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Supportive care of women with breast cancer: key concerns and practical solutions

Nicholas Zdenkowski, Stephanie Tesson, Janine Lombard, Melanie Lovell, Sandra Hayes, Prudence A Francis, Haryana M Dhillon and Frances M Boyle
Med J Aust 2016; 205 (10): 471-475. || doi: 10.5694/mja16.00947
Published online: 21 November 2016

Summary

  • Patients diagnosed with breast cancer may have supportive care needs for many years after diagnosis.
  • High quality multidisciplinary care can help address these needs and reduce the physical and psychological effects of breast cancer and its treatment.
  • Ovarian suppression and extended endocrine therapy benefits are associated with vasomotor, musculoskeletal, sexual and bone density-related side effects.
  • Aromatase inhibitor musculoskeletal syndrome is a common reason for treatment discontinuation. Treatment strategies include education, exercise, simple analgesia and a change to tamoxifen or another aromatase inhibitor.
  • Chemotherapy-induced alopecia may be a constant reminder of breast cancer to the patient, family, friends, acquaintances and even strangers. Alopecia can be prevented in some patients using scalp-cooling technology applied at the time of chemotherapy infusion.
  • The adverse impact of breast cancer diagnosis and treatment on sexual wellbeing is under-reported. Identification of physical and psychological impacts is needed for implementation of treatment strategies.
  • Fear of cancer recurrence reduces quality of life and increases distress, with subsequent impact on role functioning. Identification and multidisciplinary management are key, with referral to psychosocial services recommended where indicated.
  • The benefits of exercise include reduced fatigue, better mental health and reduced musculoskeletal symptoms, and may also include reduced incidence of breast cancer recurrence.
  • Identification and management of unmet supportive care needs are key aspects of breast cancer care, to maximise quality of life and minimise breast cancer recurrence.

  • Nicholas Zdenkowski1
  • Stephanie Tesson2
  • Janine Lombard1,3
  • Melanie Lovell4
  • Sandra Hayes5
  • Prudence A Francis6,7
  • Haryana M Dhillon8
  • Frances M Boyle2,3

  • 1 Calvary Mater Newcastle, Newcastle, NSW
  • 2 University of Sydney, Sydney, NSW
  • 3 University of Newcastle, Newcastle, NSW
  • 4 HammondCare, Sydney, NSW
  • 5 Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD
  • 6 Peter MacCallum Cancer Centre, Melbourne, VIC
  • 7 University of Melbourne, Melbourne, VIC
  • 8 Centre for Medical Psychology and Evidence-based Decision-making, University of Sydney, Sydney, NSW


Acknowledgements: 

Nicholas Zdenkowski is supported by a Hunter New England Clinical Research Fellowship. Frances Boyle is supported by the Friends of the Mater Foundation. Sandra Hayes is supported by a Cancer Council Queensland Senior Research Fellowship. We acknowledge the Australia and New Zealand Breast Cancer Trials Group and the Clinical Oncology Society of Australia for encouraging supportive care research and clinical practice in Australia.

Competing interests:

No relevant disclosures.

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