The cancer patient with borderline personality disorder: suggestions for symptom-focused management in the medical setting.

Medically ill cancer patients with borderline personality disorder (BPD) face formidable emotional challenges as they cope with cancer diagnosis and treatment. The anxiety and discomfort associated with medical treatment can lead them to have difficulties with medical caregivers, distort reality for emotional protection, or exhibit outright aggression and self-destructiveness. Co-morbid substance abuse or a history of physical or sexual trauma may further complicate cancer treatment. These patients may be in particular need of symptom-focused psychotherapeutic management, which must include comprehensive assessment and treatment of psychiatric symptoms, measures to limit aggression and self-destructiveness, and staff education and support. These interventions can reduce patients' distress and maximize cancer treatment outcomes. Copyright 2000 John Wiley & Sons, Ltd.