Breast Cancer Treatment of Women with Schizophrenia and Bipolar Disorder from Philadelphia, PA: Lessons Learned and Suggestions for Improvement

Cole, Marion E.; Padmanabhan, Aruna

doi:10.1007/s13187-012-0391-7

Cited by 13 publications

(46 citation statements)

References 9 publications

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“…Similar findings were seen in patients with a diagnosed mood disorder and breast cancer in which patients with a mood disorder had an overall poorer outcome, albeit patients diagnosed with bipolar disorder did not have an increased mortality rate (Kanani et al 2016). Elderly patients diagnosed with mental disorders showed a delay in initiation of cancer treatment, perhaps explaining some of the differences in mortality between patients with mental illness and the general population (Iglay et al 2017a), and highlighting the possible need for coordinated treatment to ensure similar treatment outcomes and options in patients with SMI as compared to patients without a psychiatric disorder (Cole and Padmanabhan 2012; Iglay et al 2017b).…”

Section: Cancermentioning

confidence: 99%

Why are somatic diseases in bipolar disorder insufficiently treated?

Nielsen

Kugathasan

Straszek

et al. 2019

Int J Bipolar Disord

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Background Somatic diseases, including cardiovascular, respiratory, and cancer diseases, are the main contributors to a shortened life expectancy of 10–20 years in patients with bipolar disorder as compared to the general population. In the general population an increase in survival has been observed over the last decades, primarily due to the advances in primary prophylaxis, medical treatment and progress in early detection and monitoring of somatic diseases. In this narrative review, we discuss the existing literature on treatment and outcomes of cardiovascular, respiratory, and cancer diseases in patients with bipolar disorder, and put this in the context of findings in studies on patients diagnosed with other severe mental disorders. Main body The existing literature suggests that patients with bipolar disorder receive fewer or delayed medical interventions, when admitted with severe somatic diseases, compared to those not diagnosed with bipolar disorder. Cardiovascular disease is the most investigated disease regarding outcomes in patients with severe mental illness, and novel findings indicate that the increased mortality following cardiac events in these patients can be reduced if they are intensively treated with secondary prophylactic cardiac intervention. Elderly patients diagnosed with mental disorders and cancer experience a delay in receiving specific cancer treatment. No studies have investigated treatment outcomes in patients with severe mental disease and respiratory diseases. Conclusion It is surprising and of major concern that patients with bipolar disorder have not benefitted from the significant improvement that has taken place over time over time of somatic treatments in general, especially in countries with equal and free access to healthcare services. Therefore, no matter whether this situation is a result of a negative attitude from health care providers to patients with mental illness, the result of the patient’s lack of awareness of their physical illness or the results of other factors, further attention including research on developing strategies for improving the management of somatic diseases in patients with bipolar disorder is needed.

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Section: Cancermentioning

confidence: 99%

Why are somatic diseases in bipolar disorder insufficiently treated?

Nielsen

Kugathasan

Straszek

et al. 2019

Int J Bipolar Disord

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“…Although understudied, there is evidence of disparities in cancer care provided to individuals with an SPI across the cancer continuum, from screening to palliative care. Review articles, case reports, opinion pieces and case series make up a significant portion of the literature that are the basis of cancer care recommendations for patients with an SPI [ 3 – 5 , 17 – 22 ]. A small amount of research has been performed to understand if individuals with an SPI are more likely to receive suboptimal oncology care [ 12 , 14 , 23 – 31 ], or investigated specific barriers to providing cancer care to individuals with a serious mental illness [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of a severe psychiatric illness on colorectal cancer treatment and survival: A population-based retrospective cohort study

