Surviving adult cancers. Part 2: Psychosocial implications.
PURPOSE: To address the psychosocial implications of surviving adult cancers by a comprehensive review of the literature. DATA IDENTIFICATION: An English-language literature search using MEDLINE (1970 to 1988). Index Medicus (1970 to 1988), and bibliographic reviews of textbooks and review articles. STUDY SELECTION: Of 103 originally identified articles, 58 that specifically addressed the stated purpose were selected. DATA EXTRACTION: Four authors reviewed and critiqued the literature extrapolating the major themes on this topic. RESULTS OF DATA SYNTHESIS: There is little information on the many psychosocial variables that affect an adult's long-term cancer survival trajectory. Collation of data identified the following significant psychosocial themes: fear of recurrence and death, relationships with the health care team, adjustment to physical compromise, alterations in customary social support, isolationism, psychosocial reorientation, and employment and insurance problems. CONCLUSIONS: The continuation of a rehabilitation effort begun around the initial diagnosis of cancer would be instrumental in providing post-therapy evaluation and guidance needed by adult long-term survivors of cancer. Education, research, and support interventions need to be mobilized for this population of adults with a history of cancer.