Post-surgical mental morbidity of breast cancer survivors in India: reflection from urban Gujarat

Abstract

Introduction: Breast Cancer (Ca) is one of the most common cancers amongst women globally as well in India. With increasing awareness and available diagnostic facilities, it is expected to increase further. One of the main stay of treatment is surgical excision of the tumor, there are ample literature on types of surgery, post surgical survival rates, health related morbidity etc. However, there is very limited research on the Post Surgical Mental health status of survivors. The present study focuses on documenting the psychological impact of mastectomy especially from urban India and also explores the insight into need for Pre and Post mastectomy counselling not only for the survivors but also for the household and family members. Method and materials: Qualitative methods mainly In-depth Interviews were conducted amongst females of Ca Breast who underwent mastectomy in urban area of Ahmadabad, Gujarat (India). Snow Ball sampling was used for identification of the Cases. The inclusion criteria was Married, Post Mastectomy survivors (more than a year) and residing in Ahmadabad. The tool used was pilot tested and Interviews were analyzed using Atlas Ti software. Results: The observations were clubbed into major themes, Denial/fear to diagnosis and Surgery, Pre and Post Surgical Experience and Mental Stress due to perception of loss of femininity, Fear of rejection and separation from husband. There was also fear of relapse causes anticipatory waiting for next checkup and Coping Mechanism. Strong social support, high family functioning are reported to be positive personal resources for coping while loss of femininity and fear of rejection by husband was the most stressful and a major cause of mental morbidity. Conclusion: Present study explores and documents mental morbidity and psychological stress that the survivors of Breast cancer face from the time since the cancer is diagnosed to rest of the life. With the incidence increasing, there is an urgent need for counselling for both patients and family members especially spouse.