What are the top needs of breast cancer patients, caregivers in Asia?

Asian breast cancer patients and caregivers place similar importance on the types of support they need at diagnosis, according to a Singapore study. Notably, patients place more value on family support, while caregivers regard prompt information and side effects at the time of diagnosis and early treatment to be extremely important.

“Therefore, it is vital to consider not only the stage of disease but also differences in the type of needs of patients and their caregivers, so as to better tailor the delivery of supportive care to the individual patient and, in so doing, improve the quality of life (QoL) of both patients and their caregivers,” the researchers said.

Perceived needs and QoL of 99 dyads of breast cancer patients and their caregivers at diagnosis were analysed in this prospective observational study. The researchers used a self-administered questionnaire to measure the perceived importance of medical and psychosocial support needs and the Short-Form-36 health survey (SF-36) version 2 to measure QoL.

In addition, they obtained patient and caregiver demographic profiles and disease-specific information, performed a descriptive analysis of perceived needs, and calculated SF-36 scores for eight domains and composite scores. Finally, significant independent predictors of QoL of patients and caregivers were identified to perform bivariate analysis and linear regression.

Patients and caregivers had mean ages of 56.5 and 51.7 years, respectively. The top three needs among these participants were as follows: to have family around (73 percent), prompt information about treatment and treatment options, including side effects (71 percent), and prompt treatment for side effects (71 percent). [Singapore Med J 2020;61:532-539]

Patients’ social functioning and bodily pain scores significantly improved with supporting nurses and prompt treatment for side effects. QoL, on the other hand, was influenced by age, education, ethnicity, and stage of disease. Only the presence of chronic disease influenced caregivers’ physical functioning and role-physical scores.

“These findings highlight the importance of personalized support from the healthcare team during the initial treatment both for patients and their caregivers, addressing their need for improved QoL,” the researchers said.

A qualitative study by Cheng and colleagues reported the need of male partners for accurate and reliable medical and treatment-related information to help them support their partners. This finding was consistent with that by other overseas researchers. [Oncol Nurs Forum 2001;28:1601-1607; Support Care Cancer 2014;22:3175-3183]

In studies involving Western population, patients and spouses reported needing counselling on changes in the patient’s body image as a result of treatment. Such need was perceived as extremely important in <40 percent of patients and 30 percent of caregivers in the current study. [Psychooncology 2014;23:963-967]

“This could be due to the relative importance of information needs during the early stages of diagnosis and treatment among Asian patients, as reported by Lam [and colleagues’] subgroup analysis, which found that Hong Kong Chinese women prioritized the need for information about their disease and treatment, whereas German Caucasian women prioritized physical and psychological support,” the researchers noted. [Breast Cancer Res Treat 2011;130:531-541]

Interestingly, a qualitative study of 35 East Asian migrant women who underwent surgical treatment for breast cancer reported that these women considered the breast as a function of their role as a wife or mother, “thus eliminating the need for breasts when these roles have been fulfilled.” [Plast Reconstr Surg 2017;139:360e-368e]