Impact of hormone therapy side effects on health-related quality of life, distress, and well-being of breast cancer survivors

Abstract

To explore the modulatory role of Adjuvant Hormone Therapy (AHT) on health-related quality of life (QoL), subjective well-being and distress prevalence in Breast Cancer (BC) survivors, considering the survival phase. Cross-sectional study with control group. 616 BC survivors participated. Examination of interaction effect between AHT and time since end of primary treatment showed that many of the positive changes observed through the survival phases were experienced exclusively by survivors without AHT. When AHT was not prescribed, longer time elapsed was associated with a decrease in distress prevalence and an improvement in subjective well-being and QoL. It seems there is a turning point around the fifth year after finalization of primary treatment, from which the survivors without AHT significantly improve in several areas and those with AHT do so to a lesser extent. It is expected that the improvement in QoL throughout the different survival phases will have a significant impact on the adherence and maintenance of AHT and, consequently, the likelihood of survival. Thus, AHT side-effects should be routinely assessed by health care providers to gain accurate knowledge that allows improving the QoL of BC survivors.

Returning to work in cancer survivors: a multi-center cross-sectional study in Spain

“…Although it is difficult to establish the directionality of the relationships found and we believe that a bidirectional influence may be likely, previous studies (28,44) have shown the benefit to the HRQOL of cancer survivors of maintaining an active work life. Based on the authors' previous results (28) , being employed has a positive impact on the domains of financial problems, sexual problems, concern about appearance, social avoidance, and negative and positive affectivity. Having a job was also associated with better HRQOL in areas directly related to common side effects of cancer treatment, such as pain and fatigue.…”

“…These results further support the need for special consideration of this phase within early survival insofar as it constitutes a transitional phase from patient to survivor. The re-entry phase involves psychosocial and behavioral experiences more pronounced and has a greater impact on HRQOL than other phases of post-treatment survival (20,24,28,38,45) .…”

“…To the more obvious economic problems associated with not returning to work after the experience of cancer it can also be added the negative impact of such a situation on the Quality of Life (QOL) (26) . Indeed, having a job has been revealed as a critical indicator of improved QOL in cancer survivors (10,19,20,24,27,28) . Certainly, employed cancer survivors report that the work activity is a way of returning to normal life, allowing for professional and personal development, increased social support, and improved quality of life; all of which in turn revert to society by improving their economic and social participation (3,29) .…”

“…Currently, the cancer survivors' risk of unemployment is higher than in the general population (3,24,28) . A systematic review by Mehnert (2011) (21) concluded that the average rate of cancer survivors returning to work was 63.5%.…”

“…Although issues related to employment and work in cancer survivors are receiving increasing attention, the research on this topic is still scarce and limited (19,21,28,35) . To date, previous studies highlight the role of some variables that hinder the development of work activity in cancer survivors.…”