Psychological Assistance

[Hopeful]

I am posting this here rather than in the Articles Forum because I think it is a topic that bears discussion. Here is a link to an article discussing how psychological intervention directly improves patient health in bc: http://www.medicalnewstoday.com/articles/95357.php

IMO, some form of counseling should be offered all patients immediately after diagnosis. We are asked to cope with a life changing diagnosis, treatment decisions, treatment side effects that severely impact our QOL and ability to work and care for our families and our initimate relationships, deal with prejudice and/or thoughtless remarks by strangers, co-workers and even family, all with only the psychological resources that we are able to muster on our own. Many doctors responses to the emotional needs of bc patients end with a prescription for either anti-depressants or dissociative drugs.

The study in the article above focused on stress management, where patients:

"met weekly in groups of 8 to 12 with a clinical psychologist. These sessions, which lasted four months, included training on relaxation and coping with stress, strategies to improve health behaviors, information on the value of exercise, communication skills for dealing with physicians, and other related issues. After four months of these weekly meetings, participants met monthly for another eight months. . . . Results showed that the use of relaxation techniques was most effective in controlling stress. Learning relaxation, as well as techniques to communicate with doctors, strategies for increasing physical activity and how to deal with stress all were related with fewer symptoms and signs associated with disease."

I saw a study last year that I did not post, that said that bc survivors are 25% more likely to commit suicide than the general population (the higher the stage at dx, the more likely). Clearly, there are huge unmet needs in this area. IMO, we need to demand more of the medical system.

I am interested in how others feel about this.

Hopeful

[PinkGirl]

Hi Hope
I agree completely. There are times when the psychological component of this disease is harder to deal with than the physical.

This type of assistance is available to me at my cancer centre. It is called Supportive Care - a program of psychology, social work, pastoral care, dietary care and smoking cessation. It is available at any time - at dx., during treatments or years later. There is individual counseling and weekly support groups. Unfortunately for me, I live 5 hours away from my cancer centre but I have the option to have counseling by teleconference or by telephone and I can make appointments when I'm at the centre for other reasons.

A social worker was part of my "team" when first dx. Of course, this service is available to everyone at the cancer centre, so she was very busy. We had a short meeting, I filled out some forms, and I was given all of the information regarding the Supportive Care program. I haven't used any of these services but it's nice to know they are there. I have participated in a few support group meetings when I've happened to me there on the right day.

[Colleens_Husband]

Dear Hopeful:

I agree with you. The mind and the body are not seperate entities. A wise physician will realize that both ought to be treated when a traumatic crisis occurs.

There are many instances when the psychological scars from breast cancer will outlast the physical scars.

Our cancer center has a counseling center which treats the patient, the patient's caregiver (that would be me), and the children of the patient for a ten dollar co-pay per each visit. If I wasn't completely snowed under at work, and caring for Colleen, and running the family and everything else, I might go there myself.

Lee

[BonnieR]

Dear Lee, Colleen's husband,
the very reasons you have stated for NOT going to the support group are, of course, the very reasons you SHOULD go!! But you already know that....

[tdonnelly]

Hi,
Your thread is very important and I am glad this topic is being looked at in a more constructive light. When I was first dx, I took it well; or so I thought. After the biopsy, the dr scheduled my surgery for three weeks later. I did not sleep for 16 days and was so frightened I cancelled my original surgery. My family had me hospitalized for exhaustion. I spent 17 days readjusting my sleep pattern and coming to terms with my cancer. It was a difficult but necessary step for me to become strong enough for surgery and the upcoming treatments. I talk about this openly as I am sure there any many others who have gone through this or similar circumstances. Mental Health is usually swept under the rug due to embarrassment and the stigma attached to it. I am happy to see the changes taking place in this much needed area of medicine.
Tamara
Invasive Ductal Carcinoma 10/2006

[Bill]

Hope, I agree, especially about encouraging new BC patients to seek an established counseling system immediately. It would be a great benefit. Lee, I've been in your shoes, buddy. I know how tough things must be for you and your family. Since everything is on you, you gotta take care of yourself too. Don't feel selfish or weak if you need to take a little time out for yourself. I know you know all this already, but try to eat well and get rest whenever you can. If you get sick or get hurt, everything gets more complicated. Exercise when you can, it really helps. I'm praying for strength for you and your family. Take care, Bill

[Mary Jo]

I, too, so agree with the counseling aspect. I also agree that yes, dealing with the psychological aspect of a cancer diagnosis is often times harder than dealing with the physical aspect of the disease - i.e. - surgery - chemo - radiation etc.

I remember while going through chemo and my bi-weekly visits with my oncologist one of the questions always asked of me was "do you have a good support system?" That always made me happy that they asked that. Although I did have a great support system I realize many people do not. If you did not have a strong support system they set something in place for those people. I also remember after my prophylactic mastectomy the social worker for the "Breast Care Clinic" came to speak with me - I'm sure to see how well I was doing or not doing - and also offering me their services if I was interested.

