social effects of breast cancer

Breast Cancer Res Treat 56:45-57, 1999. Address correspondence to Karen Kayser, Boston College, Graduate School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467; e-mail: kayserk@bc.edu. [45-47], Common Psychosocial Issues in Women With Breast Cancer. 40. Stanton AL, Ganz PA, Kwan L, et al: Outcomes from the Moving Beyond Cancer psychoeducational, randomized, controlled trial with breast cancer patients. Cross-sectional and prospective studies show a positive association between perceived social support and psychological adjustment following cancer treatment. Wolmark N, Fisher B: Adjuvant chemotherapy in stage-II breast cancer: An overview of the NSABP clinical trials. To this end, I review what we have learned about the psychological and social aspects of breast cancer during Dr. Abeloff’s distinguished career, and how leaders such as he have promoted the integration of psychosocial services into the standard care of oncology patients through their words and their actions. 36. Reconstruction was often delayed for several years after initial treatment, requiring a second surgical procedure. Abeloff MD, Beveridge RA, Donehower RC, et al: Sixteen-week dose-intense chemotherapy in the adjuvant treatment of breast cancer. This may be particularly important in patients with advanced breast cancer. Is there a difference in psychological adjustment or quality of life in the year after surgery? Social support can also take the form of support groups or therapists.3 It is important for these caregivers to listen to the unique needs and concerns of their loved one. 31. Breast cancer can also spread to the brain. They include experts in survivorship, social work, rehabilitation, alternative medicine, nutrition and other specialties. J Natl Cancer Inst 94:39-49, 2002. If genetic testing reveals a BRCA gene mutation, you might experience a range of responses to learning your test results, including: 1. • Comorbid Conditions-Several studies have indicated that women with comorbid conditions or impaired performance status report higher levels of psychological distress after a breast cancer diagnosis. Understanding the Psychological Effects of Breast Cancer. N Engl J Med 326:1147-1149, 1992. It also costs us the people we love. 42. 25. For women with some of the increased risk factors for psychological distress described earlier, adaptation and coping may be more challenging, and professional counseling may be indicated. ); KAN (L.) Source SOCIAL SCIENCE AND MEDICINE, Vol 33, N° 2, 1991, pages 177-183, 28 réf. Body image: Cancer survivors who have experienced amputations, disfigurement or a major change in physical function can suffer from a lack of self-esteem. 26. Find information and resources for current and returning patients. 8. Table 3 lists some of the most common psychosocial concerns reported by women with breast cancer. [13-16] This culminated in the widespread use of high-dose chemotherapy with autologous bone marrow or stem cell transplantation, which was ultimately found to be ineffective as well as highly toxic.[17]. Langer AS: Side effects, quality-of-life issues, and trade-offs: The patient perspective. In addition, the relevant literature on psychosocial distress also includes more global and broad concepts such as the domain of emotional well-being, within a quality-of-life framework. Greenfield S, Blanco DM, Elashoff RM, et al: Patterns of care related to age of breast cancer patients. The one that caught my attention noted remarks he made at a Johns Hopkins event in the year before his death, where he is reported to have said, “Therapies have been lengthy, toxic, and disfiguring, adding to the amount of suffering that a patient and family endures. The survey aimed to quantify the out-of-pocket costs faced by a woman in the first five years after a breast cancer diagnosis. Although it's rare, your treatment for breast cancer may cause new problems, such as: pain and stiffness in your arms and shoulders after surgery, and the skin in these areas may be tight All of these medical factors contribute to the risk of greater psychological distress in these younger women. Social support plays an important role in quality of life and health outcomes after breast cancer diagnosis and treatment. Maunsell E, Brisson J, Deschenes L: Social support and survival among women with breast cancer. PTSD can linger for years: Another 2018 study, published in the journal Cancer, found that about 6 percent of women still struggle with the disorder's physical and mental symptoms four years later. Auteur SAMAREL (Nelda); TULMAN (Lorraine); FAWCETT (Jacqueline) Source RESEARCH IN NURSING AND HEALTH, Vol 25, N° 6, 2002, pages 459-470, réf. 34. 