Psychological changes and countermeasures of breast cancer patients

This is the 4838th article of Da Yi Xiao Hu

In 2024, the National Cancer Center released the latest national cancer statistics: On February 1, 2024, according to the latest data released by IARC under WHO, it is estimated that the number of new cases of lung cancer in the world in 2022 will reach 2.48 million, exceeding the 2.3 million of breast cancer, regaining the title of the world's largest cancer. Breast cancer is no longer the world's and China's largest cancer. We may think that the efforts made by everyone in recent years in "preventing and treating breast cancer" and "early diagnosis and treatment of breast diseases" have begun to bear fruit, but there is still a problem that is often overlooked, that is, the psychological problems of breast cancer patients and the social belonging of breast cancer patients after they become ill.

At present, the treatment of breast cancer mainly focuses on surgery, radiotherapy, chemotherapy, targeted therapy, and endocrine therapy. The surgical methods mainly include modified radical mastectomy, breast-conserving radical mastectomy, and breast reconstruction after radical mastectomy. No matter which surgical method is chosen, the patient will face the fact of complete or partial loss of the breast after the operation. The breast is an important symbolic organ of women. Regardless of whether the patient has physical needs for the breast at the moment, there is still a psychological need. Therefore, when a patient is diagnosed with breast cancer, the treatment of the disease not only brings physical discomfort to the patient, but also psychological trauma, which is often ignored by people other than the patient. In the long run, it may cause serious psychological disorders and a sense of shame in the patient, and even make it difficult for the patient to accept himself and return to society.

Today we will talk about some psychological changes that may occur in breast cancer patients and how to overcome them, so as to improve the quality of life of patients and help them overcome psychological barriers and accept themselves.

Once diagnosed with breast cancer, patients will be depressed, upset, anxious, worried, and under great mental pressure. At the same time, because of the lack of a sense of physical integrity, they worry about being laughed at by colleagues and acquaintances, and being ignored and despised by their husbands; they worry about losing their jobs and status and reducing their income sources; they worry about the financial affordability of their families, which leads to mental tension and reduced quality of life. Most people spontaneously believe that cancer is an incurable disease, lose confidence in the treatment of the disease, and thus develop a fear of death. Another part of patients suffer from adverse reactions such as vomiting, hair loss, and local phlebitis after chemotherapy, which increases their psychological pressure and worries about the impact of chemotherapy on their image. The above multiple emotions may appear throughout the course of the disease, and they are intertwined and affect each other. If these negative emotions are not taken seriously and properly channeled for a long time, it will not only make the patient feel inferior, but it is also more likely to reduce the patient's compliance with treatment, thereby greatly reducing the final efficacy.

How to help patients correctly understand the disease? How to help patients get out of psychological difficulties? How to identify patients' emotional problems after surgery? Let us give you some tips:

For medical staff and the general public

1. Medical staff should provide timely health education to patients, strengthen communication with patients, enable patients to correctly view the disease and its prognosis, and recommend relevant popular science articles and lectures to patients to relieve their anxiety and prevent the occurrence of depression.

2. Studies have shown that good psychological resilience can effectively enhance patients' ability to resist stress and improve their enthusiasm in facing the disease. Therefore, medical staff should always pay attention to patients' emotional changes, guide patients to learn to manage their emotions, accept themselves, improve patients' psychological resilience, keep them positive and optimistic, reduce their sense of shame, and enable them to return to their families normally.

3. When providing rehabilitation interventions for patients, medical staff should comprehensively consider the patient's condition and combine it with the patient's family's financial situation to develop the best treatment plan for the patient and implement it effectively, so as to alleviate the patient's unnecessary worries and guilt towards the family.

For patients

1. Patients need to correctly understand the disease itself, treatment methods, disease outcomes, etc., avoid blind cognition, excessive fear and worry about the disease, which will affect the treatment effect.

2. Patients need to face and accept their new image. Mastectomy and postoperative chemotherapy and other auxiliary treatments lead to hair loss. Although it changes the appearance of patients, it does not affect their value and dignity as women. You can communicate with doctors, psychologists and other patients who have undergone similar operations to understand that your body changes are for treatment and rehabilitation, not defects. As for the image, there are usually some ways to improve the image and restore self-confidence. For patients who have undergone mastectomy, you can consult your doctor about breast reconstruction surgery. If the disease allows, you can choose a suitable method to reconstruct the breast and restore self-confidence, such as breast prosthesis implantation, autologous tissue breast reconstruction, etc. If you have concerns about the surgery, you can also choose breast prosthesis bras and other methods to help reconstruct the chest image. Choosing comfortable and well-fitting clothes can make patients feel more confident and comfortable. Makeup and hairstyle can also make patients feel better and enhance their self-confidence.

3. During treatment, patients should learn to cope with and manage their emotions. While receiving psychological support and education, they should learn positive coping strategies and gradually regain confidence and an optimistic attitude.

For patients’ families

1. The patient's family should take the initiative to understand the characteristics of the disease, treatment methods, disease prognosis, etc., to avoid excessive emotional changes and cause psychological pressure on the patient.

2. Family members should actively cooperate with the patient's psychological comfort work, give the patient enough tolerance and support, so that the patient can maintain a good attitude. If necessary, they can consult a psychologist to obtain the best adjustment method.

3. Family members should understand that a series of psychological changes in patients may include post-traumatic stress, anxiety, depression, sleep disorders, self-denial due to damaged body image, cancer-related fatigue, cancer-related cognitive dysfunction, sexual dysfunction, and fear of cancer recurrence. After understanding the psychological problems that patients may have, they should pay close attention to the psychological changes of patients. Once the above situations occur, they should actively guide and accompany the patients to the relevant departments for help. They should be more tolerant and understanding of their possible emotional changes, rather than blindly blaming and indifferent, which will only make their predicament worse.

The psychological condition of breast cancer patients is complex and changeable, so during the treatment process, they need comprehensive support and care from all walks of life, including medical staff, family members and friends. We should provide patients with reasonable psychological counseling to help them enhance their self-confidence and improve their quality of life.

As we gradually enter the era of precision treatment, we must not only heal the patient's body, but also heal the patient's mind. The illness may leave the patient's body incomplete, but we must do our best to keep the patient's mind intact. In the future when the prognosis of breast cancer is getting better and better, I hope that more and more breast cancer patients can face themselves, the society, and a hopeful tomorrow with a new look!

About the Author:

Jia Hongyan , chief physician, professor, doctoral supervisor, postdoctoral co-supervisor, returned overseas student, top talent in Shanxi, high-end leading talent in Shanxi Province's "Hundreds of Thousands of Health Talents Training Project", academic and technical leader in Shanxi Province, and chief science communication expert of the Shanxi Association for Science and Technology.

Dong Jianqiao , Department of Breast Surgery, First Hospital of Shanxi Medical University