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Psychosocial Aspects of Breast and
Cervical Cancer Diagnoses
Emily Lane, MSW, LCSW
SIU School of Medicine
A little about me…
At the end of this webinar, you should be able to…
◦ Identify possible psychosocial stressors associated with
breast and cervical cancer diagnoses.
◦ Recognize symptoms of psychological distress in newly
diagnosed patients.
◦ Utilize supportive interventions with the hopes of decreasing
the level of acute distress in patients with breast or cervical
◦ Educate patients on avenues of assistance and coordinate
appropriate referrals to alleviate some of the psychosocial
distress that they are experiencing.
What are psychosocial stressors?
◦ Social conditions that can affect our mental health.
◦ Example: financial concerns can lead to feelings of
inadequacy or depression OR major depression could
lead to missed days of work and subsequent financial
Common psychosocial stressors
for persons with cancer
Psychological Distress
◦ Unable to work due to appointments or treatment
◦ Uninsured/underinsured
◦ Out-of-pocket costs for medications
◦ Side-effects from chemotherapy, surgery, radiation
and/or hormone treatments
◦ Difficulty with activities of daily living
◦ Transportation
◦ Navigation of the healthcare system
◦ Difficulty communicating with loved ones because of high
levels of distress
◦ Little support from family and friends
◦ Too many people counting on the person with cancer
◦ Changes in libido and sexuality can lead to difficulties in
Significant pain from internal radiation which can lead to
difficulty having sex afterward. This can lead to marital
Guilt/Shame of HPV infection or stigma
Fertility concerns – early menopause
Cervical cancer is 10x more prevalent in women who are
victims of domestic violence than in general population
Cervical Cancer Specific
Body image issues may result from physical changes to the
breast from surgery, radiation
Femininity/Sexuality issues can lead to marital strain
Lymphedema – can be a financial burden due to the
supplies needed to manage the condition
Breast Cancer Specific
Difficulty sleeping
Existential questions
Difficulty concentrating
Distress over treatment choices
The emotional toll of these stressors
What is psychological distress?
The National Cancer Institute defines
psychological distress as “an unpleasant
experience of an emotional, psychological, social,
or spiritual nature that interferes with the ability
to cope with cancer treatment. It extends along
a continuum, from common normal feelings of
vulnerability, sadness, and fears, to problems
that are disabling, such as true depression,
anxiety, panic, and feeling isolated or in a
spiritual crisis”
Use of a distress
screener can help
you find out what
your patients are
dealing with both
physically and
We know the problem
How do we help?
Validation and Communication
Empathic Statements
◦ Reflection
◦ Statements of understanding
◦ Ask patients how they feel
Active Listening
Being able to just sit with a patient and their
Normalizing emotions
Building block of rapport
◦ Adds to patient’s subjective experience of a safe
place to express him or herself
Facilitates hope
Improves patient compliance and satisfaction
Why is empathy important?
Provide education as to what the next step is
regarding treatment and/or follow-up.
Ask patients if it would help them if you made the
follow-up appointments for them.
Ask them if they have any immediate concerns, such
as support at home, transportation, insurance
coverage and/or other financial issues.
Provide information regarding resources in the
A word about survivorship…
Illinois Breast and Cervical Cancer Program
American Cancer Society
◦ Patient navigators to assist with financial concerns and
other needs
◦ Wig Salon
◦ Look Good, Feel Better
◦ Road to Recovery
◦ Co-Pay Assistance
Community Action Agencies
◦ Sangamon County Resource Center
Local Support Groups
 www.getcoveredillinois.gov
 www.cancer.org
Helpful websites
Final Thoughts
Each person is unique, and their response to a
cancer diagnosis will be just as unique.
Ask your patients about how they are coping,
what they are feeling and what they need… don’t
assume to know.
Encourage them to share their feelings with their
loved ones or with a oncology social worker,
counselor or psychologist.
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Special thanks to Katherine Howerter, MSW, LCSW
and Patricia Fank, Psy.D. for their contributions and