Conclusions from questionnaires requiring more attention

As part of the implementation of the PoMasto project, the partners carried out the task connected with the distribution of questionnaires to women after mastectomy, as well as to specialists working with women after mastectomy. In the first group the respondents were women after mastectomy aged between 25 to 70 years, from countries: Poland, Romania, Turkey, Great Britain. The medical staff included specialists in the field of psychology, physiotherapy, dietetics and oncology.
It has to be remembered that each case is unique. Individual situations of women after mastectomy seriously vary: geographically, socio-economically, culturally and in relation to the education and personal values of each woman.
The following results of the questionnaires presented below with the division into particular categories require special attention and indicate further steps i.a. on the part of state institutions in the area of public health.

RESULTS FROM QUESTIONNAIRES

Physician-patient relationship

Specialists also highlighted the importance of the relationship between patients and physicians: the way the doctor communicates is important for the patients’ well-being and belief in their ability to cope with the disease and treatment.

Psychological support

All interviewed women point out that mental health care should be acknowledged not only as a normal part of the treatment process but as an integral part of the whole process. Female patients will feel less alone and more empowered to seek help and ultimately live longer and healthier.

Mental preparation

All specialists stressed on the need to improve the mental and emotional preparation of the patients, as this field is still underfunded and underestimated in the medical treatment of breast cancer female patients.
Periodic psychiatric evaluations, such as depression screenings for cancer patients should be available at the beginning of diagnosis.

Group and individual therapy – best solution

Specialists certified that both individual and group treatment in the form of therapy could provide a great support to the patients. The benefits of the individual sessions with a licensed psychologist, combined with a professionally supervised group psychological treatment with other patients have pointed as the best possible therapeutic strategy.

Breast reconstruction options

Specialists said that all women with early-stage breast cancer who are to undergo mastectomy should be informed about reconstruction opportunities. However, it is not practiced everywhere, it is also a matter of cultural differences.
Many women still need better access to counselling before any decision on mastectomy is made. They should have the opportunities to discuss all aspects of the operation, including reconstruction.

Collaboration

Specialists concluded that a collaborative, interdisciplinary approach within hospitals and medical facilities is the crucial in the development of medicine in the field of breast cancer: especially e.g, oncology and psychiatry specialists should work together. Sometimes the exchange of their opinions about the treatment is of key importance in the patient’s recuperation.
All patients with breast cancer should be managed by multidisciplinary teams and all multidisciplinary teams should be actively involved in network-wide audit of results.

Society

Community does not fully understand the importance of psychological support in cancer treatment and needs the knowledge on the importance of emotional support of patient.
Some women said that they did not find the reaction of the family adequate and supportive, due to the fact that the family lacked the factual knowledge about the illness and did not receive any psychological support for themselves.

Research

Although the theories about the role of the psyche in the course of a cancer disease are gaining acceptance (even among doctors) – there is still a long way to go before the conditions for psycho-oncological research are as good as those for traditional medical research.
Psychologists pointed out that it is still much more difficult to get funded for cancer and psyche research compared with standard biological and medical cancer research.
Specialists stated that more research on the intersection between psychological well-being and breast cancer survivorship should be held.

Conclusions from the questionnaires:

  1. In many countries there is a shortage of specialists working with women after mastectomy, specializing in psychology and rehabilitation, that is why there is a need to acquire qualifications in this field and employ specialists.
  2. There is a need for cooperation between hospitals, medical centers, specialists in the field of psychology, rehabilitation and oncology.
  3. It is advisable to establish medical centers aimed at mental health care for of patients and their families.