Efeitos biopsicos sociais e psiconeuroimunológicos do câncer sobre o paciente e familiares
DOI:
https://doi.org/10.32635/2176-9745.RBC.1997v43n2.2844Palavras-chave:
Câncer, Psiconeuroimunologia, Estresse, Qualidade de VidaResumo
Durante as duas últimas décadas, têm sido ressaltados os problemas somáticos, psíquicos e sociais de pacientes com câncer, bem como têm sido focalizadas, no âmbito do estudo oncolágico, as teorias hiopsicossociais e psiconeuroimunológicas. O presente trabalho apresenta considerações clínicas sobre esses aspectos, ressaltando-se o impacto que o câncer provoca sobre os pacientes e seus familiares. O câncer e seus tratamentos constituem uma fonte de estresse, capaz de desencadear desordens de ajustamento nestes indivíduos. A mensuração da qualidade de vida deve ser incorporada aos estudos clínicos, porque a sua inclusão tende a melhorar as indicações terapêuticas. Os relatos de pacientes sobre sintomas somáticos são associados, principalmente, às suas preocupações emocionais e sociais mais do que ao seu estado geral de saúde. A equipe responsável pelos pacientes deve compreender a dinâmica envolvida no binômio família-paciente e conhecer a influência que os fatores psicossociais exercem sobre ele. A falha do reconhecimento dessa influência e, conseqüentemente, o prejuízo provocado no suporte psicossocial da família irão privar os pacientes do conforto, amor, suporte e companheirismo de que eles precisarão através do curso da sua doença. Os médicos devem ser capazes de identificar e estimular circunstâncias que facilitem o processo de adaptação de seus pacientes. O tratamento psicológico, em pelo menos alguma extensão, sempre é benéfico.
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Referências
Latchman, D.S.- Transcription-factor mutations and disease. N Engi J Med, 334(1): 28-33, 1996. DOI: https://doi.org/10.1056/NEJM199601043340108
Bernhard, J.; Ganz, P.A. – Psychosocial issues in lung cancer patients (part 1). Chest, 99: 216-23, 1991. DOI: https://doi.org/10.1378/chest.99.1.216
Bovbjerg, D.H. - Psychoneuroimmunology: implications for Oncology? Cancer 67: 828-32, 1991. DOI: https://doi.org/10.1002/1097-0142(19910201)67:3+<828::AID-CNCR2820671413>3.0.CO;2-A
Deitos, F.H.; Gaspary, J.F.P. - Psiconeuroimunologia: Aspectos Biopsicossociais. J Bras Psiquiatria, in press, 1997.
Deitos, F.H.; Gaspary, J.F.P.; Lopes, S.A.; De Lima, G.L.; Staats, CO. – As implicações psiconeuroimunológicas do estresse no desencadeamento de doenças. JBM: in press, 1997.
Deitos, F.H.; Gaspary, J.F.P. – Implicações Clínicas das Teorias Psiconeuroimunológicas. Psiq Biol, 4(3): 127-136, 1996.
Hughes, J.E. - Depressive illness and lung cancer. II: follow-up of inoperable patients. EurJSurg Oncol, 11:21-4, 1985.
Solomon, G.F.; Amkraut, A.A. - Psychoneuroendocrinological effects on the immune response. Ann Rev Microbiol, 35: 155-84, 1981. DOI: https://doi.org/10.1146/annurev.mi.35.100181.001103
Surman, O.S. - Possible immunological effects of psychotropic medication. Psychosoniatics, 34(2): 139-43, 1993. DOI: https://doi.org/10.1016/S0033-3182(93)71904-0
Zonderman, A.B.; Costa, P.T.; McCrae, R.R. - Depression as a risk for câncer morbidity and mortality in a nationaily representative sample. JAMA, 262: 1191- 231, 1988. DOI: https://doi.org/10.1001/jama.1989.03430090053032
Walker, L.G.; Eremin, O. - Psychoneuroimmunology: a new fad or the fifth cancer treatment modality? Ani J Surgery, 170: 2-4, 1995. DOI: https://doi.org/10.1016/S0002-9610(99)80241-4
Paiva, L.; Da Silva, A. – Medicina Psicossomática, Artes Médicas, Porto Alegre (RS), 874, 1994.
