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| LETTER TO EDITOR |
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| Year : 2020 | Volume
: 3
| Issue : 4 | Page : 839-840 |
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Breaking the bad news of breast cancer: Picturing the Indian scenario
Monika Thakur1, Roopali Sharma1, Anand Mishra2
1 Amity Institute of Psychology and Allied Sciences, Amity University, Noida, Uttar Pradesh, India
2 Department of Endocrine Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| Date of Submission | 03-Oct-2020 |
| Date of Decision | 13-Oct-2010 |
| Date of Acceptance | 13-Oct-2020 |
| Date of Web Publication | 25-Dec-2020 |
Correspondence Address:
Monika Thakur
Amity University, Noida, Uttar Pradesh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/crst.crst_309_20
How to cite this article:
Thakur M, Sharma R, Mishra A. Breaking the bad news of breast cancer: Picturing the Indian scenario. Cancer Res Stat Treat 2020;3:839-40 |
Hearing about someone being diagnosed with cancer can be shocking and receiving bad news about breast cancer (BC) can be further distressful and devastating for people. In healthcare settings, bad news is defined as “any information that changes a patient's view of the future in a negative way.”[1] In general, “breaking bad news” means sharing the diagnosis with the patient; however, it can also include communicating new chronic diagnoses or worsened chronic illness.[1] A sudden diagnosis of BC not only changes the patient's physical routine but also changes their lifestyle and life planning. Various factors can be associated with or can trigger psychological trauma such as frequent hospital visits, financial concerns, treatment course, and the fear of death. The diagnosis of BC can be more distressing in women considering their sex and biological vulnerability. Several studies have been conducted to understand the area of impact of BC diagnosis, but there are very few studies that focus on dealing with the impact of BC diagnosis.
Breaking bad news is the most difficult task for physicians communicating the diagnosis. The disclosure of the bad news about BC diagnosis is even more challenging considering the high mortality and resultant psychological trauma. Approximately 50% of the patients with BC are likely to experience psychological issues, including depression postdiagnosis.[2]
In order to avoid making false promises and giving false hopes, the news is directly delivered to the patients without imparting a sense of optimism by the health-care professionals. Health-care professionals involved in the disclosure of a life-threatening illness could play a crucial role in changing the patients' perception and ensuring adherence to the treatment regimen. In a developing country like India, the burden on health-care professionals is high.[3] The patient–physician ratio is not balanced, causing the physician to be over-burdened. In such scenarios, counseling before and after the diagnosis becomes secondary to medical treatment.[4] It is difficult but critical to anticipate the impact of bad news on individuals and their family members, as the perception of bad news may vary among individuals.[1],[5],[6] Every individual has a different coping mechanism for dealing with an anxiety-provoking situation. Some may consider cancer diagnosis as a stigma,[7],[8] some as the fruits of karma, and some may consider it like any other illness. Evidence from previous research suggests that psychosocial factors such as social support, life stressors, employment status, educational status, medical history, education, and employment status might affect an individual's ability to cope with the diagnosis of BC.[2],[4] The way patients receive news about their diagnosis, the way they interpret it, and their coping mechanism might change their perspective about the disease.[1] In such situations, the other health-care professionals like psychiatric social workers, nurses, and psychologists who are trained in health psychology play a vital role to bridge the gap between medical and psychological care.[9]
Literature suggests that a greater sense of well-being is found in patients with an optimistic approach, which leads them to use healthy coping strategies.[4] At the same time, the SPIKES protocol (S: setting, P: perception, I: information or invitation, K: knowledge, E: empathy, and S: summarize or strategize)” has been found to be useful in easing the patients' distress.[10] Therefore, such guidelines can be taken into consideration in the Indian settings for better communication of diagnosis and to instill hope among patients with cancer for a better quality of life.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Rosenzweig MQ. Breaking bad news: A guide for effective and empathetic communication. Nurse Pract 2012;37:1-4.  |
| 2. | Thakur M, Gupta B, Kumar R, Mishra AK, Gupta S, Kar SK. Depression among women diagnosed with breast cancer: A study from North India. Indian J Med Paediatr Oncol 2019;40:347-52. [Full text] |
| 3. | Mallath MK, Taylor DG, Badwe RA, Rath GK, Shanta V, Pramesh CS, et al. The growing burden of cancer in India: Epidemiology and social context. Lancet Oncol 2014;15:e205-12. |
| 4. | Carver CS, Pozo C, Harris SD, Noriega V, Scheier MF, Robinson DS, et al. How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. J Pers Soc Psychol 1993;65:375-90. |
| 5. | Chandrasekharan A. A tale of two patients. Cancer Res Stat Treat 2020;3:1-2. [Full text] |
| 6. | Chittem M, Maya S. A twist in the tale: Alternate methods to communicate, or are they great expectations? Cancer Res Stat Treat 2020;3:360-1. [Full text] |
| 7. | Noronha JL. Cancer stigma – Why don't we sit down and talk about it? Cancer Res Stat Treat 2020;3:167-8. [Full text] |
| 8. | Sahoo SS, Panda UK, Parija PP. Cancer stigma: Are we asking the right questions? Cancer Res Stat Treat 2020;3:640-1. [Full text] |
| 9. | Konstantis A. Breaking bad news and autonomy of cancer patients. Cancer Res Stat Treat 2020;3:362. [Full text] |
| 10. | Kaplan M. SPIKES: A framework for breaking bad news to patients with cancer. Clin J Oncol Nurs 2010;14:514-6. |
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