Psychosocial Palliative Care in ICU for a Metastatic Breast Cancer: A Case Report

Abstract

Introduction: Palliative care does not always mean an active
treatment but maybe in the form of counseling and psychosocial
support. We present a case of metastatic breast cancer where
the psychosocial principle of palliative care was applied.
Case History: A 20-year-old breast cancer patient was
treated with surgery, radiotherapy, and chemotherapy before
it metastasized to lung and liver. The disease was slowly
progressing, and she was deteriorating symptomatically in
terms of breathlessness. The father of the patient informed
about the marriage of her younger daughter after one week and
was not able to take care of the elder daughter (patient). We
assured him to help during admission while he may continue
his preparations for the marriage. The patient had developed
pleural effusion for which she was treated by pulmonologist by
tapping the pleural fluid. One day before the marriage of her
younger sister, the condition of the patient started deteriorating.
On phone consultation and the consent, we shifted the patient
in ICU. It was a very difficult decision for a father to take care of
both her daughters at the same time. We counseled the father
and brother not to worry and assured them all logistic help
during the duration of stay in the hospital while he may continue
his preparations for the marriage of his younger daughter. The
patient expired on the day of marriage, and the father was
humbly informed about the bad news. The patient was kept in
mortuary. The father approached the hospital authorities after
two days to collect the body of his daughter. The father and son
were very grateful about the help that they received from the
institute, our team of doctors and paramedical staff.
Conclusion: In the terminal phase of cancer, we need to
approach patients as a family physician rather than treating
oncologist.