Psychological Effect of the pancréatectomy: a Feeling of Strangeness
Psychological Effect of the pancréatectomy: a Feeling of Strangeness
The cancer of the pancreas represents 1,8 % of cancers in France, with 9040 new cases in 2011
 (France). This cancer is known to be of dark forecast. Indeed, of late clinical expression,
 is diagnosed most of the time at a late stage . For that reason, the cancer of the pancreas
 is considered as the one who presents the least good prognosis for survival. He affects more
 frequently the men than the women (rate of incidence of 7,7 against 4,7 cases for 100 000).
 Between 1980 and 2005, the incidence increased by 3,8 % at the women, by 2,0 % at the men
 (INCA Source, on 2012). The number of cases of cancer of the pancreas in the world is
 estimated at 278 684, with 266 669 deaths a year (Cancer Incidence and Mortality Worldwide -
 Globocan, on 2008).

 In these cases of very grave cancers, the surgery represents the unique treatment to curative
 aim, although always not warning of a risk of relapse, and susceptible of entrainer to
 complications. Thus the pancréatectomy establishes a modality of specific treatment.
 Remaining the ultimate chance of cure, it is only rarely possible. Indeed, only 10 in 20 % of
 the cancers of the pancreas exocrines can be handled by surgery when the latter establish 95
 % of the cases of pancreatic cancer.

 To date, the psychosomatic approach goes away from the search for the causes to be interested
 more and more in the psychological consequences of the somatic disorders, what we wish to
 study in the present search.

 Once the surgical indication was put, one of the key elements in the psychological plan is
 the uncertainty as for the outcome of the ablation, as well as the consequences
 psychopathologiques which ensue from it. The mutilation of an organ, whatever it is, can have
 an impact on the identity of the person constituting at the same time a physical and
 narcissistic wound, while having psychological effect at the sick person such as of the
 anxiety, a depression, or another a state of post-traumatic stress.

 More exactly, a study was able to show a positive relation between cancer of the pancreas and
 depression in a retrospective study. A review of literature concerning the specific relations
 between depression and cancer of the pancreas was also realized. Besides, 50 % of the
 patients have a significant level of anxiety and 15 % of depression. A study was nevertheless
 able to bring to light that the depression does not affect the survival of the patient.
 Finally, a study was also able to find a decrease marked with the quality of life of the
 patients during the next first 6 months the operation.

 Various studies so studied the quality of life of the patients reached of a cancer of the
 pancreas in particular in comment surgery. It is also advisable to specify that besides the
 depression and the quality of life, the strategies of adaptation of the patients having
 undergone a pancréatectomy were also the object of studies. However, none documented, to
 date, the specific psychological consequences described clinically by certain patients, in
 particular the feeling of confusion and strangeness felt, and it in association with the
 possible presence of a state of post-traumatic stress in several weeks of the operation.
The objective of this exploratory research is to identify and to describe the psychological
 specificities of the pancréatectomy which can in particular include the feeling of
 strangeness and confusion at the sick person towards its own body.

 It will also be a question of estimating the relations of this experience with a possible
 state of post-traumatic stress. Indeed, the announcement of the cancer as well as the surgery
 in itself are two elements which can be considered as traumatic.

 For it a double methodology will be used, with a design cross-sectionnal: a quantitative
 shutter(sector) (auto-questionnaires) allowing to study aspects of the psychosocial
 functioning, and qualitative shutter with a semi-structured interview concerning the
 subjective experience of the participants. For the interpretation of the meditative data of
 the conversations, we shall use the phenomenological interpretative analysis ( IPA) which
 will allow us to investigate in a comprehensive way the subjective experience of the
 participants by studying the way the people give meaning to the fact that they live.
Inclusion Criteria:

 -  Patient of at least 18 years, presenting a good understanding and a practice of the
 French language,

 -  Having undergone a pancreatectomy (pancreatic cancer),

 -  Signed Consent of participation,

 -  Affiliating to a national social security or beneficiary of such regimen

 Exclusion Criteria:

 -  Other medical or psychiatric affection,

 -  Level of incompatible cognitive efficiency with the answer to auto-questionnaires,

 -  Patient in emergency situation, major person being the object of a legal protective
 measure (major under guardianship, guardianship or protection(saving) of justice), or
 outside state to express its consent.