Treatment-related anxieties in children and adolescents with cancer

Abstract

Side-effects of anti-cancer treatment like nausea and vomiting and frightening medical procedures are relevant sources of anxiety in children and adolescents with cancer. Anticipatory nausea and vomiting can be described in terms of respondent conditioning. Hypnosis, systematic desensitization, relaxation training and employment of video-games are effective in mitigating these unpleasant concomitants of chemotherapy. Venipunctures, bone marrow aspirations, and lumbar punctures are repetitive painful procedures. Responses of pain and anxiety are ubiquitous, but still difficult to differentiate by psychological assessment. Rating scales and checklists have been developed to evaluate various intervention programs. Hypnotherapeutic approaches and comprehensive cognitive-behavioral treatment packages have been employed successfully to reduce anxiety reactions. In the future, it might be promising to match specific intervention programs with the coping behaviors spontaneously shown by the child; for instance, patients avoiding anxiety-provoking stimuli should be supported by additional distraction techniques, whereas vigilant patients that spontaneously focus their attention on these stimuli should be shown how to transform them in a positive context.

Key Words:

• Anxiety
• childhood cancer
• coping
• medical procedures
• side-effects