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Young Women with Breast Cancer

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Submitted By jwarlick100
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Concerns of Young Women under the Age of Forty Diagnosed With Breast Cancer

Jennifer Warlick
COM/156
February 10, 2013
Keri Keith

Concerns of Young Women under the Age of Forty Diagnosed With Breast Cancer

Can you imagine being a woman under the age of forty and receiving a diagnosis of breast cancer? One out of every two hundred and ten women diagnosed will be under the age of forty. Breast cancer is the most common cancer among women. Every woman diagnosed with breast cancer will face different issues. Young women are concerned with their body image, fertility, sexual functioning, relationship issues, and premature menopause more so than older women. Young women feel they are in the best part of their life. The diagnosis of breast cancer at this age is considered a step backward for young women who feel they should be building their career and family. Women under the age of forty diagnosed with breast cancer will face their own unique set of problems and challenges. The diagnosis of breast cancer in young women is rare. When diagnosed with breast cancer at or under the age of forty young women are generally in the later stages of breast cancer. The expected outcome or course of the disease tends to be worse for women under forty versus women that are older. Research shows that breast cancer is more aggressive in younger women. Tumors are larger and more lymph nodes are affected. Younger women diagnosed in later stages can be the result of lack of awareness and effective screening options. With breast tissue being denser in younger women screening and diagnosing is difficult. Women under the age of forty do not receive regular mammograms. Breast cancer is not only more aggressive in younger women it does not respond well to treatment, which can be because of having an altered form of the genes BRCA1 or BRCA2. Treatment plans are designed based on the stage of cancer and characteristics of the tumor. With breast tumors being more aggressive in younger women cancer treatments can be more toxic than treatments given to older women. Chemotherapy, radiation, and hormonal therapies are among some of the options of treatment. There is the option of breast surgery in some cases. With breast surgery it can be the whole breast or partial breast. If surgery is needed you have the option to have reconstruction surgery Research shows that younger women face more psychological distress than older women. Psychological distress can come in the form of being emotionless, depression, and anxiety. A spouse of young women with breast cancer experience psychological distress, and in some instances a higher level of distress. Psychological distress can be increased with the issues young women face about their body image. Having the support of a partner has shown to be a crucial part of the cancer experience. Lower levels of anxiety and depression have been seen on younger women with the support of a partner. Having a partner that you can discuss issues with and that partner being able to discuss those issues with you concerning breast cancer and treatments has shown that young women adjust better psychologically. Baucom (2005) states that “It might be more helpful to think of breast cancer as a “relational cancer,” meaning that it impacts both the woman and her partner” (p.109). Having social support is essential to women with breast cancer and has been shown that younger women live a better quality of life. Young women not in relationships also need support for when they start to date and try to talk to their partner about their cancer diagnosis (Gluhoski, Siegel, Gorey, 1997). In our society, the outside beauty of a woman is valued highly, for this reason body image is a concern for younger women with breast cancer. Ganz (1998) “found that being unhappy with their body appearance was the second most frequent symptom reported by women with breast cancer, being reported by approximately two –thirds of women”(p.501 – 514). Body concerns seem to be more of an issue in women who have a mastectomy without having reconstruction surgery. Women who invest more time in their physical appearance have shown an increase in emotional distress (Carver et al., 1998). Many changes can occur during the treatment of breast cancer. Hair loss, lack of energy, and not being physically able to continue physical activities are associated with breast cancer treatments of all ages. Young women have to face the concept that they may start menopause early with treatments that are given. They can experience the feeling of aging faster in reference to their skin and loss of bone density. Along with the issues of body appearance came many women have sexual difficulties, which puts a strain on their relationship or them dating someone. No matter what a woman’s relationship status is, women have a wide range of sexual difficulties. Sexual problems seem too heightened for younger women. Younger women are just starting a relationship or have not found their partner. Sexual functioning is a common concern among younger women. Young women in relationships their partners have experienced sexual difficulties along with them. Young women have reported that they have sexual issues years after their treatment of breast cancer. Symptoms that women have can lead to the sexual difficulties. They experience vaginal dryness, lower sexual drive, and breast sensitivity which makes it difficult to have sexual relations. It has been reported that anxiety and depression are experienced within the first year of diagnoses. When faced with depression women have a lack of interest in sexuality and when they have anxiety problems they have difficulties with sexual arousal. Anxiety and depression can improve but for some women the issues of anxiety and depression are still there and can still contribute to sexual difficulties. . Discussing issues about sexual activities can become another issue which can increase anxiety levels in couples. The anxiety caused by being aware of issues can cause couples to avoid sexual activity or to even have an attack during sexual intercourse. Along with sexual functioning within a relationship, younger women have the concern of having children. This concern brings up the issues of fertility and the start of premature menopause. Most young women under the age of forty are preparing to start a family or have just started their family. With breast cancer being diagnosed in the later stages for younger women the treatments now become more aggressive. Treatments such as chemotherapy, radiation, and hormonal therapies have negative effects on a woman’s fertility. The treatments destroy the ovaries. Young women diagnosed with breast cancer need to make choices about fertility before beginning treatment. There are several different ways to preserve fertility. Mature egg freezing, embryo freezing, ovarian tissue freezing, medications, and using a donor egg are ways to preserve fertility. In vitro fertilization has shown in research studies to be the most successful method. An option is to have a surrogate or the choice of adoption for women who are afraid that breast cancer will return. During fertilization treatments, hormone therapies are given, which can increase the chances of a relapse. There are numerous studies of young women with breast cancer stating that fertility is a concern, but there is not enough information given or talked about by healthcare professionals. BCNA chief executive officer Maxine Morand (2012) said, “Fertility concerns were often overlooked by health professional when younger women were diagnosed with breast cancer or undergoing treatment, despite this being an issue of high importance to individual women” (19(11),p.36). Discussion issues about fertility may result in the fact that professionals may be uncomfortable with discussing fertility, they may not have enough time, resources, or the information needed to assist patients. Young women feel that at the time of diagnoses it would not be appropriate to talk about issues concerning fertility, but needed to be addressed early enough to make decisions. Young women feel they are not getting the level of care they should. Premature menopause and the impact it has on younger women is an issue they have to face more so than their older counterparts. Treatments such as chemotherapy can out younger women into premature menopause. Symptoms like hot flashes, reduced libido, and vaginal dryness are signs of premature menopause that can be induced by chemotherapy and become more severe than with natural menopause. Menopause is the decrease or loss of fertility. The impact of premature menopause sets off more emotional issues for younger women. Younger women feel they are in the prime of their life and this is considered a step backward in life. The experience has shown to attribute to a lower quality of life for young women. The thought of not being able to have children for those who want children is an extreme loss for them. Seeing the issues and challenges that women under the age of forty face it is hard to imagine facing a diagnosis of breast cancer. Young women diagnosed with breast cancer go from worrying about their career and family to worrying about a whole new set of problems. In conclusions, we have discussed that young women diagnosed with breast cancer now face issues with their body image, fertility, sexual functioning, relationship issues, and premature menopause. Older women are not generally concerned with these issues because of their age and where they are in their life.

