Preventing delirium in metastatic breast cancer patients

Women with breast cancer often have additional physical and psychological stresses to cope with during their treatment, many of which are preventable. For example, two thirds of those who are hospitalised with advanced metastatic breast cancer will have a delirium episode at some point during a stay in hospital.

Delirium is a serious medical condition affecting the brain, which results in confused thinking and reduced awareness of environment. It also impacts the ability to communicate at a critical time when being mentally aware and interacting with loved ones is crucial for quality of life.

Women with advanced metastatic breast cancer are at higher risk of delirium due to medical problems such as changes in blood levels of calcium or oxygen, infections, and the side effects of their medications. Each year it is estimated that at least 2000 women with advanced breast cancer experienced delirium before their death during a hospital stay. Delirium is reversible in only half of cases and there is no medication to effectively treat its symptoms.

Delirium is one of the most significant medical complications for those in the final stages of breast cancer. It has serious adverse consequences: it is highly distressing to experience for the person themselves and to witness as a family member, it increases the risk of complication in hospital such as falls, reduced independence and function and cognitive capacity, and is associated with longer hospital stays, higher health care costs and a high mortality rate.

The good news is that delirium is preventable in many cases and recent research has shown that incidences of delirium in older hospitalised adults can be reduced by up to 50 per cent. Additional data is needed specifically for the women with advanced metastatic breast cancer which takes into account other factors such as fatigue and/or limited mobility.

NBCF-funded Professor Meera Agar and her team will run a trial to collect data on the benefits of methods to avoid delirium episodes. These methods include ensuring they get enough sleep, enhancing physical function, maximising hydration and nutrition and making sure patients are not isolated from sounds and senses which help to keep them grounded.

Professor Agar’s research program aims to reduce the incidence of delirium in women with advanced metastatic breast cancer by 50 per cent, a change which would mean a significant improvement to their quality and length of life.