© 2004 by Oxford University Press
© 2004 Oxford University Press
ARTICLE |
Quality of Life at the End of Primary Treatment of Breast Cancer: First Results From the Moving Beyond Cancer Randomized Trial
Affiliations of authors: Schools of Medicine and Public Health (PAG, TRB), Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center (PAG, LK, ALS), Department of Psychology (ALS), Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, and Cousins Center for Psychoneuroimmunology, Neuropsychiatric Institute (ALS, JEB), University of California at Los Angeles, Los Angeles, CA; Department of Psychiatry, Georgetown University Medical Center, Washington, DC (JLK); Office of Cancer Survivorship, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (JHR); Department of Psychology, University of Southern California, Los Angeles (BEM).
Correspondence to: Patricia A. Ganz, MD, Division of Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Rm. A2-125 CHS, Box 956900, Los Angeles, CA 90095-6900 (e-mail: pganz{at}ucla.edu)
Background: During the last decade, survival rates for breast cancer have increased as a result of earlier detection and increased use of adjuvant therapy. Limited data exist on the psychosocial aspects of the transitional period between the end of primary treatment and survivorship. We investigated the baseline psychosocial status of women enrolled in a randomized trial testing two psychosocial interventions for women at the end of primary treatment. Methods: Participants, identified within 1 month after surgery (registration), provided demographic information and limited measures of quality of life. They were followed until they finished primary treatment (enrollment), at which time they completed a mailed baseline survey that included standardized measures of quality of life (including standardized scales of physical and emotional functioning), mood, symptoms, and sexual functioning. A total of 558 patients (mean age = 56.9 years) were enrolled in the study between July 1, 1999, and June 30, 2002. Health outcomes were examined according to treatment received: mastectomy with and without chemotherapy, and lumpectomy with and without chemotherapy. All statistical tests were two-sided. Results: Among all treatment groups, patients who had a mastectomy had the poorest physical functioning at registration (P<.001) and at enrollment (P= .05). At enrollment, mood and emotional functioning were similar among all patients, with no differences by type of treatment received. At enrollment, symptoms, including muscle stiffness, breast sensitivity, aches and pains, tendency to take naps, and difficulty concentrating, were common among patients in all groups and were statistically significantly associated with poor physical functioning and emotional well-being. Sexual functioning was worse for women who received chemotherapy than for those who did not, regardless of type of surgery (P<.001). Conclusions: At the end of primary treatment for breast cancer, women in all treatment groups report good emotional functioning but report decreased physical functioning, particularly among women who have a mastectomy or receive chemotherapy. Clinical interventions to address common symptoms associated with treatment should be considered to improve physical and emotional functioning at the end of primary treatment for breast cancer.
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