Life Experience of Inpatients with Recurrent Breast Cancer

PURPOSE: Understanding daily life experiences of patients admitted to hospital with recurrent breast cancer. METHODS: The grounded theory method was used for this study. RESULTS: Consistent comparative analysis was used throughout the study to obtain the results. Results showed that inpatients with recurrent breast cancer experience 'a co-existence of life suffering and fear of death'. The causal condition of this result was determined to be 'patient's response to cancer recurrence (acceptance/despair)', including contextual conditions such as, 'previous experience with cancer treatment', 'patient's current physical condition', and 'treatment methods for recurrent cancer'. Intervening conditions, such as 'a strong will to live', 'family support', 'moral support providers', and action/interaction strategies were found to provide patients with 'a strength to live'. Shown in these results, inpatients with recurrent breast cancer were seen to have a simultaneous 'hope for life and fear of death'. CONCLUSION: When providing nursing services to inpatients with recurrent breast cancer, people must recognize there is a notable difference between individual patients' contextual conditions and interactive strategies. Henceforth, proper cognitive nursing must be provided which encourages patients to maintain a strong will to overcome the many hardships of treatment as well as physical nursing, such as management of side effects caused by chemotherapy.

Psychiatric care for patients with breast cancer

Psychiatric management of patients with breast cancer, as well as women's emotional reactions to all phases of breast cancer, were reviewed. These patients face two major losses; one is the physical loss of part of the body and a threat to life, and the other is the loss of femininity. The patients are also likely to suffer from various psychiatric problems including anxiety and depression. Oncologists should be alert to each patient's emotional reactions and potential psychiatric problems, and if necessary, should refer them to a psychiatrist. A combination of psychotherapeutic, behavioural, and pharmacologic techniques is available for the care of patients with breast cancer. Psychotherapeutic modalities include individual therapy, family therapy, group therapy, and self-help treatment. The author divided individual therapy into general and specific treatment. General treatment deals with a crisis-intervention and cognitive-behavioral approach, whereas specific treatment deals with issues relevant to patients with breast cancer. Some of the therapeutic processes were illustrated in a case report. These guidelines will contribute to the relief and prevention of emotional suffering stemming from an encounter with the most common form of cancer in women. Also, proper and effective care for patients with breast cancer requires combined use of a variety of therapeutic modalities as well as a multi-disciplinary approach including psychiatric care.

Indicadores de riesgo de recidiva local en el tratamiento conservador del cáncer de mama / Risk indicators of local relapse in the conservative treatment of the breast cancer

Fueron evaluados los posibles factores de riesgo para recidiva mamaria en pacientes con estadio I y II de adenocarcinoma ductal invasor, sometidas a tratamiento conservador. Luego de un seguimiento promedio de 60 meses, se registraron 20 recidivas en 211 pacientes con tratamiento conservador. Sobre un total de 152 pacientes se realizó un análisis estadístico, uni y multivariado, para hallar los factores de significación respecto al riesgo de recidiva. Igual metodología de análisis fue implementada en pacientes pre y postmenopáusicas por separado. Se identificaron dos tipos de factores, aquellos asociados con la agresividad tumoral y los relacionados con la enfermedad residual. Tanto para pacientes premenopáusicas como postmenopáusicas, el factor de riesgo más significativo del primer tipo, fue la invasión vascular. Entre los factores asociados a enfermedad residual. Tanto para pacientes premenopáusicas como postmenopáusicas, el factor de riesgo más significativo del primer tipo, fue la invasión vascular. Entre los factores asociados a enfermedad residual, resultó significativo la presencia de componente intraductal extenso. Los bordes quirúrgicos comprometidos resultaron estadísticamente significativos sólo en pacientes postmenopáusicas.