Health promotion: Breast cancer in menopausal patients and Sexually Transmitted Diseases in Women Adolescents (Due 24 hours)

Breast cancer in menopausal patients

The risk of developing cancer increases as one age. The age at which one starts menopause affects their cancer risk. Starting menopause after the age of 55 increases the risk of developing breast cancer due to exposure to a higher level of estrogen (Wang et al, 2020). The risk of breast cancer is increased by late menopause. Menopause in women that have breast cancer affects the quality of life negatively. Breast cancer causes skin and hair changes. It makes hair fall out all over the body. Breast cancer causes joint pains and bone thinning. The breasts might change in size and color. They might be swollen due to the tumors.

Breast cancer in menopausal patients

Global relevance

There were more than 130,00 and 490,000 deaths in the premenopausal and postmenopausal breast cancer groups worldwide in 2018. Breast cancer in menopausal patients is relevant because the number of individuals that have been succumbing to the disease has increased. The disease has been reported in various parts of the world. The survival rates of breast cancer in menopausal patients vary from one country to another. For those in high-income countries, the survival rates are high while for those in low-income countries, the survival rates are low. The incidence of cancer in developing nations has increased steadily (Shin et al,2019).

There is a disparity in the availability of detection programs in various countries. Breast cancer in menopausal patients is likely to be treated for patients that come from developing nations. Countries that have been undergoing economic and social transitions have had more cases of postmenopausal breast cancer. Many breast cancer deaths could be avoided worldwide by improving the health outcomes for menopausal patients.

National relevance

Breast cancer in menopausal patients is relevant in the US because it affects a lot of people. The most commonly diagnosed cancer Among American women is breast cancer. 12 percent of women that are born in the US develop breast cancer. The risk of getting diagnosed with cancer increases with age. Those in menopause are more likely to get diagnosed. There have been many deaths due to breast cancer in the US. For women aged 50 years and above, death rates from cancer have been decreasing (Sun et al, 2018).

The decrease in death rates has been due to early detection and treatment advances. Breast cancer is more common in blacks than whites in the US. There is national relevance of breast cancer because there have been many people suffering from the disease, and continued research has been done to identify more effective treatments. The US has spent a lot of money on the treatment of menopausal patients with breast cancer (Sun et al, 2018).

The risk factors for breast cancer are significantly increased by a western lifestyle. Exposure to estrogen has been one of the major risk factors for breast cancer among US citizens. Some breast cancers among menopausal patients in the US have been linked to gene mutations. Mutations are inherited from one father or mother (Nabieva et al, 2019). Women that have BRCA1 gene mutations are very likely to develop breast cancer. The US has a significant number of aging population. Therefore, diseases such as breast cancer are relevant due to the increased risk of getting the disease as one age.

Local relevance and perspective

Breast cancer among menopausal patients is relevant locally because more people are getting diagnosed. Many local people believe that cancer is a "white disease". There is conflicting information from health providers, media, and family members to the menopausal patients with breast cancer (Yeo et al, 2020). Women in various localities have limited knowledge of the subtypes of cancer. Some people are not concerned about the disease because they do not have a family history of the disease. Those who consume less healthy diets are at a higher risk of getting breast cancer in menopause.

Promotion strategies

Breast cancer in menopausal patients is a global health problem. The disease tends to affect people from many countries. There is a need to develop awareness among individuals. They should obtain factual information about breast cancer. Those in menopause might be at a higher risk of developing breast cancer (Trichopoulos et al, 2021). It is good to encourage them to adopt healthy lifestyles. At the global level, the problem should be addressed by organizations such as the World Health Organization. The government should take appropriate measures to address the problem at national and local levels.

