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Psychosocial Aspects of Breast Cancer Treatment

Psychosocial Aspects of Breast Cancer Treatment

Breast Cancer – Past and Present

Breast cancer is the second most common cancer in women. A few years back, the mortality rate was very high due to this disease. Now even though mortality is declining, the diagnosis still poses a huge threat for the affected woman and her close family. 

Breast cancer surgery, which often includes reconstructive procedures, can help restore a satisfactory body image. The decision on the type of surgery should always be made together with the patient and should focus on her psychosocial needs. This article describes the psychological aspects of breast cancer for the patient and her social environment and offers ideas for a patient-oriented treatment plan.

In the past 50 years, breast cancer has been transformed from a disease in which all women were treated with a radical and disfiguring surgical procedure that amputated the breast. Now, for the majority of women, it is usually managed with only minimal removal of breast tissue and sampling of a few axillary nodes. 

During this same period of time, women with breast cancer have become increasingly involved in treatment decision-making, and have made it clear that they have a need for attention to the psychological and social aspects of their care, in addition to the targeted treatment of their tumours.

Making treatment decisions

It’s important to discuss all of your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. It’s also very important to ask questions if there’s anything you’re not sure about. 

If time permits, it is often a good idea to seek a second opinion. A second opinion can give you more information and help you feel more confident about the treatment plan you choose.

Considering complementary and alternative methods

You may hear about alternative or complementary methods that your doctor hasn’t mentioned to treat your cancer or relieve symptoms. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few.

Complementary methods refer to treatments that are used along with your regular medical care. Alternative treatments are used instead of a doctor’s medical treatment. Although some of these methods might be helpful in relieving symptoms or helping you feel better, many have not been proven to work. 

Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision. 

Who Is at Risk for Psychosocial Distress?

Psychosocial distress ranges from cancer-specific concerns, such as fear of cancer recurrence, to more generalised symptoms such as worry, trouble sleeping, fatigue, and being anxious about going to the doctor. The literature on the psychosocial aspects of breast cancer suggests that the vast majority of women adjust well to the diagnosis of breast cancer and manage to endure the complex and sometimes toxic treatments associated with primary treatment and later recurrence.

Factors That Put Women at Higher Risk for Psychosocial Distress

A number of risk factors have been identified that are associated with psychosocial distress. The specific type of breast cancer surgery, and whether a woman is receiving chemotherapy or radiation therapy does not seem to influence the level of distress. In fact, women with noninvasive breast cancer have similar concerns about recurrence as women with invasive disease.

What makes each of these patient characteristics a risk factor for psychosocial distress after breast cancer?

  • For younger women Breast Cancer causes more psychosocial distress because they don’t expect it to happen. Also it may affect their relationship with their partner and their motherhood or future motherhood.
  • It is not surprising that a woman who is already having ongoing depression or psychological distress prior to the cancer diagnosis may not be able to take this additional burden of this life-threatening disease.
  • Social support for women with breast cancer includes instrumental support, such as transportation to appointments, preparation of meals, and help with activities of daily living, as well as emotional support, meaning the availability of someone to share one’s fears, feelings, and concerns. Inadequate levels of either of these two forms of social support can increase the likelihood of psychosocial distress. 

Conclusion

In studies that have examined quality of life and depression after breast cancer, most patients and survivors demonstrate high levels of functioning in the early and later years after primary treatment, for those who remain disease-free.Even for women with a recurrence of breast cancer, psychological well-­being is often maintained.

Fortunately, most women manage their psychosocial distress relatively well, using personally available support systems (spouse, family, friends, clergy) as well as some professional resources that are accessible within many clinical settings (nurses, social workers, community resources, and support groups). However, women uniformly report that they appreciate the attention and support from their health-care team, and referral to appropriate resources as necessary. Most women will not anticipate the common side effects and complications of breast cancer treatment, so that professional guidance and more intensive support as appropriate will be of great help for them.

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