Supportive care after curative treatment for breast cancer (survivorship care): Resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement

Abstract

Breast cancer survivors may experience long-term treatment complications, must live with the risk of cancer recurrence, and often experience psychosocial complications that require supportive care services. In low- and middle-income settings, supportive care services are frequently limited, and program development for survivorship care and long-term follow-up has not been well addressed. As part of the 5th Breast Health Global Initiative (BHGI) Global Summit, an expert panel identified nine key resources recommended for appropriate survivorship care, and developed resource-stratified recommendations to illustrate how health systems can provide supportive care services for breast cancer survivors after curative treatment, using available resources. Key recommendations include health professional education that focuses on the management of physical and psychosocial long-term treatment complications. Patient education can help survivors transition from a provider-intense cancer treatment program to a post-treatment provider partnership and self-management program, and should include: education on recognizing disease recurrence or metastases; management of treatment-related sequelae, and psychosocial complications; and the importance of maintaining a healthy lifestyle. Increasing community awareness of survivorship issues was also identified as an important part of supportive care programs. Other recommendations include screening and management of psychosocial distress; management of long-term treatment-related complications including lymphedema, fatigue, insomnia, pain, and women's health issues; and monitoring survivors for recurrences or development of second primary malignancies. Where possible, breast cancer survivors should implement healthy lifestyle modifications, including physical activity, and maintain a healthy weight. Health professionals should provide well-documented patient care records that can follow a patient as they transition from active treatment to follow-up care.

An Emerging Role of Pharmacist in Pre-chemotherapy Counseling Among Breast Cancer Patients

“…This leads to extensive side effects of chemotherapy such as nausea, vomiting, myelosuppression, fatigue, mucositis, diarrhoea and alopecia. Besides suffering from these side effects of the chemotherapy, there are reported isolation feel, social and physical distress cases from the effect of chemotherapy treatment [7] among breast cancer patients. This group of patients is likely to experience uncertainty and anxiety or seek scientifically unacceptable therapies, i.e.…”

“…This group of patients is likely to experience uncertainty and anxiety or seek scientifically unacceptable therapies, i.e. from alternative healers [7,8] .…”

“…Most studies showed the positive effect of counselling on quality of life for patient [7,16,[18][19][20] . Cozaru and coworkers found that, among the categories of counselors who helped in alleviating the distress of breast cancer patient, only 23% was attributed by medical team [20] .…”

Felt Needs for Rehabilitation After Breast Cancer Treatment in Mexico

“…However, many women from low-and middle-income countries, who undergo a mastectomy, do not receive physiotherapy [16,17]. This could be due to various reasons, including the fact that women are not aware of the existence and relevance of physical therapy after surgery [17], or because availability and access to rehabilitation services is constrained [18,19].…”

“…This could be due to various reasons, including the fact that women are not aware of the existence and relevance of physical therapy after surgery [17], or because availability and access to rehabilitation services is constrained [18,19].…”