Breast cancer, the largest public health problem
Breast cancer today has become a public health problem because it is the most frequent oncological disease in women, which increases in prevalence and mortality annually with 1.671.149 new cases and 521.907 deaths per year. In Colombia, 2012 were presented.686 cases and 2 died.649 (1) and 1.38 million cases have a diagnosis confirmed to this pathology, thus becoming the main cause of morbidity and women of 20 years and more is the second in mortality (2), the repercussions of said neoplasia develops from 30 to 50 % psychological alterations, emotional that lead to episodes of depression, anxiety, stress, physical problems, changes in the family member dynamics, impact of body image, relationships, work situation, which negatively influence the adaptation and quality of life of patientsTherefore, health personnel must improve their attitude in care, optimize palliative care, in order to increase the quality of life, social and family support, that is, to guarantee multifactorial and multidisciplinary support.(3) The quality of life is affected by presenting alterations of mood, changes in lifestyle such as physical, nutritional, exercise, fear, concern, recurrence to disease or death, which prevent a good relationship withfamily, the surrounding environment, with health personnel and therefore hinders the prosperity of efficacy of treatment, since there is no collaboration when locking up in the trauma caused by this condition.(4)
Oncological treatments can damage the phases of the sexual response by affecting not only emotionally but also to central or peripheral components of the nervous system, which can generate induced menopause, vaginal dryness, lubrication reduction, less pleasure, less or no orgasm and more Factors that lead to sexual dysfunction, which oscillates between 35 and 85% related to certain surgical sequelae that can produce body image disorders, under self – esteem and loss of interest towards the couple (5), there are also cases of women With breast cancer with little interest in intercourse, mostly prefer proximity and physical contact, a sentimental sexual relationship, affective with words, caresses, love and not only the pleasure of the body, although it is common that they consider it part Of its conjugal duty, therefore it is not pleasant or an effective connection is given as a couple and all this can generate pressures in the contribution relationship Buying family breakdown, abandonment of the couple, which generates distress experienced due to the difficulty of coping with the disease that triggers a blockage or behavioral stiffness, limiting the daily life.(6)
Breast cancer generates an important economic burden for health systems, according to a Spanish study, annual costs of 5 were estimated.100 $ for hospitalized patients, 37.$ 231 for those who are outpatients and 1.037 $ is prescriptions. (7). In Colombia the most expensive stadiums for breast cancer were regional with a total of 65.603.537 $ and for metastatic cancer a cost of 144.400.865 $, the impact of systematic relapse with a value at 70.2221.061 $ and in the less aggressive stadium the cancer in situ a value of 8.996.987 $, being the radiotherapy that represents 51% of this value and chemotherapy the most expensive treatment with 75-87.6% of the total cost.(8)
Neoplastic procedures require quite aggressive treatments such as chemotherapy, radiotherapy that usually lead to a variable period of work disability caused by side effects derived from applied therapies, even when this pathology is diagnosed and treated in early stages, the same diagnosis It negatively influences the capacity of work during the 3 to 5 years and the type of treatment that is being received has an impact on this evolution, since it makes it difficult to maintain the work rate, there may be possible stigmatization by the company or trigger for possible disabilities o Disabilities derived from the sequelae of the disease (9), that is why Nursing meets a fundamental role in being responsible for coordination in comprehensive care and prevention of patient complications, control of side effects, care in psychosocial aspects, Emotional support, trust , communication, education, family integration in treatment, participation in equal group programs, based on support and sharing experiences, feelings, fears that help reduce stress that allows us to get out of some uncertainty in which they are living by The unknown and feeling understood by people who have already lived this experience or is living it, since they help improve the satisfaction and emotional state of the patient, this improves the quality of life of people, satisfaction with the treatment, the days are reduced the days of hospital admission, guarantees healthcare continuity by increasing the confidence and ability of self-care in the patient thus improving the quality of life .(10)
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