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PSYCHOLOGICAL SUPPORT OF THE BREAST PATIENT
Every year180,000 women are diagnosed with breast cancer. More than 44,000 women die from it. 2.6 million women are living with breast cancer today. 1.6 million women know about it; 1 million women have not yet been diagnosed. One out of nine women will develop breast cancer. Eighty-five percent of breast cancer occurs in women over 50 years old. These statistics reinforce the validity of a womans fear inherent in the diagnosis of breast cancer. Finding a breast lump or having a mammogram with abnormal findings is a frightening experience for any woman.
It is important to acknowledge the patients desire for urgency to be evaluated once a breast abnormality has been discovered. The level of anxiety for the patient is very high from the initial discovery until the definite diagnosis has been made. Dealing with the patients fear is a balancing act. The information given to the patient at this time stimulates new worries and upsets the balance of trying to calm the patient by providing her with information to alleviate their fears. The patient feels as if this is the beginning of the end. Most patients equate the word cancer with death. But the more information a patient is given, the more control she feels she has over what is happening to her. As the disease becomes more real, it also becomes more manageable. Knowledge is the antidote to fear. Lack of knowledge regarding breast cancer and its treatment can render the patient powerless. In most cases, once the patient knows what they are dealing with, they find the strength to deal with it.
In many instances, after a patient hears the word cancer they hear nothing else that is said. Some patients report they physically feel as if they have been kicked in the stomach and experience a feeling of numbness when they receive a diagnosis of breast cancer. For some, these emotions last for hours, for others, days and weeks. The initial encounter with the disease is a time of turmoil. It is crucial to provide a nurturing approach for the patient and the patients family. They are frightened and are experiencing deep suffering. It is important to realize the patient feels they have been catapulted into a new world with a foreign language. This may represent their first encounter in the medical field. Their relationship with their doctor should foster healing, communication, and respect.
The evolution of todays patient is a crucial factor in the treatment of their breast disease. Patients have become less submissive and better informed. It is important there be an open and honest respect between doctor and patient. This may be difficult with time constraints, pressures and the common perception of the doctor as the authority figure and the patient as someone who does what they are told. This relationship can be achieved by encouraging patients to ask questions regarding treatment options and to express any dissatisfaction with the quality of attention and care that they have received. This will help to facilitate respect and communication and become an important part of the patients healing process.
Breast cancer not only invades a womans body and endangers her life; it can also destroy a womans female identity and her confidence. Suddenly the patient is facing a variety of losses: loss of breast, loss of health, loss of hair, loss of income, loss of love and support, perhaps loss of life. It is understandable the patient expects to receive much-needed support from those closest to her-spouse, partner, children, or parents. But family and friends are also afraid. Their reactions often intensify the patients fear. The patient needs to recognize that those closest to her are experiencing the same kinds of feelings-shock, anger, fear, and helplessness. The ability to recognize and communicate these feelings will help alleviate them and make them more manageable. During this time the patient needs empathy. Acknowledge what she is going through is terrible and that you are sorry she has been diagnosed with breast cancer. Patients feel that minimizing what they are experiencing tends to be condescending.
The individual with breast cancer finds it difficult to go through the process alone. Even when family and friends are supportive, they really do not know what is feels like to have cancer. This is where the efficacy of a support group comes into play. Once a patient finds a support group where she feels comfortable discussing her situation with strangers, the people in this group will provide her with a feeling of security and belonging. The support group will become her buffer against the outside world. The patient can express powerful emotions that she was unable to verbalize to her loved ones, and she realizes she was not crazy to be feeling all the things she was feeling. Support groups provide beneficial group intervention. But it is essential for the patient to recognize when it is time to leave the group. The cancer patient needs to take stock and ask herself if she really needs to continue. She will know when it is time to move on and to concentrate on her life as a cancer survivor.
Hopefully, once the patient has completed the treatment of her breast cancer and realizes breast cancer is a survivable disease, her fear will have lessened. But patients report the fear of recurrence is always present. They have to learn to trust their bodies once again. It is very important they do not let this fear paralyze them. The patient needs to be diligent in regards to their routine medical follow-up, but they have to untether themselves from the medical aspect of their disease and resume their normal lifestyle.
Breast cancer does not necessarily make life more uncertain. It simply magnifies the uncertainty of life. No one is immortal; making each day count is the gift.
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