scholarly journals Trajectories of adjustment disorder symptoms in post-treatment breast cancer survivors

Author(s):  
Lonneke M. A. Wijnhoven ◽  
José A. E. Custers ◽  
Linda Kwakkenbos ◽  
Judith B. Prins

Abstract Objective Breast cancer survivors (BCS) may experience problems to adjust to their situation after cancer treatment completion. In case of severe distress, an adjustment disorder (AD) might develop. This study investigates the course of AD symptoms during 1 year and its predictors in BCS up to 5 years post-treatment. Methods BCS completed the Hospital Anxiety and Depression Scale (HADS) at baseline, 3, 6, and 12 months. HADS total scores were defined as no mental disorder (MD) symptoms (≤ 10), AD symptoms (11–14), and any other MD symptoms (≥ 15). Over the course of four assessments, symptom trajectories were a priori defined as no MD symptoms, AD symptoms, fluctuating AD symptoms below and above cut-offs, or any other MD symptoms. Complementary, latent class growth analysis (LCGA) was used to identify data-driven trajectories. Results Among 293 BCS with complete data, the majority was classified as no MD symptoms (54.4%), followed by 37.5% in the fluctuating AD symptoms trajectory. Only 1.4% had AD symptoms, and 6.8% had any other MD symptoms. With LCGA (N = 459), three trajectories were found: stable no MD symptoms (58.6%), stable AD symptoms (32.9%), and high increasing any other MD symptoms (8.5%). Compared to BCS with no MD symptoms, BCS with fluctuating AD symptoms or any other MD symptoms were younger, less able to handle daily activities, and showed more social support discrepancy, neuroticism, and less optimism. Conclusions Results of our study showed that AD symptoms in BCS up to 5 years post-treatment fluctuate over 1 year. It is thus important to appropriately assess AD over the course of 5 years post-treatment as AD symptoms can fluctuate.

2021 ◽  
Vol 12 (1) ◽  
pp. 013-019
Author(s):  
Mary NB Cheung ◽  
Wings Tjing Yung Loo

Purpose: To investigate the effect of Tai Chi Chuan (TCC) to improve immune system and decrease pro-metastasis markers in early post-treatment breast cancer survivors. Methods: 130 post-treatment breast cancer survivors were recruited and randomized 1:1 into TCC group and wait-list (control) group. The TCC group practiced for a 60-minutes session once per week, for a total of 52 weeks. 115 forms of Yang-style TCC were taught by a Tai Chi master. Blood samples were taken from each subject and complete blood count was performed. The expressions of NKG2D protein, P-selectin, and vascular endothelial growth factor (VEGF) in plasma were measured. Lymphocyte activity was measured by cell proliferation reagent and ATP assay. Images of lymphocyte colony formation were taken with an inverted microscope. Results: At 52 weeks, TCC group demonstrated a significantly higher WBC (p=0.001) , a significantly higher NKG2D value (p=0.001) and a significantly lower VEGF value (p=0.005) when compared to the wait-list group. However, there was a small, non-significant change for P-selectin values between the breast cancer survivor groups. After 72h incubation, TCC group had a significant increase in lymphocyte proliferation (p=0.001) and greater area of lymphocyte clusters or colonies (p=0.001). Conclusion: The practice of TCC could stimulate tumor immunosurveillance via NKG2D and activate the immune response. VEGF, a marker playing an important role in breast cancer and its metastases, was also reduced in those who practiced TCC. As an alternative for conventional exercise, post-treatment breast cancer survivors may select TCC in their rehabilitation program.


2009 ◽  
Vol 118 (2) ◽  
pp. 395-405 ◽  
Author(s):  
Neela Guha ◽  
Marilyn L. Kwan ◽  
Charles P. Quesenberry ◽  
Erin K. Weltzien ◽  
Adrienne L. Castillo ◽  
...  

2021 ◽  
pp. 1-6
Author(s):  
Danbee Kang ◽  
Nayeon Kim ◽  
Gayeon Han ◽  
Sooyeon Kim ◽  
Hoyoung Kim ◽  
...  

Abstract Objective This study aims to identify factors associated with divorce following breast cancer diagnosis and measures the impact of divorce on the quality of life (QoL) of patients. Methods We used cross-sectional survey data collected at breast cancer outpatient clinics in South Korea from November 2018 to April 2019. Adult breast cancer survivors who completed active treatment without any cancer recurrence at the time of the survey (N = 4,366) were included. The participants were classified into two groups: “maintaining marriage” and “being divorced,” between at the survey and at the cancer diagnosis. We performed logistic regression and linear regression to identify the factors associated with divorce after cancer diagnosis and to compare the QoL of divorced and nondivorced survivors. Results Approximately 11.1/1,000 of married breast cancer survivors experienced divorce after cancer diagnosis. Younger age, lower education, and being employed at diagnosis were associated with divorce. Being divorced survivors had significantly lower QoL (Coefficient [Coef] = −7.50; 95% CI = −13.63, −1.36), social functioning (Coef = −9.47; 95% CI = −16.36, −2.57), and body image (Coef = −8.34; 95% CI = −6.29, −0.39) than survivors who remained married. They also experienced more symptoms including pain, insomnia, financial difficulties, and distress due to hair loss. Conclusion Identifying risk factors of divorce will ultimately help ascertain the resources necessary for early intervention.


