Psychosocial aspects of breast cancer treatement in Accra, Ghana

OBJECTIVES: To evaluate psychosocial influences and effects of breast cancer treatment. DESIGN: Cohort questionnaire survey. SETTING: Surgical Outpatient Department, Korle Bu Teaching Hospital (KBTH), Accra, Ghana. SUBJECTS: Women previously treated for breast cancer, including those still on hormonal therapy. MAIN OUTCOME MEASURES: Perception of quality of treatment and psychosocial support; and patients' felt needs for alternative treatment. RESULTS: Eighty nine women treated one to 22 years previously were interviewed. The majority (86%) had mastectomy. Chemotherapy was the most unpleasant aspect of treatment in 58 (65.2%), and 27 (30.3%) were not warned about complications of treatment. Thirty eight (42.7%) reported being afraid (frightened or terrified) at the diagnosis; other reactions were shock, devastation, weeping and depression. Twenty two (24.7%) received no counselling and 15 (18.5%) did not have opportunity to express their fears of death 55 (61.8%), mastectomy/deformity 27 (30.3%) and financial incapability 23 (25.8%). Forty four (49.4%) used alternate 'treatment', mainly prayer camps (25 cases) and herbs (22 cases), before and during hospital treatment. Use of alternate treatment led to delays in treatment in 23 women. They had complaints about the care they received: lack of sympathy and emotional support (16 cases), lack of information and communication (13 cases), lack of counselling (9 cases) and slow processes (8 cases). CONCLUSIONS: Many patients utilise prayer camps and herbs leading to delays in treatment. Breast cancer patients in Ghana (West Africa) are not receiving satisfactory emotional support, communication and counseling. Adequate psychosocial interventions need to be implemented.