The challenge of supporting patients with gynaecological cancer: building bridges towards comprehensive care

Patients who receive a gynaecological cancer diagnosis experience significant consequences that extend beyond their physical health, affecting their emotional state and overall quality of life. Confronting the challenge of delivering comprehensive support to these women is essential, promoting a conducive environment for the disease process and enhancing their experience throughout the course of treatment and recovery.

Comprehensive support, as defined by the Hub, encompasses an understanding of six primary areas that significantly influence a patient’s life within the care process: physical activity, nutrition, sexuality, fertility, mental health, and employment. To deliver comprehensive support, it is imperative to recognise the distinct characteristics of every patient, which calls for a customised approach that addresses their specific requirements.

An in-depth examination of each aspect comprising this hexagon is justified:

Emotional and psychological support: A gynaecological cancer diagnosis elicits a spectrum of emotions, from fear and anxiety to sadness and frustration. Given the emotional challenges, psychological support assumes critical importance. Support therapies, group sessions, and individual counselling play vital roles in managing the emotional impact of the disease.

Physical activity: Gynaecological cancer treatment often entails significant physical side effects. A comprehensive approach involves providing palliative care and relief measures to mitigate these effects, such as pain management, exercise routines tailored to each patient’s needs, or physical rehabilitation for recovery after invasive treatments or for reducing physical sequelae.

Nutrition: Certain therapies, such as chemotherapy or radiotherapy, can lead to digestive issues affecting patients’ daily lives. Malnutrition, a risk factor for treatments and surgical procedures, is prevalent [1]. However, few public facilities have a nutrition service that can provide patients with resources and personalised guidance to address malnutrition, improve absorption and tolerance to treatment and/or increase their quality of life.

Sexual Health Care: Surgical and systemic cancer treatments, as well as anxiety or commonly associated depression, can affect women’s sexual health (e.g., reducing sexual desire, lack of lubrication, or decreasing libido). A portion of the reason why sexuality is still considered a controversial subject is that patients devote little consultation time to this matter and receive infrequent guidance on how to recognise and alleviate these symptoms.

Facilitating Fertility: Systemic cancer treatment can decrease the quantity and quality of a woman’s eggs. Additionally, in most gynaecological cancers, a hysterectomy (removal of the uterus) must be performed, preventing the patient from becoming pregnant. Patients with a desire for pregnancy experience doubts about alternative pregnancy options, different fertility preservation techniques, and whether they will be safe or suitable for them.

Support in the workplace: Patients encounter diverse employment-related challenges, from securing work permits for treatment to coping with fatigue and treatment side effects affecting work efficiency. Additionally, they may face employment discrimination, difficulties accessing benefits and services, as well as stigma and lack of support in the workplace. All this makes it difficult for patients to remain employed during treatment and recovery, highlighting the importance of offering them support, working on reconciliatory labour policies, and educating workplaces about the needs of people with gynaecological cancer.

It is imperative to underscore that support does not conclude with the completion of treatment. A comprehensive approach mandates continuous care throughout the patient’s life cycle, adapting to evolving needs during recovery or potential relapses.

The Hub endeavours to contribute to this area by facilitating access to validated, reliable information in a centralised manner. Collaboration with healthcare professionals from diverse disciplines, including oncologists, psychologists, social workers, nutritionists, coaches, therapists, and any other stakeholders driven by the challenge, is sought to generate ideas or solutions aimed at enhancing patient support.

Referencias:

[1] Zorlini, R., Akemi Abe Cairo, A., & Salete Costa Gurgel, M. (2008). Nutritional status of patients with gynecologic and breast cancer. Nutrición Hospitalaria, 23(6), 577-583. https://scielo.isciii.es/scielo.php?pid=S021216112008000800009&script=sci_abstract&tlng=pt

NP-ES-AOU-WCNT-240004 (v1) 02/2024

The challenge of supporting patients with gynaecological cancer: building bridges towards comprehensive care

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