The mental, spiritual, and emotional journey of breast cancer.
By Karon Warren
Receiving a breast cancer diagnosis can be devastating for patients. While there is an almost immediate focus on how severe the cancer is and what treatment options are available to eliminate it, the diagnosis calls for much more than just medicinal treatment. “Being diagnosed with and treated for breast cancer can take a toll on a person: body, mind and spirit,” says Emily Beard, women’s oncology program coordinator at Northside Hospital Cancer Institute in Atlanta. “In addition to the obvious fear and physical effects of treatment come a lot of other concerns, which vary from person to person.”
Stress over finances, worries for family members, effects on body image, and coming face-to-face with one’s own mortality are just a few of the many concerns that could and do arise following a breast cancer diagnosis. As a result, patients need much more than just medical treatment; they need palliative care that addresses these other issues. Think mental and emotional support, physical exercise, nutrition, and body image concerns.
When addressing these additional matters as part of the patient’s overall treatment plan, the benefits can be immense. “Exercise is medicine, healthy eating can aid in healing, and acknowledging and processing the feelings associated with this journey supports and empowers the survivor to tap into strengths some never knew they had,” says Jennifer Kuca Lavoie, director of wellness, worklife and fitness for Piedmont Healthcare in Atlanta. “This equals control during unsettling times.”
In recent years, there has been a shift in the medical community wherein treatment for breast cancer patients now includes these additional aspects of care. In fact, after the initial diagnosis, many facilities and doctors now include an assessment to evaluate a patient’s mental and emotional well-being, their nutritional and physical exercise habits, their stress levels, and more in order to better serve the patient.
These evaluations go a long way in assisting medical professionals with addressing patients’ other needs beyond just cancer treatment. When a need is identified, patients can be directed to the appropriate services.
Mental and Emotional Assistance
Because a breast cancer diagnosis can spark a wide range of emotions, talking with someone who understands their situation can be a huge comfort for breast cancer patients. “Psychosocial health encompasses the mental, emotional, social and spiritual dimensions of what it means to be healthy,” says Cati Diamond Stone, executive director of Susan G. Komen Greater Atlanta. “We encourage patients to talk about their feelings with a trusted source, which could be a family member, someone from their faith-based organization or a trained counselor.”
While engaging with others in similar situations can be helpful, for some patients it may be best to take it one step further and speak with a psychologist or therapist. “We perform a distress screening at the initial diagnosis or first treatment,” says Jennifer Kilkus, PhD, a clinical psychologist with the WellStar Cancer Survivorship & Support Department at Kennestone Hospital in Marietta.
If that screening identifies a high level of anxiety, stress or depression, the patient could receive a referral for a psychologist or therapist. However, because every patient is different, therapy may not be necessary. “Some patients may need to see a therapist or psychologist, while others manage well with the help of support groups or by relying on family and friends,” Kilkus says. “Our goal is to get patients the right level of care at the right time in their treatment.”
Many hospitals, cancer centers and other medical facilities offer various support groups where breast cancer patients can seek out communal interaction with other patients. Some of these groups may be as simple as gathering together to talk out their different situations. Others, though, may take it a step further, involving therapies such as music, the arts or even equine-assisted therapy.
For example, Feel Beautiful Today is a nonprofit that brings free “Arts in Health” programs to cancer patients at treatment centers around the city. “We use the arts as a tool to socially connect and encourage,” says Biviana Franco, founder and CEO of Feel Beautiful Today in Roswell. “Artistic tasks help patients understand and express themselves and hopefully lead them to an improved quality of life. We want to remind them of the person they still are despite the cancer diagnosis.”
Staying active during breast cancer treatment can go a long way in boosting the immune system, reducing stress, improving sleep or increasing emotional well-being. Although breast cancer patients may not be able to exercise at the same level they did prior to their diagnosis, physical activity is possible.