So. yes, it is SOOOO important for our medical teams to offer these very important services to us and our families. They are needed and beneficial. It's a tough disease in WAY MORE ways than one.

Thanks hopeful for bringing this to our attention.

Love & Peace,

Mary Jo

[Hopeful]

I am glad to hear from so many people who have resources available to them, it is really a relief. I suspect that there are many though who were not treated at a major cancer center, or who are isolated due to distance from treatment centers, who do not have such access. For example, although I live in a major metropolitan area with cancer centers competing for patients, I chose to be treated largely outside that system, with a surgeon who takes no insurance and an oncologist who has a private practice (for rads, of course, since no private rad oncs can afford their own accelerators, I did go to a major cancer center). There was really no where along the way that I was offered or directed to counseling. Of course, counselors abound where I live, but none of the ones in private practice advertise that they specialize in counseling cancer patients, which is really what I would be looking for. I suspect the situation would be similar for patients who are treated, as the euphemism goes, "in the community setting." Delivery of services under those conditions, I suspect, is suboptimal but very necessary. IMO, these services need to be part of the basic treatment plan.

Hopeful

[Marlys]

I know I have mentioned before how supportive my 12 Step home group has been and I do believe that this is because they (or at least most of them) love me. I am not the only cancer survivor in the group and every one of us believes that God loves us and is there for us no matter what. And then, too, there are the people here. Every day I log on just to see how you are doing and to laugh with you, cry with you and learn with you, and, when needed, pray with you. The only one of you that I have met face to face is TriciaK and she is as beautiful as her picture so I am sure the rest of you are, too.
One time, in the chat room, I mentioned that I had met her when we went to Phoenix for some preseason baseball and people were actually jealous of me. Anyway, I strongly recommend support wherever you can get it: online, at your treatment center, from your next door neighbor, or your local A.A. group!!
Love & hugs,
Marlys

[Jean]

Hopeful,
It is like anything else in life. Consider the top athlete's who have coaches to assure that they are performing to their best abilities.
Dealing with this disease the patients need all the coaching, knowledge,
and understanding of their disese to order to defeat it!

Loved the article and thank you for posting!
Hugs,
Jean

[Colleens_Husband]

Friends:

A couple of weeks back I was listening to a local radio show hosted by Dr. Dean O'Dell. The subject was about lifestyle and health. Dr. O'Dell talked about a recent study that came out about breast cancer survival rates which stated the single most important factor in predicting survivability from breast cancer was not a medical factor, but what the study called 'positive life circumstances'. Positive life experiences included such things as regularly saying prayers, being married, having a supportive family, being able to relate to others about breast cancer in a positive and constructive manner, having healthy friend relationships, a generally optimistic outlook on life, and a long list of other related factors.

The strange thing was that positive life circumstances had a greater impact on surivability than the stage of cancer, type of cancer, age of the patient, and the general health of the patient prior to getting cancer.

This fits with a study from the University of Washington Medical School abut ten years ago that found that patients with cancer who believed they would survive had almost a 30 percent greater chance of survival than patients who thought they wouldn't survive. This difference in survival rates held up no matter what type of cancer the patient had, the progression of the cancer, and any other factor.

The important thing is that one's mental health plays an incredibly important role in one's physical health.

Lee

[MJo]

I thought I would get through the cancer experience ok. Was very positive before and after surgery. The chemo talk by the oncology nurse at the cancer center sent me into a downward mental spiral. Maybe I finally realized that I had cancer. I needed a lot of help for a few months -- I saw the cancer center psychologist weekly and started on daily antidepressants and anti anxiety med as needed. Other services were available to me -- yoga, meditation, support group -- but my anxiety was so high, I got no benefit. Getting very sick from A/C didn't help. By the time my taxol and herceptin treatments started, I was much better. Now I'm in reasonably good shape, but I still take antidepressants and go to a breastcancer survivor group twice a month at the Wellness Center. A clinical social worker facilitates the group. Many days I'm as positive as Lance Armstrong, but I also days when I am very afraid. We each have cancer in a unique way, and I think each of us copes in our own way. We have to find the combination of things that get us through. My oncologist, believe it or not, told me to eat as much ice cream as I wanted. Whatever gets you through this, he said. He knew what I needed! lol

[Hopeful]

Here is a tease (all we can get for free) that others recognize the problem: http://jnci.oxfordjournals.org/cgi/content/extract/djn005v1

Hopeful

[MJo]

Forgot to mention -- I was diagnosed with seasonal affective disorder before my BC diagnosis. I hope oncologists take into consideration the effect of treatment on people with SAD. I was diagnosed end of October, and chemo started at end of December. December, January and early February are the hardest months for me as a SAD person. I think that had something to do with my very rough time taking A/C and my easier time taking Taxol/Herceptin starting in March. I wonder how many oncologists know about SAD.

[Bill]

Hi MJO! You have such gorgeous eyes and a beautiful smile. I was wondering if you've ever tried one of those special lights for the SAD. I heard that they help. Keep on smiling! Love, Bill