Psychosocial issues in breast cancer. Helping patients get the support they need

Patients are becoming increasingly involved in making informed choices regarding their care. However, in the case of breast cancer, more than medical treatment of a body part is at stake. The breast is an important cultural symbol of femininity and an intimate part of the patient's self-esteem. The disease and its treatment may cause ongoing sadness, fear, anxiety, and anger. Primary care physicians, because of their close relationship with patients, are often in a position to notice when natural and reasonable emotional reactions go too far or last too long. Sensitive support and education of patients who are trying to choose a treatment method may minimize anxiety. Formal programs, such as the American Cancer Society's Reach to Recovery and Look Good... Feel Better, can be very supportive. For interested patients, support groups provide a chance to freely express their thoughts and feelings. However, not all women wish to participate in programs and groups. In some cases, careful listening on the part of the primary care physician is the most powerful intervention.