Survivor guilt in cancer survivorship.

Attributes of survivor guilt are present in the cancer survivorship population, including the presence of distress and loss, identification with a community, and surviving a situation that others have not. Oncology social workers must be aware of feelings and experiences that may be evoked when individuals witness fellow patients suffering and/or dying. In response, survivors may compare their own lives with the lives of those who have died and struggle to justify their existence. Often underlying feelings of guilt can be a sense of overwhelming helplessness, loss of control, grief, mourning, and a deep sense of injustice. This paper will explore the clinical manifestations and therapeutic interventions used to support individuals experiencing survivor guilt through discussion and case examples. The importance of addressing survivor guilt experienced by the clinician and within medical teams will be highlighted and future recommendations for research and program planning in this area will be discussed.

Chronic cancer: counseling the individual.

Advances in medicine significantly improved outcomes for many cancer patients, effectively moving it from an acute disease to a more chronic one. Living with a chronic cancer often prompts an existential search for meaning, as multiple losses impact the individual on a personal and familial level. At the same time, these patients must learn to adapt to the functional and relational changes necessitated by their disease. Two theoretical perspectives, meaning-making and family systems, are useful in understanding the experience of patients with chronic cancer and offering psychosocial interventions aimed at improving overall adjustment.