Meme Kanseri Tedavisinde Psikolojik Destek ve Onkolojik Psikoloji
Özet
Meme kanseri, kadınlarda en sık görülen malign tümörlerden biridir ve yalnızca biyolojik değil, psikososyal açıdan da derin etkiler yaratır. Tanı süreci; anksiyete, depresyon, beden algısı bozukluğu ve uyum güçlüğü gibi psikolojik sorunlara yol açabilir. Bu dönemde onkolojik psikoloji, hastanın tedaviye uyumunu ve yaşam kalitesini artırmak amacıyla multidisipliner yaklaşımlar sunar. Bilişsel Davranışçı Terapi, Destekleyici-Ekspresif Grup Terapisi, Mindfulness, Anlam Odaklı Terapi, Psikoeğitim ve Aile Temelli Müdahaleler, en sık kullanılan ve etkinliği kanıtlanmış yöntemlerdir. Bu yaklaşımlar; kaygı, depresyon ve distresi azaltırken, hastaların baş etme becerilerini güçlendirir. Ayrıca etkili hasta-hekim iletişimi, bakım verenlerin desteklenmesi ve tedaviye uyumun artırılması, psikososyal bakımın temel bileşenlerindendir. Distres Termometresi gibi tarama araçlarıyla psikolojik gereksinimlerin erken saptanması, bütüncül onkolojik bakımın ayrılmaz bir parçası haline gelmiştir. Sonuç olarak, meme kanseri tedavisinde psikolojik destek; yalnızca tamamlayıcı değil, hastanın iyileşme sürecini doğrudan etkileyen temel bir unsurdur ve onkolojik pratiğe sistematik biçimde entegre edilmelidir.
Referanslar
Bray F, Laversanne M, Sung H, et al.. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2024;74(3):229-63.
Bultz BD, Carlson LE. Emotional distress: the sixth vital sign—future directions in cancer care. Psycho-Oncology. 2006;15(2):93-5.
Keyzer-Dekker CMG, de Vries J, Mertens MC, et al.. The impact of diagnosis and trait anxiety on psychological distress in women with early stage breast cancer: A prospective study. British Journal of Health Psychology. 2014;19(4):783-94.
Carreira H. Long-term mental health and quality of life in women with a history of breast cancer [Internet] [doctoral]. London School of Hygiene & Tropical Medicine; 2020 [a.yer 02 Mart 2025]. Erişim adresi: https://researchonline.lshtm.ac.uk/id/eprint/4657691/
Mehnert A, Brähler E, Faller H, et al.. Four-Week Prevalence of Mental Disorders in Patients With Cancer Across Major Tumor Entities. JCO. Kasım 2014;32(31):3540-6
Lemieux J, Maunsell E, Provencher L. Chemotherapy‐induced alopecia and effects on quality of life among women with breast cancer: a literature review. Psycho-Oncology. Nisan 2008;17(4):317-28.
Gielissen MFM, Schattenberg AVM, Verhagen C a. HHVM, Rinkes MJ, Bremmers MEJ, Bleijenberg G. Experience of severe fatigue in long-term survivors of stem cell transplantation. Bone Marrow Transplant. Mayıs 2007;39(10):595-603.
Carlson LE, Bultz BD. Benefits of psychosocial oncology care: Improved quality of life and medical cost offset. Health Qual Life Outcomes. 17 Nisan 2003;1:8.
Mitchell AJ, Chan M, Bhatti H, et al.. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. The Lancet Oncology. 01 Şubat 2011;12(2):160-74.
Walker ZJ, Xue S, Jones MP, et al.. Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle–Income Countries: A Systematic Review and Meta-Analysis. JCO Glob Oncol. 03 Ağustos 2021;7:GO.21.00056.
Faller H, Schuler M, Richard M, et al.. Effects of Psycho-Oncologic Interventions on Emotional Distress and Quality of Life in Adult Patients With Cancer: Systematic Review and Meta-Analysis. JCO. 20 Şubat 2013;31(6):782-93.
Northouse L, Williams A leila, Given B, et al.. Psychosocial Care for Family Caregivers of Patients With Cancer. JCO. 10 Nisan 2012;30(11):1227-34.
Carlson LE, Bultz BD. Benefits of psychosocial oncology care: Improved quality of life and medical cost offset. Health Qual Life Outcomes. 17 Nisan 2003;1:8.
Sharpe M, Strong V, Allen K, et al.. Major depression in outpatients attending a regional cancer centre: screening and unmet treatment needs. Br J Cancer. Ocak 2004;90(2):314-20.
Michelle Cororve Fingeret. Managing Body Image Difficulties of Adult Cancer Patients: Lessons from Available Research. Erişim adresi: https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.28469
SMITH HR. Depression in cancer patients: Pathogenesis, implications and treatment (Review). Oncol Lett. Nisan 2015;9(4):1509-14.
Falk Dahl CA, Reinertsen KV, Nesvold IL, et al.. A study of body image in long-term breast cancer survivors. Cancer. 2010;116(15):3549-57.
Paterson CL, Lengacher CA, Donovan KA, et al.. Body Image in Younger Breast Cancer Survivors: A Systematic Review. Cancer Nurs. 2016;39(1):E39-58.
Hulbert-Williams N, Neal R, Morrison V, et al.. Anxiety, depression and quality of life after cancer diagnosis: what psychosocial variables best predict how patients adjust? Psycho-Oncology. 2012;21(8):857-67.
Stanton AL, Rowland JH, Ganz PA. Life after diagnosis and treatment of cancer in adulthood: Contributions from psychosocial oncology research. American Psychologist. 2015;70(2):159-74.
Jacobsen PB, Andrykowski MA. Tertiary prevention in cancer care: Understanding and addressing the psychological dimensions of cancer during the active treatment period. American Psychologist. 2015;70(2):134-45.
