Psychiatric and Psychosocial Aspects of Neurooncology

Abstract

Neurologic cancers, including metastases to the central nervous system (CNS), are devastating forms of cancer and their incidence is increasing in the United States. The psychiatric and psychosocial impacts of CNS cancer and its treatment are unique, primarily because of their direct effect on the brain and thus on the mind, personality, memory, and concept of self. Patients can undergo dramatic changes in mood, cognitive integrity, and ability to function independently. The impact of these changes affects not only the patient but also the spouse, family, hospital staff, and other caregivers who are called on to provide an exhausting level of care. All caregivers are called on to provide basic nursing care, control the patient's emotional outbursts, and grieve the loss of the patient's independence and personality. This article describes the psychiatric, and psychosocial impacts of neurooncologic illness and its treatment on patients, families, and staff. It also describes psychotherapeutic interventions for patients and group interventions for spouses and hospital staff.