Colloque et conférence du Dr Delépine : Long term quality of life and psychological recovery process of patients with primary bone tumors.

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Long term quality of life and psychological recovery process of patients with primary bone tumors.



Review of literature


Quality of life includes several aspects, beyond the improvement of health meaning decreasing of symptoms, this concept concerns psychological and social aspects.
About children and young adolescents it supposes that once they become adult they have family, social and professional life.

So treatment allows, in a close future, recovery, but it's necessary to think about future in quality of life terms.

Rehabilitation / Reinsertion


Strategies for adapting to life after cancer must be thinking during the treatments with rehabilation and adaptation of the prosthesis for improving physical handicap.

Indeed, to feel cured, somatic recovery is not enough.
This rehabilitation concerns social future and professional which mark the inscription into the community underlining well-being and a positive self-esteem.

Medical supervision : the paradox of recovery


A medical supervision intervenes within the context of prevention of subsequent complications.
It confirms the vulnerability of recovery concept in oncology. The medical supervision takes part in reinsurance process, it relieves survivors, meaning that everything is well.

The survivor can have ambiguous feeling toward this supervision which recalls his fragility and his recovery.

Psychopathology and recovery : the Damocles syndrome


Recovery can produced a feeling to living under a sword.
Fear of recurrence, anxiety, and doubt make a state of apprehension dubbed Damocles syndrome.

This syndrome can express one self by the feeling under the death sentence, limiting recovery.
It can be gone with the passion for life or an hyperactivity.

Psychopathology and recovery : the Lazarus syndrome


It concerns the change from the ill state to the survivor state.
It's at the same time the feeling of being died and the anticipatory grief engaging by family members.

A patient recovery from cancer is treating by his family like a heroe.
The survivor accesses to a new birth.
However, anticipatory grief produces effects on relationships.

Our study


We interviewed 27 persons aged between 21 to 36 years old in complete remission.

Summury of results : feeling of recovery
feeling of recovery


Sentimental life
Sentimental life


Activity
Activity


To rebuild his life


The passage of time favors the feeling of recovery :
- Distance with the hospital world
- Distance with the lethal risk
- Distance with the pain

The different states


Decompensation (collapse of defenses goes with the end of treatments) is binding to the disorientation.
The advanced maturation forms a gap which reveals the consciousness of what matters in life.
First, the survivor must reduce the extraordinary dimension of lived experience.
Levelling : this is the wish to merge with the others.
First, patient recovery from cancer feel good in the hospital world but this state must be gone beyound by the desire to get off his ill identity in order to integrate others environments.

The independence process :
It fills a gap in their lives.
That is noticeable by a will of control.
Independence process come up in the acting.

Pacification process :
To accept is not to resign ourselves.
The acceptance leads to the satisfaction, the well-being and the peace.
Feeling of recovery : this is a dynamic and progressive process which is getting in interaction with various aspect of the individual touched, this concerns a reappropriation of oneself and a progressive detachment from ill identity without denying it.

The dynamic of recovery reveals that cancer experience is a clinic metamorphosis including transformation for going beyond the trauma of the disease.

To be in a dead end


Cancer's experience appears like a pending clinic, generating anxiety.
Future seems threatened this feeling can be pathological.
The loss of influence can be lived like a trauma because it's a party of submission.
The loss of control for a while of life have repercussions on various components of well-being as self-esteem.

Conclusion


The feeling of recovery means quality of rehabilitation.
Having a couple life, a family life, a professional activity signed the well-being.
A positive self-esteem sustains this well-being.

All these concepts are interlinked and help to understand the elaboration of feeling of recovery.
They underscore that follows from interaction and introspection revealing a personal work.




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