NOTE: This embargo has been lifted early. The original embargo date was March 2 at 4 PM Eastern Time, U.S.
Immediately after primary treatment for breast cancer, most women have a normal level of general mental health, but they tend to have a broad range of physical symptoms that are particularly pronounced in women who had mastectomies or underwent chemotherapy, according to a study in the March 3 issue of the Journal of the National Cancer Institute.
There have been many studies of the physical and emotional experiences of women newly diagnosed with breast cancer, and in recent years several studies have examined the experiences of long-term cancer survivors. However, there is little information available on the experiences of women in the transitional period between treatment and survivorship, when they must move beyond cancer to reestablish normal life patterns. Information from earlier studies suggest that this can be a stressful time period: Women have reported that their fear of recurrence increases, they miss ready access to the health care system, they may have lingering side effects of therapy, and they often feel uncertain about what to expect after treatment.
"In general, oncology clinicians prepare women for the acute toxicities of breast cancer treatments, … but clinicians have had only limited data on the physical and psychosocial sequelae of primary treatments," writes lead author Patricia A. Ganz, M.D., of the University of California at Los Angeles Jonsson Comprehensive Cancer Center, and colleagues. "Indeed, little is known about the pattern of recovery after the end of treatment."
To address this issue, Ganz and her colleagues collected information on the health status and quality of life of 558 women who had just had surgery for breast cancer. After the women completed their treatment, they were sent surveys to assess their quality of life, mood, symptoms, and sexual functioning. The investigators analyzed the results as a whole and by type of treatment--mastectomy plus chemotherapy, lumpectomy plus chemotherapy, mastectomy without chemotherapy, and lumpectomy without chemotherapy. Women who received chemotherapy had a much longer treatment duration than women who did not--roughly 7 to 8 months versus 2 to 4 months, respectively.
The researchers found that mood and emotional functioning were similar among all women at the end of their primary treatment, with little evidence of a depressed mood or negative affect. Women who had mastectomies reported the poorest physical functioning, both immediately following surgery and at the end of primary treatment. Sexual functioning was worse for women who received chemotherapy than for those who did not, regardless of the type of surgery. A wide variety of physical symptoms were reported in all treatment groups, such as hot flashes, night sweats, aches and pains, and vaginal dryness.
"It is clear that more attention must be paid to the symptoms that women report at the end of treatment because they are associated with poorer physical and emotional well-being," the authors write. The authors will continue to gather information on this group of women, who were enrolled in a multisite randomized trial of two behavioral interventions designed to prepare women for recovery after primary breast cancer treatment.
Source: Eurekalert & othersLast reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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