年轻患者的乳腺癌幸存者:挑战与机遇--叙事回顾。

4区 医学 Q2 Nursing Annals of palliative medicine Pub Date : 2024-09-01 Epub Date: 2024-08-13 DOI:10.21037/apm-24-64
Sandy Vuong, Ellen Warner
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引用次数: 0

摘要

背景和目的:年轻女性乳腺癌患者(YWBC)面临着独特的生存挑战,因为她们在生命中更脆弱的阶段被诊断出乳腺癌,并在生育期接受性腺毒性和/或抗雌激素治疗。本文旨在阐述这些挑战,并展示专门为 YWBC 量身定制的专业支持性护理计划如何极大地促进干预措施的提供,以应对这些挑战:使用的数据库为 PubMed 和 Medline。主要内容和研究结果:与年龄较大的乳腺癌患者相比,年轻女性乳腺癌患者通常需要更积极的治疗,而且更有可能是遗传性疾病。常见的挑战包括生育问题、过早绝经、身体形象问题、对癌症复发的过度恐惧、亲密关系方面的困难以及经济压力。解决这些需求的一个可行方案是在专门的支持性护理计划中进行纵向护理,例如加拿大安大略省多伦多市的PYNK年轻女性乳腺癌患者计划。此类干预措施的例子包括:快速跟踪生育力保留、积极治疗先天性绝经的症状、同侪支持小组以及为患者及其家人提供个性化的社会心理支持:通过满足这一人群的独特需求,支持性护理计划可以在增强年轻乳腺癌女性患者的能力方面发挥重要作用,帮助她们应对治疗期间和治疗后可能面临的身体、情感和实际挑战。其局限性在于资源的可用性和资金的可持续性。为了更好地了解年轻女性乳腺癌患者在生存期的需求,并确保旨在应对这些挑战的计划的可持续性,我们需要持续开展研究。
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Breast cancer survivorship among younger patients: challenges and opportunities-narrative review.

Background and objective: Young women with breast cancer (YWBC) face unique survivorship challenges due to being diagnosed at a more vulnerable stage in life and receiving gonadotoxic and/or antiestrogen therapy during their reproductive years. The purpose of this article is to elaborate on these challenges and demonstrate how specialized supportive care programs tailored specifically for YWBC, can greatly facilitate the provision of interventions to address these challenges.

Methods: The databases used were PubMed and Medline. Articles included those that involve young women with breast cancer and survivorship care needs.

Key content and findings: Compared to older breast cancer patients, YWBC generally require more aggressive treatments and are more likely to have a hereditary basis for their disease. Common challenges include childbearing concerns, premature menopause, body image issues, excessive fear of cancer recurrence, difficulties with intimate relationships, and financial toxicity. A possible solution to addressing these needs are longitudinal care in a specialized supportive care program, such as the PYNK Program for Young Women with Breast Cancer in Toronto, Ontario, Canada. Examples of such interventions include fast-tracking fertility preservation, aggressive management of symptoms of iatrogenic menopause, peer support groups, as well as individualized psycho-social support for the patient and her family.

Conclusions: By addressing the unique needs of this population, supportive care programs can play a crucial role in empowering young women with breast cancer to cope with the physical, emotional, and practical challenges they may face during and after treatment. The limitation lies in resource availability and funding for sustainability. Ongoing research is required to better understand the needs of YWBC patients in survivorship and ensure the sustainability of programs designed to address these challenges.

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来源期刊
Annals of palliative medicine
Annals of palliative medicine Medicine-Anesthesiology and Pain Medicine
自引率
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发文量
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期刊介绍: Annals of Palliative Medicine (Ann Palliat Med; Print ISSN 2224-5820; Online ISSN 2224-5839) is an open access, international, peer-reviewed journal published quarterly with both online and printed copies since 2012. The aim of the journal is to provide up-to-date and cutting-edge information and professional support for health care providers in palliative medicine disciplines to improve the quality of life for patients and their families and caregivers.
期刊最新文献
A narrative review of the challenges and impact of breast cancer treatment in older adults beyond cancer diagnosis. Palliative care and hepatobiliary malignancies: say no to late referral. Stepped palliative care: considerations for equitable implementation. Breast cancer survivorship care: a narrative review of challenges and future directions. Surveillance of patients after palliative radiation, how to make it feasible.
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