Uniwersyteckie Czasopisma NaukoweAdjuvant vs. neoadjuvant chemotherapy: quality of life and psychosocial variables in women with breast cancer
Słowa kluczowe:
cancer, treatments, well-being, health careAbstrakt
Background
A breast cancer diagnosis with all that it entails is a highly stressful moment for women. Chemotherapy is one of the main treatments for this type of cancer, and it also brings several side effects and physical changes that often lead to emotional distress and adjustment difficulties. This study aims to analyse the quality of life and psychosocial variables in women with breast cancer submitted to different chemotherapy procedures.
Participants and procedure
We used a convenience sample of 50 women with breast cancer submitted to adjuvant or neoadjuvant chemotherapy. Women were interviewed after obtaining their informed consent. The instruments used were: a sociodemographic and clinical questionnaire, Functional Assessment of Cancer Therapy–Breast, Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being–12-Item, Positive and Negative Affect Schedule, and Brief Resilient Coping Scale.
Results
Participants demonstrated reasonable levels of all dimensions analysed, except for resilient coping, which was relatively low. Neither treatment significantly improves quality of life or any other psychosocial variable more than the other. Most of the variables were correlated, especially quality of life.
Conclusions
The results show that the choice of treatment according to the most favourable objective criteria (e.g., stage, patients’ characteristics) and multidisciplinary work with the integration of a psychologist are vital to achieve good outcomes and the best possible quality of life. Interesting insights were obtained, such as the need for health literacy to make informed decisions and the variation of needs during the cancer course. Future research could use a longitudinal approach and a more representative sample.
Downloads
Bibliografia
Al-Ghabeesh, S. H., Al-Kalaldah, M., Rayan, A., Al-Rifai, A., & Halaiqa, F. (2019). Psychological distress and quality of life among Jordanian women diagnosed with breast cancer: The role of trait mindfulness. European Journal of Cancer Care, 28, e13082. https://doi.org/10.1111/ecc.13082.
Bayram, Z., Durna, Z., & Akin, S. (2014). Quality of life during chemotherapy and satisfaction with nursing care in Turkish breast cancer patients. European Journal of Cancer Care, 23, 675–684. https://doi.org/10.1111/ecc.12185.
Beaver, K., Williamson, S., & Briggs, J. (2016). Exploring patient experiences of neo-adjuvant chemotherapy for breast cancer. European Journal of Oncology Nursing, 20, 77–86. https://doi.org/10.1016/j.ejon.2015.06.001.
Boinon, D., Sultan, S., Charles, C., Stulz, A., Guillemeau, C., Delaloge, S., & Dauchy, S. (2014). Changes in psychological adjustment over the course of treatment for breast cancer: The predictive role of social sharing and social support. Psycho-Oncology, 23, 291–298. https://doi.org/10.1002/pon.3420.
Brady, M. J., Cella, D. F., Bonomi, A. E., Tulsky, D. S., Lloyd, S. R., Deasy, S., Cobleigh, M., & Shiomoto, G. (1997). Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-oflife instrument. Journal of Clinical Oncology, 15, 974–986. https://doi.org/10.1200/jco.1997.15.3.974.
Brown, J. L., Sheffield, D., Leary, M. R., & Robinson, M. E. (2003). Social support and experimental pain. Psychosomatic Medicine, 65, 276–283. https:// doi.org/10.1097/01.PSY.0000030388.62434.46.
Cella, D. F., Tulsky, D. S., Gray, G., Sarafian, B., Linn, E., Bonomi, A., Silberman, M., Yellen, S. B., Winicour, P., Brannon, J., Eckberg, K., Lloyd, S., Purl, S., Blendowski, C., Goodman, M., Barnicle, M., Stewart, I., McHale, M., Bonomi, P., … Harris, J. (1993). The functional assessment of cancer therapy scale: Development and validation of the general measure. Journal of Clinical Oncology, 11, 570–579. https://doi.org/10.1200/JCO.1993.11.3.570.
Cerezo, M. V., Blanca, M. J., & Ferragut, M. (2020). Personality profiles and psychological adjustment in breast cancer patients. International Journal of Environment Research and Public Health, 17, 9452. https://doi.org/10.3390/ijerph17249452.
Chatters, L. M., Taylor, R. J., & Lincoln, K. D. (1999). African American religious participation: a multisample comparison. Journal for the Scientific Study of Religion, 38, 132–145. https://doi.org/10.2307/1387589.
Coelho, R. C., Panobianco, M. S., Guimarães, P. R., Maftum, M. A., Santos, P. N., & Kalinke, L. P. (2017). Tratamento quimioterápico adjuvante e neoadjuvante e as implicações na qualidade de vida mulheres com câncer de mama [Adjuvant and neoadjuvant chemotherapy and the implications for quality of life in women with breast cancer]. Revista de Enfermagem UFPE Online, 11, 4732–4740.
