he Breast cancer diagnosis It represents a real earthquake in women’s lives. he Fear and uncertainty They make an appearance and it is difficult for them to abandon the patient throughout the process, a long road in most cases. So, what we have considered The biggest fear of patients when they face breast cancer, and we wanted to ask both a patient and an oncologist. “Most of them fear of deathCancer is still synonymous with death. And the main fear is that they are dying. And for many when they become mothers, it’s about not seeing their children grow up,” says the doctor. Laura Garcia EstevezHead of the Breast Tumor Department at MD Anderson Cancer Center Madrid.
From the patients’ point of view, no doubt, The biggest fear is that the cancer is still thereDespite treatment, care and constant monitoring. “When you’re diagnosed with breast cancer (localized, not spread to other parts of the body), your main fear in the first months of treatment is that it won’t work and, in the end, the cancer will still be there. Fortunately, in most cases, treatment is effective and the cancer can be cured at this stage. After some time of treatment, you gradually go back to your old life, but inevitably you always live with the disease. Fear of noticing any symptoms Or at some check-up they find that the cancer has returned Relapse or metastasis“, he tells us Gema Rodriguez RecioVice President and Head of Communications of the Spanish Association of Metastatic Breast Cancer.
And specific cases of metastatic breast cancer? “When you have metastatic breast cancer, your main concern is this The treatment stops working And the cancer continues to progress, or that Side effects are very toxicBecause then you have to change the treatment again and end up with another therapeutic option, which is limited today because there is still no treatment in the metastatic stage that makes the disease chronic,” he adds.
Fear of relapse
As is clear, the fear of possible relapse is usually always present. This is, perhaps, the biggest concern for many women. “Relapse depends on tumor type and diagnosis from the situation. There are patients at higher risk of relapse than others. This is what we do from a medical perspective In the first 2 or 3 yearswhich is usually where relapse peaks, Our review is a little more intense. That doesn’t mean we’re testing all the time, but it does mean we see patients probably every 3 months. and tests are usually repeated with a Annual frequency“, the doctor explains to us.
There is no doubt that each check-up, each medical appointment represents a small earthquake in the routine of many patients, since bad news always seems to be lurking. That is when psychological help becomes essential. “I think that the role of the psycho-oncologist should be there from the beginning and maybe he is the person in charge. Helps reduce stress Time to go to an appointment. It’s very difficult, as I said before it depends a lot on how you manage your emotions or how you manage your own life. And it’s a range of different personalities, There are people who come in very cool reviewsAnd very calm when it comes to taking an exam, and there are patients who experience it differently. Perhaps, there are women who need more help from psychotherapy, but not only during this check-up, but throughout the disease process,” says Laura García Estevez.
When you have metastatic breast cancer, the main concern is that the treatment will stop working or the side effects will be too toxic
Dealing with possible metastasis
In addition to repetition, Fear that the tumor will spread and metastasize It is another of the great workhorses. “The approach to breast cancer recurrence is very different from a medical point of view, it depends on where the recurrence occurs. If the relapse is local, sometimes if the patient has conservative surgery, then in most cases a mastectomy is required. And the relapse is a distant one such as bone, lung. Depending on whether the organ is present, which is the most frequent site, or the number of locations and how many locations,” the doctor told us. “A relapse is emotionally devastatingWhich, with the prognosis, is one of the most difficult situations from my point of view in managing a patient with breast cancer,” he points out.
“forecast Patients with metastatic breast cancer It depends a lot on the locationNumber of metastases and particular subtypes. There are times when metastatic patients live only 5 or 6 months, because we are talking about a very aggressive tumor, but then there are metastatic patients with a long evolution, even up to 10 years. So, it’s a very broad spectrum that depends on all these factors,” the doctor tells us.
© Getty ImagesA stage full of fear and uncertainty
What we consider The most common question That work is done Women diagnosed with breast cancerTold from the perspective of both the patient and the oncologist. The doctor is clear about this: “The first question a woman with breast cancer asks is whether she will die or live. Also if the tumor is likely to spread. This, a newly diagnosed person, is the first thing he wants to know. As you explain the procedure to follow, what worries him most is the results of imaging tests to rule out distant metastases. I think those are the main questions that come up.” Therefore, based on his experience, the doctor insists that patients should be asked to ask and Leave no doubt.
