Exploring the psychological impacts of a gestational cancer diagnosis on women: a literature review.

Abstract

Background 1 in 1000 women are diagnosed with gestational cancer in the UK, of these the greatest number being breast cancer diagnoses. The rate of gestational cancer is expected to increase due to women choosing to becoming pregnant later in life. Aims To explore the experiences of women with a gestational cancer diagnosis identify how the support provided to them by the multidisciplinary team can be enhanced. Method Systematic literature review using Medline, CINAHL Complete and Complementary Index. Inclusion and exclusion criteria applied. Critical Appraisal tool (CASP) used to score appropriate literature. Seven pieces of literature selected for in-depth analysis (4 qualitative and 3 quantitative). Thematic analysis completed and developed within academic and peer supervision. Findings Three themes were identified: ‘time pressures and decision-making, balanced with concerns for the health and wellbeing of the baby and self’; ‘fears about parenting’ and ‘the influence of support’. Within all themes, the distress was most commonly caused by poor or inconsistent communication between health professionals, that left women feeling disempowered and anxious about decision-making. Conclusion Three themes were identified: ‘time pressures and decision-making, balanced with concerns for the health and wellbeing of the baby and self’; ‘fears about parenting’ and ‘the influence of support’. Within all themes, the distress was most commonly caused by poor or inconsistent communication between health professionals, that left women feeling disempowered and anxious about decision-making. Conclusion Women diagnosed with gestational cancer have unique support needs arising from receipt of a devastating diagnosis at what should be a happy time. The experience of being under the care of two discrete teams can result in uncertainty and distress when inconsistent messages about treatment are given. Support can be significantly enhanced by having a named midwife who attends all multidisciplinary team meetings about the woman, who can assess for distress and who can signpost psychosocial support systems, based on the individual woman’s needs.