[Breast cancer: patient care, rehabilitation, psychooncology].
Zsuzsanna KahánIstván SzántóMária Judit MolnárMagda RohánszkyZsuzsa KonczMónika MailáthZsuzsanna KapitányRita Dudás
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The development of a recommendation was intended for the follow-up of breast cancer patients treated with curative intent in Hungary. Follow-up includes the permanent contact with and health education of the patient, the surveillance and control of the adverse effects of oncological therapies or radiotherapy, the screening of metachron cancers, and the comprehensive (physical, psychological and social) rehabilitation of the patient. The early detection of local/regional tumor relapse is essential with careful follow-up, but there is no need for screening of distant metastases by means of imaging studies or tumor marker tests. If adjuvant endocrine therapy is needed, optimal adherence should be ensured with supportive therapy. In rare cases, special issues such as breast cancer risk/genetic mutation, pregnancy are raised, which should be thoughtfully discussed in view of recent advances in oncology. Follow-up is generally practised by the oncologist, however, in some cases the social worker, the physiotherapist, the psychooncologist, or in special cases, the lymphoedema expert is to be involved. The follow-up approach should be comprehensive and holistic.A nemzetközi ajánlások és legújabb irodalmi adatok áttekintése alapján kívántunk ajánlást adni az emlõrák miatt kuratív ellátásban részesült betegek gondozásának magyarországi gyakorlatához. A gondozás magába foglalja a beteggel történõ kapcsolattartást, egészségnevelést, a betegség tüneteinek, illetve az onkológiai kezelés és a sugárterápia mellékhatásainak felismerését, menedzselését, a további daganatokra vonatkozó szûrést és a beteg teljes körû (fizikai, lelki és szociális) rehabilitációját. Fontos a lokális/regionális daganatkiújulás korai detektálása gondos követéssel, de nincs szükség a távoli áttétek kutatására képalkotó vizsgálatokkal vagy tumormarker-meghatározással. Amennyiben adjuváns hormonterápia szükséges, a jó adherenciát a mellékhatások megfelelõ szupportálásával segítsük. Egyes esetekben speciális kérdések (emlõrákrizikó/mutációhordozás, gyermekvállalás) is felmerülhetnek, ezek tapintatos, gondos és hozzáértõ megbeszélése az onkológia fejlõdésének tükrében elengedhetetlen. A gondozást általában onkológus végzi, de a beteg ellátásában szükség lehet a team szociális munkás, fizioterapeuta és pszichoonkológus tagjának, olykor nyiroködéma-szakembernek a bevonására. A gondozás legyen teljes körû és holisztikus szemléletû.Topics:
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