Over time, mutations can occur within our genes, these mutated genes change the cell and how it grows, the mutated cells carry on the normal process but multiply and divide uncontrollably producing many mutated cells. The mutated cells form a cluster (tumour) which develops a means to nourish itself from the hosts blood supply. There are two main types of tumour; benign and malignant, benign tumours are generally not seen as dangerous to health or life threatening and they grow very slowly with the cells being close to normal in behaviour and growth.
On the other hand malignant tumours are cancerous and if left untreated can continue to multiply and spread to other parts of the body through blood circulation and the lymphatic system. Cancer cells usually develop in the milk producing glands and ducts of the breasts, about 90% of all breast cancers are due to genetic abnormalities that are the result of ageing and normal wear and tear of life.
If these cells are left unchecked they can spread to healthy surrounding tissue, and if they reach the under arm they can then attack the lymph nodes and through the lymphatic system reach other sites where the growth and multiplication of bad cells can begin again producing tumours in different sites. The lymph nodes are an important part of the bodies defence and immune system and are part of the lymphatic system which acts as a blood filter helping combat infection.
The exact reasons why people develop this disease are still not clearly defined, but what is known is that lifestyle, inherited gene mutations and environmental factors can put the individual at a higher risk of developing breast cancer. Also certain links have been found between high oestrogen levels (female sex hormone) and the development of breast cancer). A more aggressive type of breast cancer is inflammatory breast cancer (IBC), which grows in sheets or groups of cells that attack the skin and look like a rash.
In its advanced stage breast cancer is called Metastatic breast cancer, where the cancer has spread beyond the original site and lymph nodes to other organs and bones. Symptoms The usual symptom for breast cancer is a lump found in the breast or an armpit. Symptoms that can be felt or are visible are: Swelling or lump in the breast. Swelling in the armpit or lymph nodes. Pain in the nipples. Inverted nipples. Scaly or pitted skin. Unusual sensations. Changes in shape or size. Treatment There are five standard treatments for breast cancer;
Surgery, Radiation, Chemotherapy, Hormonal Therapy and Biologic Therapies (Drugs). Each of the above treatments have debilitating side effects, some of these are physical, some visible and a large amount are psychological. The psychological effects of chemotherapy for instance have been shown to be feared as much as the onset of cancer. This was the results of the largest survey ever undertaken on behalf of the Oncology Nursing Society by Roper Starch Worldwide (1999). Of the 500 patients in the survey 68% confirmed hat there biggest concern was the side effects of Chemotherapy and not the cancer.
The revelation was that the patients perceptions and actual physical and psychological well-being could be greatly improved if appropriate psychological support were consistently made available. The chemotherapy and radiation used to destroy cancer cells also destroy good healthy cells and in so doing lower the bodies immunity to infection and secondary illness. Some of the side effects are: Loss of appetite, Nausea and vomiting, weakness and fatigue, weight gain, premature menopause and hair loss.
Patients can suffer bouts of physical exhaustion and emotional exhaustion which if not recognized can lead to high levels of anxiety and depression. Mastectomy (surgical breast removal) leaves the patient with feelings of tightness and discomfort made worse by the removal of lymph nodes. The arms usually swell (lymphedema) and there is the risk of infection and a great deal of fluid retention (seroma) around the site of the surgery. The patient will have emotional trauma to face following surgery because they relate their breasts to their sexuality and femininity.
All this leads to strong feelings of identity loss and lowered self-esteem / body image. A fear of rejection and re-occurrence brought about by anxiety from any ache or pain. Some women may feel mentally prepared for cancer treatment, but most feel anxious and fearful about the treatment and how it will affect their lives and their families. Anxiety and fear of the unknown can bring about heightened levels of stress and this has been associated with less effective cancer treatment response.
The patients friends family and workmates may also add to anxiety by adopting a different attitude towards the patient. Some women may react to the shock by becoming withdrawn and change their day to day habits in other words; eating poorly and lack of exercise. They could also develop new habits which they may view as helping them to cope, smoking, drinking, late nights and drugs. These new habits may help the person as a distraction, but become new stressors for the body to deal with by lowering the immune system further when it needs to be at peak form.
