The application of cognitive-behavioral techniques in group therapy, with women survivors of breast cancer, produces a reduction in the levels of anxiety, stress and an improvement of the QL (Bellver, 2007, Syd, 2012).
Full Answer
Why are psychological and social concerns important in breast cancer treatment?
Whether breast cancer patients are newly diagnosed, survivors, or at the end of life, attending to their psychological and social concerns will enhance the effectiveness of our treatments and palliation of symptoms.
How does breast cancer affect different ethnic groups differently?
The rate of getting and dying from breast cancer differs among ethnic groups [ 4 – 6 ]. Recent studies showed that new cases of breast cancer are about the same for Black and White women.
Are personality traits causal in the development of breast cancer?
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. The stress of breast cancer was described as arousing depression, anxiety, and anger. [6]
Do lifestyle factors influence breast cancer outcomes by race?
These studies imply that lifestyle exposures may be responsible for variations in outcomes by race in certain breast cancer subtypes; meanwhile, recent genome-wide association studies implicate novel breast cancer risk variants in women of African ancestry [48].
How does breast cancer affect someone socially?
Breast cancer is known to affect women and their husbands. They both tend to experience several psychological distresses such as depression, anxiety, communication avoidance, sexual problems, separation and/or termination of the relationship.
How does breast cancer affect family and friends?
Cancer affects family and friends, not just the person with the disease. The people in your life may also feel worried, angry, or afraid. Family members may be very supportive, or they may start acting differently towards you.
Can cancer treatment cause personality changes?
Emotional and mental health challenges such as depression, anxiety, stress, and having trouble sleeping can add to that foggy feeling. Chemo brain can also intensify feelings of frustration or anger. That's OK.
How does breast cancer affect someone emotionally?
A life-changing diagnosis like breast cancer can dig up a lot of emotions. It's not uncommon to have depression, anxiety, uncertainty, fear, loneliness, and body image issues, among others. In fact, about 1 in 4 people with any type of cancer may have major or clinical depression and benefit from its treatment.
How does cancer impact a family?
Family members of patients with cancer may experience distress as an effect of their caregiving, with negative symptoms which may include: anxiety, depression, a sense of burden, helplessness, and fear [30].
How does cancer affect a community?
Cancer and its treatment result in the loss of economic resources and opportunities for patients, families, employers, and society overall. These losses include financial loss, morbidity, reduced quality of life, and premature death.
How does cancer affect you socially?
You might feel like others can't truly understand. Friends may have retreated. You might find emotional support in counseling, a support group or faith community. Relationships: Cancer can strain relationships with friends, family and co-workers.
How does breast cancer affect a person's daily life?
These may include hot flashes and other menopausal symptoms, fatigue, chronic breast pain, lymphedema and a loss of sex drive. It can be hard to plan for or cope with these late effects since they vary from person to person.
Can cancer affect your behavior?
A cancer diagnosis can affect the emotional health of patients, families, and caregivers. Common feelings during this life-changing experience include anxiety, distress, and depression. Roles at home, school, and work can be affected.
What is the psychosocial impact of cancer?
Common reactions immediately after the diagnosis are shock and denial, frequently followed by depression, anxiety and/or anger. About a third of all cancer patients suffer from a co-morbid mental health condition, requiring professional support by the entire medical team, including psycho-oncologists.
What impact does a cancer diagnosis have on the psychosocial status of the patient and their family?
Findings of our study also showed that a diagnosis of cancer impacts on family caregivers from a psychological perspective. Significantly higher levels of stress, history of depression, and current depressive symptoms were observed in family members of cancer patients than in control subjects.
How are cancer patients emotionally treated?
Here are 7 tips to maintain or improve emotional well-being for cancer patients and caregivers:Talk to someone who is not a family member. ... Continue with daily activities, but modify if necessary. ... Plan ahead. ... Find support that works for you. ... Balance in-person and online support. ... Tap your community. ... Reach out.
What is the holistic approach to breast cancer?
Patients with breast cancer need a comprehensive and holistic approach to care that goes beyond physical treatment and includes support and intervention related to psychological needs. Trained to understand all of the factors that could compromise or improve a patient’s care, Nurse Practitioners are in a unique position to understand these patients’ needs and provide the specialized care they require.
How does logistical and financial aspects of treatment affect patients?
Navigating the logistical and financial aspects of treatment, whether addressing complicated insurance and payment questions or making difficult decisions regarding various treatment plans, can additionally contribute to stress and overwhelm patients as they map the course of action that best suits their lifestyle and needs.
