The cancer patient with borderline personality disorder: Suggestions for symptom-focused management in the medical setting

Medically ill cancer patients with borderline personality disorder (BPD) fa ce formidable emotional challenges as they cope with cancer diagnosis and t reatment. The anxiety and discomfort associated with medical treatment can lead them to have difficulties with medical caregivers, distort reality for emotional protection, or exhibit outright aggression and self-destructiven ess. Co-morbid substance abuse or a history of physical or sexual trauma ma y further complicate cancer treatment. These patients may be in particular need of symptom-focused psychotherapeutic management, which must include co mprehensive assessment and treatment of psychiatric symptoms, measures to l imit aggression and self-destructiveness, and staff education and support. These interventions can reduce patients' distress and maximize cancer treat ment outcomes. Copyright (C) 2000 John Wiley & Sons, Ltd.