There are many studies on the psychosocial aspects of breast cancer and psychological interventions that may have an effect on how patients recover from cancer treatment and how successful they return to their normal lives. The quality of life whilst being treated is very important. Weeks,1992; Ratcliffe et al Various aspects of quality of life may independently predict response to chemotherapy The emotional response to such shocking news can raise anxiety and fear, the sympathetic nervous system will react to stress by raising levels of adrenaline and shutting down the function of tissue repair, reproduction and digestion.
And increases Heart rate, blood pressure, muscle tension, perspiration and breathing. To also aid the fight or flight process the body releases hormones as it adapts to this state, if this state of fight or flight is maintained, other illnesses can arise. This is counter productive to the healing state of body and mind that is needed to aid any cancer treatment; so the focus should be on maintaining a state of relaxation. Hans Selye (1946) The journal of clinical endocrinology. 6:117-230,General Adaption Syndrome (GAS).
To help the patient prepare for treatment hypnotherapy could be used to first relieve muscle tension and promote relaxation. There are many methods used to relax a person, and an effective method used to relax prior to hypnosis is Progressive Muscle Relaxation or (PMR). This is a systematic method of relaxation, and was developed by American Physician Edmond Jacobsen: (1939)-Psycho physiological changes of Progressive Muscle Relaxation. Through observing his patients in Hospital, Jacobsens theory was that anxiety and stress led to increased muscle tension.
Jacobsen found that by progressively tensing and relaxing limbs muscle tension could be reduced, and that a muscle was either tensed or relaxed. By achieving a state of relaxation, the parasympathetic nervous system came into play and the patients anxiety was reduced. This had a beneficial effect on the patients psychological, physical and physiological well-being. This also reduced the effects of anxiety, namely; high blood pressure, increased muscle tension and Heart rate and slowed digestive system.
Patients could also be given relaxation CDs as a coping strategy for moments of anxiety, panic and fear. Hypnosis could be used to help in pain management through visualisation, disassociation, association and suggestion. How we cope with pain is a by product of conditioning from a young age, and how we associate pain will determine the severity of it. This also can be affected by our level of self esteem which if low can be a factor in diminished control, as people with low self esteem are vulnerable and vulnerable people do not exercise good personal control.
Hypnosis for Change: 136,7,8 Pain brings with it anxiety, depression, loss of appetite and fatigue,and the on-going pain continues this depressive emotional cycle which is counter-productive to healing. To break the cycle the patient through hypnotherapy can gain a sense of control by being involved with their own treatment and therapy. By using relaxation techniques and visualisation anxiety can be reduced, and any feelings of negativity can be removed and replaced with positive visualisations.
Through making associations and visualizing the pain as a shape or form the patients anxiety can be reduced, because the pain is no longer uncontrollable and ambiguous. Glove anaesthesia (one of my favourites) could also be used in pain control to numb the part of the body that is painful. Hypnosis for Change: 142. Programming the sub-conscious mind to take ownership of the illness can be very effective, the patient learns to first intensify the pain and then diminish it. Just through visualizing and affirmations the patient can encourage and promote faster healing.
Newton (1982) found that some patients can significantly alter the course of their disease through self hypnosis and hypnotherapy. Conclusion Lowered self-esteem, sadness, depression fear and feelings of hopelessness are just some of the emotions felt by cancer patients. Through my own experiences, I feel that the most traumatic period for the patient is the initial months of uncertainty and anxiety, the not knowing through lack of understanding and basic knowledge put the patient in a worst state emotionally and psychologically.
The need for counselling and psychotherapy in the early days will have a huge impact on how the patient copes. If coping skills and self hypnosis can be taught very early on the patient will be better prepared and relaxed going into treatment. There have been many studies in medical journals that have shown that people who prepare for surgery using hypnosis generally have fewer complications, heal faster and have less post-operative pain.
Hypnosis will help the patient feel calm, relaxed and positive before, during and after surgery. Because hypnotherapy can impact so many of the negative emotional responses, it can help the patient maintain a feeling of well-being and confidence which in turn can aid their recovery. Simple self hypnosis and auto-suggestion techniques will reduce the feelings of hopelessness and by maintaining self esteem the patient will be able to interact more normally in their social and family circles, thereby maintaining a quality of life.