Trzepacz, PT.; Levenson, J.L.; Tringali, R.A. - Psychopharmacology and neuropsychiatric syndromes in organ transplantation. Gen Hosp Psychiatry, 13: 223-45, 1991. DOI: https://doi.org/10.1016/0163-8343(91)90124-F
Razavi, D.; Delvaux, N. - The Psychiatrist's Persepctive on Quality of Life and Quality of Care in üncology: concepts, symptom management, communcation issues. Eur J Cancer,31A (Supp1. 6): S25-S29, 1995. DOI: https://doi.org/10.1016/0959-8049(95)00490-A
Kaasa, S. - Using quality of life assessment methods in patients with advanced cancer: a clinical perspective. Eur J Cancer, 31A(Supp1. 6): S 1, 1995. DOI: https://doi.org/10.1016/0959-8049(95)00493-3
Aapro, M.S. - Foreword. Eur J Cancer, 31A(Supp1. 6): Si, 1995. DOI: https://doi.org/10.1016/0959-8049(95)00360-U
Berkman, B.J.; Sampson, S.E. - Psychosocial effects of cancer economics on patients and their families. Cancer, 72: 2846-9, 1993. DOI: https://doi.org/10.1002/1097-0142(19931101)72:9+<2846::AID-CNCR2820721515>3.0.CO;2-3
Bernhard, J.; Ganz, P.A. – Psychosocial issues in lung cancer patients (part 2). Chesr, 99: 480-85, 1991. DOI: https://doi.org/10.1378/chest.99.2.480
Harrison, J.; Maguire, P. - Predictors of psychiatric morbidity in Cancer Patients. Br J Psychiatr 165: 593-598, 1994. DOI: https://doi.org/10.1192/bjp.165.5.593
Kissane, D.W. - Perceptions of family functioning and cancer. Psycho-Oncology, 3: 259-69, 1994. DOI: https://doi.org/10.1002/pon.2960030403
Mello, F.J. - Psicossomática hoje. Ed Artes Médicas, Porto Alegre (RS), 1992.
Trhsburg, R.W.; Van Knippenberg, F.C.; Rijpma, S.E. - Effects of psychological treatment on cancer patients: a critical review. Psychossomatic Med, 54: 489-517, 1992. DOI: https://doi.org/10.1097/00006842-199207000-00011
Derogatis, L.R.; Morrow, G.R.; Fetting, J. et al. - The prevalence of psychiatric disorders among cancer patients. JAMA, 249: 751-757, 1983. DOI: https://doi.org/10.1001/jama.249.6.751
Koller, M.; Kussman, J., Lorenz, W. et al. - Symptom Reporting in Cancer Patients. The role of negative affect and Experienced social stigma. Cancer 77: 983- 95, 1996. DOI: https://doi.org/10.1002/(SICI)1097-0142(19960301)77:5<983::AID-CNCR27>3.0.CO;2-Z
Ahmedzai, S. - Recent Clinical Trials of Pain Control: impact on quality of life. Eur J Cancer, 31A (Supp1. 6): S2-S7, 1995. DOI: https://doi.org/10.1016/0959-8049(95)00496-6
Biack, P.H. - Central Nervous System-Immune System Interactions: Psychoneuroendocrinology of Stress and its immune consequences. Antimicrobial Agents and Chemotheapy, 38(1): 1-6, 1994. DOI: https://doi.org/10.1128/AAC.38.1.1
Faliowfield, L. - Heiping the relatives of patients with cancer. Eur J Cancer, 31A(11): 1731-32, 1995. DOI: https://doi.org/10.1016/0959-8049(95)00471-T
Harrison, J.; Haddad, P.; Maguire, P. – The Impact of Cancer on Key Relatives: a comparison of relative and patient concerns. EurJ Cancer 31A(JI): 1736-40, 1995. DOI: https://doi.org/10.1016/0959-8049(95)00389-Z
Deitos, F.H.; Staats, C.G.; Lima, G.L.; Lopes, 5V.; Antoneilo, F.; Nascimento, L.L.; Gaspary, J.F.P. - Estresse e depressão, alterações neuroendócrinas e conseqüências imunológicas. Inform Psiq, 15(3): 83-89, 1996.
