Cancer, Stress, and Death

When I delivered the keynote address at our joint 1977 symposium on Cancer, Stress, and Death in Montreal, I took great pride in announcing my unique qualification for this singular honor-I had survived a normally fatal cancer, a histiocytic reticulosarcoma that had developed under the skin of my thigh several years pre­ viously. Faced with the physical and emotional realities of this situa­ tion, I refused to retreat from life in desperation. I immediately underwent surgery and cobalt therapy, but insisted on knowing my chances for a lasting recovery, which at that time seemed far from encouraging. Although I knew it would take tremendous self-discipline, I was determined to continue living and working without worrying about the outcome. I suppressed any thoughts of my ostensibly imminent death, but rewrote my will, including in it several suggestions for the continuation of my work by my colleagues. Having taken care of that business, I promptly forced myself to disregard the whole calamity. I immersed myself in my work-and I survived! But, of course, this was not my only reason for my feelings of pride and accomplishment.

Introduction: Stress as a Cause of Disease.- 1. Stress, Cancer, and the Mind.- 2. The Possible Effects of Emotional Stress on Cancer Mediated through the Immune System.- 3. Stress, Hormone Responses, and Cancer.- 4. The Biological Axis of Senescence, Stress, and Aging as Construct for Cancer, Disease, and Death.- 5. Advanced Malignant Disease and the Person Under Stress.- 6. The Homeostatic Significance of the Death-Life Cycle Dynamics in Mental Functions.- 7. The Cancer Patient as Educator and Counselor.- 8. Anticipatory Grief, Stress, and the Surrogate Griever.- 9. Bereavement: Including Some Iatrogenic Aspects of Grief.- 10. Physical Deterioriation in Patients with Advanced Cancer.- 11. Summary Comments.- 12. Telling the Truth to the Dying Patient.- 13. The Use of Group Meetings with Cancer Patients and Their Families.- 14. Stress, Cancer, Death—A Pediatric Perspective.- 15. Rural Cancer Death.- 16. Discussion.- 17. Stress and Cancer: A Disease of Adaptation?.- 18. Death Not the Mysterium Tremendum: A Summary Overview.- Recommended Reading.