How to support breast cancer patients during treatment

After a loved one receives a breast cancer diagnosis, one UAB expert says it is important for caregivers to know how they can best support the patient during the difficult time. A breast cancer diagnosis can take both an emotional and physical toll on a patient. After a loved one's diagnosis, one expert at the University of Alabama BirminghamO'Neal Comprehensive Cancer Center says it is important for caregivers to know how they can best support patients after a breast cancer diagnosis.

"A breast cancer diagnosis is a shock," said Catherine Parker, M.D., a breast surgical oncologist at the UAB O'Neal Comprehensive Cancer Center. "That shock should not be minimized. One of the most helpful things friends and family can do is let the patient know that it is perfectly OK to take time to process the diagnosis and make the treatment decision that is best for them."

After diagnosis

After a loved one receives a breast cancer diagnosis, Parker says it is important for caregivers to know how they can best support the patient during the difficult time.

"When someone is diagnosed with breast cancer, the different advice and opinions can sometimes be overwhelming for the patient," Parker said. "One of the most helpful things caregivers can do is to assure the patient that their treatment is their choice."

Parker says allowing the patient to talk through their goals can be helpful for them.

"Some patients prefer larger surgeries, and some prefer smaller surgeries," Parker said. "Helping your family member determine what their goals are can help them make the best decision for them. However, even knowing their goals, the choice can still be overwhelming sometimes. If they cannot come to that peace of mind, their provider may encourage them to start small."

Patients may feel a lot of different emotions after a diagnosis. They may feel anxious about their treatment or next mammogram. Some patients may feel guilt, because they do not see their diagnosis as "severe" as those of other patients they may encounter. After treatment, some patients may feel as though they have lost their sense of direction in life after their treatment has concluded. No matter the emotion, Parker says, it is important for patients to feel validated in those emotions and have time to process them as they come.

"Allow the patient a safe space to share what they are feeling during this process," Parker said. "As part of their support system, you do not have to offer a solution to their problems. It can be helpful for patients if someone is just there to listen to them while they go through this process."

It can be helpful to ask the patient if they would like someone to come with them to their appointments since there is a lot of information that patients will hear at their appointments. However, if the patient would rather go to their appointments alone, Parker says that is perfectly fine too. Whether they elect to have someone come with them or prefer to go alone, it can be helpful to take some time before an appointment to help the patient think of any questions they have and write them down.

During treatment

Caregivers can support patients by securing transportation to and from treatments. While some patients may prefer to drive themselves, others may prefer having someone drive them to their treatments. Caregivers should talk to the patient to determine what is best for them.

Patients may experience numerous side effects, including pain, fatigue, nausea or vomiting, hair loss, stomach issues, and more. Parker recommends talking to the patient's oncologists about these side effects and determining some ways to address them. Doctors may recommend certain medications, cold caps, moisturizers or a special diet, among other recommendations.

Some ways caregivers can support patients include:

• Going for a grocery run
• Arranging for a cleaning company to service their house
• Assisting with transporting children to extracurricular activities
• Providing child care after school hours
• Setting up a healthy meal train

Caregivers should be aware that, after cancer treatments, some patients might not have a taste for the same foods because they may taste different. Give the patient opportunities to try different foods, do not force them to eat, and encourage them to eat healthy when they can.

The patient's emotional needs should continue to be prioritized during treatment. Continue to provide them a space to communicate what they are feeling without judgment.

Resources

The UAB O'Neal Comprehensive Cancer Center has multiple resources for patients with breast cancer and breast cancer survivors.

The Angel Squad is a group of breast cancer survivors located in the Breast Health Clinic waiting room who talk with patients and answer any questions they may have about their breast cancer journey.

The Forge Breast Cancer Survivor Center, a 501(c)(3) nonprofit and UAB Medicine partner, serves breast cancer survivors and co-survivors residing or receiving treatment in the following counties: Blount, Jefferson, Shelby, St. Clair and Walker. Forge creates a personalized survivorship plan for each participant and offers a range of services, including:

• Health and wellness classes
• Professional mental health counseling
• Telephone support
• Legal and financial counseling
• Gardening, exercise and cooking events
• Support groups
• Peer-mentor matching

The American Cancer Society Hope Lodge program provides a free home away from home for cancer patients and their caregivers. The Lodge provides:

• Private guest rooms and bathrooms
• Fully equipped community kitchens for food storage and preparation
• Gathering areas/great rooms and community dining rooms
• Free laundry rooms stocked with supplies
• Outdoor, reflection or meditation spaces
• A library and/or resource rooms
• TVs and computer access
• Dedicated volunteers helping to ensure a comfortable stay for our guests and frequently cooking/providing meals

The Next Steps Clinic - Breast Cancer Survivorship offers specialized follow-up care focused on the unique needs of breast cancer patients. Survivorship care is provided by a nurse practitioner with expertise in breast cancer care needs, both during and after treatment. Nurses will work closely with the patient's primary treatment team and follow a personalized plan. Patients will receive:

• Monitoring for long-term effects of breast cancer treatment
• Referral for management of identified problems
• A Survivorship Guide Book with personalized details of your treatment and guidelines for continued monitoring
• Recommendations for preventive care
• Access to relevant information, resources and services

UAB Medicine's Supportive Care Clinic helps patients manage the symptoms and side effects often associated with serious illnesses such as cancer. Patients have access to a variety of specialists that can manage multiple conditions, including:

• Physicians and nurse practitioners who have special expertise in managing complex symptoms such as depression, anxiety, insomnia, fatigue, loss of appetite and pain syndromes
• Nurses who support patients by facilitating the clinic visits and responding to phone calls
• Physical therapists who develop individualized programs for each patient to help improve coordination, balance, strength, endurance, flexibility and range of motion
• Cancer counselors who are experienced in designing a variety of counseling sessions that meet the specific needs of each patient, such as cancer-psychological counseling to manage distress or to quit smoking
• Nutritionists who have expertise in helping ensure that patients with serious illness receive proper nourishment
• Massage therapists who are trained in many types of massage, including oncology massage, which is a specialized approach that supports the body's health before, during and after cancer treatment
• Chaplains who confidentially and compassionately support the emotional and spiritual needs of patients and their loved ones, regardless of their faith

The O'Neal Comprehensive Cancer Center offers classes to provide community and enhance well-being and healing for patients and their caregivers. Classes include:

• Knitting
• Yoga
• Spiritual health
• Mindfulness
• Arts in Medicine
• Nutrition
• General oncology support group

For questions or to register for a class, email [email protected]. For a list of other resources for patients, caregivers and survivors, visit onealcanceruab.org.

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