Mexico City. /
The day her doctor congratulated her for considering that she was “free of illness,” Raquel went into shock just like she had eight months ago. when they told her that her “lump” in her right breast was cancerous. “Of course we had to celebrate,” he says, the news was as good as a sunrise on the beach after the hurricane; However, before feeling liberated, she asks her “what if she comes back?” had assaulted her spirit.
Getting back to life after beating breast cancer is complicated for survivorssays Esther Sánchez Gamboa, a master in psycho-oncology, because they have the constant fear that he will return, feeling that will no longer be under the protective effects of the treatment or that medical surveillance will be relaxed. This fear is intense and disabling, to the extent that it can cause long-term consequences, such as alterations in appetite or sleep, due to stress, with a consequent drop in the woman’s quality of life.
“It is a very big fear because they have already lived the experience and know the effects of the treatments, in addition this latent state of danger remains before the possibility of it returning. And when it happens, the suffering is greater than the first time, because they already know what is coming,” explains Sánchez Gamboa.
The lasting side effects of treatment and psychological damage—anxiety, depression—from a breast cancer diagnosis generate a state of acute stress thatsometimes, becomes Post-Traumatic Stress Disorder (PTSD), with symptoms similar to those of people who have experienced events such as military combat, a violent assault; natural disasters and other deadly dangers, according to studies by the US National Cancer Institute (NIH, for its acronym in English).
8 out of 10 women suffer from post-traumatic stress disorder
During the first year after the diagnosis of breast cancer
According to a 2016 Munich University Hospital study, About 80 percent of women with breast cancer end up facing PTSD in the first year after diagnosis; Another study, published by the NIH Cancer journal in 2018, indicates that 6 percent of female survivors still struggle with physical and mental symptoms of the disorder four years after the cancer diagnosis.
That is why “from the diagnosis, during the treatment and afterward, it is necessary to count always with professional help, as well as friends and family to form support networks,” says Sánchez Gamboa. “And not just the patients, but also all the people around them, including the medical team that many sometimes it doesn’t go well the burden of having to communicate the diagnosis to your patients”.
It is important to take care of the emotional and mental state of the patients throughout the entire process, since “influences the response that the body will give to the disease”adds the specialist in oncological psychology.
a living memory
Psycho-emotional discomfort in breast cancer survivors is fed every day with the memory of the treatment, especially when it included a mastectomy in any degree (total, radical, only the tumor surrounding tissue or bilateral), and has not had the opportunity to undergo breast reconstruction. “Seeing themselves in the mirror is difficult for them, they cannot see themselves naturally,” says psychologist Esther Sánchez.
“It is very hard for a woman to know herself without one breast, or without both. It is a condition that must be worked on at a psychological level because a part of What characterizes women physically, culturally and socially are precisely their breasts.. Come on, you breastfeed your children with them,” she says. “They are organs that define us as women, to which women give a lot of symbolism to feel beautiful, sexual, sensual, complete,” adds Sánchez.
After mastectomy, women experience low self-esteem, finds it difficult to socialize and leave the house or go about your normal life for fear that someone “outside” will notice that something is missing. Therefore, breast reconstruction should be included in the comprehensive treatment plan of patients with breast cancer, says Juan José Ruiz Treviño, plastic surgeon, expert in this procedure.
Since breast cancer treatment is multidisciplinary and comprehensive, “When there is a mastectomy, it must include reconstruction”points out Ruiz Treviño, because “a woman who defeats cancer will be grateful to regain her health, but if she is mutilated her quality of life will be affected.”
The diagnosis of cancer “brings with it catastrophic thoughts of death, sadness and anguish, and if you look in the mirror and don’t recognize your body, the impact is greater,” adds Ruiz Treviño. “Our job as surgeons at this point is to reconstruct to help you regain your quality of life.” Nevertheless, in Mexico Only 5 percent of women treated for breast cancer undergo reconstruction.
The main impediment is the economic factor, especially because it is a part of the treatment that public health services do not cover or contemplate covering. “It is normal in a country like ours, where 75 percent of people are cared for in the public sector due to lack of resources; many They live so far from hospitals that they do not even return for follow-ups after treatment. The first objective will always be to eradicate cancer,” says Ruiz Treviño.
However, the surgeon recommends looking for the option of reconstructing the breast to close the cycle and recover quality of life in patients, and the sooner, the better. “It can be done at any time, but It is most recommended that it be at the same time as the mastectomythis way it will be more efficient,” he points out.
More than 30 percent of people
They suffer symptoms of peripheral neuropathy after chemotherapy
Very different from a breast augmentation, reconstruction involves “inventing something that is not there, which must go from being flat to being three-dimensional and as similar as possible to the original,” and to the other breast. It can be done with prosthetic material, implants, expanders, the patient’s own tissues or combined techniques, but the more time passes, the residual tissues will be less and they will have completely lost blood supply, making it difficult to achieve a more natural appearance.
Given the risk of recurrence
Surviving breast cancer requires permanent changes in lifestyle. To begin with, it must be more healthy and include physical exercise and healthy eating and sleeping habits. In addition, medical controls must be strict.
Various studies indicate that breast cancer positive for estrogen receptors tends to generate osteoporosis, so If you experience persistent bone pain for several weeks, you should contact your doctor.. Estrogen receptor-negative cancer, much less common, tends to spread to the liver, brain or lungs, so persistent pain in the upper right abdomen, chest, cough or headache are red flags. about a possible recurrence.
So things, You should have a breast exam every six months for the first five years and a mammogram every year., unless the breasts have been removed. If there was reconstruction with implants, a breast magnetic resonance imaging (MRI) is necessary every three years to detect possible ruptures, starting from the fourth year after the implant was placed.