“Because of this constant feeling of fear and uncertainty, breast cancer patients need Have access to clear, accurate and reliable information At all stages of the disease. The most frequently asked questions are usually related to treatment side effects, diagnostic tests that need to be performed, access to specialized care (such as psycho-oncology) and care that can improve your quality of life. In metastatic breast cancer patients, it is also important to do this Information on clinical trials, access to innovative medicines and new diagnostic techniques”, detailed Gema Rodriguez.
In addition to the support and information that health professionals can provide, it is important to consider the support that health professionals can provide. Patient Association. “Because people who have been through the same thing as you understand you better and can help you not only solve many of these doubts but also help you through those moments of fear and uncertainty,” he concludes.
Deal with uncertainty
What strategies are available for patients to try to manage the uncertainty associated with cancer? According to the doctor, each person handles it according to their personality, according to their philosophy of life. “There are patients who come to check-up very calm because they don’t think about the 364 days of cancer, or so they tell me, and when they come to the consultation they are nervous,” says the doctor, who adds that there are others who There are really bad times and those who suffer a lot between reviews and reviews. “There are patients who work with psychotherapy, others with acupuncture, with meditation, logically when they have any doubts, doubts or discomfort, they quickly go to the oncologist. There is no magic wand for everyone, each person uses it according to their own experience and their personality,” he tells us.
© Adobe StockWhy is it important not to leave with doubt?
There are data that indicate that more than 76% of patients remain Doubts about possible relapses. Undoubtedly, the importance is a reason to reflect Fluid and reliable communication with an oncologist or psycho-oncologist to try to shed some light on these questions. “Based on my experience, it doesn’t occur to me to talk about relapse on the first date. To be honest, it doesn’t seem like the most reasonable or the best thing to do to me. I think that What the patient wants to hear at the first visit is that he is going to get better.. You don’t want to hear that there is a percentage of relapse, we introduce it that the process of cancer is accepted, that’s how I understand it. The patient is more relaxed now, and we can now talk about the fact that there is obviously a percentage of relapse depending on the stage and subtype of the disease, but I don’t think it’s a problem to solve at the first visit.” points out the doctor, who among other things Also mentions the truth of speaking eg Side effects of treatmentThat kind of review is going to be carried out… “We can leave a lot of things. In this sense, I believe that oncologists are also human and we too can make mistakes,” says the doctor.
In this sense, Lilly, endorsed by the Spanish Breast Cancer Federation (FECMA), the Spanish Metastatic Breast Cancer Association (ACMM) and the clinical cancer research group SOLTI, has launched a campaign ‘Dr. among them. Two realities of breast cancer, same care’, which supports the promotion of quality medical information and women’s unity in the two moments of breast cancer where most doubts are raised.
The hope is that one day metastatic breast cancer may become a chronic disease
A disease that characterizes
Do patients know that cancer occurs? A disease that never seems to end. Sufferers will now be oncology patients for life, a reality that is hard to accept. “Processing cancer isn’t processed in weeks, it’s processed in months and sometimes years. I think most people have the sword of Damocles for their lives. The rest of us have the sword of Damocles, but we don’t know it, that’s the big difference. And actually, They have to be reviewed, at the age of 5 they can already withstand the annual reviews, but it is true that there is a small percentage who are reinfected, when they even forgot, at 10, at 14 years, you What do you think? Cure, because suddenly it appears again. So it’s a process that in some cases actually never ends, “comments the oncologist.
And the situation is more complicated in case of metastatic breast cancer. “When You have metastatic breast cancer The reality is very different because at this stage The disease is no longer curable. You need to be hospitalized for treatment. Lifetime testing and reviewwith ongoing side effects. All this drags not only you, but also your family and your environment, which has a high impact on all levels, psychological, economic and social,” Gema tells us, adding that the lives of these patients are also measured with some hard statistics. , because despite great advances in research in recent years, survival rate For these patients Still about 5 years left. “Our hope is that one day metastatic breast cancer can become a chronic disease. In the meantime, we want to continue living, we want to break the statistics and survive and, above all, increase our quality of life,” the patient points out.
Over time, When metastatic breast cancer can be treated, Maybe the stigma will be less and when we can cure cancer for all patients and they die of cancer, but not of cancer, then maybe it won’t be so important to see the patient with a scarf or a wig, no, because we’ll think that’s going through the process. But he will recover and die of something else, I hope. This is the dream that all oncologists dream of,” concluded the doctor.
