Managing the Psychological Challenges of Breast Cancer

Transcription

1 Managing the Psychological Challenges of Breast Cancer Sarah Delfont Lead Oncology Support Specialist FORCE Cancer Charity

2 Journey without a map a satnav without a postcode? Where s the map? Where s the crew What is needed for the journey? Uncertain forecast What control do I have?

3 Recent Changes for Breast Cancer Patients Primary Cancer: Younger women Issues such as fertility, sexuality, young family, work, early onset menopause Better outcomes for some Longer hormone treatment Misinformation media, Dr. Google, personal stories Movement towards self management Potential background of pre-existing mental health issues Secondary Cancer: Living well for longer creates different and ongoing challenges

4 The Impact of these Changes Expectations v- reality The carrot of the next cure clinical or miracle What do phrases such as primary, recurrence, secondary, remission, palliative now mean to people Public perception, private thoughts Treatments individualised Potentially choices to be made

5 What Helps? Support from others in similar situation (local groups - site specific, physical activity, walking, art, relaxation, cookery etc. and online e.g. Breast Cancer Care) Managing patient expectations, initial diagnosis Encouraging people to draw on established coping strategies (how do they normally cope?) Adopting new simple techniques Signposting to appropriate services, local and national, Timely and appropriate information Resources recommended websites, films, retreats, tried and tested!

6 It isn t what your doctor says, it is how they make you feel Medefine 2018

7 C.R.A.P. detector October 27, Skyler Johnson, MD

8 Anxiety triggers Physical symptoms Insomnia middle of night anxiety Expectations of self and others Pressure of positive thinking from others (Jimmie C. Holland: The Human Side of Cancer 2001) Hospital visits, scan results etc. (Can also be a reassurance) Lack of understanding about recovery process (Peter Harvey: After the Treatment Finishes 1996) Communication barriers

9 The Stress Reaction Fight, Flght or Freeze Loss of confidence Uncertainty Loss of control Fear of future

10 Expectation Reality

11 Challenges of a cancer diagnosis Self

12 Life beyond diagnosis and treatment Sense of Self

13 Keeping Balance Stress Relaxation Acceptance and adjustment

14 Secondary Breast Cancer We found very few of the women had any access to formal support. There have been great strides in clinical treatment but with little or no support these patients are faced with a constant cycle of illness treatment and recovery and particularly for those with more aggressive disease there was little let-up. They had an uphill struggle in trying to adapt to constant change whilst trying to manage pain in the present and a future reduced life expectancy. Reed E, Corner J Defining the illness trajectory of metastatic breast cancer BMJ Supportive & Palliative Care 2015;5:

15 Secondary Breast Cancer Support Group Audit 2014 Gill Gray & Sarah Delfont: RD&E Hospital & Force Cancer Charity I get a lot of support from attending this group both from the other members and also the facilitators who manage to get the balance of information and emotional support just right. At times there is great sadness when we lose a member but the benefits I gain from belonging to the group far outweigh the downside of these difficult times. This support group plays a very important part in helping me to cope with the difficulties I am facing with my illness. A group participant

16 It s not about waiting for the storm to pass It s about learning to dance in the rain