Advances in early detection and treatment of breast cancer, including new clinical trials, have significantly improved the prognosis for women with breast cancer in recent years.1 However, as survival rates for breast cancer patients improve, new challenges are emerging.
Being diagnosed with and undergoing treatment for breast cancer as a young adult (ages 20-39) can be physically and emotionally taxing. Young adults with breast cancer can experience multiple losses along the way to cancer, from surgical removal of the breast to possible infertility to significant changes in daily life. Because of the urgency of treatment and the realities of financial and physical health concerns, patients are often not given the space they need to emotionally process these changes. Additionally, psychological resources are limited, not provided, or not sought after by the patient. As a result, young adult breast cancer patients may have difficulty coping with the effects of treatment.
After cancer treatment, women often complain of PTSD and bereavement-like symptoms, including depression, anxiety, distrust, flashbacks, and avoidance. Dealing with these symptoms as a young person poses additional unique challenges as young people are developing their identities during this period of life. They may be working on establishing a career, raising a family, dating, or discovering who they are. Campbell-Enns and Woodgate (2015) highlight that younger breast cancer survivors tend to have a harder time coping with prognosis than older survivors due to lower perceptions of quality of life.2
Young adults also tend to have more aggressive types of cancer and, as a result, require more aggressive treatments. As a result, these patients may experience many physical changes and symptoms due to treatment, such as premature menopause, infertility, and sexual dysfunction, which may become more severe. Influence how they deal with prognosis.
Addressing psychosocial concerns
Psychiatric symptoms that occur after treatment are often ignored, ignored, or unknown to health care providers and patients’ loved ones. This is due to the common misconception that after treatment, patients should be grateful to be alive, or that their lives are better now that they have stopped treatment. Patients from different backgrounds and cultures may also not always feel comfortable sharing their feelings with or trusting health professionals. Additionally, there are limited resources and literature available to young breast cancer survivors, especially within treatment centers.
Young adult breast cancer survivors often feel a sense of loss, shame, and misunderstanding, which can negatively impact their relationships with others. For example, young adults may be unable to engage with peers who have experienced milestones during treatment, such as becoming a mother or receiving a promotion, and may feel left out or left out as a result.
They may have trouble adjusting to life after treatment and a new quality of life due to changes in their body, lingering side effects, and changes in their perception of themselves.
After breast cancer treatment, women tend to struggle with self-esteem, feeling like they are not beautiful enough or “feminine” enough because of the loss. Even women who choose reconstructive surgery still have the tough challenge of dealing with the loss of their natural breasts, and often compare their new breasts to their previous breasts. The difficulty young women have in coping effectively after treatment often impedes their recovery, including overall prognosis, treatment compliance, social functioning, and even survival.Four
Role of the healthcare provider
There are ways health care providers can help young adults navigate the psychosocial effects of breast cancer treatment. Such interventions can help improve prognosis and quality of life for young adult breast cancer patients. Below are steps that all healthcare providers can incorporate into their daily practice to ensure a successful post-treatment transition.
Get to know your patients by asking questions:
Near the end of treatment, during follow-up visits, find out how the patient is coping mentally or if they have experienced any problems recently. Additionally, ask if they feel they have sufficient physical and emotional support.
Don’t ignore your emotions.
When a patient expresses feelings or concerns, try not to minimize their feelings. For example, if a patient expresses sadness over losing a breast, acknowledge their feelings rather than saying, “It’s okay.”
Gather appropriate resources.
Learn about the various resources available when patients express psychosocial concerns. This includes knowing whether your treatment center offers community resources such as fertility preservation, as well as support groups and counseling services.
Introducing national resources.
American Cancer Society: Reaching Recovery
References
- Nardin S, Mora E, Varughese FM, et al Survival, quality of life, and late toxicity in breast cancer. front oncor. 2020;10:864. Published June 16, 2020. doi:10.3389/fonc.2020.00864
- Campbell-Enns H, Woodgate R. Psychosocial experiences of women with breast cancer across the lifespan: A systematic review protocol. JBI Database System Revision Implementer. 2015;13(1):112-121. doi:10.11124/jbisrir-2015-1795
- Partridge AH. Cancer survivorship and young breast cancer patients: addressing key issues. oncologist. 2013;18(8):e19-e20. doi:10.1634/theoncologist.2013-0300
- İzci F, İlgün AS, Fındıklı E, Özmen V. Psychiatric symptoms and psychosocial problems in breast cancer patients. J Breast Health. 2016;12(3):94-101. doi:10.5152/tjbh.2016.3041