Skip to main content

Advertisement

SpringerLink
Log in

Understanding benefit finding among patients with colorectal cancer: a longitudinal study

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Perceiving positive life changes (“benefit finding”) is thought to promote better adjustment after cancer, yet is poorly understood among colorectal cancer (CRC) patients. We characterized benefit finding and examined its relationship to demographic/medical factors, change over time, and association with distress.

Methods

CRC outpatients (N = 133, 50% metastatic) completed self-report measures (demographic/medical factors, benefit finding, distress) at baseline and 6 months later. Wilcoxon rank-sum (Kruskal-Wallis) tests or Spearman correlations tested associations between benefit finding and demographic/medical factors. Linear regressions assessed (1) change in benefit finding over time and whether this differed by demographic/medical factors, and (2) association between benefit finding and distress and whether this changed over time.

Results

Benefit finding was common among patients with CRC, with highest rated items reflecting gratitude, acceptance, and stronger family relationships. Women and racial minorities reported greater benefit finding than men (p < 0.001) and White patients (p = 0.015), respectively. Medical factors (e.g., metastatic disease) were not associated with benefit finding. Benefit finding significantly increased over time (p = 0.03). While greater benefit finding trended towards an association with lower distress, results were not statistically significant and the relationship did not change over time.

Conclusion

Benefit finding was characterized largely by perceived psychological and social benefits, as opposed to pragmatic benefits. Individual differences and social determinants may be more informative than medical characteristics when it comes to benefit finding; although, cultural factors and mediators should be examined further. Benefit finding seems to evolve over time perhaps as a coping process; however, its association with psychological distress appears tenuous.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The data supporting the findings are available from the corresponding author upon reasonable request.

References

  1. Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin 68(1):7–30. https://doi.org/10.3322/caac.21442

    Article  PubMed  Google Scholar 

  2. Sprangers MAG, Taal BG, Aaronson NK, te Velde A (1995) Quality of life in colorectal cancer. Dis Colon Rectum 38(4):361–369. https://doi.org/10.1007/bf02054222

    Article  PubMed  CAS  Google Scholar 

  3. Mosher CE, Winger JG, Given BA, Helft PR, O’Neil BH (2016) Mental health outcomes during colorectal cancer survivorship: a review of the literature. Psychooncology 25(11):1261–1270. https://doi.org/10.1002/pon.3954

    Article  PubMed  Google Scholar 

  4. Dunn J, Ng SK, Holland J, Aitken J, Youl P, Baade PD, Chambers SK (2013) Trajectories of psychological distress after colorectal cancer. Psychooncology 22(8):1759–1765. https://doi.org/10.1002/pon.3210

    Article  PubMed  Google Scholar 

  5. Tomich PL, Helgeson VS (2004) Is finding something good in the bad always good? Benefit finding among women with breast cancer. Health Psychol 23(1):16–23. https://doi.org/10.1037/0278-6133.23.1.16

    Article  PubMed  Google Scholar 

  6. Casellas-Grau A, Ochoa C, Ruini C (2017) Psychological and clinical correlates of posttraumatic growth in cancer: a systematic and critical review. Psychooncology 26(12):2007–2018. https://doi.org/10.1002/pon.4426

    Article  PubMed  Google Scholar 

  7. Shapiro JP, McCue K, Heyman EN, Dey T, Haller HS (2010) Coping-related variables associated with individual differences in adjustment to cancer. J Psychosoc Oncol 28(1):1–22. https://doi.org/10.1080/07347330903438883

    Article  PubMed  Google Scholar 

  8. Shand LK, Cowlishaw S, Brooker JE, Burney S, Ricciardelli LA (2015) Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis. Psychooncology 24(6):624–634. https://doi.org/10.1002/pon.3719

    Article  PubMed  Google Scholar 

  9. Occhipinti S, Chambers SK, Lepore S, Aitken J, Dunn J (2015) A longitudinal study of post-traumatic growth and psychological distress in colorectal cancer survivors. PLoS One 10(9):e0139119. https://doi.org/10.1371/journal.pone.0139119

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Jansen L, Hoffmeister M, Chang-Claude J, Brenner H, Arndt V (2011) Benefit finding and post-traumatic growth in long-term colorectal cancer survivors: prevalence, determinants, and associations with quality of life. Br J Cancer 105(8):1158–1165. https://doi.org/10.1038/bjc.2011.335

