• Reference Number: HEY1254/2021
• Departments: Oncology (Cancer Services)
• Last Updated: 13 October 2021

Introduction

This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

Why have I been referred to a psychologist?

A psychological consultation gives you an opportunity to discuss a range of issues affecting your decision-making, explore any concerns you have, any anxieties, and the psychological challenges of risk-reducing breast surgery. It gives you a chance to think about your motivation for surgery and your feelings and expectations regarding the outcome. The psychologist’s role is to talk through all this with you, identify potential support or additional information that may be required, and to support you in achieving the best possible surgical adjustment. 

What are the benefits of talking through the decision-making process?

The psychologist acts as a ‘sounding board’ to help you with the process of decision making. They will help you explore and understand your options, motivations, expectations, and your emotional, social, and physical wellbeing. Because it can sometimes be difficult talking with a partner or family member, this appointment will give you an opportunity to discuss these issues with somebody who is unbiased to the situation. This can help you feel more confident in your decision and the choices you make for yourself based on your wants. 

What role does the psychologist play in this process?

The psychologist you are seeing specialises in helping people with physical health concerns and is part of the cancer team. They are here to support you and to help make your decision, experience, and recovery as easy as possible. They are not here to challenge your decision. It is their job to make sure that you have thoroughly considered your decision and that it is the best option for you. They can also help you think about how you prepare for surgery and recovery, any support you may need, and decisions about reconstruction. 

What can I expect to happen at my appointment?

Your consultation will last approximately one hour, but you may be asked to attend further sessions. You may also be asked to complete some questionnaires when attending your appointment. The psychologist will use these, along with information gathered during the consultation to help outline the best course of action for your specific case. You do not have to have made your decision already. The session is a chance for you to think about what is best for you. The following are topics likely to be discussed:

• Reasons for wanting surgery
• Understanding of procedure
• Body image and intimacy
• Family and support from others
• Expectations after surgery
• Well-being
• Weighing up the pros and cons
• Feedback, recommendations and next steps 

What happens after my appointment?

Following the appointment, the psychologist will write a brief summary of any issues discussed and any recommendations. This letter will be sent to your consultant, you can also receive a copy of this letter if you would like and it can be sent to anybody else you think it would benefit. This letter may include recommendations to the surgical team regarding your suitability for surgery from a psychological perspective, areas of discussion in your next surgical appointment or a recommendation to delay surgery so that further assessment or support can be conducted. If further sessions have been jointly felt beneficial, the psychologist will be in touch regarding those appointments.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Cancer Psychological Service (01482) 461060 / 461061

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.