Personal Story: Improving the quality of life for people with metastatic breast cancer

Contents

ARTICLE AT A GLANCE

This article is about:

The cancer experience of a young woman with metastatic breast cancer, and how supportive care improved her ability to cope with treatment.

Why is this article important?

Quality of life is an important and often less discussed aspect of the metastatic breast cancer experience. 

Key points: 

This Washington Post article focuses on Tori Geib, a 30-year-old metastatic breast cancer patient. After her diagnosis, Ms. Geib began to talk to supportive care specialists. They told her about pain management, nutrition, spiritual care, acupuncture and mental health therapy.

Hearing that her cancer was metastatic, Ms. Geib said:

“If I don’t live long, I want to make sure I live my best life. ”

Pain management helped her to deal with back pain and eventually to walk without a cane. Integrative medicine reduced the anxiety she felt about the quarterly diagnostic scans that she needed.

Now 33, Ms. Geib points out:

“I’ve since learned that not everyone gets access to this kind of care, so I feel lucky. No one knows the right way how to do cancer. They’re just there to help you adjust to a new normal and be present in everyday life.”

Palliative care and integrative medicine treat the "whole person"

Palliative care is an approach that focuses on patients’ emotional needs and physical symptoms in addition to treating the disease. Integrative medicine combines traditional medicine with alternative therapies to care for the mind, body, and spirit.

Studies show that palliative care and integrative medicine can improve patient outcomes. These therapies may include mind-body issues, massage, stress management and cognitive behavioral therapy. Tools for weight loss, alcohol and exercise management might also be helpful. Palliative care also consists of management of medications for pain, nausea and other chemotherapy side effects that often affect a patient’s quality of life during cancer treatment.

In a study of metastatic cancer survivors, those who received palliative care lived five months longer than those who did not receive palliative care.

Talking about how cancer treatment has evolved, Dr. Siddartha Mukherjee, an oncologist and author of Emperor of All Maladies: A Biography of Cancer, stated:

"We don’t always give the maximal treatment. We do symptom management early. As a community, we woke up and realized we weren’t giving patients the psychological, spiritual and palliative care they needed."

Palliative care and integrative medicine have become more commonplace

Combining medical care for cancer treatment with less traditional care has become a more common practice. By 2016, 1,831 U.S. hospitals reported having a palliative care program; this is nearly three times the number available in 2000.

Mental health treatment is now recognized as an important aspect of patient care

Studies of cancer patients show that depression is common and that they are 50 percent more likely to die by suicide that the general population.

The article quotes Jeremy Hirst, MD, a palliative psychiatrist at UC San Diego Health:

“There’s a growing awareness that if we take care of how people are feeling, they will be better able to focus on treatment...We find that validating people’s experiences by giving them the space to talk about the nightmare of a cancer diagnosis and how the experience steals so much of their life helps their physical symptoms improve.”

The 2016 American College of Surgeon's report, Cancer Program Standards: Ensuring Patient-Centered Care, determined that in order to maintain accreditation, cancer programs must ask patients during an office visit about whether they are experiencing emotional distress.

Addressing lifestyle factors may also help patients

Many patients seek to change their lifestyle, either to reduce their risk of additional cancer or to help cope with symptoms of cancer or cancer treatment. Increasingly, programs are providing support for weight loss, alcohol use and exercise.

Getting connected to support services can be challenging

Although recommendations suggest that healthcare providers regularly discuss the physical and emotional impacts of cancer treatment, getting referrals to the appropriate resources or specialists can be difficult. Some insurance plans cover these services, but others do not, which can increase the challenge of coordinating care.

There is growing awareness of the role of supportive care in the treatment of cancer patients.

Linda House, president of Cancer Support Community notes:

"People are surviving longer, and they’re living better with their disease. Now we’re able to focus on all the other issues like depression and anxiety.”

What does this mean for me?

If you have metastatic cancer, you may benefit from one or more types of supportive care services. Palliative care addresses physical and emotional impacts of cancer and its treatment, including pain management, mental health care and stress management. Integrative care brings together resources and specialists from diverse fields to treat the whole person, including nutrition, massage, music therapy and acupuncture, among others. 

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Posted 3/10/20
 

References

Sarah Elizabeth Richards. "A rising trend in cancer care targets physical, existential threats patients confront.” The Washington Post. Published May 5, 2019.

Basch E, Deal AM, Dueck AC, et al. "Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment." JAMA. 2017;318(2):197–198.