Holistic Needs of a Breast Cancer Patient

INTRODUCTION

According to a study report of GLOBOCAN 2012 (Ferlay et al., 2013), it was found that almost 1.7 million women were diagnosed with Breast Cancer in 2012. In 2012 GLOBOCAN in its report revealed the striking patterns of cancer in women and also highlighted that priority should be given to cancer prevention and control measures for breast cancer globally (Ferlay et al., 2013). According to a report the incidence of Breast Cancer has been increasing in most regions of the world, but there are huge differences found in the number of breast cancer affected women between rich and poor countries (Ferlay et al., 2013).

Note: Adapted from “SEER Cancer Statistics Review, 1975–2016, Seer Cancer

Due to changes in reproductive factors, lifestyle, and increased life expectancy in many low- and middle-income countries (LMICs), the incidence of Breast Cancer is now rising sharply. Ramirez et al., in 1999; and McDonald et al., in 2004 concluded that a low level of cancer awareness is a very important risk factor for delay in a presentation by the patient. To spread awareness among all groups of women regarding breast cancer first of all we have to focus on various perceptions, signs and symptoms, risk factors, prevention, screening and treatment of breast cancer. We should arrange workshops and before that, some self-administered questionnaires in the local language to should be performed which will help us to know their perspective on breast cancer.

HOLISTIC NEEDS

The cancer patient’s well-being is determined by how well her physical, emotional, spiritual, social, and psychological needs are being met. The figure provided below is modified based on Maslow’s original framework which suits the context of breast cancer patients, that is based on concerns raised by Institute of Medicine(US) (2008), Schmid-Büchi, S. et al. (2008), NCCS Breast Cancer Survivorship Programme (2016)

Maslow Hierarchy of Needs applied in the context of breast cancer, with reference from Institute of Medicine (US) (2008), Schmid-Büchi, S. et al. (2008), NCCS Breast Cancer Survivorship Programme (2016)

As we know each patient at different stages of breast cancer faces different types of difficulties and it mostly depends on the surroundings and her own unique circumstances, so there is a need to personalize a holistic recovery package for every patient depending on periodic holistic needs’ assessment. During the treatment or before the treatment cancer care team should explain the patient’s chances of recovery, treatment benefits and disadvantages, social support, the estimated total costs, and the availability of psychological services, to the patient’s family.

The five stages of grief experienced by a breast cancer patient.

Denial:

The first reaction of a patient to a malignant diagnosis is to deny reality. Denial is a part of common human behaviour that acts as a temporary defense mechanism protecting the patient against the shock of a debilitating event.

Anger:

The next reaction of a patient may be anger due to she is forced to face the truth, as there is no option left for her to accept the truth, and then she suffers from intense pain and helplessness that manifest as anger directed to those around them. During this stage, if the people around the patient develops emotional resentments, it will worsen their relationship. So it is important for family and friends to empathize with the patient’s grieving phase.

Source: ChangeCom

Bargaining:

The patient starts thinking without breast cancer life could have been much better. She may wish that life could go back to the times before the diagnosis. Which could lead to an intense sense of guilt instead of accepting the situation.

Depression:

When the patient accepts cancer as inevitable, she feels a sense of emptiness and profound sadness. In this stage, depression is considered as a natural response to a great loss. Its time period varies from one person to another. So they may spend varying amounts of time in this stage.

Acceptance:

Then a time comes, the patient decides to accept whatever is happening. That person may not be completely fine with it but she starts adjusting herself with the situation and learns to live with it.

Holistic needs during treatment

After tumor resection or mastectomy, some people undergo chemotherapy to eliminate residual cancer cells from the body. Chemotherapy may have so many side-effects like anorexia, nausea and vomiting, alopecia, risk of infection, oral ulcers, and thrombophlebitis. Redness and dryness of skin can be a result of radiotherapy. Some other side effects may include thyroid dysfunction, early menopause-associated symptoms, and decreased libido. So there are some suggestions to alleviate the side effects.

Some targeted exercises can be helpful for rehabilitation for breast cancer survivors. In the case of lymph node removal, exercises to reduce lymphedema are recommended, and manual lymphatic drainage massage, skincare, and compression bandage should be a part of it. In breast cancer patients for better immunity, enhanced body awareness, and psychological and physical well-being some non-targeted exercises should be carried out. To reduce anxiety, depression, fatigue, and stress yoga is the best option.

Source: Onco Stem

Sometimes a patient might feel a fear of abandonment or of being a burden. So it was studied that social support for cancer patients found to be effective in reducing the negative impact of diagnosis and treatment of cancer. Motivations help to keep their hopes high, diverting attention away from the bad thoughts.

Holistic needs after treatment

Cancer Patients may think about how to integrate back into the workplace and society after a long term treatment. This is the time for support groups to be there to give them moral support, so that they may find some solace in meeting and sharing similar situations same as theirs who have recovered psychologically from breast cancer.

Patients diagnosed with advanced cancer have to undergo long-term treatment and those diagnosed with terminal cancer need end-of-life care.

Source- GM Cancer, Achieving world class outcome in Cancer: taking the strategy forward (May 2016)

CONCLUSION

The patient herself should try to stay active and do some exercise or do physical activity each day active during or after cancer treatment.
Physical activity after treatment can help to strengthen muscles, lower blood pressure, , improve fitness level and give more energy after treatment. The patient should eat a variety of foods from the four food groups each day
and intake drinks that are high in calories, fat, sugar, and sodium
Drink little and should avoid alcohol and smoking. Should visit to the doctor in every 3–6 months for 1 to 3 years after treatment for primary care and physical examination. Prepare a complete heath care routine, a list of possible late- or long-term side effects of the treatment and a schedule for follow-up exams and tests. As patients complete treatments celebrate the victory over cancer.

REFERENCE

· Akhigbe AO, Omuemu VO. Knowledge attitudes and practice of breast cancer screening among female health workers in a Nigerian urban city (2009). BMC Cancer, 9, 203–5.

· Allemani C, Weir HK, Carreira H, Harewood R, Spika D, Wang XS et al (2014). Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet, S0140–6736, 62038–9

· Ng ZX, Ong MS, Jegadeesan T, Deng S, Yap CT. Breast Cancer: Exploring the Facts and Holistic Needs during and beyond Treatment. Healthcare (Basel). 2017;5(2):26. Published 2017 May 24. doi:10.3390/healthcare5020026

· https://www.cancer.org/cancer/breast-cancer/living-as-a-breast-cancer-survivor/follow-up-care-after-breast-cancer-treatment.html

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