Psychosocial
issue in young breast cancer patients
Interview
with Neil Love, MD from Breast Cancer Update for Medical Oncologists,
Program 3 2000
Play
Audio Below:
Dr.
Love: Another topic I wanted to bring up to you – we were talking
about the younger breast cancer patient – can you talk a little
bit about some of the psychosocial issues that come up and management
of those women compared to the older patients that you run into?
Dr.
Davidson: I guess the two biggest issues I run into are those who
weren’t ready to finish their families, and so that’s
always very trying and particularly if they come to the end of their
treatment and they still are premenopausal. Then we often go through
a lot of angst about, "Should she get pregnant? When can she get
pregnant? What does all this mean? How do we integrate the tamoxifen?"
So I think that’s one whole set of issues for them. I guess
I haven’t found that they seem to have more symptom problems
than older women, for example. I guess probably the pregnancy issue
is the biggest thing, Neil. What I see is almost exclusively women
who have two kids, a husband, a dog, and a job and they don’t
seem to have a lot of free time, as far as I can tell. A lot of
them do find it’s the post-treatment period that’s the
most difficult for them in terms of coping. I’ve actually started
counseling them about that when they finish their therapy –
that your spirits may actually take a dive for the next few months
more than you might think. You think you’re done – you’re
going to feel great – and in fact, a lot of them are actually
quite blue afterwards for a couple of months. And, if they’re
forewarned, it turns out not to be a big issue. And, I guess, my
simple explanation is they’re so busy getting treatment and
sort of feeling like they’re fighting their breast cancer.
Then, suddenly, they come from a time when they saw all of us all
the time to a time when they’re in follow-up and they don’t
see many of us very much and they have this sense that: a) maybe
they’re not fighting their breast cancer anymore, you know,
they’re more vulnerable. b) they’ve been pushed out of
the nest or they’ve come out of the nest, and c) they finally
had time to think about the fact that they’ve been told they
have breast cancer, which is really very scary.