Breyer, J.- The adjustment of siblings of pediatric cancer patients - a sibling and parent perspective. Psycho-üncology, 2:201-208, 1993. DOI: https://doi.org/10.1002/pon.2960020306
Welch, A.S.; Wadsworth, M.E.; Compas, B.E. - Adjustment of chiidren and adolescents to parental cancer - Parents' and Children's perspectives. Cancer 77: 1409-18, 1996. DOI: https://doi.org/10.1002/(SICI)1097-0142(19960401)77:7<1409::AID-CNCR28>3.0.CO;2-4
Ader, R.; Cohen, N.; Felten, D. Psychoneuroimmunology: interactions between the nervous system and the imune system. Lancet, 345: 99-103, 1995. DOI: https://doi.org/10.1016/S0140-6736(95)90066-7
Khansari, D.N.; Murgo, A.J.; Faith, R.E. - Effects of stress on the immune system. Immunol Today 11: 170-5, 1990. DOI: https://doi.org/10.1016/0167-5699(90)90069-L
Ader, R. - On the Clinical relevance of Psychoneuroimmunoiogy. Clin Immunol Immunopathol, 64(1): 6-8, 1992. DOI: https://doi.org/10.1016/0090-1229(92)90051-O
Shea, J.D.; Burton, R.; Girgis, A. - Negative affect, absorption, and immunity. Physiology & Behavior, 53: 449-457, 1993. DOI: https://doi.org/10.1016/0031-9384(93)90138-6
Kiecolt-Glaser, J.K.; Glaser, R. - Psychoneuroimmunology: Can Psychological interventions modulate immunity? J Consulting Clin Psychol, 60(4): 569-75, 1992. DOI: https://doi.org/10.1037/0022-006X.60.4.569
Preger, J.; Gauer, G.C.; Von Mühlen, C.A. - Sistema Neuroendócrino e Atividade Imune no Estresse e Depressão. Psiquiatr Biol, 3(1): 14-25, 1995.
Ader, R.; Feltori, D.; Cohen, H. - Interactions between the brain and the immune system. Annu Rev Pharmacol Toxicol, 30: 561-602, 1990. DOI: https://doi.org/10.1146/annurev.pa.30.040190.003021
Cohen, S. - Psychological stress and susceptibility to upper respiratory infections. A,n J Respir Crít Care Mcd, 152: S53-S58, 1995. DOI: https://doi.org/10.1164/ajrccm/152.4_Pt_2.S53
Waidhauser, F.; Ehrhart, B.; Fiirster, E. - Clinical aspects of the melatonina action: impact of development, aging, and puberty, involvement of melatonin in psychiatric disease and importance of neuroimmunoendocrine interactions. Experientia, 49: 671-681, 1993. DOI: https://doi.org/10.1007/BF01923949
Watkins, A.D. - The role of alternative therapies in the treatment of allergic disease. Clinical and Experimental Allergy, 24: 813-25, 1994. DOI: https://doi.org/10.1111/j.1365-2222.1994.tb01804.x
Reiche, E.M.; Inouye, M.M.; Ponteilo, R. - Visão atual: a psiconeuroimunologia. Semina, 12(2): 91-94, 1991. DOI: https://doi.org/10.5433/1679-0367.1991v12n2p91
Glaser, R.; Kiecolt-Glaser, J. - Stress-associated immune suppression and acquired immune deficiency syndrome (AIDS). Adv Biochein Psychopharmacol, 44: 203-15, 1988.
