Management of Breast Cancer in the Family: Psychological Aspects

This essay provides an overview of breast cancer, including its causes, risk factors, signs, symptoms, diagnosis, and treatment. It delves into the psychological impact of breast cancer on patients and their families, discussing emotional distress, depression, guilt, low self-esteem, and potential suicidal thoughts. The essay highlights the impact on children and spouses, addressing issues like social isolation and anxiety. It examines the effects of breast cancer on a woman's self-image and femininity, and offers strategies for managing the psychological challenges, such as seeking therapy, maintaining social connections, and engaging in meaningful activities. The essay further explores psychosocial factors affecting family members, including case studies of individuals experiencing depression, anxiety, and social isolation due to the disease. It emphasizes the importance of social support, developmental crises, and socioeconomic status in influencing the psychological well-being of those affected by breast cancer.

Running head: THE PSYCHOLOGICAL ASPECT OF BREAST CANCER 1
Management of Breast Cancer in the Family
Student’s Name
Name of Institution

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1. Overview of breast cancer
Breast cancer causes and risk factors
Breast cancer is a condition that occurs as a result of mutation or change in cells in the
breast tissue (Christian,2017). The Mutation of these cells results in clustering of abnormal cells
forming a tumor. The tumor becomes malignant once the abnormal cells spread to other parts of
the breast or other parts of the body. There, exists various factors that increase the risk of breast
cancer. For instance, although breast cancer affects both genders, it has been found to be more
prevalent in women especially those over the age of fifty. Family history also comes into play
when assessing the risk of breast cancer as it can be genetically inherited. White women are also
considered to be at a slightly higher rate of developing breast cancer as compared to their Asian,
Hispanic or African counterparts. Other risk factors include exposure to radiation as well as high
alcohol consumption.
Signs and symptoms of breast cancer
Individuals with breast cancer may exhibit a variety of signs and symptoms. Early signs
include the growth of a lump on the breast or surrounding areas such as near the armpit. The
lump may at times be painful although it is not always the case. It should, however, be noted that
not all lumps are cancerous hence the need for a medical check-up. There may also be a change
in breast size resulting from swelling or shrinkage of the affected breast. Other signs include
peeling of breast skin, bloody or clear discharge from the nipples as well as swollen lymph nodes
under the arm.

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Diagnosis and treatment
Breast cancer can best be treated if it is detected early enough. Medical practitioners,
therefore, advise women to go for regular mammogram screening so as to enhance chances of
survival if diagnosed. Methods of administering breast cancer treatment vary depending on the
type, stage as well as the health condition and age of the patient. Radiation and surgery are
however the most widely used methods of cancer treatment. Surgery may involve removal of
only the portion of breast tissue containing cancer which is known as lumpectomy or removal of
the entire breast which is called mastectomy (Jaime and Kimberly, 2018).
The psychological impact of breast cancer
Breast cancer is known to cause severe emotional distress among patients and family
members. Emotional distress results from fear and uncertainty about what the future holds as
most people associate breast cancer with imminent death (Michele, 2014). Breast cancer patients
and families may also undergo emotional distress as a result of the financial burden they may
have to shoulder as a result of the disease (Towers, 2016). Breast cancer is also known to result
in major depression in some of the patients. This occurs where feelings of sadness or despair
tend to interfere with the patient’s daily activities.
Depression may be exhibited in various ways. For instance, the cancer patient may
constantly look sad or where a listless expression. The cancer patient may also experience
reduced activity and may feel less eager to carry out even the smallest of tasks. Guilt and a sense
of low self-esteem are also common depression symptoms breast cancer patients might
experience. The guilt may result from a sense of worthlessness as some cancer patients may view

