A Closer Look at Unmet Needs at the End of Primary Treatment for Breast Cancer: A Longitudinal Pilot Study

Abstract

This study describes the nature of unmet needs (UN) as women with breast cancer transition from “patient” to “survivor.” Data are from a longitudinal study of 90 women with stage I-III breast cancer. Data were collected 2–3 weeks before, and 10 weeks after, completion of radiation. A modified Cancer Survivors’ Unmet Needs (CaSUN) instrument measured UN. Most participants reported ≥1 unmet need at baseline (80.00%) and follow-up (69.31%), with UN across physical, healthcare, information, psychosocial, and survivorship domains. Total number of UN declined over time (t(87)=3.00, p<.01). UN likely to persist from baseline to follow-up involved cancer recurrence concerns, stress management, household responsibilities, and others not acknowledging/understanding cancer. Younger women (p=.01) and those with more severe (p<.01), life-interfering (p=.01) symptoms had greater burden of UN. This study highlights the dynamics of UN in the weeks before and after primary treatment. Future studies should identify long-term consequences of persistent UN.

Breast cancer survivors' perceived medical communication competence and satisfaction with care at the end of treatment

“…Overall, psychological distress was strongly associated with information needs, which confirms the importance of meeting information needs for BCS' well‐being . In addition, being younger predicted higher information needs, which is consistent with other studies in BCS . Younger BC women generally use more active coping and thus may more actively seek medical information.…”

“…BCS information needs significantly decreased over 8 months after treatment completion ( p < 0.001) as observed in previous studies with similar BCS . However, as also observed in these studies, specific information needs were still prevalent at follow‐up.…”

Patient‐reported outcome measures among breast cancer survivors: A cross‐sectional comparison between Malaysia and high‐income countries

“…Patient reported outcomes (PROs) refers to any response that is collected directly from patients using various methods and instruments . Cross‐sectional studies in predominantly high‐income countries (HICs) have shown that emotional and psychological well‐being are common themes among breast cancer survivors . These studies also found that the main needs after diagnosis or treatment are management of long‐term side effects as well as physical, cognitive, and sexual functioning needs, while longitudinal studies highlight that fear and feelings of uncertainty evolve over time after diagnosis …”

Risk factors of unmet needs among women with breast cancer in the post‐treatment phase

“…Two studies with a cancer‐specific samples (ie, women with gynecologic or endometrial cancer) found a significant association between stage and unmet needs, as measured around 4 years after diagnosis, while one study did not. Comparable studies with breast cancer, other, or mixed cancer samples often lacked information on the cancer stage at diagnosis, and did not examine its influence on separate unmet need domains post‐treatment. Only 3% of our participants were diagnosed with cancer stage 3 or 4, which meant that we could not examine the influence of later cancer stages on women's levels of unmet needs.…”

“…Based on the literature, we included age, educational level, cancer stage, types of treatment, and distress as sociodemographic, clinical, and psychosocial risk factors . We additionally included type of care insurance and comorbidity as possible risk factors that deserve more research attention . Patients may refrain from physical or psychological treatment if their insurance does not fully cover the costs.…”