2019 ◽  
Vol 3 (s1) ◽  
pp. 1-1
Author(s):  
Tamar Demby ◽  
G. William Rebeck ◽  
Christopher Albanese ◽  
Olga C. Rodriguez ◽  
Yichien Lee ◽  
...  

OBJECTIVES/SPECIFIC AIMS: Chemotherapy-related cognitive impairment (CRCI) affects 15-35% of breast cancer survivors and constitutes a significant challenge for survivor quality of life. Among older breast cancer survivors who received chemotherapy treatment, carriers of at least one ɛ4 allele of the APOE gene, which encodes apolipoprotein E, are at higher risk for developing CRCI than non-carriers. APOE4 is well characterized as the strongest genetic risk factor for Alzheimer’s disease, but how it contributes to CRCI is not yet understood, and no animal models of APOE genotype and CRCI have yet been established. To better understand how APOE4 acts as a risk factor for CRCI, we used APOE targeted replacement (TR) mice to develop a model of its effects on cognition following treatment with doxorubicin, a chemotherapy drug commonly used in breast cancer treatment. METHODS/STUDY POPULATION: Twelve-to-thirteen month old APOE3 and APOE4 targeted replacement mice expressing human APOE3 or human APOE4 under control of the endogenous murine promoter were treated with 10 mg/kg doxorubicin or equivolume saline given via two IP injections spaced one week apart. One week post-treatment, mice were tested using Open Field and Elevated Zero apparatuses to assess baseline locomotive activity and anxiety and exploratory behaviors. Five weeks post-treatment, mice were assessed using the Barnes Maze over four days of training trials and one 72 hour memory probe. RESULTS/ANTICIPATED RESULTS: We found no differences in Open Field and Elevated Zero behavior, indicating limited influence of doxorubicin treatment on locomotive and anxiety behaviors in both genotypes. During Barnes Maze training, APOE4 mice treated with doxorubicin showed increased latency compared to untreated APOE4 mice as well as treated and untreated APOE3 mice, indicating deficiencies in spatial learning. In APOE3 mice, no differences in performance were seen between doxorubicin-treated and untreated mice (n = 15-16/group, p <.0001). DISCUSSION/SIGNIFICANCE OF IMPACT: These results indicate that APOE4 targeted replacement mice have specific cognitive vulnerabilities to doxorubicin treatment that can be reliably detected using the Barnes Maze assessment. Future directions include experiments to determine how other chemotherapy drugs or drug combinations impact cognition of APOE4 mice. Ultimately this model may be used to assess preventive measures or therapies for CRCI in the vulnerable APOE4 carrier population with the ability to validate cognitive impacts of these interventions.


2018 ◽  
Vol 25 (4) ◽  
Author(s):  
S. Singh-Carlson ◽  
F. Wong ◽  
G. Oshan

Background This paper focuses on phase iii of a study evaluating the development and implementation of a survivorship care plan (scp) that could ultimately improve post-treatment quality of life for South Asian (sa) breast cancer survivors (bcss). Evaluating the utility of the scp was important to understand how sociocultural influences might affect uptake of the scp by sa bcss, especially as they transition from treatment to community care.Methods Post-treatment discharge planning using an individualized scp at discharge for sa female breast cancer patients with stage i or ii disease was offered as a pilot service to oncologists at BC Cancer’s Fraser Valley and Abbotsford centres. A longitudinal study using a mixed-methods approach was used to evaluate the utility of that service at 1 year after discharge.Results Participants (n = 16) completed a survey about their scp delivery experience, and a 1-year post implementation survey about the scp content and its utility. Most participants reported the discharge appointments to be extremely or very helpful with respect to post-treatment care questions. All have visited their family physicians for follow-up as recommended. The three major sources of support were family, faith, and family physician. Qualitative responses from the health care professionals who developed or implemented the scps identified two challenges in scp delivery: engaging patients or family members in relationship, and translating key information through interpreters.Conclusions It is important to evaluate the utility of scps for sa female survivors, who might differ from the general bcs population because of a different understanding of the disease; language barriers; strong influence of family members; societal stigmas; and personal, social, cultural, and religious beliefs and values. A formal nurse-led discharge appointment with discussions about follow-up care and an individualized scp outlining the short- and long-term effects of treatment are recommended. Particular attention has to be paid to the practical and psychosocial needs of sa bcss and their supporting family members.


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