Breast Cancer has
emerged as a significant disease in past few decades and tremendously growing
day by day as 1,082 women were diagnosed with breast cancer between 1992-1997
and 211,240 new cases have reported regarding breast cancer in 2004. By the end
of 2018, it is estimated that in the United States 1,735,350 new cancer cases
would be diagnosed and the death ratio due to cancer would be 609,640 (American
Cancer Society, 2018). Though breast cancer reported being least dangerous
compared to other types of cancers, however, there are still several marks
which show the disease adversely impact the psychological or social behaviors
of the patients and the people in the surrounding. Since the psychologists and
social workers are on the field to guide women about their issues, the major
difference rises concerning the acceptability of adverse outcomes associated
with the disease. Initially, there was minimum workforce availability in teams
and organizations to reduce the adverse effects. It was due to the lack of
acceptance level for breast cancer disease in public and their perception about
the issue. However, over the period of time, in the 20th century, significant
betterment in the situation has been reported, and therefore the social and
psychological assistance for patients proved to be useful. The current
perspective and the situation of psychosocial work activities in the domain are
in better conditions and more improvement expected in an upcoming few years.
Social support in terms of adult care, providing the best services for health
following the code of ethics and code of conduct to facilitate the patient.
Personal advocacy and social security codes for filing a complaint about a
violation of any right of the patients are also working for the betterment of
the society. There are other multiple social forces are available for the
psychosocial support of the patients. Similarly, the psychological treatment
and intervention to relax the mind and body of the patients are also in
practices for a long period of time. Social Workers and psychologists assumed
to support the patients of breast cancers for providing guidance to cope with
stressors. They focus not only highlighting the issue but also provide the
solution and psychological support to the patients as well. In the cancer care
literature, the term psychosocial refers to the person's inner world and their
relationship with her external world, e.g. environment, social norms and
adaptability. In other words, psychosocial defines a close link between psychological
aspects of women's experiences and their inclusive social experience, and the
supports refers to “serve as a foundation for something". In short,
psychosocial support contains organize pattern of care modalities and support
the individual in a social setting.
Psychological Issues
Social workers and
Psychologists often faced difficulties in performing their obligatory duties.
Breast cancer patients found to have psychological issues such as anxiety,
depression, stress, frustration, fear and low mood. It is definitely because
breasts are the organs which define women and any kind of surgery distort the
identity of the patient. Going through disease are not affluent practices, but
the disease which affects the identity specifically considered psychologically
threatening or disturbing one. In return, it is found that a fairly large
number of patients found less cooperative with the social workers to reduce the
risk of disease. Patients do not cooperate because of the trauma they are going
through. It is found that a breast cancer patient possesses psychological and
social issues on a high scale that adversely affect their social, personal and
occupational functioning. The impact of breast cancer on body image varies
greatly among women, and the significant impact the wellbeing of the patients.
The impact may include sexual dysfunctions, negative self-image, loss of
libido, and interpersonal relational problem. Studies proved that those women
who are more preoccupied with their self or body image, are more vulnerable
towards poor psychological adjustment during breast cancer. The psychological
factor which causes discomfort is embracement in exposing body, and
deformities, that results in social isolation, lack of sexual interest, and low
self-esteem.
The major
psychological issue which is being reported is the lack of self-confidence and
esteem. Women with such medical disease often start avoiding a different type
of social gathering due to the lack of constant approach of womanliness. Social
workers face difficulties because when patients avoid such gatherings, the
reduction of psychological stress become difficult for them. Members of ASCO,
ONS, and AOSW reported significant difficulties in relieving the stress of
breast cancer among patients, and the hardest part was to inform the patient
about their illness and treatments as well with a positive approach. While
research has not yet brought in an ample roadmap to describe the best way to
provide information needed at various times during and after cancer treatment.
A few types of research have lightened numerous features of the effective
endowment of information, for example,
information should be delivered according to patient expectations, e.g., information specific to the type and
stage of their cancer, treatment, prognosis, progression, etiology,
rehabilitation, achievement and maintenance of maximal health, and coping
skills. Psychological studies have termed the breast cancer as one of the
biggest issues of women, as it is related to identity. It has also been
reported that women with such issues try to avoid basic relationships. The
impact of family and surroundings often play a significant role as well, as the
family concerns stress the patients more. It is found that some of the patients
didn’t inform their families about the issue except in the crucial conditions.