Is breast cancer a physical disease?
Many of the issues that are associated with breast cancer are often exacerbated, and at times contribute to, the physical toll of the disease itself. It is essential to equip providers with the knowledge and skills that address patient’s needs beyond the physical.
What Are the Common Psychosocial Concerns of Women With Breast Cancer?
What varies, however, is the extent to which a woman accepts these concerns, copes with them, and adapts to living with a degree of uncertainty about the future, as opposed to living in a state of persistent rumination about the illness and the inability to control what will happen to her.
What is the role of the health care team in breast cancer?
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. This has been increasingly true in the past decade, as the understanding of the molecular pathology of breast cancer has increased and treatments have become more tailored.
How do women manage psychosocial distress?
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 appreciated. Support groups often provide this type of assistance and should be offered.
What is the stress of breast cancer?
The stress of breast cancer was described as arousing depression, anxiety, and anger. [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. These findings in the late 1970s were gradually disseminated to physicians and patients, and resulted in the beginnings of psychosocial support groups in the early 1980s.
What were the effects of mastectomy surgery?
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. [6] 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). The physical disruption of the radical mastectomy was substantial, making it difficult to sleep, have sexual intimacy, and adapt to clothing and body image problems. Return to usual physical and social activities was also reportedly diminished in many women.
How does cancer affect the emotional well-being of a woman?
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. Facing many months of treatment leads to disruption in social activities (childcare, work, caregiving) and decreases the ability to plan and multitask. This is exacerbated by the physical toll that primary treatment often extracts. [5]
What is the Halsted radical mastectomy?
For almost a century, the Halsted radical mastectomy was the standard surgical treatment for breast cancer. Women receiving this treatment suffered terrible cosmetic deformity, with loss of arm function through resection of the pectoral muscles, high risk for lymphedema as the result of extensive axillary nodal dissection, and significant pain and tightness across the chest wall. 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. Reconstruction was often delayed for several years after initial treatment, requiring a second surgical procedure. Immediate reconstruction and autologous tissue flaps, widely used today, did not become widespread until the turn of the 21st century.
How was the breast cancer study recruited?
Recruitment was based on a consecutive series of breast cancer patients who presented at the two hospitals for evaluation of a breast lump. The oncologist referred all newly biopsy-confirmed patients to the researcher prior to starting the treatment (surgery or chemotherapy). This study was approved by the ethical review boards of both hospitals involved. Informed consent was obtained from all patients to ensure that they understood the goal of the study and agreed to have long-term clinical follow up for at least 5 years. All contact information including phone numbers of the caregivers was collected and maintained confidentially. Each of the recruited patients was personally contacted (on average 10 contacts) during hospital visits for treatment-surgery, chemotherapy and radiotherapy. After that, they were contacted in person or telephonically (on average 18 contacts). A breast cancer support group termed “Aadhara” (meaning “support” in the local language Kannada) was formed to address multiple issues as well as conduct group contact sessions. On an average, ten individual counseling sessions were held for patients and immediate caregivers during which time information about disease perceptions were collected. Data was collected during the initial sessions on financial arrangement, members of the immediate family involved in support, decision-making for treatment and psychosocial aspects of the impact of cancer diagnosis. Information on family bonding and prioritization of self-health were collected during follow-up sessions. Support was provided through counseling lasting at least 30 min with empathetic listening techniques and approaches such as psycho-education, supportive psychotherapy and cognitive behavior therapy to increase hope and cope with illness.
How does breast cancer affect the family?
Breast cancer has an impact on the psychological and social well-being, not only of the woman affected but also on her immediate family members. In Indian culture, the family remains the dominant social unit despite a gradual shift in the focus on to the individual in more recent times, especially in urban settings. The individual and the family are closely interlinked financially and socially in all their activities.[3,4] Hence, immediate family members are closely connected, and experience challenging emotional situations as though they were personally affected. This aspect has been noted and commented upon previously in the setting of breast cancer in Indian women.[5,6,7]
How long is the median follow up for breast cancer?
The median follow-up is 7 years with only 2% lost to follow-up.
Is breast cancer in urban Indian women increasing?
The incidence of breast cancer in urban Indian women has been increasing steadily, and it has now surpassed cervical cancer to become the most frequently diagnosed cancer in this population.[1] Distressingly, the 5-year cumulative mortality remains unacceptably high at 50%, primarily due to a late-stage presentation.[2]
Is cancer a financial burden?
Cancer diagnosis poses a significant financial burden on family
What are the cultural factors that affect breast cancer?
