Coping With a Diagnosis of Breast Cancer-Literature Review and Implications for Developing Countries

Abstract:  Breast cancer is the most common cancer affecting women worldwide. Women are at an increased risk of developing both physical and psychological morbidity after diagnosis; however, many use different strategies to cope with the disease. The aim of this article is to review the available literature on the impact of breast cancer diagnoses and the strategies used by women to cope with this disease. The implications of these emerging findings are extrapolated within the context of health services provided in developing countries. Electronic databases were used to search the relevant literature. The findings showed that women who were diagnosed with breast cancer are at risk of developing several psychological morbidities such as depression, anxiety, fatigue, negative thoughts, suicidal thoughts, fear of dying, sense of aloneness, sexual and body images problems, as well as an overall decrease in the quality of life. Several strategies are used by women with breast cancer to cope with the disease, including positive cognitive restructuring, wishful thinking, emotional expression, disease acceptance, increased religious practice, family and social support, and yoga and exercise. Breast cancer diagnoses have been associated with several devastating psychological consequences; however, many women have used different coping strategies to adjust their lives accordingly. Healthcare professionals in developing countries, who work with women with breast cancer, should be aware of the different coping mechanisms that women use when diagnosed with cancer. Integrating a coping strategy into the treatment regimen would constitute an important milestone in the palliative care of patients with breast cancer.     

A service evaluation describing a nurse‐led prostate cancer service in NHS,Ayrshire and Arran

From 1999, the NHS Ayrshire and Arran Health Board implemented an innovative nurse‐led collaborative care model for the management of patients with prostate cancer (PC). This article describes the model and presents the results of a local evaluation to assess its impact. The evaluation comprised a retrospective audit of the service against national standards for PC management, undertaken in 2012. Seventy‐one patients, who were under the care of the service during June 2008, were included. Patient and staff satisfaction were also assessed using questionnaires distributed to 75 patients undergoing outpatient or telephone reviews during April 2012 and 7 one‐to‐one semi‐structured staff interviews. The patient audit showed good compliance with standards relating to selection of appropriate PC treatments according to tumour stage and grade; radiotherapy dosing and referral‐to‐treatment times. Areas requiring improvement were the documentation of patients' risk and performance status and provision of verbal and written information to patients and carers. Seventy‐three per cent of the patient questionnaires were returned, with 96% of respondents rating their overall care as ‘excellent’ or ‘very good’. Staff satisfaction was also high and interviewees described many benefits of the service for patients, hospital staff, GPs and the NHS/health board. Negative responses related mainly to demand/capacity issues. Overall, the evaluation showed good compliance with many national standards and high levels of patient and staff satisfaction. This suggests that with trained and competent nursing staff and collaborative multidisciplinary team working, safe and appropriate care can be achieved for more complex, as well as very stable PC patients.     

A study of hepatic disease in Australia antigen and antibody-positive blood donors

Thirty-nine blood donors, found on routine testing to be Australia antigen (HB Ag) or antibody (HB Ab) positive, were studied for evidence of hepatic disease. Seven had severe and 5 had minor biochemical abnormalities; 8 of these 12 subjects had HB Ag and 4 HB Ab; 4 had raised serum cholesterol but no other biochemical abnormalities; 23 subjects had normal biochemistry. Of 11 subjects who underwent hepatic biopsy, 3 were found to have evidence of chronic persistent hepatitis. Two of these 3 had HB Ag and 1 had HB Ab. Minor histological abnormalities were found in a further 5 subjects. Five subjects with normal biochemistry were biopsied, and 1 of these was found to have chronic persistent hepatitis. The results suggest that subjects with persistently positive tests for HB Ag or HB Ab may have chronic hepatic disease. Close followup of blood donors and other subjects found to have positive tests is thus indicated. Normal biochemical findings do not exclude abnormal hepatic histology.     

A case of paraneoplastic elastosis perforans serpiginosa associated with ovarian malignancy

Elastosis perforans serpiginosa (EPS) is a rare skin disorder in which there is transepithelial elimination of elastin fibers. It belongs to a group of perforating disorders of which there are four classic types. The EPS type is extremely rare. There have been no previous reports of elastosis perforans serpiginosa occurring as a paraneoplastic phenomenon. We report a case of paraneoplastic elastosis perforans serpiginosa in the setting of stage 4 ovarian cancer.