Fax: (614) 688-8261
Surviving recurrence: Psychological and quality-of-life recovery
Version of Record online: 5 FEB 2008
Copyright © 2008 American Cancer Society
Volume 112, Issue 5, pages 1178–1187, March 2008
How to Cite
Yang, H.-C., Thornton, L. M., Shapiro, C. L. and Andersen, B. L. (2008), Surviving recurrence: Psychological and quality-of-life recovery. Cancer, 112: 1178–1187. doi: 10.1002/cncr.23272
- Issue online: 19 FEB 2008
- Version of Record online: 5 FEB 2008
- Manuscript Accepted: 28 SEP 2007
- Manuscript Revised: 28 AUG 2007
- Manuscript Received: 4 JUN 2007
- American Cancer Society. Grant Number: PBR-89
- Longaberger Company-American Cancer Society Grant for Breast Cancer Research. Grant Numbers: PBR-89A, RSGPB-03-248-01-PBP
- U.S. Army Medical Research Acquisition Activity Grants. Grant Numbers: DAMD17-94-J-4165, DAMD17-96-1-6294, DAMD17-97-1-7062
- National Institute of Mental Health. Grant Number: R01MH51487
- National Cancer Institute. Grant Numbers: R01-CA92704, KO5-CA098133, P30-CA16058
- psychological stress;
- quality of life;
- functional status;
To the authors' knowledge, data characterizing patients' psychosocial experiences after a recurrence diagnosis are limited. This report provides the physical, psychological, and quality-of-life trajectories of patients with recurrent breast cancer. In addition, patients with a well–documented trajectory—patients with their initial diagnosis of breast cancer—were included as a referent group, providing a metric against which to gauge the impact and course of cancer recurrence.
Patients with a newly diagnosed, recurrent (n = 69) or initial (n = 113) breast cancer were accrued. The groups did not differ with regard to age, race, education, family income, or partner status (all P values > .18). All patients were assessed shortly after diagnosis (baseline) and 4 months, 8 months, and 12 months later. Mixed-effects models were used to determine health status, stress, mood, and quality-of-life trajectories.
In the year after a recurrence diagnosis, patients' physical health and functioning showed no improvement, whereas quality of life and mood generally improved, and stress declined. Compared with patients who were coping with their first diagnosis, patients with recurrence had significantly lower anxiety and confusion. In contrast, physical functioning was poorer among recurrence patients, quality-of-life improvement was slower, and cancer-related distress was high as that of the initially diagnosed patient. Slower quality-of-life recovery was most apparent among younger patients (aged <54 years).
Despite the physical burden, patients with recurrent breast cancer exhibit considerable resilience, with steady improvements in psychological adjustment and quality of life during the year after diagnosis. Management of patients' physical symptoms is particularly important, because patients cope with recurrent breast cancer as a chronic illness. Cancer 2008. © 2008 American Cancer Society.