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Introduction Breast Cancer Haven (BCH) is a national UK breast cancer charity supporting people through the physical and emotional experience of breast cancer. This service evaluation aimed to identify what people expected/ hoped for from BCH, and to evaluate how well those expectations were met. Methods A link to an on-line SurveyMonkey survey was emailed out during November 2014–January 2015 to 4804 people with breast cancer who had attended BCH centres in London, Yorkshire or Hereford since 2000. Frequency analyses of pooled responses to multiple choice questions were downloaded from the SurveyMonkey website. Individual free text responses were analysed by coding into common themes, clustered into categories. Results A total of 980 BCH users (98.0% female, peak age 50–54 years) completed the survey; 20.4% of those invited. Most attended a BCH centre during 2012–14, nearly half travelled 30–60 min, most visited 6–10 times. Emotional (77.6%) and physical (67.2%) were the most frequent concerns. Breast cancer information, nutritional therapy and the Welcome Day were considered the most helpful therapies. Main categories of expected/hoped for factors were information and advice, emotional support, a therapeutic space and therapeutic relationships. 84.0% participants got what they expected or much more than they expected. Conclusions The findings suggest that a third sector organisation like BCH provides a support service that meets the expectations of the majority of those attending. Regular service evaluations are needed to ensure that people with breast cancer receive those aspects of care that are often lacking in the NHS setting.

Purpose of the research: breast cancer survival rates are improving with over 60% likely to live 20 years. As 30% diagnoses occur in women over 70 the prevalence of breast cancer survivors living into older age is increasing. The specific needs and experiences of this group have rarely been addressed. This study aimed to explore older women's experience of living with breast cancer alongside other health conditions, and to identify their information and support needs and preferences.Methods and sample: data were collected from 28 semi-structured qualitative interviews and 2 focus groups (n = 14), with breast cancer survivors aged 70-90, and were analysed using thematic analysis.Key results: these older breast cancer survivors experienced a range of long-term physical problems resulting from treatment, including poor cosmetic results and poor shoulder movements, and bras and prostheses were often unsuitable. Many were keen to preserve their body image ideal irrespective of age. Reconstruction was rarely discussed, but all would have liked this option. Older women wanted to be treated as individuals rather than uniformly as older people, with their personal physical and social needs (including co-morbidities) taken into account. They expressed a preference for information direct from health professionals.Conclusions: many breast cancer survivors will live into advanced old age with permanent physical and emotional consequences of their treatment. Holistic and personalized assessment of needs becomes increasingly important with age, particularly with comorbidity. Effective rehabilitative care is important to reduce the impact of breast cancer into old age.

The European Parliamentary Group on Breast Cancer and the European Society of Breast Cancer Specialists state that there is a need for EU agreed guidelines on breast care nursing and training. Therefore the European Oncology Nursing Society (EONS) commissioned the development of a post-basic curriculum for breast cancer nursing.The goal was to define a European curriculum for the training of breast care nurses.The curriculum was developed using a variety of sources, including guidelines from a number of European and other countries world wide, relevant literature and input from an expert panel of senior European nurses with expertise in breast care nursing.An English language, European curriculum of breast care nursing was developed at a postbasic level to provide guidance for the training of breast care nurses throughout Europe. Definitions for breast care nurse roles and activities and levels of practice, as well as indicative content are provided.The training of nurses in breast cancer care should be mandatory and common practice for European countries. To enhance comparability and standard development, the indicative content should be applied in all future post-basic education.

Up to 80% of people with cancer will develop weight loss and anorexia during the advanced stages of the disease. The Macmillan Weight and Eating Studies (2000-2009) have used the Medical Research Council complex interventions framework to develop the first psychosocial intervention for weight- and eating-related distress (WRD and ERD) in people with advanced cancer and their carers: The Macmillan Approach to Weight and Eating (MAWE).This article reports the findings of a Phase II trial of MAWE that investigated its deliverability, acceptability, and patient-perceived effect on WRD and ERD.The Phase II trial, conducted in 2006-2007, was of cluster-randomized design, with two community palliative care teams randomized to different arms. It used mixed methods to compare an intervention group (n=25), the MAWE group, which was supported by MAWE-trained clinical nurse specialists, with a group that received usual care (n=25), the control group.MAWE was deliverable in clinical practice and acceptable to patients. Unplanned exposure of the MAWE group to the intervention before an initial measure of WRD and ERD proved problematic to the trial process. Despite this, quantitative and qualitative analyses indicate that MAWE does not exacerbate WRD and ERD and may help patients with advanced cancer live with the weight loss and anorexia that are the symptoms of cancer cachexia syndrome.A follow-on randomized controlled trial of MAWE is warranted but should be of a revised design.

Hot flashes are experienced by about 52% of perimenopausal women. After breast cancer, this may increase to 70%. The use of hormone replacement therapy is not recommended in women who have had breast cancer; therefore, alternatives are required to help relieve hot flashes. This study was conducted to assess the efficacy of relaxation training in reducing the incidence of hot flashes in women with primary breast cancer. This was a randomized controlled trial of 150 women with primary breast cancer who experienced hot flashes. The intervention group received a single relaxation training session and was instructed to use practice tapes on a daily basis at home for one month; the control group received no intervention. Outcomes were incidence and severity of flashes using a diary and validated measures of anxiety and quality of life. The incidence and severity of hot flashes, as recorded by diaries, each significantly declined over one month (P < 0.001 and P = 0.01, respectively), compared with the control group. Distress caused by flashes also significantly declined in the treatment group over one month (P = 0.01), compared with the control group. There were no significant differences between the treatment group and the control group at three months and no changes in anxiety or quality-of-life measures. Relaxation may be a useful component of a program of measures to relieve hot flashes in women with primary breast cancer.

For many women with breast cancer, menopausal signs may be troublesome.While there is still uncertainty about the role of hormone replacement therapy (HRT), other ways should be sought to obtain relief from symptoms. Relaxation therapy may have a combined physical and psychological effect that may help to reduce hot flushes and night sweats. A pilot study using a randomized controlled trial method was conducted to investigate this hypothesis. Twenty-four women were randomly assigned to receive either relaxation training or no intervention, although only 16 were available for final analysis. Hot flushes were measured by a patient rating and a linear analogue scale of distress factors. A trend was seen for hot flushes and night sweats to be reduced, but the results did not achieve significance. Psychological state was measured by the General Health Questionnaire. This showed a significant reduction in psychological morbidity ( P =0.05) in the relaxation group. The research method was shown to be appropriate and useful and larger studies are recommended to test this intervention.

This was a descriptive study using interviews to gain information about the experience of menopause for women who had breast cancer. Four women with menopausal symptoms were interviewed and major themes identified. Five themes were identified. They were future, interaction with cancer, loss, lack of information and self image/sexuality. The women all wanted to put what had happened behind them and get on with living a normal life, however they felt they had lost their health and normality. They viewed the cancer experience as over and it was the menopausal changes that still took away their normality. None of the women really knew what to expect during the menopause. Some had not expected to go through it at this time and there was confusion as to what problems were caused by the chemotherapy, the menopause or by tamoxifen. There was little knowledge about what precipitated flushes or what helped and no–one else was able to give them this information. All the women had suffered some changes in their self image and in their sexuality.