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Giuseppe Curigliano

Boston, MA, U.S.A.; Tuesday, 9.40 a.m. Patient: “Doctor, I am very worried about the CT scan report. It says ‘disease progression.’ ‘Progression’ means I have metastases, doesn’t it? How long will I live?” Milan, Italy; Tuesday, 11.00 a.m. Patient: “Doctor, I’m terrified. The pathology report says ‘invasive carcinoma.’ ‘Invasive’ means cancer, doesn’t it? I’ll need chemotherapy. I’ll lose my hair. I won’t see my children grow up.” Across borders and social-cultural groups of patients, a breast cancer diagnosis and the subsequent treatment is emotionally distressing. Also, I was reminded recently while serving as a visiting professor, the language of cancer distress is universal. A growing number of studies have explored the experiences of dealing with breast cancer among women of different geographic and cultural groups.1-15 These studies all identify 3 major themes: 1) the “losses” associated with breast cancer, 2) the impact beyond the patient and into the family, and 3) coping with cancer through spirituality and community involvement. 1. The predominant sense of loss associated with breast cancer is a consistent theme for all women, across any latitude or longitude. This loss is both physical and emotional. Women in all geo-cultural groups are particularly traumatized by the overt physical changes from breast cancer treatments. The stigmata of breast surgery and of treatment-related side effects such as hair loss and fatigue confirm to women the reality of their breast cancer and call to mind the chance of further losses (cancer recurrence and death). Beyond the sense of loss and suffering...