44. Financial Disclosure: The author has no significant financial interest or other relationship with the manufacturers of any products or providers of any service mentioned in this article. Over time, recognition of the importance of assessing patient needs, distress, and concerns, as well as the social context in which care is delivered, has become more evident.[49]. In delivering care for breast cancer patients today, it is expected that the health-care team will carefully evaluate the tumor pathology, biomarkers, extent of disease, and other medical aspects of the woman’s condition, to facilitate specific recommendations for oncologic management. J Natl Cancer Inst Monogr 30:143-145, 2001. Common physical side effects from each treatment option for breast cancer are listed in the Types of Treatment section. A negative body image can affect your desire for intimacy and social interaction. Ganz PA, Desmond KA, Leedham B, et al: Quality of life in long-term, disease-free survivors of breast cancer: A follow-up study. • Social Support-Social support for the woman 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 ones fears, feelings, and concerns. Relationships: You may find that friends, coworkers and family members treat you differently after a cancer diagnosis. Effects of two types of social support and education on adaptation to early-stage breast cancer. In his passing, many tributes noted Marty’s important contributions to oncology, as a pioneer in the treatment of breast cancer and as the leader of a major cancer center. 20. 28. [6] Much of the literature of the time also postulated that personality traits could be causal in the development of cancer, and that postoperative behavior might reflect pre-illness characteristics, rather than be the result of treatment. Reducing barriers to cancer care is critical in the fight to eliminate suffering and death due to cancer. Ganz PA, Hirji K, Sim MS, et al: Predicting psychosocial risk in patients with breast cancer. 46. Ganz PA, Coscarelli A, Fred C, et al: Breast cancer survivors: Psychosocial concerns and quality of life. In today’s environment, a woman who has an image-guided breast biopsy and receives a cancer diagnosis is immediately approached by other women-from her work, church, or other social network-who are breast cancer patients/survivors, and who are immediately ready to help her get through the early diagnosis and staging of the cancer, and provide support and encouragement. J Natl Cancer Inst 93:979-989, 2001. J Clin Epidemiol 45:473-485, 1992. Thus, today there is even more information to discuss with newly diagnosed breast cancer patients than before. 21. [5], Psychosocial distress refers to a broad range of affective and cognitive concerns that go beyond psychiatric diagnoses of major depressive illness or anxiety disorder. Ganz PA, Hirji K, Sim MS, et al: Predicting psychosocial risk in patients with breast cancer. Breast Cancer Res Treat 77:285-293, 2003. 2. Vancouver BC; HISLOP (T.G. Bonadonna G, Valagussa P: Dose-response effect of adjuvant chemotherapy in breast cancer. J Natl Cancer Inst Monogr 16:177-182, 1994. Med Care 31:419-431, 1993. It is most common in breast cancer (42%) and head and neck cancer (41%) patients. Español. [6] For many women, every ache and pain would trigger fear and anxiety about potential recurrence. It was noted that there are nine different types of social support, with "emotional support" being one of the most i … The social impact of cancer Dimens Oncol Nurs. Med Care 31:419-431, 1993. The complexity of primary treatment, information overload (from health-care providers, well-meaning acquaintances, books, and the Internet), the move toward shared decision-making, and the vulnerability that a cancer diagnosis engenders, all threaten the emotional well-being of the woman. Cancer 76:631-637, 1995. Since the 2000 NIH consensus conference on adjuvant therapy of breast cancer,[18] adjuvant therapy has been recommended for all women with invasive breast tumors greater than 1 cm, including chemotherapy in all and endocrine therapy if hormone receptor–positive. 35. Effects of social relationships on survival for women with breast cancer : a prospective study. [39,41] This appears to be independent of age,[42] although the likelihood of greater comorbidity at diagnosis is increased with age. Log in to our secure, personalized website to manage your care (formerly myMDAnderson). Recent Results Cancer Res 152:396-411, 1998. Frost MH, Suman VJ, Rummans TA, et al: Physical, psychological and social well-being of women with breast cancer: The influence of disease phase. Ganz PA, Schag AC, Lee JJ, et al: Breast conservation versus mastectomy. BMJ 324:1088-1092, 2002. The earliest research on the psychological impact of breast cancer focused on its attack on femininity, with amputation of the breast, and subsequent threat to sexual attractiveness. J Clin Oncol 6:1795-1797, 1988. The shared decision-making process may be stressful, and use of decision aids, as discussed in the 2000 consensus conference,[19,20] has become more common. • Preexisting Mental Illness or Psychological Distress-Although it appears that cancer, in general, does not heighten the risk for serious depression in women with breast cancer,[39] a prior history of depression and the presence of pain and physical limitations are associated with a greater likelihood of depression after diagnosis. 