et al. 2020

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Objectives To identify inequalities in cancer survival rates for patients with a history of severe psychiatric illness (SPI) compared to those with no history of mental illness and explore differences in the provision of recommended cancer treatment as a potential explanation. Design Population-based retrospective cohort study using linked cancer registry and administrative data at ICES. Setting The universal healthcare system in Ontario, Canada. Participants Colorectal cancer (CRC) patients diagnosed between April 1st, 2007 and December 31st, 2012. SPI history (schizophrenia, schizoaffective disorders, other psychotic disorders, bipolar disorders or major depressive disorders) was determined using hospitalization, emergency department, and psychiatrist visit data and categorized as ‘no history of mental illness, ‘outpatient SPI history’, and ‘inpatient SPI history’. Main outcome measures Cancer-specific survival, non-receipt of surgical resection, and non-receipt of adjuvant chemotherapy or radiation. Results 24,507 CRC patients were included; 482 (2.0%) had an outpatient SPI history and 258 (1.0%) had an inpatient SPI history. Individuals with an SPI history had significantly lower survival rates and were significantly less likely to receive guideline recommended treatment than CRC patients with no history of mental illness. The adjusted HR for cancer-specific death was 1.69 times higher for individuals with an inpatient SPI (95% CI 1.36–2.09) and 1.24 times higher for individuals with an outpatient SPI history (95% CI 1.04–1.48). Stage II and III CRC patients with an inpatient SPI history were 2.15 times less likely (95% CI 1.07–4.33) to receive potentially curative surgical resection and 2.07 times less likely (95% CI 1.72–2.50) to receive adjuvant radiation or chemotherapy. These findings were consistent across multiple sensitivity analyses. Conclusions Individuals with an SPI history experience inequalities in colorectal cancer care and survival within a universal healthcare system. Increasing advocacy and the availability of resources to support individuals with an SPI within the cancer system are warranted to reduce the potential for unnecessary harm.

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“…9 Nonadherence to treatment regimens, a lack of understanding of the disease, psychiatric complications, physician frustration, difficulty of communication, and a lack of self-respect and social support are some of the barriers that can challenge the diagnosis and treatment in patients with both mental illness and breast cancer. 10 In particular, the lack of understanding of the disease, low self-esteem, and minimal social support may in part account for why this patient did not seek medical attention for such a long period of time.…”

Section: Cancer Health Disparities and Risk Factorsmentioning

confidence: 97%

Cancer health disparities and risk factors: lessons from a woman with a 20-cm chest wall mass, growing for 2 years

Woo¹,

Palmisiano²,

Váradi³

2013

Community Oncol

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he National Cancer Institute (NCI) has defined cancer health disparities as adverse differences in incidence, prevalence, mortality, survivorship, and burden of cancer or related health conditions that exist among specific populations in the United States. 1 African Americans are more likely than members of any other racial or ethnic population to develop and die from cancer. 2 African American women are more likely than are white women to die of breast cancer, although African American women have a lower incidence rate of this disease than white women. 3,4 The most conspicuous factors that contribute to the observed disparities are associated with a lack of health care coverage, low socioeconomic status, and race/ethnicity. We recently provided care to a woman who presented to the emergency room with 20-cm chest wall mass. She was found to have inoperable stage IV triple-negative breast cancer with significantly poor prognosis. We describe her presentation, diagnosis, and treatment, identify the factors that contributed to her current condition, discuss the cancer health disparities and the associated risk factors, and reiterate what physicians should know to prevent similar unfortunate and unnecessary scenarios. Case presentation A 38-year-old African American woman with no significant past medical or surgical history presented with a fungating and malodorous anterior chest wall mass that was more than 20 cm in size.

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Breast Cancer Treatment of Women with Schizophrenia and Bipolar Disorder from Philadelphia, PA: Lessons Learned and Suggestions for Improvement

Cited by 13 publications

References 9 publications

Why are somatic diseases in bipolar disorder insufficiently treated?

Why are somatic diseases in bipolar disorder insufficiently treated?

The effect of a severe psychiatric illness on colorectal cancer treatment and survival: A population-based retrospective cohort study

Cancer health disparities and risk factors: lessons from a woman with a 20-cm chest wall mass, growing for 2 years

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