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Influence The Treatment Of Breast Cancer In Women

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Question:

Discuss the Emotional, Cognitive, and Behavioural Responses that Mary is likely to Experience in Relation to this Diagnosis.
 
 

Answer:

Introduction

In the world, today cancer is at an alarming rate, and the causal agent alludes to the lifestyle by people in different social classes. Also, a report by WHO indicated that exposure to ionizing radiations is a leading factor in causing cancer (Advisory Committee on Breast Cancer Screening, 2016). Moreover, cancer is characterized by but is not limited to social and psychological factor as cognitive behavior, and emotional factors do play a role. With the increased rate of cancer in most developed nations, the healthcare system of such nations is on the lookout to detect and treat cancer at an early stage: a move that has seen the United States record a drastic improvement in combating the situation (French Adjuvant Study Group, 2016).

What is more is that emotional and cognitive behaviors primarily influence the treatment of breast cancer in women. The commonly known behavioral symptoms of breast cancer include being moody, sleepless nights, reduced energy levels in the body, and cognition (Dupont et al., 2014). As such, the ideas in the paper will seek to illustrate the emotional and cognitive-behavioral responses that Mary: a 25-year-old woman married to an army officer and resides in the homes provided by the defense force with limited contact with family and friends, is likely to experience about the breast cancer diagnosis. Notably, the paper will set a discussion on the risk and protective factors that affect Mary. Lastly, the article will sum up the ideas concerning the thesis statement as shown below.

 

Behavioral risk and protective factors

The mentioned behavioral factors: reduced energy levels, sleepless nights, mood, and cognitive disturbances are the primary risk and protective factors that Mary is likely to face. First, the idea of reduced energy levels in the body results in fatigue as a side effect of treatment. Research by Belfer et al., 2013 reported that during the chemotherapy tests on women diagnosed with breast cancer, the radiations cause fatigue: although the condition stops after treatment in some cases, the fatigue usually persists for quite some time. Also, the NHS reported that approximately 1 out of every 4 cases of breast cancer survivors in Australia experiences fatigue up to five years after treatment (Dupont et al., 2014). With Mary who has limitations to her family and the husband is likely to experience longer periods fatigue during treatment as she lacks motivation. Again, having twins aged eight months means Mary has to commit a lot of her time to caring for the kids, yet it is evident that after the chemotherapy a patient is always tired. Therefore, the situation will lead to inefficiency in either seeking treatment or care for the kids.  

Secondly, the NHS in liaison with the WHO conducted research in Australia and found out that patients with cancer have less sleep time as compared to patients without cancer (Advisory Committee on Breast Cancer Screening, 2016). The resultant outcome is attributed to the general fatigue and pain which transits into less sleep time. Also, Miller et al., 2016 is of the opinion that women with breast cancer at an early stage have more sleep time as compared to women with the chronic condition. The primary underlying factor for insomnia is the pain, stress of being diagnosed, and the procedural treatment of cancer. Progressively, consultations and spending most of the times nursing the situation in bed alters the regular sleep routine in breast cancer patients. Also, cognitive responses towards sleep in breast cancer patients leaves them with a phobia to having enough rest as they fear they might not wake up.  Relating the situation to Mary, calls for the assessment of her social life which is wanting due to the limited contact between her husband and her family. Besides, Mary has a lot on her plate regarding caring for the babies and seeking medical attention. As a result of her busy schedule, Mary is left with limited sleep time which causes the major disturbance in her life, therefore, altering her moods and in turn affects her efforts in raising up her kids. However, Mary can reduce the risk associated with breast cancer through indulging in exercises. This follows the research by Alevandrov et al., 2013 who are of the idea those active women: more so pre-menopausal women reduce the risk of breast cancer by participating in forty minutes of brisk walking.

 

Emotional risk and protective factors

Thirdly, recent studies indicate that the first few weeks of diagnosis pose a challenge to women as they struggle to come to terms with the news (Alevandrov et al., 2013). For instance, a clinical interview study conducted in the United States to assess depression in breast cancer women recorded that out of the large population of diagnosed patients approximately 12% tested positive for depression. However, less attention has been paid to determine the degree to which depressed breast cancer women are during the first few weeks and month of diagnosis as compared to the rate after two to three years of treatment (Davies et al., 2013). Similarly, the primary cause of depression in diagnosed women is the lack of knowledge on the side effects of drugs used. As with Mary the detection of the lamp on her breast and the results confirming that she is diagnosed with breast cancer affected her mental stability. Likewise, the distance between her family and her husband plays a significant role in making her depressed. DeSantos et al., 2014 asserts that for patients diagnosed with breast cancer to avoid depression social factors need to be integrated fully to provide emotional and behavioral support. On the other hand, Mary being depressed directly affects her kids who receive less or no care at all as she is in pain, fatigue, and lonely. Resultantly, recent studies have indicated that depression in women diagnosed with breast cancer leads to increased cases of mortality.  Research shows that a protective model for breast cancer is to bear kids; the more children a lady aged less than thirty years has the minimal chances of having breast cancer and reducing the risk associated with cancer (Miller et al., 2014). Also, the military base where Mary resides has a guiding and counseling department that can offer emotional support as she seeks treatment.