Health Problem

Breast cancer is a major health concern among women. It is a major cause of mortality among women in the United States and the most common type of cancer in women accounting for 30% of cancer reported among women (Ellington et al., 2022). The risk of developing breast cancer among U.S women is 12.4%, that is, one in every eight women (Momenimovahed & Salehiniya, 2019). The risk of breast cancer increases with an increase in age, particularly among women aged 50 years old or above (Momenimovahed & Salehiniya, 2019). The U.S. Preventive Services Task Force recommends women aged between 50-74 years undertake breast cancer screening, while those aged between 20 to 49 years should discuss their cancer risk with their providers (Ellington et al., 2022).

The proposed health promotion program would be targeted at menopausal women to improve their knowledge on the risk of developing breast cancer. The program would utilize pedagogical groups, which will allow women to work together to enhance their breast cancer awareness. Each member of the group will be required to participate in enhancing their understanding and facilitating collective and collaborative learning. The individuals involved in the health promotion program will be educated about the preventive methods that can be used to protect them from getting breast cancer. The program will be essential in helping menopausal patients to live healthier lives.

Vulnerable Population

Menopausal women can easily develop breast cancer than other age groups. As such, the cases of breast cancer are higher after menopause than before menopause, which indicates that the risk increases with age (Heer et al., 2020). One of the major risk factors that expose menopausal women to breast cancer is age. In 2018, Heer et al. (2020) indicated the new breast cancer cases among postmenopausal women was 1.4 million, while about 645,000 cases were reported among premenopausal women globally.

The other risk factor is obesity, as obese older women are at a higher risk than those with normal weight. Mohanty and Mohanty (2019) suggested that postmenopausal obesity increases breast cancer risk since adipose tissue is a major reservoir for the biosynthesis of estrogen after menopause. Besides, physical activity at menopause also influences the breast cancer risk at menopause. Niehoff et al. (2019) established that women with a low activity level at menopause are more likely to be affected than those that are physically active.

Review of literature

Evidence-based interventions can be used to educate menopausal women and reduce the risk of developing breast cancer. Sauter (2018) recommended the Gail breast cancer risk assessment tool (BCRAT) as an effective tool for estimating the risk of getting breast cancer. The assessment tool can be useful as a breast cancer prevention strategy as women that are found to be at a higher risk of breast cancer can modify their lifestyles to avoid modifiable risk factors. Also, the knowledge of breast cancer risk can help menopausal women to get an early diagnosis, which is a major factor that determines the effectiveness of treatment.

Anastasi and Lusher (2019) stated that breast screening awareness influences the behaviors of women, increasing their likelihood to conduct breast self-examination and attend breast cancer screening when they identify any abnormalities on their breasts. There is a close association between breast cancer awareness and the uptake of screening services among women (Anastasi & Lusher, 2019). In another study, Pan et al. (2019) found that weight loss intervention can be used to reduce the cases of breast cancer in postmenopausal women. Weight loss is a lifestyle intervention that can be used to encourage women to modify their dietary intake to mitigate breast cancer risk.

Strength and weakness

Sauter (2018) reviewed current literature on the approaches that can be used in preventing breast cancer. The major strength of the article is that it provides evidence on various interventions that can be used in the primary prevention of breast cancer. The author used current evidence to support their ideas, which makes the source appropriate for use in evidence-based practice. The main weakness of the article is that it is not a primary source. Primary sources provide firsthand evidence collected from research.

Anastasi and Lusher (2019) explored the effectiveness of breast screening awareness on patients’ attendance in breast cancer screening. The major strength of the article is that it provides information about the effectiveness of an intervention that can be used as an intervention to prevent breast cancer. The article provides a systematic review of high-quality evidence from scholarly articles derived from leading British nursing databases. The main weakness of the article is that it does not provide adequate summaries of the articles reviewed. In the other study, Pan et al. (2019) examined the findings of two complementary studies that investigated the relationship between weight loss and dietary patterns on breast cancer outcomes in postmenopausal women. The strength of the source is that the studies reviewed were primary studies with relatively large samples, which enhances the reliability of the findings. The weakness of the source is inconsistent information, as the two studies reviewed had different hypotheses.

