Breast cancer survivors: Psychosocial concerns and quality of life
- 1k Downloads
To describe the psychosocial concerns and quality of life of breast cancer survivors evaluated 2 and 3 years after primary treatment.
A sample of 139 breast cancer survivors who had been interviewed during the first year after primary treatment participated in a mailed survey at 2 years (N = 69) and 3 years (N = 70) after initial surgery. A random sample of these survivors were also interviewed in person. The mailed questionnaire included standardized instruments to assess quality of life (QL), rehabilitation needs, and psychological distress. Additional survey questions were developed to examine post-surgical recovery, employment and insurance problems. social support, and existential concerns. The in-person interviews expanded on these questions and systematically compared these patients' rehabilitation needs to those which existed at the time of an interview 1 year after surgery.
The 2 and 3 year participants in this follow-up study did not differ from each other on their prior assessments with standardized QL instruments during the first year after surgery, nor did they differ from the full study sample of 227 women. The scores on the Profile of Mood States and the Functional Living Index-Cancer were the same for the 2 and 3 year survivor groups and did not differ from the previous assessments at 1 year after initial treatment. The scores on the Cancer Rehabilitation Evaluation System showed a significant decline in Global Quality of Life, Sexual Functioning and Marital Functioning between the 1 year and 3 year evaluations. For the 2 year sample only Sexual Functioning showed a deterioration between the 1 and 2 year evaluations. Using the RAND 36-Item Health Survey 1.0, the breast cancer survivors were compared with patients from the Medical Outcomes Study. The breast cancer survivors demonstrated higher levels of functioning in many dimensions (role functioning, social functioning, pain, and general health) than the patients with chronic medical conditions. In spite of relatively good physical and emotional functioning on this generic measure of health status and quality of life, these breast cancer survivors reported a number of important and severe rehabilitation problems that persisted beyond one year after primary treatment. Especially frequent were problems associated with physical and recreational activities, body image, sexual interest, sexual function, and problems with dating for those who were single.
Breast cancer survivors appear to attain maximum recovery from the physical and psychological trauma of cancer treatment by one year after surgery. A number of aspects of QL and rehabilitation problems worsen after that time. Nevertheless, breast cancer survivors rate their QL more favorably than outpatients with other common medical conditions, and they identify many positive aspects from the cancer experience.
Key wordsbreast cancer quality of life rehabilitation sexual functioning
Unable to display preview. Download preview PDF.
- 1.Boring CC, Squires TS, Tong T, Montgomery S: Cancer Statistics, 1994. CA-Cancer Journal for Clinicians 44: 7–26, 1994Google Scholar
- 2.Ganz PA for the ASCO Committee on Patient Advocacy: The physician as the patient's advocate. J Clin Oncol 11: 1011–1013, 1993Google Scholar
- 3.Leventhal BG, Shearer PD: Recognizing and managing the late effects of cancer treatment. Oncology 3(5): 73–84, 1989Google Scholar
- 9.Ganz PA, Schag CAC, Lee JJ, Polinsky ML, Tan S-J: Breast conservation versus mastectomy: Is there a difference in psychological adjustment or quality of life in the year after surgery? Cancer 68: 1729–1738, 1992Google Scholar
- 12.Ganz PA, Rofessart J, Polinsky ML, Schag CC, Heinrich RL: A comprehensive approach to the assessment of cancer patients' rehabilitation needs: The cancer inventory of problem situations and a companion interview. J Psychosocial Oncol 4: 27–42, 1986Google Scholar
- 13.Collins MS: Distinguishing among the attributions of causality, responsibility, and blame, including the effects of each on adjustment to a victimizing event. Doctoral Dissertation, University of California, Los Angeles, 1990Google Scholar
- 14.Taylor SE, Wayment H, Collins MS: Positive illusions and affect regulation. In: Wegner DM, Oennebaker JW (eds) Handbook of Mental Control, Prentice Hall, Englewood Cliffs, NJ, 1993, pp 325–343Google Scholar
- 19.Schipper H, Clinch J, McMurray A, Levitt M: Measuring the quality of life of cancer patients: The functional living index-cancer: Development and validation. J Clin Oncol 2: 472–483, 1984Google Scholar
- 23.Stewart AL, Ware JE (eds): Measuring function and well-being. The Medical Outcomes Study Approach. Duke University Press, Durham, 1992Google Scholar
- 24.McNair PM, Lorr M, Droppelman L: EITS manual for the profile of mood states. Educational and Industrial Testing Service, San Diego, CA, 1971/1981Google Scholar
- 25.Cassileth BR, Lusk EJ, Brown LL, Cross P: Psychosocial status of cancer patients and next of kin: Normative data from the profile of mood states. J Psychosoc Oncol 3: 99–105, 1985Google Scholar
- 26.Cella DF, Tross S, Orav EJ, Holland JC, Silberfarb PM, Ralfa S: Mood states of patients after the diagnosis of cancer. J Psychosoc Oncol 7: 45–54, 1989Google Scholar
- 28.Polinsky ML: Functional status of long-term breast cancer survivors: Demonstrating chronicity. Health and Social Work 19: 165–173, 1994Google Scholar
- 29.Schover LR: The impact of breast cancer on sexuality, body image, and intimate relationships. CA-A Journal for Clinicians 41(2): 112–120, 1991Google Scholar
- 30.Kaplan HS: A neglected issue: The sexual side effects of current treatment for breast cancer. J Sex and Marital Therapy 18: 3–19, 1992Google Scholar