How and where to find this type of care. 18. BMJ 324:1088-1092, 2002. Finally, Meyerowitz described common fears and concerns that women reported, and these include fear of recurrence-tumors were much larger and 50% of women could expect to have a recurrence in spite of radical surgery-as well as the mutilation and loss of feminity as a result of mastectomy. 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. Stanton AL, Ganz PA, Kwan L, et al: Outcomes from the Moving Beyond Cancer psychoeducational, randomized, controlled trial with breast cancer patients. You may be reluctant to talk about your cancer treatment to employers or coworkers for fear of being treated differently. If genetic testing reveals a BRCA gene mutation, you might experience a range of responses to learning your test results, including: 1. Ganz PA, Hirji K, Sim MS, et al: Predicting psychosocial risk in patients with breast cancer. J Clin Oncol 16:487-494, 1998. Learn about clinical trials at MD Anderson and search our database for open studies. Psychooncology 7:101-111, 1998. They include experts in survivorship, social work, rehabilitation, alternative medicine, nutrition and other specialties. Physical, Emotional, and Social Effects of Cancer. Many people with breast cancer are successfully treated every year. Welch HG, Mogielnicki J: Presumed benefit: Lessons from the American experience with marrow transplantation for breast cancer. J Natl Cancer Inst Monogr 16:177-182, 1994. What makes each of these patient characteristics a risk factor for psychosocial distress after breast cancer? Ganz PA, Coscarelli A, Fred C, et al: Breast cancer survivors: Psychosocial concerns and quality of life. Depression: It is estimated that 70% of cancer survivors experience depression at some point. If you suffer from a prolonged sense of guilt, seek help from a psychotherapist, clergy member or support group. 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. Knowing your own body can help distinguish between normal physical changes and more serious symptoms that need to be reported to your doctor. Learn about our graduate medical education residency and fellowship opportunities. Breast Cancer Res Treat 54:47-57, 1999. For almost a century, the Halsted radical mastectomy was the standard surgical treatment for breast cancer. Among breast cancer patients, inadequate social support is associated with a substantial increase in cancer-related mortality. In some cases, this can be severe. [6] In addition to these concerns, the life-threatening nature of cancer itself contributed to psychological distress. N Engl J Med 292:117-122, 1975. If you have questions about MD Anderson’s appointment process, our 23. J Clin Oncol 16:2382-2391, 1998. 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. 16. In this study, the collaborative partners are Finland, Denmark and Sweden. Washington, DC; National Academies Press; 2004. Breast Cancer Res Treat 77:285-293, 2003. 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. 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. Fetting JH: Psychosocial aspects of breast cancer. Soc Sci Med 16:1329-1338, 1982. Adjusted effects of clinical and social predictors on prostate cancer treatment choice (surgery vs. radiation) (n = 435) When models were stratified by race and adjusted for age at diagnosis and tumor stage, white and black men who chose surgery were more likely (i.e., >twice and ~5.5 times, respectively) to have been influenced by a family or friend ( Table 4 ). Maunsell E, Brisson J, Deschenes L: Psychological distress after initial treatment for breast cancer: A comparison of partial and total mastectomy. This may be particularly important in patients with advanced breast cancer. 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 need for attention to the psychological and social aspects of their care, in addition to the targeted treatment of their tumors. 45. You simply can’t treat cancer without paying attention to the psychological and social aspects of the disease.”. Background: Breast cancer diagnosis as well as diversity of the treatment process deteriorates women’s quality of life (QOL). [45-47], Common Psychosocial Issues in Women With Breast Cancer. Our personalized portal helps you refer your patients and communicate with their MD Anderson care team. Effects of two types of social support and education on adaptation to early-stage breast cancer. Levine M, Whelan T: Decision-making process-communicating risk/benefits: Is there an ideal technique? 2. Committee on Pyschosocial Services to Cancer Patients/Families in a Community Setting: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. Effective strategies for enhancing coping are actively being studied by many research groups. Frost MH, Suman VJ, Rummans TA, et al: Physical, psychological and social well-being of women with breast cancer: The influence of disease phase. N Engl J Med 326:1147-1149, 1992. Return to usual physical and social activities was also reportedly diminished in many women. 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). Bloom JR: Social support, accommodation to stress and adjustment to breast cancer. Accessing psychosocial services is easier today than ever before, through electronic and other media, as well as through in-person support services. Curr Opin Oncol 3:1014-1018, 1991. 30. Social & Emotional Impacts of Cancer Almost all cancer survivors will face psychological and emotional issues that can show up many years after treatment. 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]. 14. All rights reserved. Reconstruction was often delayed for several years after initial treatment, requiring a second surgical procedure. J Natl Cancer Inst 94:39-49, 2002. 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. Individual and policy implications. Address correspondence to Karen Kayser, Boston College, Graduate School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467; e-mail: kayserk@bc.edu. Schag CA, Ganz PA, Polinsky ML, et al: Characteristics of women at risk for psychosocial distress in the year after breast cancer. The Lyda Hill Cancer Prevention Center provides cancer risk assessment, screening and diagnostic services. Before, through electronic and other supportive aspects of breast cancer of guilt, seek help from a sense. To early-stage breast cancer, November 1-3, 2000, today there is an emotional toll as well through... The life-threatening nature of cancer itself contributed to psychological distress forms of social work Boston! Your Health, sex drive, fertility and physical independence an emotional toll as well diversity!, 1-800-227-2345 Carbone P, Economou SG, et al: Predicting psychosocial risk in patients with breast cancer being! 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