Supportive care is important

Supportive care programs have increasingly come to be seen as a basic requirement for cancer patients. Research has shown they impact treatment outcomes positively. The diagnosis of cancer can be a devastating experience for anyone. Patients go through a range of emotions such as anxiety, fear, denial and uncertainty about the future. Handling the emotional turmoil, stress, and psychosocial complications such as disclosing the situation to family and friends are other challenges they face. That is not all. Patients also need to understand the treatment involved and choose the right doctor or hospital.

Once treatment begins, coping with the side effects of medicines, fatigue, sleeplessness and perception of their body image with changes happening due to treatment create further emotional and psycho-social upheaval. The treatment of certain cancers also causes functional disturbances such as pain, loss of a limb or disfigurement.

Women can be more vulnerable. Issues related to body image are especially common in women undergoing surgery for breast and gynaecological cancers. Hair loss that follows chemotherapy causes significant distress to them both in anticipation and experience. Younger women have to deal with sexual and fertility problems, marital issues and social stigma. The family is in many instances deeply disturbed or thrown out of gear due to the cost of treatment. In such cases, supportive care can be life-altering for cancer patients. A supportive program empowers them, improves their quality of life and transforms them so that they can actively participate in the healing process. It helps them cope better with the treatment regimen, rebuilds their confidence, and gets them back on track with life. Supportive care programs are increasingly seen as a basic requirement for cancer patients. Yoga and mindfulness helps

Research has shown that supportive care for cancer patients positively helps in treatment outcomes. For example, in a study, it was shown that yoga and mindfulness practices helped with both physical and psychological symptoms in addition to overall well-being and spiritual development post-treatment. Yoga with aerobic exercises has been found to have a positive impact on rehabilitation. Some randomized control tests have shown a correlation between physical activity and survival of post-breast cancer.

The impact of a good supportive care program was shown in a year-long study at Prameya Health involving more than 300 cancer patients undergoing a comprehensive supportive care program, the SAHAI FENS. The study showed complete resolution of symptoms related to anxiety and depression and better-coping abilities for patients who participated in the program.

Supportive care varies from patient to patient, depending on their stage of treatment. Different needs are identified and addressed at appropriate times by a team of experts. Supportive care should not merely focus on a single dimension of care such as physical or nutritional. It should instead cover a wide range of unmet needs and address these holistically, including emotional and spiritual aspects.

A good supportive care program should include emotional support, family and community support, advice about nutrition, wigs, prosthesis, and lymphedema care. Post-treatment supportive care helps patients embark on a journey of wellness, integrating them back into normal life. A team of cancer specialists, nutritionists, yoga instructors, fitness and physical therapists, counsellors and community art and cultural practitioners are needed to fulfil the functional, emotional, nutritional and spiritual needs of patients. Functional aspects deal with bodily changes and requirements to maintain a proper exercise regime.

These are addressed through general fitness sessions and workshops in yoga, dance, music, arts and crafts that involve physical as well as mental engagement. This helps keep the patient’s mind calm. Special sessions on Lymphoedema care also need to be given. Emotional requirements involving anxiety, depression, stress are addressed through motivation talks and counselling, meditation and other practices.

Psychosocial rehabilitation and social integration programs become a great place to meet new people and be part of a cancer support community. Nutritional aspects deal with food requirements and various questions regarding diet before, during and after treatment, and addressing the important issue of weight management. The spiritual aspects deal with re-establishing an inner connection with oneself to accelerate the process of healing.

(The writer is a breast cancer surgeon and Founder of Prameya Health, a supportive care centre for cancer patients)