IV-Rehabilitation

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What is palliative care?

"Palliative Care (PC) is an approach that promotes the quality of life of patients and their families in the face of diseases that threaten the continuity of life, through the prevention and relief of suffering, through early identification, assessment and treatment of pain and other problems, physical, psychological and spiritual”. This concept can bring some difficulty in understanding, by most health professionals, who confuse disease in progression or in the final stage of life, but PC must be understood as appropriate for any age or stage of the disease, including chronic diseases of difficult to control and can also be offered in the curative treatment phase.

The objective of palliative care is to anticipate, prevent and reduce the suffering of patients and their families and maintain the best quality of life regardless of the stage of the disease or the need for other treatments. Therefore, it can or should be started at the time of diagnosis and it becomes the main focus of care when treatments aimed at the disease that prolong life are no longer effective, appropriate or desired.

- Provide relief from pain and other symptoms such as asthenia, anorexia, dyspnea and other oncological emergencies;

- Reaffirm life and death as natural processes;

- Integrate psychological, social and spiritual aspects to the clinical aspect of patient care;

- Do not rush or postpone death;

- Offer a support system to help the family deal with the patient's illness, in their own environment;

- Offer a support system to help patients live as actively as possible until their death;

- Use an interdisciplinary approach to address the clinical and psychosocial needs of patients and their families, including counseling and grief support.

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How does integrative medicine work?

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The principles of Integrative Medicine involve the notion of partnership between therapist and patient, the consideration of all factors that influence health, well-being and illness, including mind, spirit, body and the community, in which both are inserted. Thus, it provides for the use of conventional and complementary methods that enhance the patient's natural healing capacity, giving preference to the use of less invasive interventions whenever possible.

The American Society of Clinical Oncology expert panel has endorsed the Society of Integrative Oncology guidelines, concluding that they are clear, complete, and based on scientific evidence.

Key recommendations include the following:

Music therapy, meditation, stress management and yoga are recommended to reduce anxiety/stress., depression/mood disorders. and to improve the quality of life;

Acupressure and acupuncture are recommended to reduce chemotherapy-induced nausea and vomiting;

No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related adverse effects.

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What is acupressure?

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Used for thousands of years in China, acupressure is based on the same principles as acupuncture to promote relaxation and well-being and treat illness. Shiatsu is a Japanese form of acupuncture.

Traditional Chinese medical theory describes meridians, invisible channels in the body that carry energy called qi (ch'i). They start at your fingertips and connect to your brain and then to an organ or organ networks to create a communication system. When one of these meridians is blocked or out of balance, you get sick. Acupressure uses specific points along these meridians to help restore balance.

What is spiritual support?

Relieving symptoms and side effects is an important part of treatment called palliative care or supportive care. Spiritual support is a type of palliative care. It can help with some concerns and questions you and your loved ones have during cancer and treatment.

What is the association between breast cancer and depression?

Discovering a disease is never easy. In the case of breast cancer, for many patients, the psychological impact can trigger depression. The occurrence of depression in these cases is common, although it is not frequently diagnosed. "It is a challenge to differentiate what characterizes an installed depression picture from a 'normal' sadness, as it is one thing for a person to be sad and downcast and trying to overcome, and another is the more lasting and persistent depression (sadness and apathy)",

To better understand how depression is characterized, it is important to know that it generates spontaneous biological and psychological symptoms, apparently disproportionate in intensity and duration to the events that caused them. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM – V), depression is characterized as having at least five or more of the following symptoms persistent for more than two weeks:

- Depressed mood most days;

- Weight loss or gain without being on a diet;

- Increased or decreased appetite;

- Insomnia or other sleep disorders;

- Fatigue and energy loss;

- Feeling of uselessness or excessive or inadequate guilt;

- Impaired ability to think or concentrate or indecision;

- Concern about death and suicidal ideation;

- Difficulty concentrating;

- Crying fits.

There are different types of treatment for depression, which help to mitigate the effects of the disease, including in cancer patients. The main treatment possibilities are:

- Medicines (usually antidepressants);

- Psychoeducation (joint discussion about side effects and treatment expectations);

- Psychotherapy from diagnosis, as depression control helps cancer patients manage the disease better;

- The main objective of therapy is to awaken in the patient the coping with the disease and the development of problem solving skills;

- The techniques of Cognitive Behavioral Therapy are indicated;

- Support groups show good results for cancer patients who present with depression.

The support of close people and some activities can also be essential to complement the treatment.

- Physical activity is essential, as this practice facilitates the release of hormones that increase the feeling of well-being and disposition;

- Psychotherapy to help recover self-esteem;

- Family and friends support are essential at this time;

- If possible, continue with professional life;

- Dance, art therapy and recreational activities are allied in this process;

- Eating as healthy as possible.

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