Women who could have professional duties and life found to have a positive
approach towards life regardless of useless thoughts as compared to household
women with no meaning in life.
Managing Fear related to treatment and sexual life
The aspects of social
work for the social worker are difficult to handle when patients become scared
about the condition of treatment. Though the issue is very much resolved
nowadays due to the advanced treatments but patients are still have concerned
about their life after treatment. Cancer patient also experiences pain while
taking treatment, this pain often is not fully excluded despite the management
of pain reliever and other therapies. Moreover, pain may cause the problem even
when no sign of cancer appeared. AHRQ’s 2002 evidence elaborated that
cancer-related pain to fatigue, cause impaired function, and a range of other
psychosocial issues. Mostly the lack of
support from the partner increases the fear of death among the patient. Other
than that, the aspect of body image, intimacy issues with the partner, and fear
of treatment affect the patients will fight against the disease. Social workers
in this domain play their significant role in order to reduce those issues.
They work and strive to maintain situation normal for the patients and it is
surrounding so that the patient develops the positive approach towards life.
Such issues are often difficult to handle, but the negotiation and
communicative skills as well as concerns to deal with the situation in the best
way to bring improvement among the patients as well as for their families.
Social workers are more effective for the solution to the problem. This is the
way which provides assistance to avoid psychological issues of the patients.
Psychosocial Treatment
Breast cancer remains a tremendously prevalent and
extremely traumatic experience for thousands of women each year in the United
States and now in the developing countries of the world. Psychosocial
researchers have provided a depiction of the emotional and social impact of
breast cancer, which is associated with better versus worse adjustment.
Psychosocial interventions proved to be beneficial in reducing the stress and
tension of a patient’s life. According to Spiegel, Bloom, Kramer & Gotheil
psychosocial interventions directly affects the survival period. Those patients
who receive psychological interventions more likely to live longer than the
non-receivers. A comparative study has
been conducted to assess the impact of the intervention on the survival of the
patients, which indicated that the treatment group survived longer than the
control group because they have been receiving Self-hypnosis for pain recovery.
There are many types of psychological treatment which brings fruitful results,
like individual and group therapies work effectively. The Individual sessions
with a psychologist help in understanding and modification the patterns of
thought process which further leads to positive feelings and behaviors. The
Group psychological treatment with similar breast cancer women gives a chance
to share their similar experience and receive emotional support from each
other, and also effective in learning the coping strategies from them.
The supportive
counseling is widely used by the psychologist and social workers to bring about
the behavioral changes in managing the impacts of disease in different setting
e.g. school, family, and workplace etc. The collaborative work between the
psychologists and the diagnosed women helps to identify and sort out the
negative emotional behavioral problem and bring about insight to cope with
stresses. Another technique which could be beneficial in the management of psychological
impacts of breast cancer is psychotherapy. The psychotherapy carried out a wide
range of psychological therapies, consisted of the modification of feeling,
thoughts, emotions, behavior, and attitudes. Psychoanalysis is the more
productive technique of psychotherapy, which deals with unconscious aspects of
behavior, to control the conscious actions and feelings of pain. The cognitive
therapy also deals with the thinking pattern, according to the cognitive
therapist modification in thinking can alter the feelings as well. If someone
has a poor self-image (I have poor body image) and feels disappointed, by
modifying the self-image (I’m average if not perfect) the feeling of
disappointment can be a later inappropriate mood. The breast cancer patient if
had poor body image or severe pain the cognitive therapy can be very effective
healing procedure. The basic goal of the psychologist is the information
provided to the victim women about her disease and psychological condition.
Women going through breast cancer treatment have a right to get a wide range of
information about the disease, including the onset of the disease, prognosis,
progression, etiology, treatment and its side-effects, and psychosocial
services as well. The self-examination and Chemotherapy may reduce the risk of
disease and also have a significant impact to enhance the quality of woman’s
physical, emotional state and sexual dysfunction, which in turn may affect the
quality of life. Recent studies suggested that chemotherapy had significant effects
on sexual dysfunction, including pain or difficulty with intercourse, vaginal
dryness, impaired sexual activity, and decreased sexual orgasm. Psychologists
can bring the breast cancer patient stress level down in order to enhance their
psychosocial functioning.