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Rinaldis M, Pakenham KI, Lynch BM (2010) Relationships between quality of life and finding benefits in a diagnosis of colorectal cancer. British journal of psychology (London, England : 1953) 101(Pt 2):259–275. https://doi.org/10.1348/000712609x448676

    Article  Google Scholar 

  12. Salsman JM, Segerstrom SC, Brechting EH, Carlson CR, Andrykowski MA (2009) Posttraumatic growth and PTSD symptomatology among colorectal cancer survivors: a 3-month longitudinal examination of cognitive processing. Psychooncology 18(1):30–41. https://doi.org/10.1002/pon.1367

    Article  PubMed  PubMed Central  Google Scholar 

  13. Kinsinger DP, Penedo FJ, Antoni MH, Dahn JR, Lechner S, Schneiderman N (2006) Psychosocial and sociodemographic correlates of benefit-finding in men treated for localized prostate cancer. Psychooncology 15(11):954–961. https://doi.org/10.1002/pon.1028

    Article  PubMed  Google Scholar 

  14. Bellizzi KM, Smith AW, Reeve BB, Alfano CM, Bernstein L, Meeske K, Baumgartner KB, Ballard-Barbash RR (2010) Posttraumatic growth and health-related quality of life in a racially diverse cohort of breast cancer survivors. J Health Psychol 15(4):615–626. https://doi.org/10.1177/1359105309356364

    Article  PubMed  Google Scholar 

  15. Rinaldis M, Pakenham KI, Lynch BM (2012) A structural model of the relationships among stress, coping, benefit-finding and quality of life in persons diagnosed with colorectal cancer. Psychol Health 27(2):159–177. https://doi.org/10.1080/08870441003768047

    Article  PubMed  Google Scholar 

  16. Jayawickreme E, Blackie LE (2014) Post-traumatic growth as positive personality change: evidence, controversies and future directions. Eur J Personal 28(4):312–331

    Article  Google Scholar 

  17. Park CL, Lechner SC, Antoni MH, Stanton AL (2009) Medical illness and positive life change: can crisis lead to personal transformation? American Psychological Association

  18. Helgeson VS, Reynolds KA, Tomich PL (2006) A meta-analytic review of benefit finding and growth. J Consult Clin Psychol 74(5):797–816. https://doi.org/10.1037/0022-006X.74.5.797

    Article  PubMed  Google Scholar 

  19. Barskova T, Oesterreich R (2009) Post-traumatic growth in people living with a serious medical condition and its relations to physical and mental health: a systematic review. Disabil Rehabil 31(21):1709–1733. https://doi.org/10.1080/09638280902738441

    Article  Google Scholar 

  20. Marziliano A, Tuman M, Moyer A (2019) The relationship between post-traumatic stress and post-traumatic growth in cancer patients and survivors: a systematic review and meta-analysis. Psychooncology. 29:604–616. https://doi.org/10.1002/pon.5314

    Article  Google Scholar 

  21. Reese JB, Handorf E, Haythornthwaite JA (2018) Sexual quality of life, body image distress, and psychosocial outcomes in colorectal cancer: a longitudinal study. Support Care Cancer:1–10

  22. Reese JB, Shelby RA, Keefe FJ, Porter LS, Abernethy AP (2010) Sexual concerns in cancer patients: a comparison of GI and breast cancer patients. Support Care Cancer 18(9):1179–1189. https://doi.org/10.1007/s00520-009-0738-8

    Article  PubMed  Google Scholar 

  23. Reese JB, Shelby RA, Abernethy AP (2011) Sexual concerns in lung cancer patients: an examination of predictors and moderating effects of age and gender. Support Care Cancer 19(1):161–165. https://doi.org/10.1007/s00520-010-1000-0

    Article  PubMed  Google Scholar 

  24. Tomich PL, Helgeson VS, Nowak Vache EJ (2005) Perceived growth and decline following breast cancer: a comparison to age-matched controls 5-years later. Psychooncology 14(12):1018–1029. https://doi.org/10.1002/pon.914

    Article  PubMed  Google Scholar 

  25. Tomich PL, Helgeson VS (2006) Cognitive adaptation theory and breast cancer recurrence: are there limits? J Consult Clin Psychol 74(5):980–987. https://doi.org/10.1037/0022-006x.74.5.980

    Article  PubMed  Google Scholar 

  26. Shacham S (1983) A shortened version of the profile of mood states. J Pers Assess 47(3):305–306

    Article  CAS  Google Scholar 

  27. Curran SL, Andrykowski MA, Studts JL (1995) Short form of the profile of mood states (POMS-SF): psychometric information. Psychol Assess 7(1):80–83

