The diagnosis of breast cancer, being the most common cancer among women, creates a crisis situation that affects women's lives in various aspects, physically, psychologically, socially and spiritually. In this crisis situation, some reactions are universal for every patient, regardless of age, ethnic group or stage of the disease, and these reactions generally focus on two areas. The first reactions are related to the possibility of cancer spreading, uncertainty, suffering and death, and the later reactions are problems related to body image, self-esteem and sexuality related to breast loss.
The main problems experienced by women with breast cancer are; physical losses, emotional distress, and destruction in family, work and social roles. In addition, intensive and long-term treatments for cancer and the severe side effects of these treatments negatively affect women's daily life functions and cause various psychosocial problems.
Psychological problems
Being diagnosed with cancer is perceived as a threat to the future. Breast cancer is a disease in which women perceive both life and femininity as threatened. It has been stated in the literature that breast cancer diagnosis and treatment causes psychological problems in patients such as anxiety, depression, anger, uncertainty about the future, hopelessness, helplessness, fear of cancer recurrence, decreased self-esteem, distortion of body image, fear of losing feminine characteristics and fear of death. However, breast cancer can also lead to changes in women's beliefs and value structures. As can be seen, all these problems, in addition to being universal reactions to cancer, are specific reactions to breast loss, which contains many symbols in the female body.
As a result of studies conducted with breast cancer patients, the most common psychological problems are adjustment disorder, depression and anxiety. It has been reported that. It has been determined that 80% of breast cancer patients experience anxiety about cancer recurrence, anxiety about death, and sexual problems during the first treatment. Within a year after diagnosis, 20-30% of breast cancer patients cannot adapt to living with breast cancer, and 30% of them report to psychological counseling after treatment. It was determined that he was experiencing physical tension. Uncertainty about the recurrence of the disease, fear of death, and desire to live were stated as the most common concerns among women with breast cancer. It has also been stated that after mastectomy, young women have more fear of recurrence of the disease and experience more intense feelings about breast loss, whereas women in the older age group perceive breast cancer as less threatening in their future lives.
Problems related to body image, self-perception and sexuality Affecting fertility and causing hair loss can have devastating consequences for patients. In many societies, a woman's breast is seen as a symbol of aesthetic appearance, sexuality, motherhood and the nutrition of the baby. From this perspective, breast loss due to mastectomy is perceived as the loss of femininity, fertility, attractiveness and sexuality, and this causes various psychosocial problems due to damage to the woman's body image. This situation becomes even more important in underdeveloped societies like ours, where women's social values other than femininity, sexuality and fertility remain in the background.
Domestic problems
Relatives of women with breast cancer often experience psychological problems such as anxiety, uncertainty and helplessness. The reasons for the problems experienced by spouses in this process are usually the change in roles and responsibilities related to the home and the feelings of inadequacy and helplessness felt in the face of the emotional problems of the sick spouse. At the same time, children may have different fears and anxieties depending on their developmental level and can be easily affected by this difficult and stressful process due to their sensitivity. Due to the uncertainty of the disease process, the presence of young children in the family, especially dependent on the family, causes family members to worry about the future of the children. Another concern that breast cancer creates in family members is the hereditary nature of the disease. It has al properties. Due to genetic predisposition, the possibility of breast cancer occurring in other women in the family may cause fear and anxiety in family members. In addition, the fear experienced by potential supporters may deprive the individual with cancer of necessary support. Individuals without cancer may distance themselves from patients with cancer due to their own fear of cancer or death. On the other hand, family and friends may avoid contacting and openly discussing the patient because of their own confusion, uncertainty, and uneasiness about how to act. Stigmatizing attitudes towards cancer can cause inconsistent and confused behavior and destructive feedback in patients.
Professional and economic problems
Breast cancer affects women's professional careers, It also causes significant problems in their working lives and economic situations. These problems are generally problems such as health insurance or security, inability to re-enter business life, changes in work activities and priorities, stigma and job discrimination. they may encounter problems. Although the degree of discrimination in the workplace varies, attitudes such as avoidance and hostility can be observed. Other difficulties experienced by patients regarding their working life are decreased working abilities and poor performance due to disease symptoms such as nausea, vomiting and pain. In addition, patients without health insurance experience economic difficulties due to the high costs of long treatments for cancer.
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