Psychosocial Needs of Women with Breast Cancer: How can Social Workers Make a Difference?(Practice Forum‪)‬

In 2001 it was estimated that 233,000 new cases of breast cancer would be diagnosed among women in the United States (American Cancer Society, 2001). The diagnosis and treatment of breast cancer can result in a range of psychological and emotional challenges. Studies estimate that between 20 percent and 66 percent of cancer patients suffer long-term psychological distress (Breitbart, 1995; Rieker, Fitzgerald, Kalish, & Robertshaw, 1989). Although the exact number of women with breast cancer experiencing long-term or severe psychological distress is unclear, it appears to be considerably greater than that of women in the general population. For example, Fallowfield and colleagues (1990) found that 29 percent of women suffered depression after a mastectomy and 22 percent after conservative therapy, and that 21 percent of both groups suffered depression 12 months later. Similarly, Dean (1987) reported that 20 percent of women undergoing adjuvant therapy for breast cancer experienced minor depression and 10 percent were regarded as psychiatrically ill. Estimates of the proportion of women experiencing sexual problems after diagnosis and treatment of breast cancer ranged from 10 percent to 50 percent (Hughson, Cooper, McArdle, & Smith, 1988; Maguire et al., 1978; Schain, d'Angelo, Lichter, & Pierce, 1994). Research shows that women who had a mastectomy before age 50 were twice as likely as women over age 50 to experience sexual difficulties (Hughson et al.). The experience of breast cancer may affect some women emotionally long after their diagnosis. Residual concern about recurrence and fear of checkups may last for many years after the original diagnosis, with up to 50 percent of women experiencing psychiatric disorders (Hall, Fallowfield, & A'Hern, 1996; Jenkins, May, & Hughes, 1991). The recurrence of disease has been shown to have a significant effect on the family (Carlson, Bultz, Speca, & St. Pierre, 2000; Christ et al., 1993; Lewis & Deal, 1995).