Costa, M. P. (2010). Qualidade de vida, espiritualidade e seus correlatos em mulheres com cancro da mama [Quality of life, spirituality and its correlates in women with breast cancer] (Master’s thesis). Fernando Pessoa University. Retrieved from https://bdigital.ufp.pt/handle/10284/1203.
Dooley, L. N., Slavich, G. M., Moreno, P. I., & Bower, J. E. (2017). Strength through adversity: Moderate lifetime stress exposure is associated with psychological resilience in breast cancer survivors. Stress Health, 33, 549–557. https://doi.org/10.1002/smi.2739.
Fitchett, G., Peterman, A. H., & Cella, D. F. (1996, October). Spiritual beliefs and quality of life in cancer and HIV patients. Paper presented at World Congress of Psycho-Oncology, New York.
Galinha, I. C., & Pais-Ribeiro, J. L. (2005). Contribuição para o estudo da versão portuguesa da Positive and Negative Affect Schedule (PANAS): II – Estudo psicométrico [Contribution to the study of the Portuguese version of the Positive and Negative Affect Schedule (PANAS): II – Psychometric study]. Análise Psicológica, 23, 219–227. https://doi.org/10.14417/ap.84.
Hu, J., & Gruber, K. J. (2008). Positive and negative affect and health functioning indicators among older adults with chronic illnesses. Issues in Mental Health Nursing, 29, 895–911. https://doi.org/10.1080/01612840802182938.
Huang, Y., Huang, Y., Bao, M., Zheng, S., Du, T., & Wu, K. (2019). Psychological resilience of women after breast cancer surgery: a cross-sectional study of associated influencing factors. Psychology, Health & Medicine, 24, 866–878. https://doi.org/ 10.1080/13548506.2019.1574353.
Karimi, F., Shandiz, F., Abdollahi, M., & Andaran, Z. (2020). Investigating functional and symptom scales of quality of life and its effective factors among patients with breast cancer during chemotherapy. Middle East Journal of Cancer, 11, 209–215. https://doi.org/10.30476/mejc.2019.78686.0.
Knobf, M. T. (2007). Psychosocial responses in breast cancer survivors. Seminars on Oncology Nursing, 23, 71–83. https://doi.org/10.1016/j.soncn.2006.11.009.
Kreitler, S. (2019). Psycho-oncology for the clinician: The patient behind the disease. Springer.
Kross, E., Berman, M. G., Mischel, W., Smith, E. E., & Wager, T. D. (2011). Social rejection shares somatosensory representations with physical pain. Proceedings of the National Academy of Sciences, 108, 6270–6275. https://doi.org/10.1073/pnas.1102 693108.
Kumar, C. R., & Parashar, N. (2015). Death anxiety, coping and spirituality among cancer patients. Indian Journal of Positive Psychology, 6, 291–294.
Macía, P., Barranco, M., Gorbeña, S., & Iraurgi, I. (2020). Expression of resilience, coping and quality of life in people with cancer. PLoS One, 15, e0236572. https://doi.org/10.1371/journal.pone.0236572.
Manning-Walsh, J. (2005). Social support as a mediator between symptom distress and quality of life in women with breast cancer. Journal of Obstetric, Gynecologic & Neonatal Nursing, 34, 482–493. https://doi.org/10.1177/0884217505278310.
Meiser, B., Quinn, V. F., Mitchell, G., Tucker, K., Watts, K. J., Rahman, B., Peat, M., Saunders, C., Geelhoed, E., Gleeson, M., Barlow-Stewart, K., Field, M., Harris, M., Antill, Y. C., Susman, R., Bowen, M. T., Mills, L., & Kirk, J. (2018). Psychological outcomes and surgical decisions after genetic testing in women newly diagnosed with breast cancer with and without a family history. European Journal of Human Genetics, 26, 972–983. https://doi.org/10.1038/s41431-017-0057-3.
Milbury, K., Kavanagh, A., Meng, Z., Chen, Z., Chandwani, K. D., Garcia, K., Perkins, G. H., McQuade, J., Raghuram, N. V., Nagarathna, R., Liao, Z., Nagendra, H. R., Chen, J., Guo, X., Liu, L., Arun, B., & Cohen, L. (2017). Depressive symptoms and positive affect in Chinese and United States breast cancer survivors: a cross-cultural comparison. Support Care Center, 25, 2103–2109. https://doi.org/10.1007/s00520-017-3612-0.
Mohlin, A., Bendahl, P., Hegardt, C., Richter, C., Hallberg, I. R., & Rydén, L. (2021). Psychological resilience and health-related quality of life in 418 Swedish women with primary breast cancer: Results from a prospective longitudinal study. Cancers, 13, 2233. https://doi.org/10.3390/cancers13092233.
Paris, A. R., Camacho, S. P., & Alcedo, J. M. (2014). Esperanza, bienestar subjetivo y psicológico en pacientes en tratamiento y sobrevivientes al cáncer de mama [Hope, subjective and psychological wellbeing of patients in treatment and breast cancer survivor]. Revista Latinoamericana de Psicología Positiva, 2, 33–45.
