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First day of radiotherapy for women with breast cancer: predictors of anxiety

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Abstract

Purpose

Radiotherapy treatment may generate anxiety, especially on the first day of treatment. This study aimed to identify potential predictors of radiotherapy-related anxiety in women  with breast cancer before treatment initiation, in terms of treatment concerns and trait anxiety.

Methods

This transversal study included 94 patients from one Radiation Oncology Department, who had been diagnosed with primary breast cancer and who had been prescribed external radiotherapy for the first time. Patients completed a Treatment Concerns Questionnaire and the State-Trait Anxiety Inventory (STAI) before the  first treatment session.

Results

Women identified radiation involved in the procedure and treatment efficacy as major concerns surrounding radiotherapy. No significant differences were found between patients with higher and lower state anxiety scores, or by age, level of education, cancer treatment protocol used, prior information given about treatment, or report of doubts before treatment initiation. In the final model, the combination of trait anxiety (49.1% of the total variance) with two treatment-related concerns, regarding radiation and the duration of treatment (plus 10.8% of the total variance), significantly predicted treatment-related anxiety experienced on the first day of treatment.

Conclusion

Our findings highlight the need to identify women with moderate or higher levels of trait anxiety before radiotherapy initiation and to provide them with a more approach to personalized care, adjusted to their specific concerns and susceptibility to anxious reactions. Effective education sessions involving the discussion of specific treatment concerns, and anxiety coping strategies training should be developed and applied in initial interactions with breast cancer patients.

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Funding

This project has been partially supported by CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal (Ref.ª UID/PSI/04527/2019).

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Authors and Affiliations

  1. ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal

    Ana M. Grilo, Ana I. Gomes, Daniel Albino & Cláudio Augusto

  2. CICPSI, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013, Lisbon, Portugal

    Ana M. Grilo & Ana I. Gomes

  3. H&TRC- Centro de Investigação em Saúde e Tecnologia, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096, Lisbon, Portugal

    Fátima Monsanto

  4. Unidade de Radioterapia, Hospital CUF Descobertas, R. Mário Botas, Parque das Nações, 1998-018, Lisbon, Portugal

    Catarina Pragana

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  1. Ana M. Grilo
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Correspondence to Ana M. Grilo.

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Grilo, A.M., Gomes, A.I., Monsanto, F. et al. First day of radiotherapy for women with breast cancer: predictors of anxiety. Support Care Cancer 28, 1241–1248 (2020). https://doi.org/10.1007/s00520-019-04902-1

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