A healthy lifestyle leads to better recovery during and after breast cancer treatment
Care project: involving family members in post-operative care
Around 14,000 women are diagnosed with breast cancer each year. About a quarter of them are under 50. Breast cancer treatment is becoming increasingly successful, and the majority of patients have a good prognosis. However, both treatment and disease are far-reaching, both having a major impact on physical as well as psychosocial function, and getting back to work.
Scientific research has shown that adapting lifestyle and mindset early on leads to better recovery and therefore better quality of life in both the short and longer term. "Good aftercare starts with advance care."
We started two years ago with a project called 'nutrition advice for breast cancer patients having systemic therapy'. The aim of the project was, in particular, a survey of whether to give lifestyle advice, and how useful it is.
Fonkel’s bike programme
At the Amsterdam University Medical Center, AMC site, care of cancer patients who have undergone major abdominal surgery is shared between nurses and carers.
These patients require highly complex care. Following discharge, care continues at home with family members. Family members are not usually well-prepared for this active role. A programme was therefore developed for actively involving family members in care, during the stay in hospital. This programme fits in well with the current trend for patient and family-centred care. Family members get involved in precisely those activities that are known to have a preventive effect against complications arising. Examples include: early exercise, oral hygiene, breathing exercises or cognitive activities reducing the risk of episodes of sudden confusion. The programme was devised at a multidisciplinary level, and includes the following elements: rooming-in (optional), attending a doctor's round, written information, training by nurses, hands-on participation in care activities. Depending on the patient’s care needs and the carer’s skills, they can also help with other care activities such as dealing with wounds, running enteral feeds or injecting fraxiparin. An app has also been developed, where carers can look up information and keep track of their activities. Nurses were trained prior to the project, to involve carers actively in healthcare. To facilitate the family's presence in the hospital, two special informal care rooms were set up in the department. These rooms have a homely feel to them, and there is also a bed for the carer.
Patients are more susceptible to fatigue during chemotherapy. Being in good condition helps improve recovery. Oncology patients at Rivierenland Hospital in Tiel can use an electric bike during their treatment. Patient eligibility is assessed on the basis of inclusion criteria. The bike is loaned to them by the Friends of the Hospital Foundation, and the project is managed by Gejo Cycleworld in Tiel. There are 15 bicycles in use. The bike is collected from the patient a week after the final chemotherapy. The service is free to the patient, they are only asked for a deposit.
Breast cancer patients who have to undergo surgery at the Albert Schweitzer Hospital are given a free handmade heart-shaped cushion by breast care nurses. This heart cushion can be carried under the arm, and cushions the sensitive area operated on (breasts and armpit glands). The pillow’s shape and soft material ensure a comfortable position and relieve pain. Swelling, pressure or tension in the shoulder are relieved when carrying the pillow. During long car journeys, the cushion can be placed beneath the seat belt to protect the area operated on.