From helplessness to self help: Breast cancer surviorship in India.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 208-208 ◽  
Author(s):  
Rebecca DeSouza ◽  
Shona Milon Nag ◽  
Rama Sivaram ◽  
Anupama Dutt Mane

208 Background: In The Indian Scenario, a diagnosis of cancer is accompanied with social stigma and emotional upheavals, especially in breast cancer patients. They are typically thinking: “I would be less of a woman,” “I don’t know if people understand me,” “I feel isolated from myself, my family and my friends,” “Would I be normal again?” “Do I know how to help myself?” or “What will happen in the future, to my kids, to my husband?” Methods: All of these concerns are not always addressed by the medical professions. To address these issues, the Indian Breast Cancer Survivors Conference was organized as an annual conference with an attendance of 200-250 breast cancer survivors from the state of Maharashtra, India. The conference would address the psychological, emotional and social distress experienced by the patients with an aim from living a longer life to living a better and fulfilled life. Results: The emphasis of the sessions were educational (with recent updates on the surgical, medical and radiation therapy aspects of breast cancer treatment), practical (emphasized important issues like side-effects of treatment, patient advocacy, complementary therapies, spirituality, lifestyle changes, etc.), and entertaining. The summary and outcomes of the last 5 annual survivorship conferences will be described and enumerated. Results of questionnaires administered during the last 2 conferences and addressing health behavior patterns of survivors will be presented. Conclusions: We can evaluate through post conference support group discussions and conference feedback, qualify patient psychological and social health as 1) Physical:There are side effects but I choose to go on; 2) Mental: There are times that I am low, depressed, anxious, scared, guilty, but this is my new normal; 3) Emotional:Little things upset me, angry quickly but I am dealing with it; 4)Spiritual:Moved away from bargaining with God to accepting, from rituals to spiritual; 5) Social:don’t hesitate to reach out for support and to support; and 5) Intellectual:Knowledge is power, so I have learned to ask, to question, and then to decide. Achieving psychological and social health is the effort of the patient, the treating team and the support group.

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 178s-178s
Author(s):  
S. Nyagabona ◽  
F. Rubagumya ◽  
A. Longombe ◽  
A. Manirakiza ◽  
T. Maniragaba ◽  
...  

Background and context: Breast cancer is a common type of cancer among women worldwide, with about 2 million new cases diagnosed in the yearly. It is the second common cancer and leading cause of cancer mortality among women in Tanzania, after cervical cancer. More than 70% of breast cancer patients in developed countries are diagnosed at early stages, whereas in low and middle-income countries, only 20%–60% of patients are diagnosed early. Physician in developed countries consults on average 15-20 breast cancer patients daily, while in developing countries the number triples. This high load does not allow a treating physician to spend ample time with patients explaining hence leaving patients not informed about their diagnosis, side effects of treatments and even living with the physical, emotional and psychological challenges of their disease. Residents at the Ocean Road Cancer Institute (ORCI), initiated a patient support group targeting breast cancer patients for feasibility. Aim: Provide forum for patients with same diagnosis to share common challenges Provide peer emotional, psychosocial support and cancer education Organize activities that will help to spread awareness to the community Initiate projects to improve socioeconomic status of breast cancer survivors in Tanzania Strategy/Tactics: Involved the ORCI administration from the beginning Involved the academic and research unit of ORCI Residents prepared session curriculum and teaching materials Sessions took place once a month Sessions were two hours long divided into three components, where the first is introduction of participants, then survivors led discussions or lectures prepared by an expert in the topic and lastly closing remarks by a physician Breakfast was provided Program/Policy process: Open membership for all breast cancer patients Physician lead face to face peer discussions Institutional acknowledgment of the support group Provision of primary registry of patients for follow-up Provision of a link to other social organizations Outcomes: Increase knowledge of cancer in general and breast cancer in particular A total of seven sessions were held to date For each session, participation ranged from 30-50 breast cancer survivors, and on average attendance was 4 sessions out of 7 Topics covered over a period of seven months included Coping with a cancer diagnosis and treatment Living with cancer and its changes to daily life Exercise Nutrition Breast cancer general knowledge Collaboration with other stake holders including IST secondary school students who initiated breast prosthesis knitting club What was learned: A need to reach out and give psycho-social support to ORCI patients Through education we can improve treatment adherence Possible partners are available if we reach out Exist a need to address misconceptions in the community so as to avoid stigma to patients.


2018 ◽  
Vol 18 (6) ◽  
pp. e1237
Author(s):  
Christina Kozul ◽  
Lesley Stafford ◽  
Chad Bousman ◽  
Allan Park ◽  
Kerry Shanahan ◽  
...  

