Surviving Recurrence: Coping with the First and Second
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Series/Report no.:2015 Edward F. Hayes Graduate Research Forum. 29th
Objective: Of the 230,000 annual cases of breast cancer, 20% of patients will recur at least once. There are no data examining psychological responses to 2nd recurrence. Available data point to differences between initial diagnosis and 1st recurrence, with patients with recurrence having lower functional status and reporting more pain, fatigue and relationship problems (Frost et al., 2000; Northouse et al., 2002; Sarenmalm, Öhlén, Odén, & Gaston-Johansson, 2008). Data documenting patients’ psychological responses to initial and 1st and 2nd recurrence breast cancer diagnoses is provided. Methods: Breast cancer patients (N=215) newly diagnosed with initial disease (n=90), or a 1st (n=108) or 2nd recurrence (n=17) were assessed at diagnosis and 4 months later. Measures of stress (IES), mood (POMS), quality of life (QoL; SF-36), sexual satisfaction (SEX), and nurse-rated Karnofsky Performance Status (KPS) were used. Linear regressions tested whether (1) recurrence status (none, 1st, 2nd), (2) time (baseline, 4 months), and (3) the interaction (recurrence status by time) predicted psychological outcomes. Results: All patients had reduced cancer stress, reduced negative mood, and improved mental QoL, but poorer physical QoL by 4 months (all ps<.05). Recurrence status significantly predicted lower SEX and lower KPS across time points (ps<.01). Across time, SEX and KPS were highest for initial diagnosis (SEX:M=4.4, KPS:M=86, respectively), middling for 1st recurrence (SEX:M=3.4, KPS:M=75), and lowest for 2nd recurrence patients (SEX:M=3.0, KPS:M=73). Conclusions: New data is provided showing that 2nd recurrence patients report lower sexual satisfaction and nurse rated performance status, but the level and change in their other psychological/QoL responses were comparable to those of other diagnosis groups. These data suggest that existing interventions to reduce stress and enhance coping might be applicable for all newly diagnosed patients, with any alterations focused on the unique problem areas within a group.
Poster Division: Arts, Humanities, and Social Sciences: 1st Place (The Ohio State University Edward F. Hayes Graduate Research Forum)
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