BACKGROUND: The psychological situation of patients undergoing radiotherapy has been investigated in a joint research project of the Department of Medical Psychology and the Department of Radiology of the University Clinic, Hamburg. This project developed interventions to support these patients psychologically. PATIENTS AND METHOD: Between 1990 and 1993 77 patients with final prognosis have been regularly seen by a psychologist during radiotherapy and some of them afterwards in addition. With these patients, medical doctors and relatives 763 contacts have been documented by verbal description and analyzed, aided by a special computer program for qualitative analysis. This paper is concerned with only one topic that has emerged from the material: hope. RESULTS: Patients with final prognosis oscillate between hope and anxiety. Hope goes along with mechanisms of defence like denial and displacement which are adopted to counter anxiety and to protect personal integrity. There is a wide range of carriers of hope, including the doctor in charge and the magic healer as well. Nonstandard alternative therapy is often mediated by an initiative from a relative. The hopes of patients are not only focused on therapy but also on decent human responsiveness to their predicament. CONCLUSIONS: Hope is a basic emotional stand that is of vital importance for many patients, even when facing impending death.
