This is exacerbated by the physical toll that primary treatment often extracts. In a prospective study of newly diagnosed breast cancer patients, Maunsell et al found that a past history of depression and serious life events in the 5 years preceding the cancer diagnosis were both predictive of higher levels of distress after breast cancer. However, it is the responsibility of the health-care team to orient women to the likelihood of needing these services at some point along their journey with breast cancer. 44. Meyerowitz also noted the identification of changes in life patterns that resulted from the diagnosis and surgical treatment of breast cancer, including insomnia, recurrent nightmares, loss of appetite, difficulty returning to usual household activities and work, and inability to concentrate. Our personalized portal helps you refer your patients and communicate with their MD Anderson care team. Breast Cancer Res Treat 54:47-57, 1999. Almost all cancer survivors will face psychological and emotional issues that can show up many years after treatment. You simply can’t treat cancer without paying attention to the psychological and social aspects of the disease.”. Langer AS: Side effects, quality-of-life issues, and trade-offs: The patient perspective. “They may also still have fatigue, pain, sleep problems that affect their quality of life that they're grappling with,” Ashton adds. [3,4,31,35,36] In fact, women with noninvasive breast cancer have similar concerns about recurrence as women with invasive disease.[37,38]. Inadequate levels of either of these two forms of social support can increase the likelihood of psychosocial distress. • 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, a prior history of depression and the presence of pain and physical limitations are associated with a greater likelihood of depression after diagnosis. Breast Cancer Res Treat 38:183-199, 1996.  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. J Clin Epidemiol 53:615-622, 2000. 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. 28. Auteur SAMAREL (Nelda); TULMAN (Lorraine); FAWCETT (Jacqueline) Source RESEARCH IN NURSING AND HEALTH, Vol 25, N° 6, 2002, pages 459-470, réf.  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. Table 3 lists some of the most common psychosocial concerns reported by women with breast cancer. 21. The good news is that you don’t have to suffer alone. In this study, the collaborative partners are Finland, Denmark and Sweden. Your gift will help make a tremendous difference. [3,23-27] 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. N Engl J Med 304:10-15, 1981. 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. Loss can include your health, sex drive, fertility and physical independence. If you have questions about MD Anderson’s appointment process, our Finally, for younger women this is often the first encounter with the health-care system (other than childbirth or minor health conditions), and this adds considerable distress. A number of different psychological and social factors can affect the emotional stability and physical outcomes for patients with breast cancer. 7. Hewitt ME, Herdman R, Holland JC: Meeting psychosocial needs of women with breast cancer. In contrast, older women may have had other medical conditions or operations, or may have cared for loved ones with cancer, thus blunting some of the initial distress with having to face a new illness. , Psychosocial distress refers to a broad range of affective and cognitive concerns that go beyond psychiatric diagnoses of major depressive illness or anxiety disorder. Therapy, support groups, social media and community resources are available to help you cope with these issues.  Although these may have been manifestations of depression, they were only considered abnormal if they persisted beyond the period of physical recovery from surgery (ie, several months). October 20, 2016 In the United States, more than 230,000 women and approximately 2,600 men receive a breast cancer diagnosis each year. Types of Palliative Care. 4. These range from cancer-specific concerns, such as fear of cancer recurrence, to more generalized symptoms such as worry, trouble sleeping, fatigue, being anxious about going to the doctor. What is Palliative Care? Eur J Cancer 43:549-556, 2007. 36. Is there a difference in psychological adjustment or quality of life in the year after surgery? Log in to our secure, personalized website to manage your care (formerly myMDAnderson). Reconstruction was often delayed for several years after initial treatment, requiring a second surgical procedure. Lash TL, Silliman RA: Patient characteristics and treatments associated with a decline in upper-body function following breast cancer therapy. For example, tamoxifen, a common breast cancer treatment, can cut a woman’s rate of breast cancer recurrence by up to 50 percent. Patients fighting breast cancer experience psychological distress. Español. J Clin Oncol 3:1553-1560, 1985. This can help you make a caregiving plan. A negative body image can affect your desire for intimacy and social interaction. In a recently completed randomized controlled trial, Stanton