Tumor patients experience discomfort such as nausea, vomiting, and insomnia during chemotherapy, (╥╯^╰╥) obvious claustrophobia in a closed examination space, {{{(>_<)}}} and strong resistance to examinations such as MRI...
These physiological discomforts and behavioral resistances during tumor diagnosis and treatment often make patients and their families fall into anxiety and helplessness. These manifestations may be the external projection of the patient’s psychological stress response.
Fluctuations in psychological state not only directly affect the patient’s compliance with the treatment plan but also have a far-reaching impact on the treatment effect, quality of life, and long-term prognosis.
Therefore, paying attention to the mental health problems of tumor patients and actively seeking psychological assistance are not only practical needs to alleviate the physical and mental pain of patients but also important guarantees to improve the overall treatment effect and the patient’s life quality.
Tip Case One
Ms. Zhao is a colorectal cancer patient. When she was about to start her third chemotherapy after surgery, she came to see a doctor due to nausea, severe vomiting, and insomnia.
She demonstrated that during the second chemotherapy (from two days before chemotherapy to one week after the end), she continued to experience nausea, vomiting, and loss of appetite, which seriously affected her sleep quality. Although antiemetic drugs such as ondansetron hydrochloride and aprepitant were used, the effect was still unsatisfactory. Therefore, she had a strong stress response to the upcoming third chemotherapy. Besides the symptoms of nausea, vomiting, and general weakness again, she also showed emotional fluctuations such as irritability and crying. The family members, witnessing the patient’s suffering, are consumed by profound emotional torment, but they still hoped that she would adhere to the treatment and never give up.
Zheng Huining, a doctor from the Department of Psychiatry and Psychological Counseling Clinic in Hainan Cancer Hospital, said that Ms. Zhao hadtypical symptoms such as anticipatory nausea and vomiting.
Q: What is anticipatory nausea and vomiting?
Anticipatory nausea and vomiting isa special physiological and psychological reaction caused by conditioned reflex which is formed by previous bad chemotherapy experiences. The cause of anticipatory nausea and vomiting is closely related toconditioned reflex. In other words, severe nausea and vomiting caused by the previous several chemotherapies form a conditioned reflex in the patient’s brain. Generally speaking, the more severe the nausea and vomiting after the previous several chemotherapies, the more likely anticipatory nausea and vomiting are to occur.
Q: What are the causes of anticipatory nausea and vomiting?
Anticipatory nausea and vomiting are often induced by some chemotherapy-related cues, such as hospital environment, smell, chemotherapy drug names, etc. Some patients will feel nauseous when entering the ward environment or smelling the hospital smell, when hearing the name of chemotherapy drugs or seeing the same color as chemotherapy potions. What’s more, seeing the nurse who injected chemotherapy drugs for them last time will even cause nausea and vomiting.
Q: How to treat anticipatory nausea and vomiting?
Severe anticipatory nausea and vomiting can lead to the termination of chemotherapy. Conventional antiemetic drugs have limited effects and need to be assisted by psychiatric drugs or psychological treatment to relieve them. Psychiatric drugs, such as olanzapine, can achieve the antiemetic effect by blocking dopamine receptors. While benzodiazepine drugs, such as lorazepam, have good curative effects on refractory chemotherapy-related vomiting caused by high anxiety level.
Q: In addition to drugs, what other methods can treat anticipatory nausea and vomiting?
In addition to drugs, psychological treatment can also reduce anticipatory nausea and vomiting. One of the highly effective psychological treatment methods is systematic desensitization, which is to find out the stimulating factors that induce anticipatory nausea and vomiting and reduce the patient’s sensitivity to these stimulating factors through step-by-step systematic desensitization treatment, thereby reducing the occurrence of anticipatory nausea and vomiting.
Additionally, there are some behavioral therapy methods that can reduce the frequency or severity of anticipatory nausea and vomiting, such as progressive muscle relaxation training, imagery guidance, and music therapy.
Tip Case Two
Mr. Li, a lung cancer patient, visited the doctor because he was afraid of MRI examination.
He demonstrated that he suddenly felt chest tightness, shortness of breath, and near-death-experience during the MRI examination. He interrupted the examination twice before completing it. Now he is extremely fearful at the thought of re-examination. It is understood that the patient is timid and introverted. When he was a child, he was once locked in the house alone. That’s why he also has similar feelings in closed scenes such as crowded shopping malls and elevators.
It was diagnosed that Mr. Li suffered from typical claustrophobia. Doctor Zheng Huining prescribed quick-acting antianxiety drugs for him and guided him to relieve the symptoms through mindfulness-based stress reduction and abdominal breathing. In view of the fact that growth experience, personality traits, and traumatic memories are the main causes of the disease, Doctor Zheng actively guided Mr. Li to recognize the disease. One week later, Mr. Li said that the symptoms were significantly improved and he could self-regulateduring the follow-up visit.
Q: What is claustrophobia?
Claustrophobia (closed space phobia) is an anxiety disorder about enclosed spaces. Patients may experience unknown fear in some narrow and closed places, such as elevators, carriages, aircraft cabins, as well as during MRI examinations or radiation therapy. Severe cases may even have anxiety and obsessive-compulsive symptoms. Once leaving this environment, the patient’s symptoms will quickly ease.
Q: What are the causes of claustrophobia?
There are many causes of claustrophobia, such as growth experience, personality factors, psychological pressure, etc., but traumatic experiences in childhood are more related to claustrophobia.
Q: What are the manifestations of claustrophobia?
The main symptoms are fear, anxiety, rapid breathing, accelerated heart rate, blushing, and sweating in a closed space. In severe cases, dizziness, suffocation, or near-death-experience may occur.
Q: What are the treatment methods for claustrophobia?
The treatment of claustrophobia includes drug therapy, psychotherapy, and behavioral therapy:
Drug therapy: Certain anxiolytic and antidepressants can effectively improve claustrophobia.
Psychotherapy: Such as cognitive therapy, systematic desensitization, exposure therapy, music therapy, etc.
Behavioral therapy: Such as meditation relaxation training, mindfulness-based stress reduction, biofeedback therapy, etc.
Reminder
During illness or anti-tumor treatment, if you frequently experience physical discomforts such as nausea and vomiting, or exhibit abnormal reactions like intense fear and resistance to enclosed spaces, these are likely warning signs of psychological issues. Please promptly seek help from professional psychiatrists or psychologists. Scientific intervention can alleviate physical and mental stress, facilitating the smooth progress of treatment.
Please select the PsychiatryDepartment when making an appointment(Psychological Counseling Clinic).
On-duty Physician
Zheng Huining
Attending Physician of Psychiatry Department
National Licensed Psychotherapist
Medical Expertise
Dr. Zheng is adept at psychoanalysis, cognitive-behavioral therapy, personal meaning-centered therapy, narrative therapy and other psychotherapies. With rich experience in counseling experience in adolescent emotional problems, parent-child communication, emotion and stress management, tumor disease psychology, etc., she also specializes in diagnosing and treating general psychological problems and severe psychological problems, anxiety disorders, depression, bipolar disorder, sleep disorders, neurosis and other related mental and psychological diseases.
Clinic Time
Full-day on Monday, Tuesday and Wednesday (08:00-12:00 in the morning and 14:00-17:00 in the afternoon), and appointments are required for coming to the clinic on Thursday and Friday.
Clinic Location
Psychological Consultation Clinic in the Third Consulting Area on the Second Floor of the Outpatient Department of Hainan Cancer Hospital
Consultation Telephone
16689797849
Article | Psychological Consultation Clinic