Address correspondence to Karen Kayser, Boston College, Graduate School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467; e-mail: kayserk@bc.edu. Ganz PA: Treatment options for breast cancer-beyond survival. Types of Palliative Care. However, women uniformly report that they appreciate the attention and support from their health-care team, and referral to appropriate resources as necessary. The stress of breast cancer was described as arousing depression, anxiety, and anger. Many people with breast cancer are successfully treated every year. High-dose therapy has been largely abandoned, and treatments have been further modified through better understanding of the molecular risk profiles for primary breast cancer, including HER2 overexpression. Effects of a Randomized Couple-based Intervention on Quality of Life of Breast Cancer Patients and Their Partners Karen Kayser, PhD. Although serious depression is not seen in the majority of breast cancer patients and survivors, many will experience treatment-related distress, fear of recurrence, changes in body image and sexuality, as well as physical toxicities that result from adjuvant therapy. J Clin Oncol 6:1795-1797, 1988. At the OHSU Knight Cancer Institute, we offer teams of specialists who can help. A study of 152 breast cancer patients found that approximately 32% experienced GAD, an anxiety disorder in which a general feeling of unease or fear is present, despite little or no threat. Choose from 12 allied health programs at School of Health Professions. They include experts in survivorship, social work, rehabilitation, alternative medicine, nutrition and other specialties. Maunsell E, Brisson J, Deschenes L: Psychological distress after initial treatment for breast cancer: A comparison of partial and total mastectomy. This is exacerbated by the physical toll that primary treatment often extracts. [24,25,30-34] The specific type of breast cancer surgery, and whether a woman is receiving chemotherapy or radiation therapy does not seem to influence the level of distress. 1. Effects of social constraints and web-based psychoeducation on cancer-related psychological adjustment early-after breast cancer diagnosis. Medical debt is one factor. Ganz PA, Rowland JH, Meyerowitz BE, et al: Impact of different adjuvant therapy strategies on quality of life in breast cancer survivors. Support groups often provide this type of assistance and should be offered. But for others, the cancer comes back and spreads to another area of the body (metastasises).When breast cancer spreads it is called secondary breast cancer, and is often more difficult to treat. Survivor guilt: Some people wonder why they survived cancer when others don't. 40. Fisher B, Redmond C, Brown A, et al: Treatment of primary breast cancer with chemotherapy and tamoxifen. Loss can include your health, sex drive, fertility and physical independence. 31. For example, tamoxifen, a common breast cancer treatment, can cut a woman’s rate of breast cancer recurrence by up to 50 percent. Facing many months of treatment leads to disruption in social activities (childcare, work, caregiving) and decreases the ability to plan and multitask. 2. To this end, I review what we have learned about the psychological and social aspects of breast cancer during Dr. Abeloff’s distinguished career, and how leaders such as he have promoted the integration of psychosocial services into the standard care of oncology patients through their words and their actions. Further refinements in surgical staging, including the sentinel lymph node biopsy, have now begun to limit the extent of axillary surgery for women with small tumors and low metastatic potential. 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. The good news is that you don’t have to suffer alone. Med Care 31:419-431, 1993. If you suffer from a prolonged sense of guilt, seek help from a psychotherapist, clergy member or support group. • Comorbid Conditions-Several studies have indicated that women with comorbid conditions or impaired performance status report higher levels of psychological distress after a breast cancer diagnosis. You may be reluctant to talk about your cancer treatment to employers or coworkers for fear of being treated differently. Cancer 76:631-637, 1995. [3,23-27] In studies that have examined quality of life and depression after breast cancer, most patients and survivors demonstrate high levels of functioning in the early and later years after primary treatment, for those who remain disease-free. 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. J Natl Cancer Inst 94:39-49, 2002. Social support is regarded as a complex construct which has long been suggested to have direct and buffering effects on patients' wellbeing and emotional adjustment to cancer. 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. Wolmark N, Fisher B: Adjuvant chemotherapy in stage-II breast cancer: An overview of the NSABP clinical trials. Committee on Pyschosocial Services to Cancer Patients/Families in a Community Setting: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. In today’s environment, a woman who has an image-guided breast biopsy and receives a cancer diagnosis is immediately approached by other women-from her work, church, or other social network-who are breast cancer patients/survivors, and who are immediately ready to help her get through the early diagnosis and staging of the cancer, and provide support and encouragement. 1p. Our personalized portal helps you refer your patients and communicate with their MD Anderson care team. There can be significant psychosocial effects of a cancer diagnosis, especially amongst patients with a pre-existing mental health condition. 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