Perspectives of the Breast Cancer Survivorship Continuum: Diagnosis through 30 Months Post-Treatment

Abstract

This study explored breast cancer survivors’ perspectives regarding their experiences of the survivorship continuum from diagnosis through 30 months post-treatment. The sample included women (N = 379) with newly-diagnosed breast cancer undergoing treatment at a Midwestern university-affiliated cancer center. Semi-structured interviews were conducted using the Lymphedema and Breast Cancer Questionnaire at time of diagnosis, post-operatively, quarterly during the first year, and then semi-annually thereafter through 30 months post-treatment. A mixed-methodology was used to analyze participants’ comments. Themes central to long-term survivorship experiences included social support, positive worldviews, breast cancer and lymphedema health literacy, religious/spiritual beliefs, self-empowerment, and recovery expectations. These themes were consistent with a psychoneuroimmunological model of health in which psychosocial variables mediate stress and influence health outcomes. Qualitative data showed that social support and positive worldviews were the two themes with the most significant impact on long-term breast cancer survivorship experiences. Survivors expressed a need to advance their health care literacy in order to share ownership of breast cancer and lymphedema treatment decisions. Since breast cancer is an immune-mediated disease, long-term survivorship planning should address psychosocial factors that influence the long-term psychological distress associated with immune dysfunction.

Gratitude, Psychopathology and Subjective Well-Being: Results from a 7.5-Month Prospective General Population Study

“…However, the study by Wood et al (2008a) specifically focused on the mechanics of gratitude during a life transition, and the study sample therefore consisted of first year undergraduate students (18-19 years old) who had just started their studies, whereas the current study was performed in a large, demographically diverse general population sample without a specific focus on life events. The discrepancy in findings between Wood et al's study (2008a) and ours may therefore suggest that the protective impact of gratitude on psychopathology is possibly more apparent in the context of a stressful life event, during which an individual undergoes changes in levels of mental health (Wheaton 1990), as further evidenced by longitudinal studies linking gratitude to post-traumatic growth (Tsai et al 2016;Zhou and Wu 2015), and long-term survivorship in cancer patients (Hulett et al 2015). Further longitudinal studies are needed, however, to systematically map the mechanics of gratitude in the context of adjustment and resilience to adversity.…”

“…In addition, the majority of studies on the relationship between gratitude and mental health were carried out among adolescent (mainly student) convenience samples (Gillham et al 2011;Kleiman et al 2013;Kong et al 2015;Petrocchi and Couyoumdjian 2016;Watkins et al 2003;Wood et al 2008a), among elderly individuals (Krause 2009), or among individuals within a particular psychological context, such as earthquake survivors (Lies et al 2014;Zhou and Wu 2015), military veterans (Tsai et al 2016), breast cancer survivors (Hulett et al 2015), or children with a life threatening illness (Chaves et al 2015). It remains uncertain to what extent the results produced by these studies reflect general patterns at the population level.…”

Inequalities in long term health‐related quality of life between partnered and not partnered breast cancer survivors through the mediation effect of social support

“…Previous studies have demonstrated the importance of social factors in the recovery from breast cancer [5,13,14]. A qualitative study found that the majority of women nominate a positive social support system as the most important consideration in their survivorship from breast cancer [13]. Emotional, informational, and affectionate social support is a protective factor for physical and mental HRQOL post-breast cancer diagnosis [5].…”

“…The large sample size and the six-year follow-up data is a strength of this study which enabled the analyses. Previous studies have demonstrated the importance of social factors in the recovery from breast cancer [5,13,14]. A qualitative study found that the majority of women nominate a positive social support system as the most important consideration in their survivorship from breast cancer [13].…”

The role of tumor grade, demographics and psychological factors in Cancer survivorship

“…Cancer survival means the lives of cancer patients from diagnosis until death with a focus on physical, psychological, and socioeconomic issues (7). Exact methods of diagnosis, improved treatment and supportive care of cancer have increased survival rate (8).…”