O'Learly, A. - Stress, Emotion, and Human Immune Function. Psychological Bull, 108(3): 363-382, 1990. DOI: https://doi.org/10.1037/0033-2909.108.3.363
Kiecolt-Glaser, J.K.; Glaser, R. - Psy-choneuroimmunology and health consequences: data and shared mechanisms. Psychosom Mcd, 57(3): 269-74, 1995. DOI: https://doi.org/10.1097/00006842-199505000-00008
Whiteside, T.L.; Herberman, R.B. – The role of natural killer cells in human disease. Clin Jmmunol Immunopathol, 53: 1-23, 1989. DOI: https://doi.org/10.1016/0090-1229(89)90096-2
Brittenden, J.; Heys, S.D.; Ross, J. et al. - Natural Killer Cells and Cancer. Cance, 77: 1226-43, 1996. DOI: https://doi.org/10.1002/(SICI)1097-0142(19960401)77:7<1226::AID-CNCR2>3.0.CO;2-G
Holmes, G.P.; Kaplan, J.E.; Gantz, N.M. et al. - Chronic fatigue syndrome: a working case definition. Ann Int Mcd, 108: 387-89, 1988. DOI: https://doi.org/10.7326/0003-4819-108-3-387
Vollhardt, L.T. - Psychoneuroimmunology: a literature review. Amer J Orthopsychiat, 61(1): 35-47, 1991. DOI: https://doi.org/10.1037/h0079226
Irwin, M.; Lacher, U.; Caldwell, C. - Depression and reduced natural killer cytotoxicity: a longitudinal study of depressed patients and control subjects. Psychological Mcd, 22: 1045-1050, 1992. DOI: https://doi.org/10.1017/S0033291700038617
Lin, C.C.; Kuo, Y.C.; Huang, W.C.; Lin, C.Y - Natural Killer Celi activity in lung cancer patients. Chest, 92: 1022-24, 1987. DOI: https://doi.org/10.1378/chest.92.6.1022
Boyce, W.T.; Jensen, E.W.; Cassel, J.C.; Colher, A.M.; Smith, A.H.; Ramey, C.T. - Influence of live events and Family routines on childhood respiratory tract illness. Pediatrics, 60: 609-15, 1977. DOI: https://doi.org/10.1542/peds.60.4.609
Jacobs, M.A.; Spilken, A.Z.; Norman, M.M.; Anderson, L.S. - Life stress and respiratory illness. Psychosom Mcd, 32: 233-42, 1970. DOI: https://doi.org/10.1097/00006842-197005000-00003
Schindler, B.A. - Stress, affective Disorders, and immune function. Mcd Clin NorthAm, 69(3): 585-597, 1985. DOI: https://doi.org/10.1016/S0025-7125(16)31034-3
Fawzy, F.L.; Fawzy, N.W.; Arndt, LA.; Pasmau, R.O. - Critical review of psychosocial interventions in cancer care. Arch Gcn Psychiatr,4 52: 100-113, 1995. DOI: https://doi.org/10.1001/archpsyc.1995.03950140018003
Goldberg, R.J. - Diagnostic dilemas presented by patients with anxiety and depression. AmJMcd, 98: 278-284, 1995. DOI: https://doi.org/10.1016/S0002-9343(99)80375-1
Siegel, K.; Yates, J.W. – Psychosocial barriers to employment of the cancer survivor. J Psychosoc Oncology, 5: 97-109, 1988. DOI: https://doi.org/10.1300/J077v05n04_08
Fawzy, F.L.; Kemeny, M.E.; Fawzy, N.W. et al. -A structured psychiatric intervention for cancer patients. II. Changes over time in immunological mensures. Arch Gcn Psychiatr 47: 729-735, 1990. DOI: https://doi.org/10.1001/archpsyc.1990.01810200037005
Fawzy, F.L.; Fawzy, N.W.; Hyun, C.S. et al. - Malignant melanoma: effects of na early estructured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later. Arch Gen Psychiatry, 50: 681-689, 1993. DOI: https://doi.org/10.1001/archpsyc.1993.01820210015002
Molin, C.; Arrigo, C. - Clinical Triais and Quality of Life Assessment: the nurses's viewpont. Eur J Cancer 31A(Supp1. 6): S8-S10, 1995. DOI: https://doi.org/10.1016/0959-8049(95)00495-5
Cohen, S.R.; Mount, B.M.; Tomas, J.N.; Mount, L.F. - Existencial WeI1-Being is an important determinat of quality of life. Evidence from the McGi11 quality of life questionnaire. Cance, 77: 576-86, 1996. DOI: https://doi.org/10.1002/(SICI)1097-0142(19960201)77:3<576::AID-CNCR22>3.0.CO;2-0
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