Staying active can be as simple as taking a walk or attending a yoga class. “There is proof [from the American Society of Clinical Oncology] that for women who suffer from depression and anxiety, yoga and meditation are beneficial,” says Anita Johnson, MD, FACS, breast surgical oncologist at Cancer Treatment Centers of America, Atlanta.
When going through chemotherapy and radiation to treat breast cancer, patients may experience a number of diet-related side effects, including loss of appetite, a change in taste buds, and weight loss. To address these potential issues, many medical facilities offer dietitian services.
“For me, this meant meeting with a nutritionist at my doctor’s office to learn more about how to eat healthy foods that will support my treatment,” says Stone, who is also a breast cancer survivor.
One struggle many breast cancer patients face is with their body image. With the possibility of losing their hair, dealing with a gaunt appearance and especially dealing with the aftereffects of a mastectomy, keeping their self-esteem at a high level could be difficult. That’s why there are services that address this concern.
For instance, at the Cancer Support Center, housed at the Cancer Institute at Gwinnett Medical Center (GMC) in Lawrenceville, patients can attend the “Look Good Feel Better” class, a resource from the American Cancer Society.
“We bring patients in, do their makeup through the Look Good Feel Better class, and a patient navigator based at GMC from the American Cancer Society can help them try on free wigs,” says Amy McEachin, RN, BSN OCN, oncology support clinic manager at Gwinnett Medical Center Cancer Institute.
At One Journey Together – A Cancer and Healing Boutique in Alpharetta, founder Lisa Gibson, also a breast cancer survivor, has brought together salon and spa services, custom wigs, prosthetics, compression garments and other complementary therapies to help cancer patients address their body image concerns.
For example, many patients are told they should not receive skin and nail treatments at traditional salons and spas because of their compromised immune system. However, at One Journey Together, they are specially trained to assist these patients with these services. “We offer our patients a safe, clean and comfortable environment where they can still receive the services they are used to getting with qualified professionals that understand the unique needs of the cancer patient,” says esthetician Caitlyn Smith.
Receiving this multitude of services sounds easy given there are so many providers available in the Atlanta area; however, the costs could be prohibitive for many patients. For psychological and mental treatment, it is possible health insurance may cover those appointments if the policy contains a mental or behavioral provision.
In addition, many of the support services like yoga classes, support groups and meetings with dietitians may be free or very low-cost at area medical centers and hospitals. For instance, Lavoie says that Chapman Cancer Wellness at Piedmont Healthcare offers comprehensive programs including exercise programs for women with breast cancer at no charge to the patients and their family members. WellStar also offers many support services for free.
Local nonprofits such as TurningPoint Breast Cancer Rehabilitation can also be an option for low-cost services and even financial assistance. The main mission of The Eric R. Beverly Family Foundation is to improve the survival rates of lower income breast cancer patients by providing grants for insurance co-pays, prescription costs, transportation to and from treatment, and basic living necessities such as rent, utilities and groceries.
In the last 10 years, there has been a major shift to extend breast cancer treatment beyond just treating the disease, and this shift will continue going forward. “Cancer centers and hospitals are now more fully integrating services like nutrition and fitness counseling, mental health services and other palliative care,” Stone says. “It’s been a shift in the approach, and it is positively impacting the overall treatment plan and outcomes.”
Cancer Treatment Centers of America, CancerCenter.com
The Eric R. Beverly Family Foundation, BeverlyFamilyFoundation.org
Feel Beautiful Today, FeelBeautifulToday.org
Gwinnett Medical Center Cancer Institute, GwinnettMedicalCenter.org
Northside Hospital Cancer Institute, Northside.com/CancerInstitute
One Journey Together – A Cancer and Healing Boutique OneJourneyTogether.net
Piedmont Healthcare, Piedmont.org
Susan G. Komen Greater Atlanta, KomenAtlanta.org
TurningPoint Breast Cancer Rehabilitation, MyTurningPoint.org
WellStar Kennestone Hospital, WellStar.org