Psychological treatment can extend metastatic breast-cancer patients’ lives, while partners can play a crucial role in maintaining patients’ emotional well-being.
Depression, perhaps unsurprisingly, is a common reaction to an MBC diagnosis. Nearly half of MBC patients suffer from depression, says Dr. Luzia Travado, Head of Psycho-Oncology at the Champalimaud Clinical Centre in Lisbon, "because they’re facing their worst fear, which is the confrontation of a chronic disease that will ultimately lead to their death." While acknowledging that somber reality, Dr. Travado also counsels that there is reason for hope: Recent scientific evidence shows effective depression treatment can actually prolong patients’ lives. "Before, people thought psycho-social care was a luxury," she says. "But now we know it supports clinical outcomes."
Practically, that means that women with MBC should have access to professional care – such as individual, group or couples’ therapy - to recalibrate their expectations about their lives in light of their diagnosis. "Sometimes, people aren’t able to enjoy the life they have because they’re mourning their death," says Dr. Travado. "The psychological intervention is to help them focus on the life they have and live it to the fullest of their ability." The lifesaving impact of such interventions led the International Psycho-Oncology Society, of which Dr. Travado is president, to update its Quality Cancer Care Standards in 2014 to include psycho-social care as a universal human right. But to date, just ten of 30 European countries surveyed by Dr. Travado include such care in their national cancer-care budgets. "It’s still very irregularly offered," she notes. "Treating MBC patients’ psychosocial needs is still a real gap in care."
Patients’ personal relationships also have a major impact on their emotional well-being, and thereby may influence their survival. Women with solid family and spousal support fend off depression better than those who are isolated or in rocky partnerships. Supportive spouses can help women deal not only with their existential angst but also with the physical insecurities that can follow surgery or chemotherapy, says Dr. Travado: "Women need a lot of validation that they’re still loved, that it’s not about their hair but about themselves." Spouses themselves – particularly men, who may tend to give practical rather than emotional support – also often need guidance in the wake of a diagnosis. Among the options Dr. Travado suggests: attending therapy sessions with patients and tapping breast-cancer organizations such as Europa Donna or spouse-specific groups such as Men Against Breast Cancer. Most important, she notes, is that the spouses "feel they’re part of the team, because the partner is the most important person for the patients’ well-being."