Caring For Following Treatment For Breast Cancer Patients
Breast cancer patients who have recovered still have risk to relapse again. Study in the UK showed that after 5 years of adjuvant endocrine therapy, breast cancer recurrences continued to occur steadily throughout from 5 to 20 years . After undergoing therapy, breast cancer patients follow a series of follow-ups. Some follow-ups are doctor visit, mammogram screening, pelvic exams, and bone density test. Completed of follow up assesment breast cancer patients on Table 3.
Surveillance and screening for asymptomatic breast cancer survivors.
After breast surgery, physical changes can make some women less comfortable with their bodies. There may be a loss of sensation in the affected breast. Other treatments for breast cancer, such as chemotherapy, can change your hormone levels and affect sexual interest and/or response. Partner may worry about how to express love physically and emotionally after treatment, especially after surgery. But breast cancer can be a growth experience for couplesespecially when partners take part in decision-making and go along to treatments .
Caring in breast cancer patients after treatment can be given by group like in Canada there is CanIMPACT . Similar teams from either the health team or from community groups are needed by breast cancer patients to survive.
Nursing Considerations For Breast Cancer Survivorship Care
More than 3.5 million people in the United States are living with a breast cancer diagnosis. Despite their large number, patients often report they do not receive appropriate follow-up care after completing treatmentand the situation is worsening, with pandemic-related delays in care affecting approximately half of breast cancer survivors.
The American College of Surgeons Commission on Cancer updated its 2020 standards to include a dedicated survivorship program team to develop appropriate services such as treatment summaries, care plans, and screening and preventative services. The standards also recommend targeted strategies to address the many physical and psychosocial effects associated with a cancer diagnosis. Organizations such as ONS, the American Society of Clinical Oncology, and National Comprehensive Cancer Network have evidenced-based guidelines for supportive and disease-specific survivorship care. Each survivor needs a comprehensive care plan individualized to their personal health, family history, and type of treatment.
Optimizing Screening And Appropriate Follow
Each province and territory has provided their own content and measures this indicator differently. Because of these differences, data cannot be compared across jurisdictions. See the technical specifications for more details. Also, references for the Canada-wide information are also available.
Why we are focusing on optimizing screening participation
- 80% of Albertas eligible population will be up to date for cervical cancer screening.
- The Alberta Cervical Cancer Screening Program aims to:
- Reduce the incidence of cervical cancer in Alberta
- Reduce disparity in participation rates across the population
- Build awareness and integration of cervical cancer prevention and screening
- Engage in continuous quality improvement and assurance across the screening continuum
- The Alberta Breast Cancer Screening Program engages individuals in screening, develops partnerships and participates in research to enhance program quality.
- Breast cancer screening program screens eligible people aged 50-74 every two years with a mammogram.
- Cervical cancer screening with a Pap test is recommended for people aged 25-69 with a cervix every three years.
- Percentage of individuals aged 40-49 who completed at least one screening mammogram in 2019
- Annual return to screen recommendation by radiologist rate in 2019
- Percentage of people with a cervix aged 18-24 who received at least one Pap test in 2019, by age group
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Find Out Your Family History
Women with a strong family history of cancer can take special steps to protect themselves, so its important for women to know their family history. You may be at high risk of breast cancer if you have a mother or sister who developed breast or ovarian cancer or if you have multiplefamily members who developed breast, ovarian or prostate cancer. A doctor or genetic counselor can help you understand your family history of the disease.
Ten Lifestyle Changes That May Help
All breast cancer survivors live with the concern about a recurrence or a new cancer. This fear is usually the biggest worry of all. Many women feel that their body has betrayed them and therefore it takes time to trust it again.
Learning how to cope with fears of recurrence is important. Though your body has gone through many changes as a result of a cancer diagnosis and treatment, most women become healthy, strong and optimistic once again.
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The Following Are Protective Factors For Breast Cancer:
Reproductive history resulting in less exposure to estrogen
A womans reproductive history can affect the length of time her breast tissue is exposed to estrogen. Early onset of menstruation, late onset of menopause, later age at first pregnancy, and never having given birth have been linked to an increase in estrogen exposure and breast cancer risk. The following reproductive factors decrease the length of time a woman’s breast tissue is exposed to estrogen and may help prevent breast cancer:
- Early pregnancy: Estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have not had children or who give birth to their first child after age 35.
- Breast-feeding: Estrogen levels may remain lower while a woman is breast-feeding. Women who breastfed have a lower risk of breast cancer than women who have had children but did not breastfeed.
