title: Extensive basal cell carcinoma of the face: an extreme case of denial.
abstract: Patients with head and neck cancer are particularly susceptible to using denial as a coping mechanism. While some forms of denial may help patients achieve better levels of physical functioning, persistent denial can serve as a major barrier to treatment. We report a case of extreme denial by a 60-year-old woman with an extensive basal cell carcinoma of the face that had been neglected for more than 20 years. We present this case to raise awareness of the potential danger of denial, and we discuss strategies that physicians can undertake to properly manage patients who engage in it. Since the diagnosis and treatment of head and neck cancer can result in profound psychological trauma, gaining an appreciation for how patients cope with it is an important part of the comprehensive care of head and neck oncology patients.
authors.affiliation: Department of Head and Neck Surgery, Ronald Reagan UCLA Medical Center, 10833 LeConte Ave., Room 62-132 CHS, Los Angeles, CA 90095, USA. soroush.zaghi@gmail.com.
authors.forename: Soroush
authors.initials: S
authors.lastname: Zaghi
authors.forename: Pedram
authors.initials: P
authors.lastname: Ghasri
authors.forename: Paul
authors.initials: P
authors.lastname: Busse
authors.forename: John
authors.initials: J
authors.lastname: Clark
authors.forename: Kevin
authors.initials: K
authors.lastname: Emerick
mesh_terms: D000223:Adaptation, Psychological; D002280:Basal Cell Carcinoma / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D003717:Denial, Psychological; D005153:Facial Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D012535:Scalp; D012878:Skin Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D016312:Treatment Refusal