The drug of choice for the treatment is neuroleptic haloperidol.

Dementia is described as a disorder with memory impairment and at least one symptom from another cognitive domain: aphasia, apraxia, agnosia or disturbances in executive functioning. The dementia’s subtypes are Alzheimer’s disease, vascular dementia, dementia with Lewy bodies and fronto-temporal dementia. A definitive diagnosis in physically unwell patients poses challenges and follow-up assessment should be arranged. Among oncological forms of comorbid mental pathology in cancer patients depression predominates.The most common form of depression in cancer patients is an adjustment disorder with depressed mood, sometimes referred to as reactive depression which is under-recognized and undertreated. For the treatment there’re psychosocial & pharmacological interventions.

Cognitive impairments in cancer patients are well documented, their prevalence proved to reach 75%; diagnosis is based on clinical evaluation determining cognitive function.