Treatment and Supportive Therapy in Breast Cancer

Broj žena oboljelih od karcinoma dojke u stalnom je porastu te upravo zbog toga karcinom dojke je izazov za javnozdravstveni sustav. U Republici Hrvatskoj se provodi nacionalni program za rano otkrivanje raka dojke kojem je cilj karcinom otkriti u što ranijem stadiju i započeti s liječenjem. Svaka novootkrivena promjena na dojci zahtijeva dodatnu provjeru radi otklanjanja sumnje na karcinom dojke. Prije postavljanja dijagnoze potrebno je obaviti opsežnu dijagnostiku koja obuhvaća klinički pregled, radiološku obradu i patohistološku obradu. Nakon obavljenih pretraga određuje se stadij karcinoma dojke prema TNM klasifikaciji i stupanj proširenosti karcinoma. U skladu sa stadijem i stupnjem proširenosti karcinoma dojke određuje se terapija i proces liječenja. Liječenje karcinoma dojke obuhvaća operacijsko liječenje, radioterapiju, kemoterapiju, endokrinu terapiju, imunoterapiju i pružanje suportivne terapije. Cilj suportivne terapije je upravljanje i ublažavanje neželjenih simptoma i nuspojava koje prate proces liječenja. Terapija i liječenje karcinoma dojke izaziva širok spektar nuspojava koje zahtijevaju dodatnu njegu, pozornost i skrb kako bi se poboljšala narušena kvaliteta života pacijentice. Pružanje suportivne terapije utemeljeno je na cjelovitom i individualnom pristupu koji je ujedno i temelj sestrinskog rada. Medicinska sestra kao dio multidisciplinarnog tima prepoznaje narušene osnovne ljudske potrebe pacijentice te u skladu s tim provodi sestrinske intervencije. Sestrinske intervencije su usmjerene na pružanje neposredne fizičke pomoći te pružanje psihološke i socijalne podrške.The continuously increasing number of women diagnosed with breast cancer is one of the biggest challenges the public healthcare system is facing. In the Republic of Croatia, an early breast cancer detection program is enforced to ensure early stage diagnosis so proper treatment could be given in time. Every new and visible change to the breast requires further examination to rule out breast cancer. Before a diagnosis is made, patients must undergo an extensive diagnostic screening which encompasses a clinical examination, radiological screening and a pathohistological evaluation. After the diagnostic screening is concluded, the breast cancer stage and metastatic process of cancer are graded through the TNM classification system. In accordance with that, cancer treatment is decided and the patient begins the treatment. Treating breast cancer includes surgical treatment, radiotherapy, chemotherapy, endocrine therapy, immunotherapy and supportive therapy. The main goal of supportive therapy is the management and mitigation of unwanted symptoms and side effects that occur during the treatment process. Breast cancer treatment causes a wide array of side effects which require additional care, attention and support to help improve the patient's impaired quality of life. Providing supportive therapy is based on a holistic and individual approach which is also the foundation of nursing care. As a part of the multidisciplinary medical team, the nurse knows to recognize when a patient needs assistance with basic human needs, which is then enforced through a nursing intervention. Nursing interventions are focused on providing direct physical assistance as well as psychological and social support