Posts in Quality of Life
A healthy lifestyle leads to better recovery during and after breast cancer treatment

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.

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Care project: involving family members in post-operative care

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.

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Recipe book and cookery workshop for oesophageal cancer patients

Everyday activities such as eating and swallowing are very difficult for patients with oesophageal cancer. The therapy they get can also lead them to lose, change or reduce their sense of taste. Oesophageal cancer patients shared tips with each other as part of a cancer rehabilitation programme, helping them keep in shape, make swallowing easier, prevent weight loss, and combat nausea. These tips had proven themselves in practical, everyday life but appeared not to be written down anywhere.

So, the Upper GI service at Ziekenhuisgroep Twente in Almelo published a recipe book for patients with oesophageal cancer. The recipe book includes recipes, stories and tips for and by patients following treatment for oesophageal cancer. Various professionals also talk about the diagnosis and treatment of this form of cancer.

Following on from the book, patient workshops have also been devised. For this, recipes from the book were prepared under the guidance of a chef and a dietician. The doctors involved took part in the workshop, so that patients could not only talk to one other, but also to the doctors in an informal setting.

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Cardiotoxicity risk factor screening in breast cancer

Cardiovascular disease is the leading cause of death in the Western world. Cancer treatment can also have cardiotoxic effects on cardiac function and cardiovascular structures, creating a risk of cardiovascular complications. Breast cancer patients have a 10% chance of developing cardiotoxicity following surgery and (neo)adjuvant therapy. To identify this issue early, and respond to it quickly, all patients at the Beatrix Hospital in Gorinchem are screened, following breast cancer diagnosis.

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Head and neck massage accompanied by handpan and meditation

Within the context of "look good, feel better", patients with haematological malignancies receive a head and neck massage accompanied by handpan at the Amsterdam University Medical Center. The massage session lasts 45 minutes and is accompanied by meditative music played on the Handpan or Hang. The live music accompaniment is tailored to the patient, and changes with each session. This puts patients into a different mood, leaving space for inward reflection, processing, relaxation and emotions.

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Fonkel’s bike programme

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.

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Cooking project for cancer patients

Patients undergoing chemotherapy often have to cope with loss of, changes in, or reduction in their sense of taste and often lose their appetite, whereas good food is essential.

The Rivierenland Hospital in Tiel is organising workshops for cancer patients. Here, they get advice from a culinary specialist on how to give flavour to their food once again. There is an opportunity to taste food during the workshop. The meetings are arranged once or twice a month, in collaboration with chef Eric Jan Wissink and students from the RSG Linge College in Tiel. It’s free to take part, and each workshop can host around 5 people.

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Flavoursome food during chemotherapy

Patients undergoing chemotherapy often have to cope with loss of, changes in, or reduction in their sense of taste and often lose their appetite, whereas good food is essential. At the Dijklander Hospitals (Hoorn and Purmerend), diet chef Cees Neefjes gets the patient to take a taste test. In doing so, he is looking at the total taste profile: taste (the five basic tastes: sweet, salty, sour, bitter and umami), stimulation and olfactory (fragrance). By investigating which of the three aspects are diminished in the patient, he can adjust the taste.

Following the test, patients can get tailor-made advice which fully or partially restores their sense of taste. The sooner their sense of taste is restored, the sooner the patient eats better. Patients can get advice individually, but can also have a workshop at home or an interactive meal in the hospital's restaurant.

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Patient hand massage by volunteers

Every day, volunteers working at the Groene Hart Hospital offer patients in 12 therapy departments a hand massage. The massage is for relaxation. Nurses are also trained in this. The massage uses essential oils, so aromatherapy is also contributing to relaxation. Massages can be used widely. Not only do the patients get a massage, it is also sometimes given or taught to a loved one. District nurses and Pluszorg workers in the Groene Hart region are now also having massage lessons. Massages are also being given to members of the public during hospital open days, and even to nurses themselves on working days.

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Book ‘Borst vooruit’ (Chest out)

At the Albert Schweitzer Hospital, breast cancer patients are given the “Borst vooruit” book. It includes the experiences of 64 women with breast cancer. Their experiences and advice can support women who have recently been diagnosed. The book is an initiative of the breast cancer unit at the Erasmus University Medical Center, and proceeds will go to breast cancer research.

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Heart cushion

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.

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