and colleagues found that a 23-minute video, designed to facilitate emotional and physical recovery after breast cancer treatment, significantly enhanced the return of vitality. J Clin Oncol 16:487-494, 1998. Battling breast cancer is more than just a physical fight; there is an emotional toll as well. Lansky SB, List MA, Herrmann CA, et al: Absence of major depressive disorder in female cancer patients. This can result in a host of neurological effects, including: 1. blurry or double vision 2. confusion 3. headache 4. memory loss 5. mobility issues 6. speech difficulties 7. seizures With the prevalence of clinically significant mental disorders among adults estimated at 15%, it is not uncommon for women with breast cancer to be predisposed to cancer-related psychosocial distress. Test results can't determine your exact level of risk, at what age you may develop cancer, how aggressively the disease might progress or how your risk of death from cancer compares with other women's risks. Social and Emotional Side Effects of Cancer It's not uncommon for cancer patients to face a mix of emotions and adjustment issues. Many people with breast cancer are successfully treated every year. A report of early findings. J Natl Cancer Inst 94:39-49, 2002. 16. Bonadonna G, Valagussa P: Dose-response effect of adjuvant chemotherapy in breast cancer. 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. 12. Although serious depression is not seen in the majority of breast cancer patients and survivors, many will experience treatment-related distress, fear of recurrence, changes in body image and sexuality, as well as physical toxicities that result from adjuvant therapy. Psychooncology 7:101-111, 1998. Cross-sectional and prospective studies show a positive association between perceived social support and psychological adjustment following cancer treatment. 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. One in three breast cancer survivors end up unemployed after treatment. Facing many months of treatment leads to disruption in social activities (childcare, work, caregiving) and decreases the ability to plan and multitask. Choose from 12 allied health programs at School of Health Professions. If you suffer from a prolonged sense of guilt, seek help from a psychotherapist, clergy member or support group. 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. At the OHSU Knight Cancer Institute, we offer teams of specialists who can help. 33. Greenfield S, Blanco DM, Elashoff RM, et al: Patterns of care related to age of breast cancer patients. 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. Search … Cancer 70:120-125, 1992. Such resources are widely available in the community. Maunsell E, Brisson J, Deschenes L: Psychological distress after initial treatment of breast cancer. information page may be the best place to start. • Younger Age-Most breast cancer occurs in women older than 50 years (about 75% of cases). Schag CA, Ganz PA, Polinsky ML, et al: Characteristics of women at risk for psychosocial distress in the year after breast cancer. Spirituality: Many survivors find that life takes on new meaning after cancer and will renew their commitment to spiritual practices or organized religion. How this complex information is communicated, and how the physician assesses the woman’s psychological status and desire for detailed information vs more general concepts, often sets the stage how the woman will adapt to her diagnosis and need for treatment. Learn about our graduate medical education residency and fellowship opportunities. • 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. The Lyda Hill Cancer Prevention Center provides cancer risk assessment, screening and diagnostic services. 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]. 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 Further refinements in surgical staging, including the sentinel lymph node biopsy, have now begun to limit the extent of axillary surgery for women with small tumors and low metastatic potential. The first step in coping with psychosocial changes is realizing that you have an issue and having the courage to reach out for help. Washington, DC; National Academies Press; 2007. 17. National Institutes of Health Consensus Development Conference Statement: Adjuvant therapy for breast cancer, November 1-3, 2000. 29. 2. Bull AA, Meyerowitz BE, Hart S, et al: Quality of life in women with recurrent breast cancer. Psychol Bull 87:108-131, 1980. 41. Moreover, for women who do not have a spouse or intimate partner, there may be heightened concerns about future potential for such a relationship after a breast cancer diagnosis. 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. 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 appreciated. Explore www.cancer.org or call our National Cancer Information Center toll-free number, 1-800-227-2345. The involvement of mental health experts in the problems of persons with health conditions began to accelerate during the 1960s and 1970s, just as the national focus on cancer treatment and the war on cancer was taking shape. 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