    Article  Google Scholar 

  28. Baker F, Denniston M, Zabora J, Polland A, Dudley WN (2002) A POMS short form for cancer patients: psychometric and structural evaluation. Psycho-Oncology 11(4):273–281

    Article  Google Scholar 

  29. Buuren SV, Groothuis-Oudshoorn K (2010) Mice: multivariate imputation by chained equations in R. Journal of statistical software:1–68

  30. Tedeschi RG, Calhoun LG (2004) Posttraumatic growth: conceptual foundations and empirical evidence. Psychol Inq 15(1):1–18. https://doi.org/10.1207/s15327965pli1501_01

    Article  Google Scholar 

  31. Adorno G, Lopez E, Burg MA, Loerzel V, Killian M, Dailey AB, Iennaco JD, Wallace C, Sharma DKB, Stein K (2018) Positive aspects of having had cancer: a mixed-methods analysis of responses from the American Cancer Society study of Cancer survivors-II (SCS-II). Psychooncology 27(5):1412–1425. https://doi.org/10.1002/pon.4484

    Article  PubMed  Google Scholar 

  32. Thornton AA (2002) Perceiving benefits in the cancer experience. J Clin Psychol Med Settings 9(2):153–165. https://doi.org/10.1023/a:1014996127535

    Article  Google Scholar 

  33. Stanton AL, Bower JE, Low CA (2006) Posttraumatic growth after cancer. Handbook of posttraumatic growth: Research and practice:138–175

  34. Conley CC, Small BJ, Christie J, Hoogland AI, Augusto BM, Garcia JD, Pal T, Vadaparampil ST (2020) Patterns and covariates of benefit finding in young black breast cancer survivors: a longitudinal, observational study. Psycho-Oncology n/a (n/a) 29:1115–1122. https://doi.org/10.1002/pon.5398

    Article  Google Scholar 

  35. Urcuyo KR, Boyers AE, Carver CS, Antoni MH (2005) Finding benefit in breast cancer: relations with personality, coping, and concurrent well-being. Psychol Health 20(2):175–192

    Article  Google Scholar 

  36. Taylor SE (1983) Adjustment to threatening events: a theory of cognitive adaptation. Am Psychol 38(11):1161–1173

    Article  Google Scholar 

  37. Lechner SC, Zakowski SG, Antoni MH, Greenhawt M, Block K, Block P (2003) Do sociodemographic and disease-related variables influence benefit-finding in cancer patients? Psychooncology 12(5):491–499. https://doi.org/10.1002/pon.671

    Article  PubMed  Google Scholar 

  38. Park CL, Folkman S (1997) Meaning in the context of stress and coping. Rev Gen Psychol 1(2):115–144

    Article  Google Scholar 

  39. Hoffman CJ, Ersser SJ, Hopkinson JB, Nicholls PG, Harrington JE, Thomas PW (2012) Effectiveness of mindfulness-based stress reduction in mood, breast- and endocrine-related quality of life, and well-being in stage 0 to III breast cancer: a randomized, controlled trial. J Clin Oncol 30(12):1335–1342. https://doi.org/10.1200/jco.2010.34.0331

    Article  PubMed  Google Scholar 

  40. Carlson LE, Ursuliak Z, Goodey E, Angen M, Speca M (2001) The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients: 6-month follow-up. Support Care Cancer 9(2):112–123

    Article  CAS  Google Scholar 

  41. Sawyer A, Ayers S, Field AP (2010) Posttraumatic growth and adjustment among individuals with cancer or HIV/AIDS: a meta-analysis. Clin Psychol Rev 30(4):436–447. https://doi.org/10.1016/j.cpr.2010.02.004

    Article  PubMed  PubMed Central  Google Scholar 

  42. Camacho AA, Garland SN, Martopullo C, Pelletier G (2014) Positive and negative meanings are simultaneously ascribed to colorectal cancer: relationship to quality of life and psychosocial adjustment. Palliative & supportive care 12(4):277–286. https://doi.org/10.1017/s1478951513000151

    Article  Google Scholar 

  43. Hart SL, Vella L, Mohr DC (2008) Relationships among depressive symptoms, benefit-finding, optimism, and positive affect in multiple sclerosis patients after psychotherapy for depression. Health Psychol 27(2):230–238. https://doi.org/10.1037/0278-6133.27.2.230

