Diana Jeleč Kaker, Ph.D., Soc. WorkInstitute of Oncology Ljubljana, Slovenia

FIFTEENTH EASOM SUMMER SCHOOL 2015: Teaching Trainees in Occupational Medicine about Psychosocial Risk Factors at work,

Bled, Slovenia, 26th – 29th August 2015

PATIENT WITH BREAST CANCER – A CASE

STUDY

DIAGNOSIS: BREAST CANCER

Brings about changes:

Patient X:

temporary permanent

metastatic breast cancer born in 1965 married two daughters employed as a cook lives in a block of flats

THE DISEASETHE DISEASE

Influences:

•physical – own attitude towards health, appearance

•psychological distraction (anxiety, depression)

•partner relationship

Patient X:

•Suffers from feelings of inferiority and low self-image

•Depression

•Has a great support from the family (husband and two daughters)

COPING AND ACCEPTING THE DISEASE

Methods:

• fighting

• avoiding

• stoical acceptance

• helplessness

• anxiety

Patient X

•The patient choses fighting as a way of coping with the disease

REHABILITATION

Approach: team work

Patient Discussions and

consultation Encouraged to actively

participate in the treatment, strengthening the abilities

FamilyThe whole family is

affected.It is an important factor insupport

Society Self-help groups

Patient X

Addresses the professionals (doctor, nurse and social worker)

Offered a lot of support by the family

Refuses to participate in the self-help group

REHABILITATIONReturning to the workingenvironment Sick leave The possibility to gradually

return to work Work at home The option of training /

professional retraining

Purpose Achieving the desired work

efficiency Return/inclusion into society

Patient X

•Loses her job

•Has difficulties in finding new employment

•Takes sick leave

MEDICALMEDICAL DEVICESDEVICES

Medical devices: Temporary breast prosthesis

Silicone breast prosthesis

Self-adhesive breast

prosthesis

Orthopaedic bra

Wig

Elastic glove

TEMPORARY BREAST TEMPORARY BREAST PROSTHESIS PROSTHESIS

Temporary breast prosthesis

Designed to be worn immediately after surgery, until the operative wound heals

SILICONE BREAST PROSTHESIS SILICONE BREAST PROSTHESIS AND ORTHOPAEDIC BRA AND ORTHOPAEDIC BRA

Silicone breast prosthesis

Self-adhesive breast prosthesis

ORTHOPAEDIC BRA FOR THE ORTHOPAEDIC BRA FOR THE BREAST PROSTHESISBREAST PROSTHESIS

• Wide and adjustable straps

• Comfortably sewn under the armpit

• The bottom border for additional support

MEASUREMENTS TO MEASUREMENTS TO DETERMINE THE BRA SIZEDETERMINE THE BRA SIZE

• Measure the chest circumference directly under the bust. Round the measured value to the nearest multiple of number 5.

Example: measured 78 cm = bra size 80 cm. This is the bra size.

Measure distance from the middle of sternum across the healthy breast to the centre of the spine. Multiply the measured value by two to obtain the cup size.

Example: 48 cm x 2 = 96 cm. This is the cup size.

BRA / CUP SIZEBRA / CUP SIZE

The difference between the cup circumference and the bra size determines the size of the cup:

96 cm (cup circumference) - 80 cm (bra size) = 16 cm

•Example: 80 C

Difference in cm

Cup size

8 -10 AA

10 - 12 A

12 - 15 B

15 - 18 C

18 - 20 D

20 - 23 DD

WIG, ELASTIC COMPRESSION WIG, ELASTIC COMPRESSION GLOVE GLOVE

• Alopecia

• Lymphoedema

PROGRESS OF DISEASE PROGRESS OF DISEASE

Social assistance services

Help at home

Institutional care

Patient X

Refused by the patient

Receives help from the family

Thank you for your attention