Delay in specialist consultation in cancer patients.

A psychiatric evaluation of 75 cases of different types of cancer revealed significant psychological morbidity in 81% of cases. The time lag, if any, between primary diagnosis and presentation to oncologists was noted and the reasons for the delay were ascertained. 62% of patients (N = 47) delayed three months or more and this group also showed significantly greater (p < 0.05) psychological morbidity compared to those who delayed less than three months (N = 28). 89% of patients used denial as a mental defence mechanism and there was no significant difference in the degree of denial displayed by both groups. Psychological reasons such as denial of the illness, fear of cancer, fear of its treatment, and domestic difficulty were commonly cited as causes of delay. It is hoped that addressing these issues will reduce delay and help early detection in cancer programmes.

A psychiatric evaluation of referred cancer and medical patients: a comparative study.

We evaluated the psychiatric status of referred cancer patients (N = 39) and referred medical patients at two other institutions (N = 64, N = 62). Depression, anxiety, psychosis, delirium occurred with comparable frequency in both groups. Cancer patients presented with somatic complaints more frequently. However the average number of referrals of cancer patients to the psychiatric service was very low (3/months) compared to referral of medically ill patients (32/month, 10/month). The data suggests that a comparable level of psychological distress exists in cancer patients, and psychiatric referral may help in its early recognition and alleviation.