Someone you love may have breast cancer. how can you help?

Women with breast cancer deserve our complete support during a time of physical as well as psychological turmoil. Here’s more on how to help. 
In this interview, we meet Dr. Radheshyam, M.B.B.S, M.D, D.M, a noted Consultant Medical Oncologist with HCG Hospital, Bangalore. He talks about the emotional fallout of breast cancer – the psychological issues that women experience during diagnosis and treatment, and how they can deal with this difficult situation.

How do you typically break the news to a breast cancer patient?

There are two ways in which we do this. We may either speak to the family members first and then the patient, or we may speak to family and the patient together. Most patients today insist on knowing specific details about the cancer, but some also leave it to their family. Further discussions are carried out based on what the patient is comfortable with.

Do you recommend that the patient be with a friend or family member while hearing the news?

Of course, this is very important. Most of the patients who come to us may already have a suspicion that they have cancer. However, it will be extremely difficult for a person to absorb the impact of such grave diagnosis on their own.
We recommend that trusted family members, and even friends if possible, be with the patient during the time. This serves two purposes. Firstly, they are able to provide moral support to the patient. Secondly, they are in a better state of mind to listen to more details about the disease and the treatment. The patient may go into a state of shock and be unable to comprehend everything that is discussed at the time.

What are the common reactions of patients as they in the news?

Patients typically register shock. If they already suspect that they may have cancer, they are better able to handle the news.
But it really depends on several other factors as well. Is this new or recurrent cancer? Is the patient’s family supportive? Is the patient herself mentally strong? Is she under stress otherwise? Does she suffer from clinical depression or other mental disorders such as schizophrenia or bipolar disorder? The reaction of the patient varies according to their personality and current circumstances.
Anger, numbness, and anxiety are common reactions. Some patients also start doubting the diagnosis and want to seek a second opinion. For such cases, we immediately refer them to another oncologist.

How do you help patients who are unable to handle the news well?

If the overall personality and mental health of the patient are relatively stable, they are able to handle the news pretty well. But some are unable to do that. In these cases, we seek the help of a psycho-oncologist or even a psychiatrist. We send the patient to their office, where they will address the patient’s emotional difficulty in coming to terms with the diagnosis.

Are there any specific things that family members should watch out for to ascertain whether the depression of the patient is prolonged or if she is having trouble coping?

Yes. Family members must keep an eye on the patient while she is undergoing treatment. This is especially true if there has been a previous history of depression. A danger sign to look out for is denial that they have cancer, and therefore refusal of treatment. If the patient also seems to be persistently depressed and stops eating or sleeping well, that is also a sign that something is wrong. You may need the help of psychologists to deal with the situation.

What are the physical and psychological difficulties that women can expect while undergoing treatment for breast cancer? How can they prepare for it?

Breast Cancer is a difficult disease, and so is the treatment. If mastectomy is required, it may lead to body image issues and feelings of loss of sexuality. Chemotherapy often results in loss of hair. The patient may feel that she is alone and nobody understands her, and therefore feel abandoned. Fever, tiredness, and nausea are some of the physical side effects that patients can expect.
During treatment, there is typically a role reversal that happens in the household. The husband may have to take care of the household duties more, and some women resent this loss of control. At the same time, the husband may also resent having to deal with this difficult situation. Cancer is tough on everyone – the patient and the family members.
We help the patient prepare for what is to come by showing them post-surgery pictures and also encouraging them to meet with cancer survivors. Cancer support groups within the hospital help significantly. There may be online support groups as well, but human touch is very important. Most cancer hospitals will have their own support groups within.

Is there any specific advice that you’d like to give the spouse or other family members?

We provide counselling to the family members and give them booklets that discuss everything that they need to know about. Similar to patient support groups, family members also have a group within the hospital to help them cope. There are also volunteers who are available to talk whenever things get too difficult to handle.

Would there be any fallouts even after successful treatment? What must patients expect from life after cancer?

Cancer brings out your core personality. Some people face the disease with courage, and emerge victorious. They begin to see life in a new light, and become grateful for the second chance. Their life becomes qualitatively better after the disease. On the other hand, some people may continue to be depressed because of fear of recurrence. All I can say is that it depends on your basic personality, and the kind of support that you receive from your loved ones.