Cultural factors such as spirituality, misconception on the susceptibility of breast cancer, cultural beliefs and views as well as medical mistrust are more prominent in Black women when deciding about breast cancer screening, diagnosis, and treatment options. Spirituality has a strong influence on how many Black women manage their health condition [ 65, 66 ]. Black women are more likely than White women to rely on divine intervention alone for treatment rather than seeking appropriate medical treatment which can be detrimental for their survival [ 67 ]. However, other studies have suggested that spirituality could be beneficial in the life of some Black women as it can also promote early breast cancer screening and proper treatment [ 68, 69 ]. Some Black women tend to believe that they have lower risks of developing breast cancer than White women [ 67, 70 ], regardless of their family history of breast cancer [ 71, 72 ]. This view contributes to a decrease in mammography screening and inadequate actions to address breast issues [ 67 ]. Beliefs and attitudes towards breast cancer differ between White and Black women as well. Some Black women believe that any breast trauma or big breast is risk factors for breast cancer [ 73, 74 ], More likely than White women, Black women would consider any swelling or lump in the breast that is not painful as non-cancerous and would not seek immediate care [ 75 ]. Overall, factors such as poverty, culture, and social injustice contribute directly and indirectly to breast cancer disparity among women. Black women are more likely to be affected by those determinants than White women. These factors often lead to lower breast cancer survival rates among Black women as compared to White women.
What are the risk factors for breast cancer?
Family history of breast cancer is a heterogeneous risk factor that depends on the number of family members affected, the age at diagnosis, and the number of unaffected women in the pedigree. A woman’s breast cancer risk is increased if she has a first-degree relative with breast cancer at a young age or if she has multiple relatives with breast cancer [ 79 – 81 ]. Approximately 5–10% of breast cancers are thought to be hereditary [ 82 ], The BRCA1 (breast cancer gene 1) and BRCA2 (breast cancer gene 2) gene mutations located on chromosomes 17 and 13, respectively, account for most of the autosomal dominant inherited breast cancers. BRCA1 and BRCA2 are human genes that produce tumor suppressor proteins. These proteins help repair damaged DNA and play a role in ensuring the stability of the cell’s genetic material. When these genes are mutated, altered, or do not function property, DNA damage is repaired. Thus, cells are more likely to generate additional genetic alterations that can lead to cancer development. Prevalence rates of these mutations vary by ethnicity and race. For instance, BRCA1 mutations, the highest rates occur among Ashkenazi Jewish women (8.3%), followed by Hispanic women (3.5%), non-Hispanic white women (2.2%), Black women (1.3%), and Asian women (0.5%) [ 83, 84 ]. Approximately 55–65% of women who inherit a harmful BRCA1 mutation and about 45% of women who inherit a harmful BRCA 2 mutation will develop breast cancer by the age of 70. Moreover, 39% of women who inherit a harmful BRCA1 mutation and 11–17% of women who inherit a harmful BRCA2 mutation will develop ovarian cancer by the age of 70 [ 85, 86 ]. Women who have been diagnosed with breast cancer with harmful BRCA1 or BRCA2 mutations are more likely to develop a second cancer in with the ipsilateral breast or the contralateral breast than women who do not carry these mutations. Breast cancers in women with a harmful BRCA1 mutation are also more likely to be triple-negative cancers, which have poorer prognosis than other breast cancers. BRCA2 is a risk factor for male breast cancer [ 87 ]. Therefore, doctors recommend that women with early-onset breast cancer and women with a family history consistent with a mutation in BRCA1 and BRCA2 genes have genetic testing when breast cancer is diagnosed.
What are the most common mutations in breast cancer?
Rare mutations include PTEN, TP53, MLH1, MLH2, and STK11 genes, as well as ATM, BRIP1, CDH1, CHEK2, MRE11A, NBN, PALB2, RAD50, RAD51C, and SEC23B [ 90 ]. The majority of the mutations in these other genes are linked with smaller increases in breast cancer risk than are seen with mutations in BRCA1 and BRCA2. However, mutations in the PALB2 gene are associated with a risk of breast cancer almost as high as the risk associated with inherited BRCA1 and BRCA2 mutations. PALB2 is a tumor suppressor gene. The PALB2 protein interacts with the BRCA1 and BRCA 2 proteins to help repair breaks in DNA. Approximately 33% of women with a harmful mutation in the PALB2 gene will develop breast cancer by age 70. The risk is even higher at 58% for women who have a family history of breast cancer and the harmful PALB2 mutation [ 91 ].
What is triple negative breast cancer?
