A cancer diagnosis often brings about feelings of fear and anxiety. But when the diagnosis is triple negative breast cancer (TNBC), the patient often experiences even more anxiety when she learns about the high recurrence rates and lack of targeted drug treatments available for this particular subtype of breast cancer. Helping patients understand the disease, how it is treated, and dispelling myths related to it are important factors to improve their ability to cope with their diagnosis.
Triple negative breast cancer accounts for 15% to 20% of breast cancer cases.1 TNBC is a subtype of breast cancer that lacks typical receptors: estrogen, progesterone, and HER2. Treatments such as tamoxifen and trastuzumab (Herceptin) act as receptor blockers, which slow or stop cancer growth and prevent recurrences. However, because TNBC lacks receptors, these targeted therapies are ineffective treatments for TNBC.
Throughout the treatment process, doctors and nurses should explain the diagnosis and treatment plan to patients in simple, understandable terms. Providing written information is also helpful as many patients are overwhelmed and in shock during their initial appointments. Living Beyond Breast Cancer offers the “Guide to Understanding Triple Negative Breast Cancer,” which provides useful information about the disease, treatment options, and posttreatment recommendations.
People who read about TNBC on the internet will likely be bombarded by scary information. Talking to patients about what they read online and dispelling misinformation they come across is important. These are the most common myths, with corresponding facts that can be given to discount them.
Myth: Triple negative breast cancer is a death sentence.
Fact: TNBC is not a death sentence! Make sure patients know there are effective treatments for this disease, and people can survive. Be sure to point out that TNBC is particularly sensitive to chemotherapy, and many clinical trials are available if standard treatment is ineffective.2
Myth: Triple negative breast cancer is difficult to treat.
Fact: Although there is a lack of targeted treatment options, an array of effective chemotherapies are out there to treat this disease.2 Patients should know that just because receptor blockers are not effective for this type of breast cancer, this does not mean their cancer is untreatable.
FOSTERING RESILIENCE AND RECLAIMING CONTROL
Normalizing and validating patients’ concerns will go a long way in promoting a sense of resilience. Health care professionals can also build resiliency in patients by educating them and fostering active participation in their treatment plan. Resilience can also come from a strong support network. Ask patients to identify their supports and urge them to reach out when help is needed.
Patients often lose their sense of purpose during treatment, especially if they stop working. They should be encouraged to identify new roles or activities that are meaningful to them such as cultivating their spirituality, getting involved in the cancer community, or identifying a new hobby that is tolerable during treatment.
Patients may feel out of control, particularly once treatment is complete and they are dealing with the unknown. When the risk of recurrence is high, they are frequently preoccupied with the idea of their cancer coming back. Patients can be taught mindfulness and to concentrate on the here and now.
What can bring them joy, comfort, or happiness today? It can be something as simple as a visit from a loved one or taking a soothing bath after treatment. Help patients focus on the things they can control. Patients can choose to follow a healthier lifestyle and exercise more. They can choose to surround themselves with supportive people. They can come up with an aftercare plan that might include a schedule of follow-up appointments, lists of doctors or nurses they can call in case they have a pressing concern, or tips on how to cope with posttreatment anxiety. Patients’ anxiety will likely lessen once they have a sense that they can control some parts of their life.