Gaynor Siobhan, O'Meara Yvonne, Mulvaney Emer, Keogh Rachel J, Weadick Catherine S, Duane Fran J, Mc Brien Ann, Greally Helen, O'Leary Mary Jane, Teiserskyte Ieva, Beristain Isabel, Marron Jacinta, Mulroe Eibhlin, Donachie Vicky, Mc Loughlin Sarah, O'Reilly Seamus
Cancer Trials Ireland, RCSI House, 123 Stephens Green, Dublin 2, Ireland.
University College Dublin, Dublin 7, Ireland.
Breast. 2025 Feb;79:103837. doi: 10.1016/j.breast.2024.103837. Epub 2024 Nov 20.
Although treatment advances have improved survival rates for patients with metastatic breast cancer (MBC), patient expressed needs have not been evaluated in Ireland to date.
A 76 item questionnaire was designed by the lead author and a cohort of 41 other MBC patients in collaboration with a multidisciplinary team. The online survey was publicised nationally on all media platforms.
246 patients completed the survey between July and October 2023. Most patients were satisfied with the manner of disclosure of their diagnosis but 77 % wanted more prognostic information. Disparate information sources were used to provide support. Only 35 % of patients had access to their records, yet 99 % of patients without access desired to have it. The majority (83 %) of patients were amenable to earlier palliative care referral. The symptom burden of respondents was high, 87 % experienced mental health issues and 68 % of those with menopausal symptoms were dissatisfied with the support. These burdens were compounded by financial stress with 20 % of patient unable to meet monthly expenses and by time toxicity with 25 % attending emergency departments in the previous 6 months.
Currently the needs of MBC patients in Ireland and Northern Ireland have many unmet needs. The routine early provision of palliative care, psycho-oncology, medical social worker and dedicated liaison nurse supports guided by national guidelines and education for healthcare professionals, integrated with living well with cancer clinics and a dedicated medically verified website would provide an ecosystem where MBC care could be optimised for patients and their families.
尽管治疗进展提高了转移性乳腺癌(MBC)患者的生存率,但爱尔兰至今尚未评估患者表达的需求。
由第一作者与其他41名MBC患者组成的队列,与多学科团队合作设计了一份包含76个条目的问卷。该在线调查在全国所有媒体平台上进行了宣传。
2023年7月至10月期间,246名患者完成了调查。大多数患者对诊断结果的披露方式感到满意,但77%的患者希望获得更多预后信息。患者使用了不同的信息来源来获取支持。只有35%的患者能够获取自己的病历,然而99%无法获取病历的患者希望能够获取。大多数(83%)患者愿意更早接受姑息治疗转诊。受访者的症状负担较重,87%的患者有心理健康问题,68%有更年期症状的患者对所获得的支持不满意。这些负担因经济压力而加剧,20%的患者无法支付每月开支,同时因时间毒性而加剧,25%的患者在过去6个月内去过急诊科。
目前,爱尔兰和北爱尔兰的MBC患者需求有许多未得到满足。按照国家指南并在医疗专业人员接受教育的指导下,常规早期提供姑息治疗、心理肿瘤学、医疗社会工作者和专门的联络护士支持,与癌症患者生活良好诊所和专门的医学验证网站相结合,将提供一个生态系统,在此生态系统中,可以为患者及其家人优化MBC护理。