Pertinence de l’éducation thérapeutique dans le cancer du sein

Abstract

L'augmentation de la durée de vie des patientes atteintes de cancer du sein contribue progressivement à donner à cette pathologie les caractéristiques d'une maladie chronique à l'instar du diabète ou de l'asthme qui bénéficient déjà d'une éducation thérapeutique pour le patient (ETP) bien codifiée. L'ETP est l'ensemble des pratiques visant à permettre au patient d'acquérir et de conserver les capacités et compétences pour la prise en charge active de sa maladie. Dans le cancer du sein, du diagnostic à l'après-traitement, nous proposons diverses pistes d'éducation thérapeutique. Les équipes soignantes qui accompagnent ces patientes assurent déjà une éducation thérapeutique partielle et non formalisée en particulier dans le dispositif autour de l'annonce. La prise de conscience de cet état de fait et une formation en ce sens permettraient d'améliorer les pratiques et le service médical rendu. En raison de la spécificité du cancer du sein qui atteint la femme au plus profond de sa féminité, le terme d'accompagnement thérapeutique nous paraît plus adapté dans cette situation que celui d'éducation thérapeutique. Pour citer cette revue : Psycho-Oncol. 4 (2010).Mots clés Éducation thérapeutique · Cancer du sein · Empowerment · Dispositif d'annonce · Chimiothérapie · Effets secondaires · Accompagnement thérapeutique · Vitamine D · Activité physique Abstract The increase of life expectancy in breast cancer patients has progressively led us to see this pathology as a chronic disorder. We have studied the usefulness of therapeutic patient education (TPE) with respect to this pathology in the light of what is already an established practice in the case of diabetes and asthma. TPE is a range of practices which aims to enable patients to acquire and to retain the ability and necessary skills for an active management of their disease. In breast cancer, from diagnosis through to post-treatment follow-up visits, we offer several approaches to therapeutic education. The physicians and the support team who accompany these patients already supply partial and informal therapeutic education particularly at the moment of diagnosis disclosure. A greater awareness of this situation and specific training would enable healthcare providers to improve their approach and efficacy. Given the specificity of breast cancer, affecting as it does a woman at the very core of her femininity, we would prefer to use the expression "therapeutic accompaniment" rather than "therapeutic education." To cite this journal: PsychoOncol. 4 (2010).

Homeopathic Treatment of Insomnia and Symptom Clusters Related to Cerebral Chemotoxicity in Oncology

“…Statistically significant cross-correlations exist between chemo-induced symptom clusters (fatigue, insomnia, depression, quality of life) after chemotherapy, with a peak between the third and fifth day. 24 All of these data could usefully be integrated into the therapeutic education programme of patients 25 to prepare them for future side effects after chemotherapy by reassuring them about a general health improvement after 1 week or so, given that this recovery time becomes progressively longer as the sessions continue. 24 Apart from chemotherapy, other possible causes of insomnia are pain induced by cancer itself, corticosteroids, hot flushes, radiotherapy, 26 nocturnal polyuria, fatigue 27 and anti-androgenic hormone therapy.…”