2013 ◽  
Vol 27 (2) ◽  
pp. NP495-NP505
Author(s):  
Noor Lide Abu Kassim ◽  
Khayriyyah Mohd Hanafiah ◽  
Humairah Samad-Cheung ◽  
Mohammad Tariqur Rahman

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 257-257
Author(s):  
Hong Kyu Jung ◽  
Jihyoun Lee ◽  
Zisun Kim ◽  
Min Hyuk Lee ◽  
Ilkyun Lee

257 Background: Breast cancer survivors have slightly increased risk of second primary cancers. Importance of screening for second cancers has been raised due to increased survival in those populations. Not only having genetic risk such as BRCA mutation, but also treatment-related risk presents. The most common second primary cancer is breast cancer. Colon cancer, uterine cancer, and ovarian cancer showed increased cumulative incidence. In this study, we assessed development second primary cancers in breast cancer survivors. Methods: Medical record of breast cancer patients was reviewed retrospectively in three tertiary medical institutions. Available data of ICD-9 record after breast cancer diagnosis was evaluated. Diagnosis of second primary breast cancer was excluded in evaluation. Results: Since Jan 1989 to Jan 2014, available medical records were reviewed in breast cancer patients(N = 5880) in three institutions(one urban and the other two rural institutions). Cumulative incidence of overall second primary cancers was 4.57%. Among 269 second primary cancers, thyroid cancer(44.2%) was most common second primary cancer, followed by gastric cancer(10.0%). Gastric cancers were more common in rural institution than urban area(14.2 % vs 5.5%), while incidence of thyroid cancer is elevated in urban institution(57.8% vs 31.9%). Among 9 patients who has been diagnosed endometrial cancer, 7 patients had history of selective estrogen receptor modulator(tamoxifen or toremifen) treatment. Development of lung cancer was not related to breast cancer radiation treatment(4 of 15 patients). Leukemia after breast cancer treatment was diagnosed in 5 patients (8.5% of second primary cancers), three of them were adult T cell leukemia and two of them were acute myeloid leukemia. Conclusions: Incidence of cancer in general population was reflected to development of second primary cancer in breast cancer survivors. Endocrine treatment was related increased incidence of endometrial cancer, respectively. Application of personalized cancer screening plan would be important in this patient group.


2013 ◽  
Vol 22 (3) ◽  
pp. 256-262 ◽  
Author(s):  
Jun J. Mao ◽  
Annie Chung ◽  
Adrian Benton ◽  
Shawndra Hill ◽  
Lyle Ungar ◽  
...  

In this study we gathered data in July 2016 by means of questionnaires from breast cancer survivors following initial consult in a naturopathic clinic. Most patients surveyed had previously or concurrently had total surgical resection of their tumor burden, followed by at least 36 treatments of intravenous nutrients, including water -soluble vitamins and minerals. We compare those having a history of surgery with those not having that history. We also compare outcomes among those having a history of radiation therapy and those without, as well as those having a history of chemotherapy and those without. Some of those in remission chose to return for follow-up intravenous nutrients once per month after achieving remission from their cancers. We compare the different cohorts, among the various stages of cancer, for treatment choices and disease status. 97 total cancer survivors responded fully and promptly to the questionnaires. 37 of those were breast cancer patients.


Author(s):  
Yuk Yee Karen Lee ◽  
◽  
Kin Yin Li ◽  

"Breast cancer is a major concern in women’s health in Mainland China. Literatures demonstrates that women with breast cancer (WBC) need to pay much effort into resisting stigma and the impact of treatment side-effects; they suffer from overwhelming consequences due to bodily disfigurement and all these experiences will be unbeneficial for their mental and sexual health. However, related studies in this area are rare in China. The objectives of this study are 1) To understand WBC’s treatment experiences, 2) To understand what kinds of support should be contained in a transdisciplinary intervention framework (TIP) for Chinese WBC through the lens that is sensitive to gender, societal, cultural and practical experience. In this study, the feminist participatory action research (FPAR) approach containing the four cyclical processes of action research was adopted. WBC’s stories were collected through oral history, group materials such as drawings, theme songs, poetry, handicraft, storytelling, and public speech content; research team members and peer counselors were involved in the development of the model. This study revealed that WBC faces difficulties returning to the job market and discrimination, oppression and gender stereotypes are commonly found in the whole treatment process. WBC suffered from structural stigma, public stigma, and self-stigma. The research findings revealed that forming a critical timeline for intervention is essential, including stage 1: Stage of suspected breast cancer (SS), stage 2: Stage of diagnosis (SD), stage 3: Stage of treatment and prognosis (ST), and stage 4: Stage of rehabilitation and integration (SRI). Risk factors for coping with breast cancer are treatment side effects, changes to body image, fear of being stigmatized both in social networks and the job market, and lack of personal care during hospitalization. Protective factors for coping with breast cancer are the support of health professionals, spouses, and peers with the same experience, enhancing coping strategies, and reduction of symptom distress; all these are crucial to enhance resistance when fighting breast cancer. Benefit finding is crucial for WBC to rebuild their self-respect and identity. Collaboration is essential between 1) Health and medical care, 2) Medical social work, 3) Peer counselor network, and 4) self-help organization to form the TIF for quality care. The research findings are crucial for China Health Bureau to develop medical social services through a lens that is sensitive to gender, societal, cultural, and practical experiences of breast cancer survivors and their families."


