Dealing with breast cancerA few weeks ago I talked with psychologist Dr. David Wellisch about his work at the UCLA Revlon Breast Center. According to the research, the risk of being diagnosed with some form of cancer in ones lifetime is 1 in 3 for women and 1 in 2 for men. Women in the United States have a 1 in 8 chance of getting breast cancer, although across the board, lung cancer now takes more lives. The risk of developing breast cancer increases with age: 1 in 25 women between the ages of 40 and 59 are at risk; 1 in 15 women between the ages of 60 and 79 are at risk. Once a woman has been diagnosed with cancer, particularly breast cancer, not only her life, but the thoughts, feelings, and lives of her entire family and her friends are changed. Researchers have noted that there is an increased likelihood of psychological disorders in both patients and close family members following a diagnosis of cancer. The most common include depression, anxiety, adjustment and stress disorders. As stressful as it may be, the majority of people facing cancer do not develop a psychological diagnosis as a result. Among the factors associated with increased psychological illness, says Dr. Wellisch, is the presence of severe pain. “If one has pain, the likelihood of having a psychological diagnosis is essentially doubled. So pain management is a very critical aspect of care, a foundational intervention.” Generally, people who have the most difficulty coping are those with recurrent conditions. “That*s the time when it*s most reasonable to seek psychological care,” says Dr. Wellisch. For many patients, the return of a cancer that was once thought cured or in remission is the “first real confrontation with death.” What are the consequences of breast cancer for close relatives, especially daughters? Daughters and other close relatives of women with breast cancer comprise an ideal and compelling group for early intervention and treatment. In recognition of this, a multidisciplinary team at the UCLA Revlon Breast Center developed a program, the High Risk Clinic, that provides educational tools to assist participants in understanding their actual levels of risk, coping with the stresses of their risk status (including the illnesses of close family members), and developing medically appropriate early cancer detection and treatment programs. Dr. Wellisch and his colleagues found that 22 percent of the women who enrolled in the program at the High Risk Clinic reported clinically significant depressive symptoms, with 38 percent reporting significant anxiety symptoms. Almost all of the women overestimated their risk of getting breast cancer. After participating in the high-risk education and support program, the participants' scores on depression and anxiety were moderately reduced; perception of increased risk was significantly reduced. Dr. Wellisch offers some compelling recommendations for all women, especially women already at risk. He reminds us that that regular exercise can decrease the risk of breast cancer by reducing the amount of circulating estrogen, as does lowering the percentage of body fat. He also recommends that women either refrain from drinking alcohol or drink modestly, as high alcohol consumption is associated with increased cancer risk. "Early diagnosis is critical, critical, critical,” he says, “and that means all women having mammograms and examinations on a yearly basis after age 40.” Whether it’s by offering our support to others in need or asking for it from them when it is needed, we can all heal and grow together by reaching out, listening and touching each other with our caring and our time, with words and actions that say we are our best when we are with each other. |