References:
Baucom, D.H., Porter, L.S., & Kirby, J.S., Gremore, T.M., Keefe, F.J., (2005/2006). Psychosocial Issues Confronting Young Women with Breast Cancer. Breast Disease, 23(11), 103-113. Retrieved from http://web.ebscohost.com.ezproxy.apollolibrary.com
Carver, C.S., Pozo-Kaderman, C., & Price, A.A., Noriega, S.D., Harris, R.P. Derhagopian, D.S. Robinson and F.L. Moffatt (1998, March). Concerns about aspects of body image and adjustment to early stage cancer. Psychosomatic Medicine, 60(2), 168- 174 . Retrieved from http://www.psychosomaticmedicine.org/content/60/2/168.abstract
Ganz, P.A., Rowland, K.A., & Meyerowitz, B.E. (1998). Life after Breast Cancer: Understanding Women's Health - Related Quality of Life and Sexual Functioning. Journal of Clinical Oncology, 16(), 501-514.
Gluhoski, V.L., Siegel, K., & Gorey, E. (1998). Unique Stressors Experienced by Unmarried Women with Breast Cancer. Journal of Psychosocial Oncology, 15(3-4), 173-183. Retrieved from http://Http://dx.doi.org/10.1300/j077v15n03_08
New fertility resource for young women with breast cancer. (2012, June). Australian Nursing Journal, 19(11), 36-37. Retrieved from http://web.ebscohost.com.ezproxy.apollolibrary.com

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