39. professor Graduate School of Social Work, Boston College, Chestnut Hill, MA. A common explanation is that socially isolated individuals fare worse due to reduced instrumental support (i.e., assistance meeting the demands of treatment). One in three breast cancer survivors end up unemployed after treatment. This discussion should include physical, emotional, and social effects of cancer. N Engl J Med 292:117-122, 1975. [49], Long before psychosocial services for women with breast cancer were widely available, Martin Abeloff and his colleagues took on the challenge of describing the experience of patients with cancer, and noted the importance of addressing these concerns as part of the care of the whole patient. How and where to find this type of care. ); MEARS (B. 12. In addition, breast cancer in younger women is often temporally related to a recent pregnancy or may occur during pregnancy, and thus, these women often have small children to care for at the same time that they must deal with a life-threatening disease. All rights reserved. We have a lot more information that you might find helpful. This paper discusses the importance of identifying the psychological and social concerns of breast cancer patients in the medical setting, and assisting them in obtaining appropriate psychosocial services. Assessing the psychological aspects of breast cancer treatment and identifying activities that can alleviate stress involved in the treatment process, could reduce the anxiety and emotional upheaval associated with breast cancer. The “Moving Beyond Breast Cancer” video is available at no cost through the National Cancer Institute Cancer Information Service (1-800-4-CANCER or http://cis.nci.nih.gov/). Univ British Columbia. Ganz PA, Hirji K, Sim MS, et al: Predicting psychosocial risk in patients with breast cancer. The trauma of breast cancer surgery has diminished substantially in the past 2 decades, but women are still left with many physical and psychological problems as a result of complex multimodal treatments, including chemotherapy and adjuvant endocrine therapies.[3-5]. Social and Emotional Side Effects of Cancer It's not uncommon for cancer patients to face a mix of emotions and adjustment issues. Authors S F Pardue, M V Fenton, L R Rounds. Even the most psychologically strong individual will be overwhelmed by the number of medical visits, procedures, and waiting times during the initial diagnostic process. Soc Sci Med 16:1329-1338, 1982. Maunsell E, Brisson J, Deschenes L: Psychological distress after initial treatment for breast cancer: A comparison of partial and total mastectomy. Auteur WAXLER-MORRISON (N.) CAN. Cancer costs us billions of dollars. Create a caregiving plan with this 1-page fact … Attempts to restore body image with external prostheses were variably effective, and reconstructive surgery with implants did not become widely available until the last 2 decades of the 20th century. Spirituality: Many survivors find that life takes on new meaning after cancer and will renew their commitment to spiritual practices or organized religion. Bloom JR: Social support, accommodation to stress and adjustment to breast cancer. 1p. This can help you make a caregiving plan. 23. Curr Opin Oncol 3:1014-1018, 1991. Fairclough DL, Fetting JH, Cella D, et al: Quality of life and quality adjusted survival for breast cancer patients receiving adjuvant therapy. Now, for the majority of women, it is usually managed with only minimal removal of breast tissue and sampling of a few axillary nodes. 30. Background: Breast cancer diagnosis as well as diversity of the treatment process deteriorates women’s quality of life (QOL). Call 713-563-6666 to request a referral. [3,23,27,28] Even for women with a recurrence of breast cancer, psychological well-­being is often maintained.[26,27,29]. 9. Learn about our graduate medical education residency and fellowship opportunities. Therapy, support groups, social media and community resources are available to help you cope with these issues. 10. 