Problems and coping behaviour of facial cancer patients.

On the basis of an arrangement scheme by Cohen and Lazarus, an investigation has been made into the literature on problems patients experience after having undergone tumour surgery resulting in facial mutilation. Furthermore, the ways in which these patients cope with their problems have been looked at. The greatest problems arise at the interpersonal level, and in particular with intimate (sexual) relationships and with superficial, anonymous contacts. The face is found to be of essential importance in interpersonal relationships. During the first phase of the disease, when all attention is focused on the fact of having cancer, patients especially react with intrapsychic coping mechanisms. Later, after surgery, the problems are mainly concentrated on the inescapable necessity to live with a clearly visible mutilation. At this stage, in order to be able to talk about his experiences, to find recognition; and to adapt his self-image, the patient particularly turns to other people for support. It turned out that the ordering of Cohen and Lazarus' arrangement scheme gives a good outline of the difficulties patients encounter. In addition to this, several psychological theories and concepts offer good explanations for the facts as found.