Target practice: Decision making v. treatment trajectories in breast cancer care

Sally J E Sargeant, Penelope List, Neda Baniamer, Sankar Narayanan, Heather K. Smith

Research output: Contribution to conferenceAbstractResearch

Abstract

This research qualitatively investigates experiences of breast cancer treatment, with a focus upon individuals’ decision-making processes. Treatment pathways involve many procedures, from diagnostics through to mastectomy and adjuvant therapy. Numerous guidelines stipulate that treatment decisions should be shared between physicians and patients. Additionally, the UK Department of Health sets target treatment times which are likely to decrease due to improved diagnostic technologies. One example is Sentinel Lymph-node Biopsy (SLB). At the University Hospital of North Staffordshire (UHNS), lymph-nodes are assessed after initial surgery, with patients waiting up to 10 days for results. If cancer has spread all lymph-nodes are removed in a second operation. However, new intra-operative techniques allow SLB results to be returned during initial surgery, allowing all nodes to be removed immediately and necessitating only one operation. Our recent audit of services within the breast clinic at UHNS (N = 60) revealed that patients were generally satisfied with current practice, but needed more information and discussion about new technologies. Of particular note were responses that hypothetically consented to concurrent initial treatment and lymph-node removal, yet inversely indicated a wish to discuss the removal procedure after the SLB result. Therefore a critical view is imperative to review the psychological impact of procedures that are consented to hurriedly to satisfy targets, and to address the clinical versus personal agenda as patients adjust to diagnosis, treatment and possibly a changed body. There is also scope to explore when psychological intervention is most appropriate based upon personal narratives rather than institutionally target-driven practice.
Original languageEnglish
Pages61
Number of pages61
Publication statusPublished - 18 Apr 2011
Externally publishedYes
EventISCHP (International Society of Critical Health Psychology) 7th Biennial Conference: Experiences of Illness and Treatment - University of Adelaide, Adelaide, Australia
Duration: 18 Apr 201120 Apr 2011

Conference

ConferenceISCHP (International Society of Critical Health Psychology) 7th Biennial Conference
CountryAustralia
CityAdelaide
Period18/04/1120/04/11

Fingerprint

Decision Making
Breast Neoplasms
Sentinel Lymph Node Biopsy
Lymph Nodes
Therapeutics
Personal Narratives
Psychology
Technology
Mastectomy
Breast
Guidelines
Physicians
Health
Research
Neoplasms

Cite this

Sargeant, S. J. E., List, P., Baniamer, N., Narayanan, S., & Smith, H. K. (2011). Target practice: Decision making v. treatment trajectories in breast cancer care. 61. Abstract from ISCHP (International Society of Critical Health Psychology) 7th Biennial Conference, Adelaide, Australia.
Sargeant, Sally J E ; List, Penelope ; Baniamer, Neda ; Narayanan, Sankar ; Smith, Heather K. / Target practice : Decision making v. treatment trajectories in breast cancer care. Abstract from ISCHP (International Society of Critical Health Psychology) 7th Biennial Conference, Adelaide, Australia.61 p.
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Sargeant, SJE, List, P, Baniamer, N, Narayanan, S & Smith, HK 2011, 'Target practice: Decision making v. treatment trajectories in breast cancer care' ISCHP (International Society of Critical Health Psychology) 7th Biennial Conference, Adelaide, Australia, 18/04/11 - 20/04/11, pp. 61.

Target practice : Decision making v. treatment trajectories in breast cancer care. / Sargeant, Sally J E; List, Penelope; Baniamer, Neda ; Narayanan, Sankar; Smith, Heather K.

2011. 61 Abstract from ISCHP (International Society of Critical Health Psychology) 7th Biennial Conference, Adelaide, Australia.

Research output: Contribution to conferenceAbstractResearch

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T2 - Decision making v. treatment trajectories in breast cancer care

AU - Sargeant, Sally J E

AU - List, Penelope

AU - Baniamer, Neda

AU - Narayanan, Sankar

AU - Smith, Heather K.

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N2 - This research qualitatively investigates experiences of breast cancer treatment, with a focus upon individuals’ decision-making processes. Treatment pathways involve many procedures, from diagnostics through to mastectomy and adjuvant therapy. Numerous guidelines stipulate that treatment decisions should be shared between physicians and patients. Additionally, the UK Department of Health sets target treatment times which are likely to decrease due to improved diagnostic technologies. One example is Sentinel Lymph-node Biopsy (SLB). At the University Hospital of North Staffordshire (UHNS), lymph-nodes are assessed after initial surgery, with patients waiting up to 10 days for results. If cancer has spread all lymph-nodes are removed in a second operation. However, new intra-operative techniques allow SLB results to be returned during initial surgery, allowing all nodes to be removed immediately and necessitating only one operation. Our recent audit of services within the breast clinic at UHNS (N = 60) revealed that patients were generally satisfied with current practice, but needed more information and discussion about new technologies. Of particular note were responses that hypothetically consented to concurrent initial treatment and lymph-node removal, yet inversely indicated a wish to discuss the removal procedure after the SLB result. Therefore a critical view is imperative to review the psychological impact of procedures that are consented to hurriedly to satisfy targets, and to address the clinical versus personal agenda as patients adjust to diagnosis, treatment and possibly a changed body. There is also scope to explore when psychological intervention is most appropriate based upon personal narratives rather than institutionally target-driven practice.

AB - This research qualitatively investigates experiences of breast cancer treatment, with a focus upon individuals’ decision-making processes. Treatment pathways involve many procedures, from diagnostics through to mastectomy and adjuvant therapy. Numerous guidelines stipulate that treatment decisions should be shared between physicians and patients. Additionally, the UK Department of Health sets target treatment times which are likely to decrease due to improved diagnostic technologies. One example is Sentinel Lymph-node Biopsy (SLB). At the University Hospital of North Staffordshire (UHNS), lymph-nodes are assessed after initial surgery, with patients waiting up to 10 days for results. If cancer has spread all lymph-nodes are removed in a second operation. However, new intra-operative techniques allow SLB results to be returned during initial surgery, allowing all nodes to be removed immediately and necessitating only one operation. Our recent audit of services within the breast clinic at UHNS (N = 60) revealed that patients were generally satisfied with current practice, but needed more information and discussion about new technologies. Of particular note were responses that hypothetically consented to concurrent initial treatment and lymph-node removal, yet inversely indicated a wish to discuss the removal procedure after the SLB result. Therefore a critical view is imperative to review the psychological impact of procedures that are consented to hurriedly to satisfy targets, and to address the clinical versus personal agenda as patients adjust to diagnosis, treatment and possibly a changed body. There is also scope to explore when psychological intervention is most appropriate based upon personal narratives rather than institutionally target-driven practice.

M3 - Abstract

SP - 61

ER -

Sargeant SJE, List P, Baniamer N, Narayanan S, Smith HK. Target practice: Decision making v. treatment trajectories in breast cancer care. 2011. Abstract from ISCHP (International Society of Critical Health Psychology) 7th Biennial Conference, Adelaide, Australia.