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themselves as a burden. In extreme cases, breast cancer patients may experience suicidal
thoughts especially when life becomes overly challenging.
Children and spouses of breast cancer patients may also experience depression
symptoms (Tanja, 2015). For instance, children may show less interest in relating with their
friends or peers. They may also become more irritable and easily angered. Additionally, such
children may find it hard to concentrate in class activities thus leading to a decline in grades and
overall performance. Spouses, on the other hand, may become more anxious and frustrated as
they feel the need to step up and shoulder the burden of the sick patient. The spouse may thus
feel guilty in case he or she is unable to meet the family needs.
Breasts are among the features that define womanhood and femininity. Breasts, therefore,
play an important part in a woman's confidence and sense of worth (Cordella, 2010). This is
proven by the fact that many girls are desperate to grow a pair of breasts from as early as eight
years (Cordella, 2010). In many societies, breasts are also associated with sex and breastfeeding.
Additionally, many societies also consider exposure of a woman’s breasts as indecent and
inappropriate. Breast cancer diagnosis is therefore psychologically devastating to most women.
First, a woman diagnosed with breast cancer has to endure the horror of repeatedly showing her
breasts to strangers during treatment which this makes breast cancer patients feel violated
(Cordella, 2010).Surgical breast cancer treatment can also bring about poor self-image which is
likely to undermine a woman’s confidence (Chen and Wang, 2018) .Many women also report
that they feel less attractive after being diagnosed with breast cancer.
Dealing with the psychological impact of breast cancer

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It is normal for the breast cancer patient to experience sadness and fear upon being
diagnosed with the disease. It is, however, essential to seek psychological assistance if such
emotional feelings persist long after diagnosis. The breast cancer patient and other affected party
can seek the services of a therapist who will give them a chance to openly express their worries
and gain professional medical help. It is also essential for the patient to remain in touch with
friends as sharing helps relieve emotional worries and offers one the chance to receive
encouragement. Most importantly, it is essential for the patient to realize that breast cancer is not
a death sentence and there still exists a chance of them surviving. The patients should also
engage in hobbies and activities that arouse their interest. Engaging in interesting activities helps
give value to life and helps one regain their sense of worth thus reducing depression in breast
cancer patients.
The intricacies of breast cancer treatment such as an overload of information and the
weight of decisions can be overwhelming to a patient (Patricia, 2008). The amount of stress can
further be exacerbated by the adverse of effects of Chemotherapy. Patricia, however, argues that
most of the women diagnosed with breast cancer have been found to manage psychosocial
distress quite effectively with the availability of proper support systems.
2. Psychosocial factors affecting the psychological health of family members
Debbie is experiencing clinical depression. From the case study, we can see that Debbie
blames herself for contracting the disease as she believes it resulted from her smoking habits.
Additionally, Debbie is experiencing a decline in energy levels as she feels tired all the time. As
a result, she is unable to take part in activities that are of interest to her. Up to 21.5% of women

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diagnosed with breast cancer experience depression in the course of their treatment (Debasweta,
Chitra, Kesavankutty, and Unnikrishnan, 2017). Additionally, 22% of the depression cases are
clinical in nature and they adversely affect the patient’s quality of life as well as response to
medication (Debasweta, Chitra, Kesavankutty, and Unnikrishnan, 2017).
Paul, on the other hand, is struggling with anxiety disorder resulting from stress.
Psychologists argue that major life changes can result in stress. In the case study, Paul’s family
has experienced a major life change since Debbie was diagnosed with breast cancer. For
instance, Paul has had to adapt to being the sole breadwinner. This means that Paul has to work
more hours than normal thus reducing the time he spends with his family. Such changes can be
overwhelming and resulting in stress. Financial problems are also another common external
source of stress. In Paul’s case, there has been a huge financial burden that has resulted from
Debbie’s diagnosis and job loss. This has made Paul strive more to meet all the financial needs
of the family. Additionally, Paul has already started imagining the fact that Debbie may not
survive her condition, this has resulted in increased worry and anxiety regarding what the future
holds. Paul's body is, therefore, reacting to this overwhelming amount of stress through anxiety
and depression. Paul exhibits various symptoms of anxiety such as insomnia as it is narrated that
he finds it difficult to sleep. Paul is also very apprehensive as we are told that he is often restless
and on edge. He also experiencing stomach churning which psychologists associate with anxiety.
According to doctors, a stress response leads to the secretion of stress hormones into the
bloodstream which suppresses digestion and causes stomach muscles to tighten resulting in
nervous stomach anxiety which includes churning.