1. If you are ready to make an appointment, select a button on the right. What is Palliative Care? 5. Twelve percent of survivors were still paying off medical debt four years after treatment. But for others, the cancer comes back and spreads to another area of the body (metastasises).When breast cancer spreads it is called secondary breast cancer, and is often more difficult to treat. Introduction People in a patient's social support network include family members, spouses, children and friends. Given the limited amount of information exchanged between doctors and patients at this time regarding the natural history of breast cancer and its prognosis, as well as the lack of adjuvant therapies to prevent a recurrence, it is not surprising that these fears were commonplace. Grief is a natural result of loss. Cancer 70:120-125, 1992. National Institutes of Health Consensus Statement: Early stage breast cancer. Ganz PA: Quality of life and the patient with cancer. 29. Loss can include your health, sex drive, fertility and physical independence. Effective strategies for enhancing coping are actively being studied by many research groups. The workplace: Cancer survivors often feel that they can no longer relate to co-workers who haven’t experienced cancer. Accessing psychosocial services is easier today than ever before, through electronic and other media, as well as through in-person support services. • Social Support-Social support for the woman 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 ones fears, feelings, and concerns. Researchers have examined social support and its relations with QOL overall, but less is known about effects of social support on changes in QOL. [6] In some of the first systematic and comparative studies, mastectomy patients were found to be more distressed than women with benign lumps, and often this distress persisted for more than a year following surgery, but over time seemed to resolve. GAD sufferers spend most of the day worrying, often to the point of mental exhaustion, and experience physical symptoms such as restlessness, irritability, muscle tension and sleep disturbances. 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, removed pectoral muscles, and included an extensive axillary dissection. As part of our mission to eliminate cancer, MD Anderson researchers conduct hundreds of clinical trials to test new treatments for both common and rare cancers. 38. van Gestel YR, Voogd AC, Vingerhoets AJ, et al: A comparison of quality of life, disease impact and risk perception in women with invasive breast cancer and ductal carcinoma in situ. Given the urgent demands of treatment, it can be easy for primary care providers, like Family Nurse Practitioners, to focus on physical aspects of care when a diagnosis occurs. How it differs from hospice care and tips for talking about your needs and expectations. Breast Cancer Network Australia (BCNA) commissioned Deloitte Access Economics to survey its members about the out-of-pocket costs of their breast cancer treatment and care, and other associated costs. Inadequate levels of either of these two forms of social support can increase the likelihood of psychosocial distress. Spring 1989;3(1):5-13. In her classic 1980 paper on the psychosocial correlates of breast cancer and its treatments, Meyerowitz pointed out that during this time, most patients were not told their diagnosis, for fear of the emotional response it would evoke. The new project, SALiCCS (Socioeconomic Consequences in Adult Life after Childhood Cancer in Scandinavia), aims is to detect delayed psychosocial and socioeconomic effects experienced by former cancer patients. Social support is regarded as a complex construct which has long been suggested to have direct and buffering effects on patients' wellbeing and emotional adjustment to cancer. Breast Cancer Res Treat 54:47-57, 1999. Support groups and counseling can help you work through these issues. Cancer 69:1729-1738, 1992. Schover LR: Sexuality and body image in younger women with breast cancer. Patients fighting breast cancer experience psychological distress. For instance, they should be sensitive to the desire of the patient to share and know information about their cancer, treatment options, and their prognosis.3 A support network can greatly help reduce the stress of dealing with cancer. 15. Facing many months of treatment leads to disruption in social activities (childcare, work, caregiving) and decreases the ability to plan and multitask. 14. If you have questions about MD Anderson’s appointment process, our © 2021 MJH Life Sciences and Cancer Network. J Clin Oncol 11:783-793, 1993. J Clin Epidemiol 53:615-622, 2000. The first large trials of adjuvant chemotherapy were reported in high-profile medical journals in the 1970s and 1980s,[7-10] leading to the rapid expansion of clinical trials of this treatment across all stages of breast cancer throughout the world, with testing of new drugs and their combinations, including the addition of endocrine therapies to the treatment strategy. 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