BREAST CANCER PSYCHO-SOCI~L ~SPECTS OF E~RLY DETECTION AND TREATMENT

BREAST CANCER PSYCHO-SOCI~L ~SPECTS OF E~RLY DETECTION AND TREATMENT

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8RIA5T CANCIR PSYCHO-SOCI~L ~SPECTS OF E~RLY DETECTION AND TREATMENT A Workshop Meeting Report Edited Py p. C. Brand and P. A.van Keep The International Health Foundation MTP

Published by MTP Press Limited St Leonard's House St Leonardgate LANCASTER Copyright 1978 MTP Press Limited Softcover reprint of the hardcover 1st edition 1978 No part of this book may be reproduced in any form without permission from the publishers, except for the quotation of brief passages for the purpose of review. ISBN 978-94-010-9138-1 ISBN 978-94-010-9136-7 (ebook) DOI 10.1007/978-94-010-9136-7

Contents List of Participants Preface vii ix 'Reach to Recovery': C.M. 2 Women who have had a mastectomy need increased psycho-social support. How do these women value mutual support groups? J. M. Wenderlein 9 3 Mastectomy - experiences of women and professional.helpers: C. M. van Brederode 15 4 Couples and mastectomy: E. Metze 25 5 Adjustment to mastectomy: the psychological impact of disfigurement: C. Ray 33 6 Psychiatric problems after mastectomy: G.P. Maguffe 47 7 Delay in seeking medical advice for breast symptoms: M. Humphrey 57 8 Reconstruction of the breast - some considerations: J. Baruch 67 v

CONTENTS 9 Psychological problems related to the conservative treatment of breast cancer: P. Juret 73 10 Psychological reactions of breast cancer patients to radiotherapy: K. Gyllenskold 81 11 Factors affecting participation in cancer screening programmes: L. Vermost 91 12 Participants and non-participants in a mammography mass screening - who is who: W. J. A. van den Heuvel 97 General 105 Index 113 VI

List of Participants President: Dr P. A. VAN KEEP, International Health Foundation, Geneva, Switzerland Chairman: Dr P. C. BRAND, International Health Foundation, Geneva, Switzerland Participants: Professor J. BARUCH, Plastic Surgeon, Centre Hospitalo-Universitaire Henri Mondor, Faculte de Medecine, Paris XII, France Dr C. M. V AN BREDERODE, Social- Nederlands Instituut voor Sociaal Sexuologisch Onderzoek, Zeist, The Netherlands Dr K. GYLLENSKOLD, Department of Education, University of Stockholm, Stockholm, Sweden Dr W. J. A. VAN DEN HEUVEL, Studiecentrum Socia Ie Oncologie, Amsterdam, The Netherlands Dr M. HUMPHREY, Department of Psychology, St George's Hospital Medical School, London, England Dr P. JURET, Oncological Endocrinologist, Centre Regional Fran90is Bac1esse, Caen, France C.M., Volunteer Worker, 'Vivre comme Avant' (French equivalent of 'Reach to Recovery'), Paris, France Dr G. P. MAGUIRE, Psychiatrist, The University Hospital of South Manchester, Manchester, England DrE. METZE, Danish Cancer Society, Ega, Denmark Dr C. RAY, University College, Cardiff, Wales, United Kingdom Dr L. VERMOST, Sociologist, Department Sociologie, Afdeling Medische Sociologie, Katholieke Universiteit Leuven, Louvain, Belgium Dr J. M. WENDERLEIN, Gynaecologist- Frauenklinik mit Poliklinik und Hebammenschule der Universitat Erlangen-Niirnberg, Erlangen, West Germany vii

Preface Undoubtedly, the medical aspects of mammary carcinoma-its cause, early detection and treatment- have received considerable attention. Rightly so. The disease is widespread and may be regarded as one of the most important health hazards for women. The psycho-social aspects of the problem, however, have so far received far less attention. Yet these aspects are of the utmost importance, as became evident once more during our workshop conference, of which this book presents the proceedings. It dealt with two aspects of psycho-social problems resulting from breast cancer: 1. The psycho-social difficulties that women may face when the diagnosis is given and when mastectomy has been performed. 2. The psycho-social factors that play a role in participation or nonparticipation in screening programmes for mammary carcinoma. These two areas, and some related topics, have been the subject of a 2-day meeting in Brussels, organized by the International Health Foundation. A number of papers was presented and discussed. The meeting ended with a general discussion. The editors are grateful to the participants for their willingness to share their knowledge and ideas with them. It is hoped that this book will be of some help to all those who are involved in the treatment and the care of women who are to undergo or who have had a mastectomy and to those who plan the strategy of screening programmes for carcinoma of the breast. Patrick C. Brand Pieter A. van Keep ix