Taking estrogen-only hormone therapy after hysterectomy, selective estrogen receptor modulators, or aromatase inhibitors and inactivators
Estrogen-only hormone therapy after hysterectomy
Hormone therapy with estrogen only may be given to women who have had a hysterectomy. In these women, estrogen-only therapy after menopause may decrease the risk of breast cancer. There is an increased risk of stroke and heart and blood vessel disease in postmenopausal women who take estrogen after a hysterectomy.
Selective estrogen receptor modulators
Navigating Your Path To Breast Care: Newly Diagnosed
A new diagnosis of breast cancer is often paired with difficult sensations, emotions and responses including fear, shock, numbness and disbelief, as well as anger, betrayal, grief and sadness. In the midst of this emotional trauma, women must gather information, often learn a new language of medical terms, understand treatment choices and make difficult decisions. Women often report being overwhelmed or at least intensely challenged to make sense of the medical maze.
Three specialty areas of central importance in the treatment of breast cancer include: surgical oncology, medical oncology and radiation oncology. Not everyone is treated with all of these modalities, but each is weighed for the benefits offered and for the potential risks incurred.
Each of these areas can be thought of as the treatment building blocks they may be given in different orders, over differing amounts of time, all depending on the stage and biological behavior of the breast cancer and the individual references of the women diagnosed with disease. A combination of treatment strategies from the three key breast cancer modalities is often the best method to achieve both local and systemic control of breast cancer.
The treatments are accompanied by a range of emotions, possible side effects and potential variability in response to treatment. While none of these treatments is easy to undergo, many women weather breast cancer treatments with support.
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Paget Disease Of The Breast
Paget disease of the breast is a rare type of breast cancer. It develops as a rash or other skin changes on the nipple, usually on only one breast. This is more common in women over the age of 50. Most women with Paget disease also have invasive ductal carcinoma or ductal carcinoma in situ . The cancer can then spread to the dark-colored skin around the nipple .
Paget disease of the breast usually causes changes to the nipple, including:
Crusting, scaling, or flaking
Redness of the nipple and areola
Burning or itching
Here Are Some Tips On How You Can Care For Both Your Loved One With Breast Cancer And Yourself:
Communicate with your loved one. If youre unsure about something, ask. Share your feelings, and listen when your loved one wants to talk. You dont have to offer opinions or solutions just lend a caring ear.
Respect your loved ones decisions. Even if you are in a position to share decision-making, remember that your spouse or partner is the one facing cancer and treatment. Decisions about care and life are ultimately up to your loved one to make. Its also important to let your loved one decide how family and friends can help them cope throughout treatment.
Ask how you can help with medical matters. Would your loved one like you to join them to medical appointments? Taking notes during visits to the doctor can be helpful. Or perhaps you can help by keeping a calendar of doctor appointments. Ask your loved one how you can be involved throughout treatment.
Offer to take responsibility for practical needs. Your loved ones cancer treatment will generate a lot of paperwork. You can help by offering to take care of important paperwork like medical records, bills or insurance claims.
Volunteer to manage the financial paperwork. Your loved ones cancer treatment will generate a lot of paperwork. You can help her cope by offering to take care of medical records, bills, insurance claims, and so on.
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The Benefits Of Using Proven Strategies
More breast cancer screening would:
- REDUCE deaths. Compared to no screening, screening every 2 years reduces breast cancer deaths by 26% for every 1,000 women screened.4
- INCREASE life expectancy. Women who are screened every 2 years can expect to live 1.4 months longer than women who are not screened.4
- the number of women diagnosed with late-stage cancer. Screening has contributed to a 29% reduction in the number of women diagnosed with breast cancer that has spread to other parts of the body.5
- INCREASE 5-year survival rates. Almost 99% of women diagnosed with breast cancer at the earliest stage live for 5 years or more, compared to about 27% of those diagnosed at the most advanced stage.2
- SAVE money. Breast cancers diagnosed at an early stage are much less expensive to treat than those diagnosed at a late stage.6,7
About 5.3% of US women aged 40 to 64 were eligible for NBCCEDP breast cancer screening services during 20162017. The program was able to serve 15% of eligible women during this time.8
Help Getting Through Cancer Treatment
People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.
Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life.
Different types of programs and support services may be helpful, and can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.