Framework for the proposal

The Stages of Change model is the most preferred framework for the proposed health promotion program as it describes how individuals integrate new behaviors (Liu et al., 2018). The model provides five stages through which individuals modify their behaviors. The first stage is pre-contemplation, in which individuals have no intention to alter their behaviors since they are unaware of their problems or are not committed to acting. In this stage, the target individuals will be provided with the information to influence them to develop the urge to modify their behaviors. The second stage is the contemplation stage, where individuals intend to act in the near future, probably the next six months, as they recognize the need for change. In this stage, the target menopausal women targeted by the proposed health promotion would be informed about the pros and cons of changing their behaviors.

In the third stage, the preparation stage, individuals are willing to act within the next thirty days. They begin to take the necessary steps towards the target behavioral change and believe that the change would have a positive health outcome. The fourth stage is action, where individuals modify their behaviors and are willing to take more steps forward with the behavior change. In this stage, the individuals would modify their existing behaviors or adopt new healthier behaviors and commit their time and energy towards the change. The last stage is maintenance, where people focus on ways to sustain the change and also prevent relapse. In this stage, menopausal women would be keen to utilize the knowledge they have gained from the health promotion program. The Stages of Change model allows the program organizers to understand that change does not occur instantly and individuals require time to change their behaviors (Liu et al., 2018).

MAP-IT stands

Breast cancer in menopausal patients is a high-risk factor in women. With this in mind, we are partnering with the Florida Health Department, Health People 2020 and CDC to ensure that our women are protected from health risks. In this partnership, we aim to ensure that women at a high risk of breast cancer are educated on detecting early signs of breast cancer. We aim to achieve this goal by heavily investing in patient education (Biglia, 2020).

With the partnerships onboard, the assessment will be done by a team of doctors to determine if the program is being excutd in an anticipated manner. After each week, a report will be sent to the partners (Biglia, 2020). The report will indicate the areas covered, how many patients returned positive cases of breast cancer and the stage of breast cancer on each patient who returned positive results.

The program will be planned effectively to ensure that the objectives will be effectively met. The first planning stage will set up teams that will move in their designated areas (Ohlschlegel, 2018). The teams will be required to do testing and provide patient education on the targeted patients. Each team will be required to provide a report used to write the final report to be sent to the partners.

A team from all the partners will do the implementation. The partners onboard will be required to provide two personnel who will represent them in the program (Ohlschlegel, 2018). The individuals from the different partners will be tasked with implementing the program and ensuring they meet the intended goals. The main responsibilities of the implementation team will be to provide resources and monitor the utilization of the resources within the duration of the program .

Tracking will assess how effective the plan is by impacting patient education (Lagord et.al, 2019). The program's main goal is to ensure that the targeted audience can identify the early signs of breast cancer and seek treatment. Frequent evaluation of the goal will ensure that the program achieves the intended goals and objectives.

SMART goal (of this project)

Menopausal patients will improve awareness about the risk for developing breast cancer during the three months after diagnosis through pedagogical (focus) groups

References

Anastasi, N., & Lusher, J. (2019). The impact of breast cancer awareness interventions on breast screening uptake among women in the United Kingdom: A systematic review. Journal of Health Psychology, 24(1), 113-124. https://doi.org/10.1177/1359105317697812

Biglia, N. (2020). Breast Cancer Service Accreditation Project. European Journal of Cancer, 50, 34–43. https://doi.org/10.1016/s0959-8049(14)70085-1

Ellington, T. D., Miller, J. W., Henley, S. J., Wilson, R. J., Wu, M., & Richardson, L. C. (2022). Trends in breast cancer incidence, by race, ethnicity, and age among women aged≥ 20 years—United States, 1999–2018. Morbidity and Mortality Weekly Report, 71(2), 43. http://dx.doi.org/10.15585/mmwr.mm7102a2

