Nonfinite losses
I am a cancer research nurse working in gastrointestinal and head/neck cancers. This entry focuses on head/neck cancer patients and their issues with disfigurement as a nonfinite loss.
Cancer in general is difficult, and survivors are not immune to tactless responses to their suffering. One group of cancer patients who experience this quite a bit are head and neck cancer patients, as their cancers can leave them disfigured. Despite this, people will tell them that disfigurement is a luxury when the other choice is death, ignoring the toxicity of treatment mentally, physically, and financially. When these patients are treated, they are often left with very visible scars and other evidence of the often-razed earth approach of radiation, chemotherapy, and surgery. Even with treatment, only a little over half of patients are alive after five years.
Disturbance of appearance can affect people mentally and emotionally. They don’t recognize themselves in the mirror or are unable to hear their voice anymore, and this is distressing. They deal with somatic symptoms, depression, lower overall health, and the inability to adjust psychosocially. Their quality of life is profoundly affected.
Grief does not have to include a death – it includes nondeath losses as well. These can have severe effects on patients’ mental, physical, and emotional states just as deaths do. This can be considered nonfinite loss, or loss that is continuous and ongoing, prevents normal developmental expectations, and leads to a feeling of loss of self. There is chronic sorrow involved.
Survivors of head and neck cancer should feel validated in their loss. Encouraging reintegration of body image is vitally important for mental and emotional functioning. Early intervention is very important, and cognitive behavioral therapy is a good option for this population. They must avoid social isolation as well. Lastly, they must be supported as they worry about possible recurrence, particularly if they do recur and look toward end of life.
