[Adolescent confronting cancer and its place in the family].
Adolescent medicine is expanding in Europe with particular attention being given to cancer of adolescents and its treatment. At a time where specialised units for adolescents are being born, it is essential to collect the current knowledge on the pathological impact of the illness in this age period whose limits themselves are often blurred (13-21 years or 15-25 years). Adolescence is a transition between childhood and adulthood, during which one seeks psychological and emotional development. Cancer, by its direct repercussion on the adolescent and also by the disorganisation of the family, can involve risks impending the process of maturation and can also be a purveyor of psychological after-affects. The occurrence of the illness can isolate the adolescent and leak to a restriction of the psychological investment. The reality of possible death can hinder the ill adolescent from developing his natural opposition to the adults who represent authority such as parents or nurses, thereby hindering access to autonomy, independence and identity construction. One can find oneself locked in a state of trouble, confusion, becoming a stranger to oneself, with an impression of distance waxing between the young patient and others. The parents find themselves weakening and must make calls on their supporters. The siblings see their daily life becoming more unsettled and find themselves confronted by parents less available and reassuring. The impact on the brothers and sisters vary depending on their age and the capacity of the parent's adaptation. From the onset, adolescents struck by cancer necessitate an adaptation of the medical staff. The medical information, the treatment and the aid-care contracts must be approved by the adolescent himself but the parent's involvement remains essential. It is necessary to create an alliance of three. Conflicts and rivalry occur frequently between parents and the medical staff. One must study the possibility of creating a place adapted to care, with flexible surrounding, respecting the identity of the adolescent while supporting his educational or professional investments and his personal interests revolving around the exterior world. The psychological and social care must be accessible to all the family members. The terms and conditions of this psychological and material support are itemised.
Chavand
Aurélie
A
Inserm U558, Faculté de Médecine, 37, allées Jules-Guesde, 31073 Toulouse Cedex.
Grandjean
Hélène
H
Vignes
Michel
M
D000223:Adaptation, Psychological; D000293:Adolescent; D041923:Adolescent Development; D016497:Adolescent Health Services; D001293:Attitude to Death; D005190:Family / Q000523:psychology*; D006801:Humans; D008016:Life Change Events; D009369:Neoplasms / Q000523:psychology*; D010290:Parents / Q000523:psychology; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D000297:Psychology, Adolescent; D011788:Quality of Life; D035781:Siblings / Q000523:psychology