Psychological Adjustment in the Context of Perinatal Cancer

Aims: To assess the influence of pregnancy and recent motherhood on the psychological adjustment to cancer in women diagnosed with a perinatal cancer. Procedure: ECHOCALG is an exploratory and comparative study combining quantitative and qualitative methods. Twenty-four women who had received a perinatal cancer diagnosis (75% had breast cancer, 25% had brain or colon cancer, Hodgkin or melanoma) completed the MAC44 scale and responded to a semi-structured clinical interview to identify the psychological adjustment to cancer. Eighteen of them responded to a semi-structured interview to identify the conditions of psychological adaptation to the disease, as well as the defense mechanisms used. The data were compared with that of a control group of nineteen women diagnosed with non-perinatal and non-metastatic breast cancer, aged less than 45. Results: Women diagnosed with perinatal cancer showed more difficulty adjusting to the disease than control women. Denial and avoidance are strongly correlated with a negative adjustment to cancer. The interviews showed at the start of treatment the presence of defense mechanisms such as denial and trivialization as well as a suspension of the process of psychological adaptation to the disease and the treatments. The distress of a mother is linked to the feeling of being unable to take care of the baby and to cope concomitantly with motherhood and illness, as well as difficulties related to sexuality and emotional and social support. Conclusion: Pregnancy and recent motherhood have an impact on the adjustment to cancer. Women with perinatal cancer show a negative adjustment and an important psychological distress linked to difficulties of mothering and physical and emotional consequences of treatment.