Anxiety and its time courses during radiotherapy for non-metastatic breast cancer: A longitudinal study

Abstract

a b s t r a c tPurpose: To our knowledge, no study has specifically assessed the time course of anxiety during radiotherapy (RT). The objective of this study was to assess anxiety time courses in patients with nonmetastatic breast cancer. Material and methods: This multicenter, descriptive longitudinal study included 213 consecutive patients with breast cancer who completed visual analog scales (VASs) assessing state anxiety before and after the RT simulation and the first and last five RT sessions. Results: Pre-and post-session anxiety mean levels were highest at the RT simulation (respectively, 2.9 ± 2.9 and 1.6 ± 2.5) and first RT session (respectively, 3.4 ± 2.9 and 2.0 ± 2.4), then declined rapidly. Clinically relevant mean differences (P1 cm on the VAS) between pre-and post-simulation/session VAS scores were found only for the RT simulation (À1.3 ± 2.7; p < 0.001) and first RT session (À1.4 ± 2.4; p < 0.001). Five percent to 16% of patients presented clinically relevant anxiety (pre-and post-simulation/session VAS scores P 4 cm) throughout treatment. Conclusions: To optimize care, RT team members should offer all patients appropriate information about treatment at the simulation, check patients' understanding, and identify patients with clinically relevant anxiety requiring appropriate support throughout RT.

Trajectories and predictors of state and trait anxiety in patients receiving chemotherapy for breast and colorectal cancer: Results from a longitudinal study

“…Burgess et al, 2005;Jacobsen, Bovbjerg, & Redd, 1993;Lewis et al, 2014;Lim, Kamala Devi, & Ang, 2011;Van Esch et al, 2011). On the one hand, this is reasonable as women typically report more anxiety problems (McLean & Anderson, 2009), but additionally accounting for male patients in this study allows testing of such gender effects.…”

“…Anxiety in patients with cancer is a topic of great importance: previous research shows that this particular emotion is not only extremely common in this patient group (Burgess et al, 2005;Lewis et al, 2014), but it also has far-reaching effects on symptom experiences during treatment (Lockefeer and Vries, 2013;Saevarsdottir et al, 2010;Whitford and Olver, 2012), treatment compliance (Greer et al, 2008), patient outcomes such as experienced side-effects (Van Esch et al, 2011), and even survivorship (García-Torres and Alós, 2014). A useful theoretical framework for researching anxiety throughout the course of cancer treatment is Spielberger's anxiety model (Spielberger, 1989;Spielberger et al, 1983), which differentiates between state and trait anxiety.…”

“…Lewis et al (2014) repeatedly assessed anxiety levels of 213 patients with non-metastatic breast cancer undergoing radiotherapy. Within this patient group, initially high anxiety rapidly declined with the start of treatment, suggesting habituation effects.…”

Is it possible to improve communication around radiotherapy delivery: A randomized study to assess the efficacy of team training?

“…As a result, patients often express numerous concerns regarding radiotherapy treatment and its side effects [6][7][8][9][10]. Furthermore, many patients experience feelings of anxiety at the start of their treatment [6,11]. Communication in the radiotherapy context involves the transmission of complex information, and regular assessment of the patients' physical state and of his or her information and supportive needs.…”

“…However, the first and last sessions represent significant encounters for the patient. For example, at the first session of treatment, patients often experience fears regarding their treatment [9,21], clinically relevant anxiety [6,11], they express numerous treatment-related information needs [7], and it is often their first contact with the machine that will deliver their treatment. During the first session, team members have an opportunity to create a relationship with the patient, to transmit information about what will happen and how, and to evaluate the patient's emotional state.…”