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Poppy is experiencing social isolation as a result of increased responsibilities which have
reduced her interaction with friends. Poppy is forced to take up numerous responsibilities at a
very young age. This deprives her the joy of being a child as she has to worry about the well-
being of her mother and siblings. She is, therefore, experiencing mild depression as a result of
the sudden changes in her life. This explains Poppy's lapses in concentration. Debbie’s condition
also denies Poppy the chance to attend her gymnastics sessions which further increases her
isolation and results in loneliness. This loneliness is further compounded by the lack of parental
guidance and advice since Paul is always at work.
The family also does not enjoy a proper social support. From the narration, it is clear that
neighbors rarely have time for Debbie because of busy schedules. Additionally, there is no
mention of relatives or friends to offer moral support. The family is thus forced to face this new
development on their own which is taking a toll resulting in emotional distress and anxiety.
Social support is an important psychosocial need in the treatment of cancer patients
(Donald and George, 2014). It not only involves the provision of emotional support but also
informational advice as well as knowledge. Social support may entail both formal and informal
relationships. The informal relationships offer emotional support thus enhancing the patient’s
sense of security, love, and comfort. Social support may also involve the provision of material
factors needed in the treatment of the disease as well as the well-being of the family (Patricia,
2015). In the case of Debbie, social support in terms of material factors would reduce Paul’s
financial burden and thus give him more time to be with his family. Emotional support would
also give Debbie an assurance that she is not to blame for the condtion.This would, in turn,

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improve her attitude which might better her response to medication thus reducing progression of
the disease.
The family members Debbie, Paul and Poppy are also experiencing a developmental
crisis. Developmental crisis occurs when an individual is met with new changes regarding
personal life or a natural process (Ellen and Frances, 2010). Developmental crisis is common
during adolescence, maturity, old age or during unexpected life events such as terminal illnesses
(Çömez, & Karayurt, 2016). When such life events occur, the affected individual finds it difficult
to adapt to the new roles or changes which in turn results in distress and anxiety. This is seen in
the case of Paul who has to shoulder new responsibilities to ensure the financial sustainability of
his family. Poppy is also experiencing lapses in concentration as a result of the sudden changes
and overwhelming responsibilities she has to bear. Debbie, on the other hand, blames herself for
being diagnosed with breast cancer.
Socioeconomic status is also a psychological factor that seems to adversely affect the
psychological health of family members especially Paul. From the case study, it is clear that
Debbie’s leave is likely to, affect the financial stability of the family hence the need for Paul to
step up. This shows that the family is not that financially well off to guarantee Debbie’s quality
of health. The financial struggles are therefore one of the main contributors to Paul’s poor
psychological health.
3. Possible psychological interventions
i) Cognitive behavioral therapy

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Therapy is required to help Paul adapt to Debbie’s new condtion.This would involve
private interviews with a qualified therapist in order to determine the problems and come up with
relevant solutions. Therapy sessions would give him the chance to open up on his concerns and
worries regarding Debbie’s condition. For instance, through these sessions, Paul would acquire
advice on how to provide financial support while at the same time being available for his wife
and children. This would reduce his feelings of guilt and self-blame as well as reduce his level of
anxiety which is adversely affecting his health. Cognitive behavioral therapy is one of the most
effective ways of treating depression and anxiety disorders (Conal, Gary and Michael, 2015).
The study which involved the use of twenty-nine randomized control trials in three separate
meta-analyses revealed that cognitive behavioral therapy was even more effective than
medication in treating those dealing with cases of anxiety and depression. Cognitive behavioral
therapy should be the first option and that medication should only be used as last resort (Rutgers
Cancer Institute of New Jersey, 2016).
ii) Self-support groups
Self-support groups are helpful in providing social support and peer assistance in solving
problems (Monica and Martine, 2009).Self-support groups are often composed of members who
are facing similar problems or experiences and clinical psychologists who offer expert advice. A
support group would be helpful in the case of Debbie who seems to be socially isolated as a
result of Paul’s absence and a lack of social interactions. A self-support group would give
Debbie the opportunity to meet fellow breast cancer patients and survivors who have positive
stories to tell regarding their condition. Such stories would offer encouragement and boost

