Each year 30.000 women in this country learn that they have breast cancer. Given that less than a quarter of them have genetic or other known risk factors, the diagnosis can often come as a complete shock. The resulting emotional turmoil often affects the woman’s physical health as well as her psychological well-being. In this article we will deal with the psychosocial impact of cancer and offer advice on how to adapt to the disease as well as support for coping with it.
Receiving a diagnosis of breast cancer can be one of the most distressing moments in a woman’s life resulting in significant psychological changes for both her and her family. These effects depend on the type of tumour diagnosed, medical treatment given, the patient´s support systems, the time at which cancer is diagnosed, the way in which a person deals with life’s problems as well as diseases previously suffered… and a host of other factors. As a result, the experience of cancer is different for every patient and every family.
One of the most common emotional reactions when a diagnosis of breast cancer is made is denial. While some women suspect they could be suffering from a serious illness before it is confirmed by the doctor, others block it out to the extent that when the diagnosis is confirmed, they don’t believe it. They seek second opinions, trying to find a professional who will confirm that there is no cancer; asking their doctor to repeat the tests carried out hoping to obtain different results; or they believe that the results of medical tests are not theirs, but someone else’s.
Sadness is a typical reaction in women diagnosed with breast cancer and can often be accompanied by frequent crying and feelings of confusion. Sometimes a woman might not feel anything at all, a sort of emotional numbness which passes as time moves on.
If you have been diagnosed with breast cancer, the oncology team at HC Marbella International Hospital would like to make a few suggestions to get you through this period:
– Give yourself time to get used to the diagnosis. This time will vary from person to person as well as between different members of the family.
– Ask the doctor for the information you need to clearly understand the disease and the treatments that you are going to receive. Take an active role in medical decisions and try to “team up” with the specialist.
– Surround yourself with loved ones, this will help you to confront a reality that is often difficult to cope with.
– Express how you feel, not only will it make you feel better but will give those around you an opportunity to support you.
– Treatments are becoming less toxic and more effective.
– Remember that the cancer survival rates continue to rise.
The anguish usually continues even after the initial impact of the diagnosis has passed. As women begin what is often a long treatment process, they can face new problems. For example, there can be confusion in personal relationships or relationships with partners. They may feel really tired all the time and become very focused on symptoms, treatment or death.
Increasingly the disease is not treated by radical surgery, the aim is to minimize mutilation and focus principally on systemic treatment to cure the disease in the long term and prevent relapse.
Those diagnosed may need to cope with treatment which is not what they were hoping for, this may be due to the cover provided, leading patients to feeling discriminated against by their insurance company. Factors such as these can contribute to chronic stress, anxiety and depression.
These negative emotions may cause women to adopt habits which are not good for the health of any person, but which are especially worrying in those who have a serious illness. Women with breast cancer can begin to eat less and to select foods with low nutritional content. They may also stop exercising and have trouble sleeping well at night, and even start distancing themselves from family and friends. They may also turn to tobacco, caffeine, alcohol, and other substances in an attempt to stay calm.
Here are some of our Oncology Unit’s recommendations to support you through this period:
• Although becoming less and less common, if you have undergone mastectomy, ask to have breast reconstruction at the same time as the breast is removed if possible, therefore avoiding the experience of seeing yourself without the breast(s). Within the area of plastic surgery, breast reconstruction after cancer is currently one of the safest and most satisfying surgical procedures for patients, the development of new techniques makes it possible to create a breast that is very similar in shape, texture and characteristics to the unoperated breast.
• Psychologists and other mental health professionals with experience in the treatment of breast cancer provide great support. Their main objective is to help women learn how to cope with the physical, emotional and life-style changes related to cancer, as well as the medical treatments that might be painful or traumatic. Some women want to focus on how to explain their illness to their children or how to deal with their partner’s response. Others prefer to concentrate on how to choose the appropriate hospital or medical treatment. For others, the focus is on how to manage stress, anxiety, or depression. Psychologists can help women cope with their pain, fear and other emotions.
For many women, this potentially life threatening crisis is an opportunity for personal growth and a time to make improvements in life. Breast cancer patients are not the only ones who benefit from psychological treatment. Psychologists often assist partners, who are expected to provide emotional and practical support whilst dealing with their own feelings. Children, parents, and friends involved in supporting the patient often benefit from psychological help themselves. As part of their role the Complementary Medicine at HC Marbella provides patients with psychological care. Meeting and chatting with people outside the healthcare field, but who understand the situation, is also considered to be emotionally beneficial for patients and their family members. For this reason, at HC we facilitate, “a chat over a coffee,” with cancer patients who have overcome their disease.
• A family who are flexible and pull together, and who maintain open and honest communication, generally adjust better to the reality of the disease. Some families describe being more united after passing through this painful experience, and state that the cancer has helped them to share what they are feeling and thinking, and to appreciate their life together more.
When treatment is completed, many believe that the woman must feel happy. While this is true for many women, others describe a perceived threat to their lives that can persist for a long time. Despite having a good prognosis, the fear that the disease will return or that the tumour has not responded effectively to treatment often persists. On the other hand, some women describe a great pressure on them to immediately return to their normal activities. The fatigue and other side effects from the disease and its treatment can often take a long time to improve, it is important that the affected person is allowed to recover fully, physically and psychologically. In short, while some women go through a devastating experience with cancer, others are quick to describe it as something that has helped them to enjoy and appreciate the little things in life.
Some suggestions to help you through this period:
• Try to focus on the here and now.
• Exercise! It has been proven that correctly prescribed, physical exercise can be practised without risk during, and after, chemotherapy and radiotherapy treatment. However, it is necessary to adapt the intensity, duration, frequency and type of exercise to the patient’s general condition. The key is to ensure that the exercise does not carry any risk, in other words, to wait until the surgeon gives the go ahead following surgery and/or wait until the oncologist considers that the patient’s general condition is suitable if undergoing chemotherapy and/or radiotherapy.
• Reintroduce routine activities little by little but never before physical and psychological recovery.
• And never forget to cry in moments of sadness: the tear that weighs more is the one not cried; but also remember to fight when feeling strong.
October 19, 2017
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