Psychosocial responses to oral and maxillofacial surgery for head and neck cancer.

This study involved extensive interviews with 28 patients who had disfiguring oral and maxillofacial surgery for head and neck cancer. The patients, ages 42 to 76 years, had all been informed of their diagnosis and were in 2- to 5-year postoperative follow-up. Findings pertain to how patients deal with the interpersonal and social ramifications of diagnosis and surgical treatment. Fatalism, delays in help-seeking, responses to diagnosis, postsurgical anxiety, and adjustment were reported. Reassurance prior to surgery was sometimes found to limit understanding of postoperative impairment. Oral and maxillofacial surgeons were seen in heroic or imposing roles that impacted on their capacity to be supportive to patients coping with life change and "handicap." The patient treatment decisions were found to be determined by attitudes about death, which motivated patients and surgeons to make difficult or extreme choices. Suffering, social changes, and postoperative uncertainty were patient concerns. Patient strategies for adjusting to disfiguration are examined, and specific recommendations for the oral and maxillofacial surgeon are made.