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Breast cancer, Life is forever changed; An exploration of the impact that a diagnosis of breast cancer can have upon an individual, their family and implications for nursing practice.

Breast cancer, Life is forever changed; An exploration of the impact that a diagnosis of breast cancer can have upon an individual, their family and implications for nursing practice.

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An essay for the 2012 Undergraduate Awards Competition by Sharon McDaid. Originally submitted for BSc Honours in General Nursing at Letterkenny Institute of Technology, with lecturer Breda Mulgrew in the category of Nursing & Midwifery
An essay for the 2012 Undergraduate Awards Competition by Sharon McDaid. Originally submitted for BSc Honours in General Nursing at Letterkenny Institute of Technology, with lecturer Breda Mulgrew in the category of Nursing & Midwifery

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Published by: Undergraduate Awards on Aug 31, 2012
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10/27/2013

 
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Breast cancer, Life is forever changed; An exploration of the impact that a diagnosis of breast cancer can have upon an individual, their family and implications for nursingpractice.
Life has changed and will never be the same again! A diagnosis of breast cancer immediatelyinstils fear in all who are affected. This is a potentially life limiting diagnosis. Althoughtreatments are available, there are no guarantees in place. This means that after enduringdisfiguring surgery, invasive therapies such as chemotherapy and radiotherapy and theirassociated side effects they still may not survive. The concept of survivorship is a complexmultifaceted one which encompasses the patient, their family and social support structures. Ithas no boundaries and has biological, psychological, socio-cultural, environmental andpolitico-economic implications for all parties (Roper et al 2000). A review of the currentliterature has identified several key areas and these have been expanded upon in text. Theseinclude relationships, quality of life, coping strategies, genetics, transitions in care andinformation. The key theme that has developed is the concept of survivorship and how it isinterpreted by those who have cancer as opposed to general society. There are indications thatthe whole area of cancer care needs to be re-evaluated and adapted to the needs of theindividual. Not to the needs that society expects these individuals should have. Severalimplications for nursing practice have also been outlined.Where this journey begins is easily pinpointed however, this journey is unending
 
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Survivorship! The buzz word associated with life after cancer. It conjures up images of warswon and enemies defeated yet this one word does not even begin to describe the highs, lowsand challenges that face a woman with breast cancer. Life is forever changed. This is not anew concept; Tighe et al (2011), McCann et al (2010) and Rasmussen et al (2010) suggestthat survivorship is a dynamic and lifelong process which is similar to Kaiser (2008)suggestions that a breast cancer patient is a survivor from the day she is diagnosed. However,an interesting anomaly has also been identified by Kaiser (2008). Evidence suggests thatbreast cancer patients rarely use the term to describe themselves; they use it to describeothers.Several papers have explored these aspects and several possibilities have been explored.There are suggestions that these individuals refuse to adopt this terminology as they feel theyare fighting an ongoing battle with cancer and they acknowledge the constant threat of recurrence (Kaiser 2008). Others report that they did not think that they were sick enough anddid not want to accept the sick role that society expects. This sick role, which society asforced on these individuals as society as a whole are afraid to be reminded of their ownmortality (Sadler et al 2010). The women involved in Sadler et al (2010) qualitative studyidentified that they did not want to fall into this role, mainly as it was further evidence of their loss of control as did Costelloe and Nelson (2004), Hinnen et al (2009), Stang andMittlemark (2010).Perrault and Bourbonnais (2005) indicates that the cancer journey begins at diagnosishowever, it could be suggested this journey begins at the routine screening processes or whena breast abnormality is detected during self examination. This journey also begins at adifferent stage for those affected by familial breast cancer. Bruno et al (2010) identify thatthese women often undergo genetic screening in order to gain control over their perceived
risk of cancer and also identify their children’s risk.
However, Perreault and Bourbonnais
 
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(2005) question the current emphasis on genetic and familial screening for hereditary breastcancer and the vindicate this position by indicating that these processes lead to unnecessaryphysical and psychological trauma as well as over monopolising the limited diagnosticprocedures (Shiloh et al 2009). Another aspect to be considered is what action should betaken if these individuals are identified as carriers of breast cancer genes. Prophylacticbilateral mastectomy is one of the options to prevent the development of cancer yet Lostumboet al (2010) clearly identify that there is no available evidence to support this radicaltreatment. Sivell et al (2008) reviewed three trials relating to genetic breast cancer screeningand all three support the need for proper risk assessment and genetic counselling in order toreduce distress and prevent unnecessary screenings.Each woman living with breast cancer undergoes a unique, individualised journey which isoften based on their perception and understanding of the disease. It is vital to remember thatthese women do not undertake the journey alone. They bring with them spouses, children,family and friends who are all affected by this disease and its treatments (Langtry et al 2009).In the initial phase they and their family may be inundated with information and faced withmaking life altering decisions in a very short time frame and the transition from health toillness is almost instantaneous (Boehmke and Dickerson 2006). These increased levels of stress have huge implications for long term health as Von Ah et al 2007) suggest that it maylead to a poorer immune response. Financial difficulties may also be encountered, whether asa result of long term sick leave or increasing health care costs (McCann et al 2010).Camp-Sorrell (2009); Coyne and Borbasi (2006) explains that improved screening andtreatments for breast cancer have led to an increased number of survivors living with breastcancer. Young women, classified as those less than fifty years old face specific problemsrelated to fertility and childbearing(Thewes and Wilde 2005). Treatment aimed at slowing orcuring breast cancer comes with huge, life altering side effects. Knobf (2008) identifies one

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