    Article  PubMed  PubMed Central  Google Scholar 

  44. Zoellner T, Maercker A (2006) Posttraumatic growth in clinical psychology—a critical review and introduction of a two component model. Clin Psychol Rev 26(5):626–653

    Article  Google Scholar 

  45. Antoni MH, Lehman JM, Kilbourn KM, Boyers AE, Culver JL, Alferi SM, Yount SE, McGregor BA, Arena PL, Harris SD, Price AA, Carver CS (2001) Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychol 20(1):20–32. https://doi.org/10.1037/0278-6133.20.1.20

    Article  PubMed  CAS  Google Scholar 

  46. Garland SN, Carlson LE, Cook S, Lansdell L, Speca M (2007) A non-randomized comparison of mindfulness-based stress reduction and healing arts programs for facilitating post-traumatic growth and spirituality in cancer outpatients. Support Care Cancer 15(8):949–961. https://doi.org/10.1007/s00520-007-0280-5

    Article  PubMed  Google Scholar 

  47. Vranceanu A-M, Merker VL, Plotkin SR, Park ER (2014) The relaxation response resiliency program (3RP) in patients with neurofibromatosis 1, neurofibromatosis 2, and schwannomatosis: results from a pilot study. J Neuro-Oncol 120(1):103–109. https://doi.org/10.1007/s11060-014-1522-2

    Article  Google Scholar 

  48. Stanton AL, Danoff-Burg S, Sworowski LA, Collins CA, Branstetter AD, Rodriguez-Hanley A, Kirk SB, Austenfeld JL (2002) Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. J Clin Oncol 20(20):4160–4168

    Article  Google Scholar 

  49. Milbury K, Engle R, Tsao A, Liao Z, Owens A, Chaoul A, Bruera E, Cohen L (2018) Pilot testing of a brief couple-based mind-body intervention for patients with metastatic non-small cell lung cancer and their partners. J Pain Symptom Manag 55(3):953–961. https://doi.org/10.1016/j.jpainsymman.2017.11.027

    Article  Google Scholar 

  50. Otto AK, Szczesny EC, Soriano EC, Laurenceau JP, Siegel SD (2016) Effects of a randomized gratitude intervention on death-related fear of recurrence in breast cancer survivors. Health Psychol 35(12):1320–1328. https://doi.org/10.1037/hea0000400

    Article  PubMed  PubMed Central  Google Scholar 

  51. Milbury K, Tsao AS, Liao Z, Owns A, Engle R, Gonzalez EA, Bruera E, Cohen L (2018) A research protocol for a pilot randomized controlled trial designed to examine the feasibility of a couple-based mind-body intervention for patients with metastatic lung cancer and their partners. Pilot Feasibility Stud 4:37. https://doi.org/10.1186/s40814-018-0231-6

    Article  PubMed  PubMed Central  Google Scholar 

  52. Hu Y, Liu T, Li F (2019) Association between dyadic interventions and outcomes in cancer patients: a meta-analysis. Support Care Cancer 27(3):745–761. https://doi.org/10.1007/s00520-018-4556-8

    Article  PubMed  Google Scholar 

Download references

Funding

This study was supported by the American Cancer Society (PF-09-154-01-CPPB) and the National Cancer Institute (P30CA006927, 2 T32-CA-009035).

Author information

Authors and Affiliations

  1. Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA

    Lauren A. Zimmaro, Mengying Deng, Elizabeth Handorf, Carolyn Y. Fang & Jennifer B. Reese

  2. Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA

    Crystal S. Denlinger

  3. Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA

    Jennifer B. Reese

Authors
  1. Lauren A. Zimmaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mengying Deng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elizabeth Handorf
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carolyn Y. Fang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Crystal S. Denlinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jennifer B. Reese
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lauren A. Zimmaro.

Ethics declarations

Conflict of interest

Dr. Denlinger received honoraria from Taiho Oncology, Eli Lilly & Co, Exelixis, and Astellas. She has received institutional grant support from Agios Pharmaceuticals, Amgen, Array BioPharma, BeiGene, Bristol Myer Squibb, Astra Zeneca, Sanofi Aventis, Macrogenics, Zymeworks, and Lycera. The other authors have no conflicts of interest to disclose.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zimmaro, L.A., Deng, M., Handorf, E. et al. Understanding benefit finding among patients with colorectal cancer: a longitudinal study. Support Care Cancer 29, 2355–2362 (2021). https://doi.org/10.1007/s00520-020-05758-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-020-05758-6

Keywords

Search

Navigation