Pessoa, E. C., Rodrigues, J. R., Michelin, O., Luca, H., Kamiya, C. P., Traiman, P., & Uemura, G. (2007). Avaliação da resposta à quimioterapia primária em amostra de mulheres brasileiras com tumores de mama localmente avançados [Evaluation of response to primary chemotherapy in Brazilian patients with locally advanced breast cancer]. Revista Brasileira de Ginecologia e Obstetrícia, 29, 18–26. https://doi.org/10.1590/S0100-72032007000100004.
Peterman, A. H., Fitchett, G., Brady, M. J., Hernandez, L., & Cella, D. (2002). Measuring spiritual well -being in people with cancer: The Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp). Annals of Behavioral Medicine, 24, 49–58. https://doi.org/10.1207/s15324796abm2401_06.
Purnell, J. Q., & Andersen, B. L. (2009). Religious practice and spirituality in the psychological adjustment of survivors of breast cancer. Counseling and Values, 53, 165–182. https://doi.org/10.1002/j.2161-007X.2009.tb00123.x.
Rabin, C., Rogers, M. L., Pinto, B. M., Nash, J. M., Frierson, G. M., & Trask, P. C. (2007). Effect of personal cancer history and family cancer history on levels of psychological distress. Social Science & Medicine, 64, 411–416. https://doi.org/10.1016/j.socscimed.2006.09.004.
Reich, J. W., Zautra, A. J., & Davis, M. (2003). Dimensions of affect relationships: Models and their integrative implications. Review of General Psychology, 7, 66–83. https://doi.org/10.1037/1089-2680.7.1.66.
Ribeiro, J. L. (1999). Escala de satisfação com o suporte social (ESSS) [Social Support Satisfaction Scale]. Análise Psicológica, 17, 547–558.
Ribeiro, J. L., & Morais, R. (2010). Adaptação portuguesa da Escala Breve de Coping Resiliente [The Portuguese adaptation of the Brief Resilient Coping Scale]. Psicologia, Saúde & Doenças, 11, 5–13.
Silva, S., Bettencourt, D., Moreira, H., & Canavarro, M. C. (2011). Qualidade de vida de mulheres com cancro da mama nas diversas fases da doença: O papel de variáveis sociodemográficas, clínicas e das estratégias de coping enquanto factores de risco/protecção [Quality of life of women with breast cancer at different phases of the disease: The role of sociodemographic, clinical variables and coping strategies as factors of risk/protection]. Revista Portuguesa de Saúde Pública, 29, 64–76. https://doi.org/10.1016/S0870-9025(11)70009-8.
Simão, M. J., & Saldanha, V. (2012). Resiliência e psicologia transpessoal: Fortalecimento de valores, ações e espiritualidade [Resilience and transpersonal psychology: Enhancing values, action and spirituality]. O Mundo da Saúde, 36, 291–302. https://doi.org/10.15343/0104-78092012362291302.
Sinclair, V. G., & Wallston, K. A. (2004). The development and psychometric evaluation of the Brief Resilient Coping Scale. Assessment, 11, 94–101. https://doi.org/10.1177/1073191103258144.
Sousa, H., Guerra, M., & Lencastre, L. (2015). Preditores da qualidade de vida numa amostra de mulheres com cancro da mama [Quality of life predictors in a sample of women with breast cancer]. Análise Psicológica, 33, 39–53. https://doi.org/10.14417/ap.832.
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063– 1070. https://doi.org/10.1037//0022-3514.54.6.1063.
Wevers, M. R., Schou-Bredal, I., Verhoef, S., Bleiker, E. M., Hahn, D. E., Brouwer, T., Kieffer, J. M., Ausems, M. G., & Aaronson, N. K. (2020). Psychological distress in newly diagnosed breast cancer patients: an observational study comparing those at high risk of hereditary cancer with those of unknown risk. Journal of Psychosocial Oncology Research and Practice, 2, e18. https://doi.org/10.1097/OR9.0000000000000018.
Wink, P., & Dillon, M. (2002). Spiritual development across the adult life course: Findings from a longitudinal study. Journal of Adult Development, 9, 79–94. https://doi.org/10.1023/A:1013833419122.
Zdenkowski, N., Butow, P., Spillane, A., Douglas, C., Snook, K., Jones, M., Oldmeadow, C., Fewster, S., Beckmore, C., & Boyle, F. M. (2019). Patient-reported outcomes with neoadjuvant vs. adjuvant systemic therapy for operable breast cancer. The Breast, 46, 25–31. https://doi.org/10.1016/j.breast.2019.04.003.
Zhang, H., Zhao, Q., Cao, P., & Ren, G. (2017). Resilience and quality of life: Exploring the mediator role of social support in patients with breast cancer. Medical Science Monitor, 23, 5969–5979. https://doi.org/10.12659/MSM.907730.
