Adjusting to life after treatment: distress and quality of life following treatment for breast cancer

Abstract

Clinical and anecdotal findings suggest that the completion of cancer treatment may be marked by heightened distress and disrupted adjustment. The present study examined psychological adjustment during the 3 months following treatment among 89 women with stages 0-III breast cancer. Participants completed measures of depression, cancer-related anxiety, cancer concerns, and quality of life at three time points: during treatment, 3 weeks following the end of treatment, and 3 months post-treatment. Post-treatment scores were suggestive of good psychological adjustment among the majority of women. Moreover, distress did not increase following treatment; longitudinal analyses showed no significant changes in depression or recurrence worry, while intrusive thoughts decreased, and quality of life improved. Younger age predicted greater distress across measures. A history of depression or anxiety predicted greater depressive symptomatology, while more extensive treatment predicted greater cancer-related anxiety. Despite the lack of distress endorsed on general depression and anxiety indices, participants reported moderate distress associated with cancer-related concerns, including physical problems, fear of cancer recurrence, and resuming normal life. In sum, while breast cancer survivors demonstrate good adjustment on general distress indices following treatment, some women are at risk for sustained distress. Moreover, significant cancer-related concerns are prevalent and may be important intervention targets.

Figure 1

Age predicts intrusion, F(1,76)=12.12, P=0.001. Age is illustrated by quartiles.

Figure 2

Education predicts intrusion, F(3,77)=6.77, P<0.001.

Figure 3

Psychiatric history predicts depression, F(1,80)=4.12, P=0.046, and the trajectory of depression over time, F(2,143)=3.50, P=0.033.

Figure 4

Adjuvant treatment predicts intrusion, F(1,81)=6.71, P=0.011.