Illness far from home: psychosocial challenges and coping

Abstract

Introduction: Adaptation to a diagnosis of cancer has aspects common to all patients, regardless of the path each individual takes. In this case, we show how the challenges faced by the patient were shaped by their specific circumstances. Description of the case: A 53-year-old businesswoman from an African country was diagnosed with breast cancer during a visit to Portugal. The patient perceived the disease and its effects negatively. The initial reaction was clearly aversive. She was far from home during treatment and never felt integrated despite the presence of relatives. She experienced economic difficulties, which were aggravated by political turmoil in her country of origin. With time, she came to know the disease better, overcame some challenges, and became adjusted to the changes in her life. Finally she accepted her new circumstances and was able to plan her future constructively. Comment: Geographical distance between home and the place of treatment increases the psychosocial demands of a disease. This case shows the adoption of a variety of coping strategies with assessment and reassessment of the circumstances. Coping has multiple functions, including emotional regulation and management of problems that cause distress. Coping, based on personal resilience, allows for control and resolution of problems or acceptance of circumstances when change is not possible. This case shows how challenges of a disease can be overcome, even in difficult situations. The general practitioner can follow the adaptation of the person to chronic disease and promote function. This involves managing emotions, including modification of the patient’s negative emotions about the disease.