Heer, E., Harper, A., Escandor, N., Sung, H., McCormack, V., & Fidler-Benaoudia, M. M. (2020). Global burden and trends in premenopausal and postmenopausal breast cancer: a population-based study. The Lancet Global Health, 8(8), e1027-e1037. https://doi.org/10.1016/S2214-109X(20)30215-1

Lagord, C., Kearins, O., Lawrence, G., Bishop, H., Monypenny, I., & Bates, T. (2019). Breast cancer clinical outcome measures project: National results from Year 1. Breast Cancer Research, 8(S1), 22–28. https://doi.org/10.1186/bcr1483

Liu, K. T., Kueh, Y. C., Arifin, W. N., Kim, Y., & Kuan, G. (2018). Application of transtheoretical model on behavioral changes, and amount of physical activity among university’s students. Frontiers in Psychology, 2402. https://doi.org/10.3389/fpsyg.2018.02402

Mohanty, S. S., & Mohanty, P. K. (2019). Obesity as potential breast cancer risk factor for postmenopausal women. Genes & Diseases, 8(2), 117–123. https://doi.org/10.1016/j.gendis.2019.09.006

Momenimovahed, Z., & Salehiniya, H. (2019). Epidemiological characteristics of and risk factors for breast cancer in the world. Breast Cancer (Dove Medical Press), 11, 151–164. https://doi.org/10.2147/BCTT.S176070

Nabieva, N., Fehm, T., Haeberle, L., de Waal, J., Rezai, M., Baier, B., ... & Fasching, P. A. (2018). Influence of side-effects on early therapy persistence with letrozole in postmenopausal patients with early breast cancer: Results of the prospective EvAluate-TM study. European journal of cancer, 96, 82-90.

Niehoff, N. M., Nichols, H. B., Zhao, S., White, A. J., & Sandler, D. P. (2019). Adult physical activity and breast cancer risk in women with a family history of breast cancer. Cancer Epidemiology, Biomarkers & Prevention, 28(1), 51–58. https://doi.org/10.1158/1055-9965.EPI-18-0674

Ohlschlegel, J. (2018). Effectiveness of planned teaching program (PTP) on breast cancer among working women at selected colleges in Haridwar, Uttrakhand. International Journal of Science and Research (IJSR), 5(5), 1036–1040. https://doi.org/10.21275/v5i5.nov163493

Pan, K., Luo, J., Aragaki, A. K., & Chlebowski, R. T. (2019). Weight loss, diet composition and breast cancer incidence and outcome in postmenopausal women. Oncotarget, 10(33), 3088–3092. https://doi.org/10.18632/oncotarget.26864

Sauter, E. R. (2018). Breast cancer prevention: Current approaches and future directions. European Journal of Breast Health, 14(2), 64–71. https://doi.org/10.5152/ejbh.2018.3978

Shin, J. J., Choi, Y. M., Jun, J. K., Lee, K. H., Kim, T. Y., Han, W., & Im, S. A. (2019). Amenorrhea and menopause in patients with breast cancer after chemotherapy. Journal of breast cancer, 22(4), 624-634.

Sun, L., Zhu, Y., Qian, Q., & Tang, L. (2018). Body mass index and prognosis of breast cancer: An analysis by menstruation status when breast cancer diagnosis. Medicine, 97(26).

Trichopoulos, D., MacMahon, B., & Cole, P. (2021). Menopause and breast cancer risk. Journal of the National Cancer Institute, 48(3), 605-613.

Wang, C., Chen, C., Lin, Y., Zhou, Y., Mao, F., Zhu, H., ... & Sun, Q. (2020). Validation of CTS5 model in large-scale breast cancer population and the impact of menopausal and HER2 status on its prognostic value. Scientific reports, 10(1), 1-9.

Yeo, W., Pang, E., Liem, G. S., Suen, J. J., Ng, R. Y., Yip, C. C., ... & Mo, F. K. (2020). Menopausal symptoms in relationship to breast cancer-specific quality of life after adjuvant cytotoxic treatment in young breast cancer survivors. Health and quality of life outcomes, 18(1), 1-9.