P his co-workers at this institution has developed certain concepts concerning the emotional impact of cancer and its treatment. 1. T h e experience of having cancer and radical surgery is seen by patients as a special and severe form of stress involving possible mutilation, or death, or both. 2. T h e experience of having cancer cannot be separated from the experience of its cure, be it surgery or radiation therapy. 3. Each class of operation has special problems peculiar to it. I n order to understand the reaction of a patient to cancer surgery, it is necessary to know:
(1) the realistic anatomical and physiological changes attendant upon a particular operation; (2) the patient's private physiological and anatomical beliefs about the function, value, and importance of the organ removed; and (3) the patient's major patterns of adaptation to life that may be disrupted by both the realistic and the irrationally conccived effects of surgery.
Every individual has evolved patterns of adaptation that we define as the characteristic and habitual patterns of behavior that are designed to satisfy personal needs, maintain feelings of safety and security and reconcile