Psychological problems may arise in connection with oncomedical treatments in three ways: 1. acute and/or 2. chronic ways, as well as 3. co-morbid psychiatric diseases that already exist must also be taken into account. Immunotherapies have the most common and also clinically relevant psychological side effects. Fatigue, anhedonia, social isolation, psychomotor slowness is reported during treatment. Anti-CTLA-4 antibody (ipilimumab) immunotherapy can present one of the most modern opportunities for adequate treatment for patients having distant metastasis or unresectable tumour. In relation to immunotherapies, acute psychological side effects (acute stress) emerging during treatments develop in a way that can mostly be linked to environmental factors, e.g. notification of diagnosis, hospitalisation, progression, deterioration in quality of life, imminent dates of control. Crisis is a temporary and threatening condition that endangers psychological balance. In such conditions, enhanced psychological vulnerability must be taken into account and doctors play a key role in the rapid recognition of the condition. Chronic psychological problems, which may arise from the depressogenic effect of the applied treatment or originated from a pre-melanoma psychiatric condition, may exceed the diagnostic and psychotherapeutic competences of a clinical psychologist. Even in case of a well-defined depressogenic biological mechanism such as the activation of the pro-inflammatory cytokine pathway, positive environmental effects can reduce symptoms and thus increase compliance. Side effects can be treated successfully using psychotherapeutic methods and/or psychiatric medicines. The application of routinely used complex psychosocial screening packages can provide the easiest method to identify worsening psychological condition during immunotherapy and give rapid feedback to the oncologist and the patient. Team work is of particular importance in a situation like this as it requires complex, interdisciplinary and high-level professional collaboration. Multidisciplinarity is the basic framework for modern tumour therapy where, under the guidance of oncologists, the work of specialist nurses, social workers, physiotherapists, dieticians and last but not least psychiatrists/psychologists are indispensable and play a significant role.
A melanoma malignum korszerû kezelésében az immunterápiás modalitások a betegség különbözõ stádiumaiban egyre jelentõsebb szerepet kapnak. Mind a betegség okozta környezeti tényezõk okán többnyire akutan megjelenõ szorongás, mind a biológiai hátterû pszichoneuroimmunológiai hatásmechanizmusokon keresztül eszkalálódó depresszió az elhúzódó orvosi kezelések során az életminõség jelentõs romlását és emiatt sokszor a terápiahûség elvesztését eredményezik. A kezelések pszichológiai mellékhatásai megfelelõ körültekintéssel történõ pszichoszociális szûréssel, team-munkában végzett együttmûködés által idõben és adekvát módon megelõzhetõk, a medikális kezelések során pedig jól kézben tarthatók és kezelhetõk.