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Debbie’s spirit thus enhancing her chances of survival. Through encouragement from group
members, Debbie would also be able to regain her energy levels as well as pursue her interests.
Support groups are effective in improving patient's response to breast cancer treatment as
well as their overall quality of health (Fang-Yu, Frances and Lilly, 2016). Support groups use
social-cognitive processing theory to facilitate emotional adjustment to cancer (Hasson-
Ohayon, Goldzweig, Braun and Galinsky, 2010). Psychologists, support groups offer cancer
patients a conducive environment which improves cognitive processing by enabling cancer
patients to recount and discuss their thoughts and feelings regarding the disease (Park, &
Hwang, 2009). What's more, support groups also help patients also helps patients adjust their
expectations, knowledge, and attitudes about breast cancer.
iii) Supportive Psychotherapy
Psychological intervention involves offering support to patients by encouraging them to open
up and express their feelings (Brian and Jennifer, 2012). Supportive psychotherapy also tries to
reach out to a patient’s strong personality traits in coping with the new situation (National
Institute of Medicine, Board on Health Care Services, National Cancer Policy Forum, 2011).
Supportive psychotherapy would be helpful in Debbie’s situation since it would help her build a
sense of safety and trust in the reality of the disease. Psychotherapy also enhances proper mental
balance which is vital in facilitating positive response to the treatment (Martha, 2017).
iv) Medicine
Another psychological intervention involves the prescription of medicine to deal help
manage stress levels. Medicines such as anti-depressants and anti-anxiety would be applicable
especially in the case of Paul who is experiencing lack of sleep. Steroids such as prednisone used

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in the treatment of cancer are usually responsible for some of the negative moods in cancer
patients (Grace, Carolyn and Lynn, 2015). High doses of morphine are also known to affect the
mental process and therefore the use of antidepressants may be required to counter any adverse
psychological effects (Park & Hwang, 2009). Such drugs, however, should only be taken with
the prescription of a certified psychologist.
v) Increasing the social network
From the case study, it is clear that Debbie’s family is facing social isolation. This
adversely affects Debbie's treatment as she lacks the much-needed support in her treatment.
Socially isolated breast cancer patients face a higher risk of cancer recurrence as well as higher
mortality risk compared to patients with large social networks (Martha, 2017). This is because
socially isolated patients are predisposed to emotional distress as well as depression, unlike their
socially active counterparts. Debbie’s family should thus work on improving her social network
as this will positively impact her psychological health further boosting her chances of recovery.
Debbie can increase her social network by keeping in touch with friends through social
media platforms such as Facebook and Instagram. This way, she can talk about her progress as
well as arrange visits. She can also take-up blogging where she can open up about her
experiences with breast cancer and give advice to those facing a similar condition. Social
interaction tends to improve the patient's will to live and will encourage Debbie to be more
optimistic in her treatment.
Conclusion

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From the above report, it is clear that breast cancer has a huge psychological impact on
the patient as well as the family members. The psychological impact of breast cancer is mainly a
result of the complex medical process and financial burden that the patient and family may have
to endure in the course of treatment (Çömez, & Karayurt, 2016). Psychological distress is also
compounded by the reality that the patient may not survive the disaeses.The patient may,
therefore, experience despair and lose interest in life. This may be exhibited in the patient's lack
of enthusiasm in social interactions as well as constant pessimism. The family members may also
experience anxiety as they have to take on additional responsibilities to ensure the comfort and
well-being of the patient (Tânia, Marc& Paula 2014).It is therefore important for the family
members to seek psychological help so as to effectively manage the patient’s health.
Psychological intervention may occur in the form of cognitive behavioral therapy, self-support
groups, medicine, as well as increasing the patient’s social networks. It is also essential for
parents to pay attention to the emotional and psychological well-being of the children who are
the most vulnerable (Ellen and Frances, 2010). Additionally, it is important for women to
undergo regular breast cancer screening to facilitate early diagnosis and timely treatment.