Social support for breast cancer survivors
When Flora Law Shuk-ting was first diagnosed with stage IIb breast cancer in February, she reacted the same way that any 45-year-old who has lived a largely healthy lifestyle would: with shock and tears.
But she wasn't crying because of the diagnosis - "I immediately focused on what I had to do next," she says - but because she was touched by the concern that so many friends showed her.
"My mailbox was full," says Law, a general manager with a logistics company. "Relatives, colleagues, friends, even friends of friends, e-mailed me information and advice they had seen on the internet, on television and in books. I had so much information, I was very confused."
Fortunately, her doctor told her to phone the Hong Kong Cancer Fund (HKCF) CancerLink helpline to clear the air, alleviate worry and set her on the right treatment path. "The social worker talked to me and filtered the right information from the wrong. She helped me think logically," she says.
Although Law initially didn't know anyone directly affected by breast cancer, through the HKCF she found many other sufferers. A few survivors rallied around her during her treatment, providing support and sharing their experience. Surgery to remove Law's right breast was followed by four months of chemotherapy.
"I was quite optimistic [about the treatment]," she says, "but after speaking to the survivors, I was so optimistic. Throughout the chemotherapy, I was so positive and relaxed mentally."
Psychosocial support can make a huge difference for breast cancer patients, many of whom are devastated by the news. A report by the Hong Kong Breast Cancer Registry this year found that among 5,399 patients surveyed, one in four reacted to their diagnosis with acceptance and a positive attitude to fight. But one in three patients felt depressed, and 18 per cent of patients were in disbelief.
Figures from the registry show that breast cancer has been the most common cancer affecting women in Hong Kong since 1993. Cases diagnosed annually have more than doubled, rising from 1,152 in 1993 to 2,945 in 2009. On average, about eight women are diagnosed with breast cancer every day in the city.
A recent HKCF-funded study by the University of Hong Kong of 246 breast cancer patients who had completed primary treatment showed that one in seven patients experienced chronic psychological instability. More than 40 per cent reported having symptoms of distress - lack of energy, itching and acute anxiety.
Dr Wendy Lam Wing-tak, psycho-oncologist and assistant professor at HKU's School of Public Health, says that younger patients have more difficulty dealing with the symptoms and the impact of the treatment. "The impact on their lives is perhaps more apparent and imminent than it is for older women," she says.
Effective symptom management can help prevent chronic psychological instability, says Lam. With these findings, the HKCF plans to enhance its post-treatment rehabilitation to focus on managing these symptoms.
"The study found out more than we could observe during daily interaction with the patients," says Tammy Leung Yuk-chun, HKCF's head of service. "We can now plan treatment programmes in a more professional and precise way."
Earlier this year, a study published in the journal
Biological Psychiatry showed that psychological intervention through a stress management programme could alter tumour-promoting processes at the molecular level in breast cancer patients. The 10-week group-based programme developed at the University of Miami in Florida combined relaxation, imagery and deep breathing, along with cognitive behaviour therapy, which is designed to help patients reduce bodily tension, change the way they deal with intrusive stressful thoughts, decrease negative moods and improve their interpersonal communication skills.
The patients who went through the 10-week programme adapted better psychologically to the whole treatment process for breast cancer. There were also physiological changes that indicated the women were recovering better than the control group who didn't go through the programme.
Psycho-therapeutic support offered by the HKCF includes art and dance therapy, yoga and meditation, peer support and life coaching, as well as a "look good, feel good" class.
"Some patients thank the disease for giving them new meaning in life, but others get stuck in the trauma," says Leung. "We [the HKCF] want to teach them how to carry on with their lives."
Last week, Law completed six weeks of radiation therapy. This month, she plans to go back to work. But she will continue as a volunteer with HKCF, counselling other patients. "In the beginning, it's especially important to know you're not alone," she says.
CancerLink hotlines: 3656 0800 (Kowloon), 3667 3000 (HK Island), 3919 7000 (New Territories)