 

Cognitive risk and protective factors

Furthermore, a study by the NHS indicated that women treated with chemotherapy had cognitive complications due to the ionizing radiations emitted during the test (Semkus et al., 2013). For instance, a cross-sectional research conducted in Queensland recorded that out of ten women diagnosed with breast cancer four showed impairment during and after treatment: an indicator that radiations are harmful to the brain cells. Coupled with the growing need for understanding the relation between cognitive impairment and chemotherapy, the integration of neuroimaging in assessing cognitive behaviors in breast cancer patients provides a compelling view (Von Minckwik et al., 2014). Similarly, after some time approximately one year, Mary will start exhibiting cognitive impairment as a result of the treatment and the need to take care of her kids. Also, lack of company will facilitate the impairment as she is unable to overcome the challenges by herself. Interestingly, research indicate that if Mary breastfeeds the twins for more than twelve months reduce the risk associated with breast cancer. Also, being the wife to a military soldier, Mary is entitled to medical insurance.  Mary is committed to treatment and has the support of her family. Also, she has well established interpersonal skills and is committed to nurturing her kids. Besides, Mary always communicates with the husband via Skype every day.

 

Conclusion

To that end, it is possible to discern that fatigue, depression, insomnia, and cognitive behavior are the main behavioral symptoms presented by women diagnosed with breast cancer. As mentioned lack of clinical intervention to correct the symptoms result in increased mortality rate in patients diagnosed with breast cancer. Moreover, Mary's case provides a platform for the assessment of social and psychological factors about the diagnosis. Socially, Mary is limited to contact with her family and husband: a scenario that significantly affects her ability to withstand the treatment and raise her children efficiently.  However, several protective factors have been outlined showing how Mary gets support to overcome the behavioral, emotional, and cognitive risks. For instance, the military scheme that covers for medical care for all soldiers and their family members.

 

Reference

Advisory Committee on Breast Cancer Screening. (2016). Screening for breast cancer in England: past and future. Journal of Medical Screening. Retrieved from www.bmj.com/content/332/7540/499

Alexandrov, L. B., Nik-Zainal, S., Wedge, D. C., Aparicio, S. A., Behjati, S., Biankin, A. V., ... & Boyault, S. (2013). Signatures of mutational processes in human cancer. Nature, 500(7463), 415-421.

Belfer, I., Schreiber, K. L., Shaffer, J. R., Shnol, H., Blaney, K., Morando, A., ... & Kehlet, H. (2013). Persistent postmastectomy pain in breast cancer survivors: analysis of clinical, demographic, and psychosocial factors. The Journal of Pain, 14(10), 1185-1195.

Davies, C., Pan, H., Godwin, J., Gray, R., Arriagada, R., Raina, V., ... & Bradbury, J. (2013). Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. The Lancet, 381(9869), 805-816.

DeSantis, C., Ma, J., Bryan, L., & Jemal, A. (2014). Breast cancer statistics, 2013. CA: a cancer journal for clinicians, 64(1), 52-62.

Dupont, A., Bower, J. E., Stanton, A. L., & Ganz, P. A. (2014). Cancer-related intrusive thoughts predict behavioral symptoms following breast cancer treatment. Health Psychology, 33(2), 155.

French Adjuvant Study Group. (2016). Benefit of a high-dose epirubicin regimen in adjuvant chemotherapy for node-positive breast cancer patients with poor prognostic factors: 5-year follow-up results of French Adjuvant Study Group 05 randomized trial. Journal of Clinical Oncology.

 Miller, A. B., Wall, C., Baines, C. J., Sun, P., To, T., & Narod, S. A. (2014). Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. Bmj, 348, g366.

 Miller, K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J. H., ... & Jemal, A. (2016). Cancer treatment and survivorship statistics, 2016. CA: a cancer journal for clinicians, 66(4), 271-289.

Senkus, E., Kyriakides, S., Penault-Llorca, F., Poortmans, P., Thompson, A., Zackrisson, S., & Cardoso, F. (2013). Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, mdt284.

 Von Minckwitz, G., Schneeweiss, A., Loibl, S., Salat, C., Denkert, C., Rezai, M., ... & Zahm, D. M. (2014). Neoadjuvant carboplatin in patients with triple-negative and HER2-positive early breast cancer (GeparSixto; GBG 66): a randomised phase 2 trial. The lancet oncology, 15(7), 747-756.

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