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19603-19603
Author(s):  
C. O. Ruud ◽  
K. Francis ◽  
C. Stephens ◽  
M. H. Rajab

19603 Background: The ASCO 2006 guidelines specify that regularly scheduled follow-up care of breast cancer survivors should be the standard. Follow up care is a “teachable moment” to train survivors in positive habits. A group visit model at the Cleveland Clinic proved feasible and improved patient satisfaction for other diseases. Our objectives include assessing the feasibility of an adapted group follow-up visit for the care of breast cancer patients and patient satisfaction. Methods: A feasibility study targeting breast cancer patients who completed primary therapy and were scheduled for a routine appointment. We mailed letters inviting patients to a follow-up group visit. Patients were divided into 3 groups, each scheduled for a separate (90–120 minute). During the first half of the visit, participants were divided into three groups; 5-minute physician exam, nurse review of medications and vital signs, and instruction by a social worker. Groups were rotated. During the second half the doctor, nurse, and social worker met with all participants in one room starting with an educational presentation about fatigue and exercise. Each participant was subsequently interviewed by the physician in the presence of their peers. Shared complaints were investigated first. Patients rated their satisfaction with the different parts of the visit on a scale of 1–5. Participants were surveyed pre- and post- education session and asked if they would participate again. Participants were allowed to bring a family member or friend. Results: 29 (29.6 %) out of 98 consented and 22 (22.5%) attended;10 in first visit, 5 in second visit and 7 in last visit. Average age 61±8, ranged from 46–72 years. Most participants were satisfied with all parts of the group visit, except two in the first group were less satisfied with the check in process and moving between rooms. Comparing the pre- vs. post- educational session surveys showed an improved understanding of the importance of fatigue or exercise. 17 (77%) out of 22 participants agreed to participate in another group visit. Conclusion: Group visit format is feasible and provides patient satisfaction. No significant financial relationships to disclose.


2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 21-21
Author(s):  
Dean Alden Shumway ◽  
Rebecca Leinberger ◽  
Kent A. Griffith ◽  
Brian Zikmund-Fisher ◽  
Sarah T. Hawley ◽  
...  

21 Background: Worry about recurrence is a significant concern for breast cancer survivors. We explored physicians‘ confidence and practices in identifying and managing worry. Methods: We surveyed a random sample of 1,500 surgeons and medical oncologists drawn from the AMA Masterfile in 2012. Physician responses to questions regarding their confidence were stratified by practice specialty and compared using the Wilcoxon rank-sum test. Correlates of use of each strategy for managing worry were modeled using multiple variable logistic regression. Results: 896 physicians (59.7%) responded: 498 surgeons and 398 medical oncologists, of whom 85.5% saw breast cancer patients. 62% reported initiating discussions regarding worry about recurrence. Overall, medical oncologists reported more confidence than surgeons in their ability to present risk information to patients, identify survivors with high levels of worry, and help patients manage their worry (p<0.001). Of note, 40.2% of physicians reported low levels of confidence managing worries surrounding recurrence. Confidence presenting risk information was significantly associated with treatment volume, which was highest with >50 cases/year. Surgeons who routinely followed breast cancer survivors for >3 years reported higher confidence; no such correlation existed among medical oncologists, but >90% of this group routinely followed patients for >3 yrs. Female physicians were significantly more likely to report being able to identify survivors with high levels of worry. Practice in an academic setting demonstrated associations with increased confidence. Use of worry management strategies varied by specialty. Medical oncologists were more likely to prescribe medication, address concerns in detail themselves, or refer to a psychologist or social worker. Longer follow-up was associated with increased likelihood of physicians addressing concerns themselves. Conclusions: A sizeable minority of physicians lack confidence in their ability to identify and manage worry in cancer survivors. Medical oncologists and surgeons differ significantly in their approach to worry management, suggesting that greater attention toward this issue in training and continuing education may be warranted.


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