Triple-negative breast cancer is a heterogeneous disease in which tumors are defined by lack of expression of the estrogen receptor, the progesterone receptor, and the human epidermal growth factor receptor 2. It account for about 10–20% of invasive breast cancers and this subtype carries a poorer prognosis than the luminal tumors [ 22 – 24 ]. There are no targeted therapies currently available for the treatment of triple-negative breast cancer.
How can breast cancer be prevented?
The majority of breast cancer cases are prevented if chemoprevention is applied in appropriate at-risk populations and the major modifiable risk factors such as maintaining a healthy weight, exercising regularly , and reducing alcohol intake are instituted [ 119 ]. Lack of insurance, fear of testing, delay in seeking care, barriers to early detection and screening, more advanced stages of disease at diagnosis among minorities, and unequal access to improvements in breast cancer treatment may explain the differences in survival rates between African American and White women [ 120 – 122 ]. Breast cancer tumors among Black and Hispanic women are more likely to be greater than 2 cm in diameter at diagnosis, are more likely to be estrogen-receptor and progesterone-receptor negative, and are more likely to have characteristics of poor differentiation, with nuclear atypia and higher S phase fraction. Furthermore, the prevalence of estrogen receptor-positive breast tumors is lower in African Americans and Hispanics than in Whites [ 123, 124 ], which might account for racial/ethnic differences in the use of tamoxifen. Scientific evidence suggests that, because of the increased risk of stroke, pulmonary embolism, and deep vein thrombosis associated with tamoxifen, African Americans, who already have a higher prevalence of risk factors for these conditions, may receive less overall benefit from tamoxifen [ 125 ]. Physician behaviors contribute to disparities in breast cancer mortality. For instance, a survey from York State hospitals revealed that physicians have more negative perceptions towards African Americans and people of low or middle socioeconomic status (SES) than of Whites and people of high socioeconomic status [ 126 ]. This finding and lack of information on how physician attitudes toward patients affect their care need further research, particularly with regard to how such negative perceptions might contribute to racial/ethnic disparities in breast cancer treatment.
How common is breast cancer?
It currently affects more than one in ten women worldwide . The chance for a female to be diagnosed with breast cancer during her lifetime has significantly increased from 1 in 11 women in 1975 to 1 in 8 women (Altekruse, SEER Cancer Statistics Review, 1975–2007. National Cancer Institute, Bethesda, 2010). This chance for a female of being diagnosed with cancer generally increases with age (Howlader et al, SEER Cancer Statistics Review, 1975–2010. National Cancer Institute, Bethesda, 2013). Fortunately, the mortality rate from breast cancer has decreased in recent years due to increased emphasis on early detection and more effective treatments in the White population. Although the mortality rates have declined in some ethnic populations, the overall cancer incidence among African American and Hispanic population has continued to grow. The goal of the work presented in this book chapter is to highlight similarities and differences in breast cancer morbidity and mortality rates among non-Hispanic white and non-Hispanic black populations. This book chapter also provides an overview of breast cancer, racial/ethnic disparities in breast cancer, breast cancer incidence and mortality rate linked to hereditary, major risk factors of breast cancer among minority population, breast cancer treatment, and health disparity. A considerable amount of breast cancer treatment research have been conducted, but with limited success for African Americans compared to other ethnic groups. Therefore, new strategies and approaches are needed to promote breast cancer prevention, improve survived rates, reduce breast cancer mortality, and ultimately improve the health outcomes of racial/ethnic minorities. In addition, it is vital that leaders and medical professionals from minority population groups be represented in decision-making in research so that racial disparity in breast cancer can be well-studied, fully addressed, and ultimately eliminated in breast cancer.
What is the most common cancer in women?
Apart from skin cancer, breast cancer is the most common form of cancer affecting women in the U.S. It is also the most prevalent cancer affecting women of every ethnic group in the United States. Breast cancer currently affects more than one in ten women worldwide [ 3 ]. The rate of getting and dying from breast cancer differs among ethnic groups [ 4 – 6 ]. Recent studies showed that new cases of breast cancer are about the same for Black and White women. However, the incidence rate of breast cancer before age 45 is higher among Black women than White women, whereas between the ages of 60 and 84, breast cancer incidence rates are strikingly higher in White women than in Black women. Yet, Black women are more likely to die from breast cancer at every age [ 7, 8 ]. Meanwhile, incidence and death rates for breast cancer are lower among women of other racial and ethnic groups than among non-Hispanic White and Black women. Asian/Pacific Islander women have the lowest incidence and death rates [ 7, 8 ].