Do ongoing lifestyle disruptions differ across cancer types after the conclusion of cancer treatment?
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Cancer interferes with participation in valued lifestyle activities (illness intrusiveness) throughout post-treatment survivorship. We investigated whether illness intrusiveness differs across life domains among survivors with diverse cancers. Intrusiveness should be highest in activities requiring physical/cognitive functioning (instrumental domain). Intrusiveness into relationship/sexual functioning (intimacy domain) should be higher in prostate, breast, and gastrointestinal cancers than in others.
Cancer outpatients (N = 656; 51% men) completed the Illness Intrusiveness Ratings Scale (IIRS) during follow-up. We compared IIRS Instrumental, Intimacy, and Relationships and Personal Development [RPD] subscale and total scores across gastrointestinal, lung, lymphoma, head and neck, prostate (men), and breast cancers (women), comparing men and women separately.
Instrumental subscale scores (Mmen = 3.05–3.80, Mwomen = 3.02–3.63) were highest for all groups, except prostate cancer. Men with prostate cancer scored higher on Intimacy (M = 3.40) than Instrumental (M = 2.48) or RPD (M = 1.59), p’s < .05; their Intimacy scores did not differ from men with gastrointestinal or lung cancer. Women collectively showed higher Instrumental (M = 3.39) than Intimacy (M = 2.49) or RPD scores (M = 2.27), p’s < .001, but not the hypothesized group difference in Intimacy.
Post-treatment survivors continue to experience some long-term interference with activities requiring physical and cognitive functioning. Sexual adjustment may be of special concern to men when treatments involve genitourinary functioning.
Implications for Cancer Survivors
Ongoing monitoring with the IIRS to detect lifestyle interference throughout survivorship may enhance quality of life. Screening and intervention should target particular life domains rather than global interference.
KeywordsCancer diagnosis Cancer survivorship Illness intrusiveness Psychosocial factors Quality of life
This research was supported by funding from the University Health Network (UHN) Quality Program, the Princess Margaret Hospital’s Department of Radiation Oncology, and the Princess Margaret Hospital’s Quality of Life Clinical Research Program. This research was also supported in part by the Canadian Institutes of Health Research (CIHR) through a post-doctoral fellowship to Kenneth Mah and a Senior Investigator Award to Gerald M. Devins. Thanks to Bev Devins and Wendy Maharaj for assistance in collecting the data. We extend our gratitude to the members of the UHN Psychosocial Oncology and Palliative Care Quality of Life Manuscript-Review Seminar for their invaluable feedback on earlier versions of this manuscript.
- 1.Lo C, Li M, Rodin G. The assessment and treatment of distress in cancer patients: overview and future directions. Minerva Psichiatr. 2008;49:129–43.Google Scholar
- 10.Devins GM. Illness intrusiveness and the psychosocial impact of lifestyle disruptions in chronic life-threatening disease. Adv Ren Repl Ther. 1994;1:251–63.Google Scholar
- 22.Devins GM, Stam HJ, Koopmans JP. Psychosocial impact of laryngectomy mediated by perceived stigma and illness intrusiveness. Can J Psychiatr. 1994;39:608–16.Google Scholar
- 49.Mah K, Bezjak A, Loblaw DA, Gotowiec A, Devins GM. Measurement invariance of the Illness Intrusiveness Ratings Scale’s 3-factor structure in men and women with cancer. Rehabil Psychol. 2010; accepted for publication.Google Scholar
- 50.Nunnally JC. Psychometric theory. 2nd ed. New York: McGraw-Hill; 1978.Google Scholar
- 64.Breukink SO, Wouda JC, van der Werf-Eldering M, van de Wiel HBM, Bouma EMC, Pierie JP, et al. Psychophysiological assessment of sexual function in women after radiotherapy and total mesorectal excision for rectal cancer: a pilot study on four patients. J Sex Med. 2009;6:1045–53.CrossRefPubMedGoogle Scholar
- 66.Rosenthal R, Rosnow RL. The volunteer subject. New York: Wiley; 1975.Google Scholar