Contrary to psychologists’ expectations, breast cancer survivors don’t experience an extended emotional crisis after their treatment regimens end, according to a recent study by researchers at the School of Medicine.
The study was published in a recent issue of Supportive Care in Cancer.
“We thought we’d find that women do worse psychologically after treatment,” said Teresa L. Deshields, Ph.D., assistant professor of medicine and manager of psycho-oncology services at the Siteman Cancer Center. “That’s the clinical lore. After all, many of the patients referred to us are the ones struggling at the end of treatment.
“But our study shows that within two weeks most women adjust very well to survivorship.”
The research team surveyed 94 women drawn from patients of the radiation oncology practice at Siteman. The women, averaging 55 years of age, had stage 0, I, II or III breast cancer and at the start of the study were completing the last of a six- to seven-week course of daily radiation treatments.
Researchers surveyed the women five times: on their last day of radiation treatment, two weeks later, 4-6 weeks after their treatment, and at three and six months. The survey measured patients’ depressive symptoms and quality of life, a set of attributes that include physical, social/family, emotional and functional well-being and breast cancer-specific concerns.
For the group of breast cancer survivors, the average score for indications of depression was higher at the end of treatment, indicating more severe depressive symptoms, compared with a group of healthy men and women.
The measure of depressive symptoms dropped significantly after treatment, reaching a low two weeks later and staying fairly stable to the six-month time point.
The average quality-of-life score for the breast cancer survivors was low at the end of treatment when tested using a scale that captures important breast-cancer-specific issues. Lower scores indicate worse quality of life.
The average patient’s score rose significantly over the survey period. At the two-week mark, the average quality-of-life score for these breast cancer survivors was near the average score of a control group that consisted of other breast cancer patients and reached and then exceeded that number at the time of follow-up and later times.
“Previous studies had never looked at breast cancer survivors so soon after treatment, and we were surprised that most improvement happened so quickly,” Deshields said. “There’s a concept called resiliency, the notion that people can withstand a lot and come through fine. Our largest patient group by far was these resilient patients who never experienced clinically significant depressive symptoms.”
Deshields said oncologists can reassure patients at the end of treatment that their quality of life will improve quickly and any depressive feelings are likely to dissipate soon. However, while most patients do bounce back after treatment, the study also found a small group stayed depressed.
“When treatment ends, suddenly patients are let go — that’s very hard for some people,” Deshields said. “Often patients try to reintegrate into their usual lives. Inevitably, they find that life is different — they can’t go back to where they were before treatment. They have to find a new normal.”