We investigated the psychological effects of amputation on adolescent patients by interviewing 27 persons who had a limb amputation because of cancer during their adolescence and compared them to data obtained from eight patients with amputations due to trauma at similar ages. In cancer patients, mobility-related activities and social matters including relations with peers and the opposite sex and self-consciousness were of paramount concern. All cancer patients considered themselves functionally independent and 67% had little or no concern for the future. While malignancy and amputation had a significant impact on the patients' lives, the vast majority had a positive view of life and 85% were found to have what we assessed as adequate overall adjustment. Individual variables examined included marital and child-bearing patterns, educational attainments, vocational attainments, perceived parental and peer support, adaptation to prosthesis, and variables relating to general outlook on life and psychological adjustment. Our results suggest that the patients who have had amputations due to malignancy differ from traumatic amputees in their adjustment to amputation, with cancer patients showing, in many instances, evidence of better adaptation to disability. This may in part be due to different backgrounds and social orientation of traumatic amputees. We found the majority of cancer amputees to adjust well to their circumstances and to report leading full and productive lives.

Amputation is often a component in the treatment of bone tumors such as osteogenic sarcoma, which is most prevalent in the adolescent age group. Adaptation to cancer and loss of a limb requires a significant multidimensional effort. To examine the role of social support systems, 27 adolescents who had undergone amputations for cancer were interviewed. Inquiries were made regarding patients' perceived social support providers and the impact of amputation upon their lives and independence. Parents, especially mothers, were perceived as realistic and most helpful at the time of surgery (80%), followed by professional hospital staff (59.3%), and siblings (59.3%). Friends of patients were less helpful, as many reported their friends felt sorry for them (65.4%), avoided them (33.3%), or drifted away (40%). Only 7.4% of the patients had a clear preference to be associated with other amputees. This study details other preferences and difficulties encountered by the adolescent amputees and the role of support systems in their adaptation to their disease and amputation.

There are no known means of preventing breast cancer, and efforts to control the disease must be directed toward early detection and improved treatment. To assist in achieving this, we developed a two-tier educational program aimed at educating women regarding breast cancer facts and the proper performance of breast self-examination (BSE). Educational efforts are first directed at nurses who are then encouraged to transmit this information to women and their partners in the community. The program combines a lecture and demonstration with more informal small group discussions that allow for individual demonstrations of the technique of BSE. Follow-up of both nurse and lay participants by means of telephone interviews has shown that women can be motivated to practice BSE, and be made aware of proper techniques.

Control of cancer through risk reduction and early detection has great potential. Roswell Park Memorial Institute's Prevention-Detection Center addresses a community need for health promotion, disease prevention, and cancer detection as well as providing opportunity for research on the efficacy of such a program. The Prevention-Detection Center offers a range of services including education, genetic counseling, risk assessment, counseling in smoking cessation and other means of risk reduction, and screening for cancer. It is also involved in evaluation of new technologies of cancer detection such as the ultrasonic examination of the breast. A community outreach program is aimed at attracting high-risk populations. In its first eighteen months of operation; the Prevention-Detection Center detected 24 confirmed cancers. The Center is used by approximately 60 persons each week. Interviews with persons using the clinic over a two-week period indicate that most are motivated to attend because a relative has had cancer or because of a belief in the importance of regular checkups. Client satisfaction with the clinic is high. Although many of the activities of the prevention-Detection Center have a research dimension, many of its activities and services are suited to the community ambulatory health care setting.