Garcia SF, Cella D, Clauser SB, et al.. Standardizing patient-reported outcomes assessment in cancer clinical trials: a patient-reported outcomes measurement information system initiative. J Clin Oncol. 10 Kasım 2007;25(32):5106-12.
Faller H, Schuler M, Richard M, et al.. Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. J Clin Oncol. 20 Şubat 2013;31(6):782-93.
Zhang C, Hu G, Qiu X, et al.. Global trends of researches on pycho-oncology during 1999-2019: A 21-year bibliometric study based on VOSviewer [İnternet]. Research Square; 2020 [a.yer 20 Nisan 2025]. Erişim adresi: https://www.researchsquare.com/article/rs-22565/v1
Azizi M, Heshmatnia F, Milani H, et al.. The Effectiveness of Cognitive Behavioral Therapy on Depression and Anxiety Symptoms in Breast Cancer Patients and Survivors: A Systematic Review of Interventional Studies. Brain and Behavior. 2024;14(10):e70098.
Foley E, Baillie A, Huxter M, et al.. Mindfulness-based cognitive therapy for individuals whose lives have been affected by cancer: a randomized controlled trial. J Consult Clin Psychol. Şubat 2010;78(1):72-9.
Breitbart W, Poppito S, Rosenfeld B, et al.. Pilot randomized controlled trial of individual meaning-centered psychotherapy for patients with advanced cancer. J Clin Oncol. 20 Nisan 2012;30(12):1304-9.
Wang X, Wang N, Zhong L, et al.. Prognostic value of depression and anxiety on breast cancer recurrence and mortality: a systematic review and meta-analysis of 282,203 patients. Mol Psychiatry. Aralık 2020;25(12):3186-97.
Lai J, Song H, Ren Y, et al.. Effectiveness of Supportive-Expressive Group Therapy in Women with Breast Cancer: A Systematic Review and Meta-Analysis. Oncology Research and Treatment. 28 Nisan 2021;44(5):252-60.
Park S, Sato Y, Takita Y, et al.. Mindfulness-Based Cognitive Therapy for Psychological Distress, Fear of Cancer Recurrence, Fatigue, Spiritual Well-Being, and Quality of Life in Patients With Breast Cancer-A Randomized Controlled Trial. J Pain Symptom Manage. Ağustos 2020;60(2):381-9.
Breitbart W, Pessin H, Rosenfeld B, et al.. Individual meaning-centered psychotherapy for the treatment of psychological and existential distress: A randomized controlled trial in patients with advanced cancer. Cancer. 01 Ağustos 2018;124(15):3231-9.
Andersen BL, Yang HC, Farrar WB, et al.. Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial. Cancer. 15 Aralık 2008;113(12):3450-8.
Northouse LL, Katapodi M, Song L, et al.. Interventions with Family Caregivers of Cancer Patients: Meta-Analysis of Randomized Trials. CA Cancer J Clin. 2010;60(5):317-39.
Staff TAP. High Levels of PTSD May Exist Among Caregivers of Adult Patients With Cancer [Internet]. [a.yer 01 Mayıs 2025]. Erişim adresi: https://ascopost.com/news/march-2025/high-levels-of-ptsd-may-exist-among-caregivers-of-adult-patients-with-cancer/
Communication in Cancer Care (PDQ®) - NCI [Internet]. 2008 [a.yer 02 Mayıs 2025]. Erişim adresi: https://www.cancer.gov/about-cancer/coping/adjusting-to-cancer/communication-hp-pdq
Fogarty LA, Curbow BA, Wingard JR, et al.. Can 40 seconds of compassion reduce patient anxiety? J Clin Oncol. Ocak 1999;17(1):371-9.
Bonvicini KA, Perlin MJ, Bylund CL, et al.. Impact of communication training on physician expression of empathy in patient encounters. Patient Educ Couns. Nisan 2009;75(1):3-10.
Hershman DL, Kushi LH, Shao T, et al.. Early discontinuation and nonadherence to adjuvant hormonal therapy in a cohort of 8,769 early-stage breast cancer patients. J Clin Oncol. 20 Eylül 2010;28(27):4120-8.
Hershman DL, Kushi LH, Hillyer GC, et al.. Psychosocial Factors Related to Non-persistence with Adjuvant Endocrine Therapy among Women with Breast Cancer: The Breast Cancer Quality of Care Study (BQUAL). Breast Cancer Res Treat. Mayıs 2016;157(1):133-43.
Mausbach BT, Schwab RB, Irwin SA. Depression as a predictor of adherence to adjuvant endocrine therapy (AET) in women with breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat. Temmuz 2015;152(2):239-46.
Green SMC, French DP, Graham CD, et al.. Supporting adjuvant endocrine therapy adherence in women with breast cancer: the development of a complex behavioural intervention using Intervention Mapping guided by the Multiphase Optimisation Strategy. BMC Health Serv Res. 24 Ağustos 2022;22(1):1081.
Lazenby M, Tan H, Pasacreta N, et al.. The five steps of comprehensive psychosocial distress screening. Curr Oncol Rep. 2015;17(5):447.
Carlson LE, Waller A, Groff SL, et al.. Online screening for distress, the 6th vital sign, in newly diagnosed oncology outpatients: randomised controlled trial of computerised vs personalised triage. Br J Cancer. 07 Ağustos 2012;107(4):617-25.
Mitchell AJ, Chan M, Bhatti H, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. Şubat 2011;12(2):160-74.
Martinez MR, Pasha A. Prioritizing Mental Health Research in Cancer Patients and Survivors. AMA Journal of Ethics. 01 Mayıs 2017;19(5):486-92.