The American Cancer Society also has programs and services including rides to treatment, lodging, and more to help you get through treatment. Call our National Cancer Information Center at 1-800-227-2345 and speak with one of our trained specialists.
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Why Ontario Needs An Indigenous Cancer Strategy
There is an urgent need for action to prevent cancer and other chronic diseases among Indigenous people.
- Ontario is home to the largest Indigenous population in Canada, with an estimated 236,680 First Nations,* 120,585 Métis peoples and 3,360 Inuit.Open
- First Nations people have more new cases of certain cancers than other people in Ontario.
- Death rates from cancer are also significantly higher in First Nations people than in other people in Ontario.
- Obesity, which raises the risk of developing cancer and other chronic diseases, is markedly more common in Indigenous people than in the general population.Open Close * Reference 4:Close referenceWithrow D, Amartey A, Marrett LD. Cancer risk factors and screening in the off-reserve FirstNations, Métis and non-Aboriginal populations of Ontario. Chronic Diseases and Injuries inCanada. 2014 34: 103-12.Open Close
These facts point towards a future of dramatically increased rates of cancer and other chronic diseases among Indigenous people.
For more information about cancer risk factors and screening for Indigenous people, see the following resources:
On average, in Canada Indigenous men live 4 years less than non-Indigenous men do. Indigenous women live an average of 6 years less than non-Indigenous women do.Open Close * Reference 8> :Close referenceHealth C. First Nations and Inuit Health: Diseases and Health Conditions. Ottawa: Health Canada 2014Open Close
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Implications For Future Research And Clinical Practice
Strategies are currently being implemented to encourage timely help-seeking for breast concerns.
In the National Health Breast Screening Program in the United Kingdom, Burgess and colleagues45 developed a research-based psycho-educational intervention comparing a booklet only with a booklet and interview conducted by a radiologist, which uses behavioural change techniques to encourage older women with breast concerns to present earlier to their physicians. The authors postulate that if their initiative is effective at encouraging earlier presentation, then it should be tested in the primary care setting as well.
However, even the most astute, caring family physician will encounter a woman presenting late with advanced breast cancer. There will be women who delay their presentation because of complex contextual or personal factors that are beyond the influence of their family physician this problem requires more investigation20. Better understanding of these complicated dynamics might further enhance the development of strategies to encourage earlier presentation.
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Tamoxifen And Raloxifene For Women At High Risk
Although not commonly thought of as a healthybehavior, taking the prescription drugs tamoxifenand raloxifene can significantly lower the risk ofbreast cancer in woman at high risk of the disease.Approved by the FDA for breast cancer prevention,these powerful drugs can have side effects, sothey arent right for everyone. If you think youreat high risk, talk to your doctor to see if tamoxifen or raloxifene may be right for you.
Avoid Menopausal Hormone Therapy
Menopausal hormone therapy shouldnt be taken long term to prevent chronic diseases. Studies show it has a mixed effect on health, increasing the risk of some diseases and lowering the risk of others. And both estrogen-only hormones and estrogen-plus-progestin hormones increase the risk of breast cancer. If women do take menopausal hormone therapy, it should be for the shortest time possible. The best person to talk to about the risks and benefits of menopausal hormone therapy is your doctor.
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How Breast Cancer Is Treated
In cancer care, doctors specializing in different areas of cancer treatmentsuch as surgery, radiation oncology, and medical oncologywork together with radiologists and pathologists to create a patients overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, nutritionists, and others. For people older than 65, a geriatric oncologist or geriatrician may also be involved in their care. Ask the members of your treatment team who is the primary contact for questions about scheduling and treatment, who is in charge during different parts of treatment, how they communicate across teams, and whether there is 1 contact who can help with communication across specialties, such as a nurse navigator. This can change over time as your health care needs change.
A treatment plan is a summary of your cancer and the planned cancer treatment. It is meant to give basic information about your medical history to any doctors who will care for you during your lifetime. Before treatment begins, ask your doctor for a copy of your treatment plan. You can also provide your doctor with a copy of the ASCO Treatment Plan form to fill out.
Learn more about making treatment decisions.
Physical Emotional And Social Effects Of Cancer
In general, cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Supportive care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive supportive care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Supportive care treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies.
Music therapy, meditation, stress management, and yoga for reducing anxiety and stress.
Meditation, relaxation, yoga, massage, and music therapy for depression and to improve other mood problems.
Meditation and yoga to improve general quality of life.
Acupressure and acupuncture to help with nausea and vomiting from chemotherapy.
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