Promoting adjustment after treatment for cancer

Abstract

The transition from the period of diagnosis and medical treatment of cancer to survivorship (i.e., the reentry phase) is an understudied phase in the cancer trajectory. The objectives of this report were 1) to illustrate several adaptive tasks of the reentry phase, 2) to provide examples of research on factors that predict positive adjustment during this phase, and 3) to discuss interventions that address the adaptive tasks of early cancer survivorship. Although the pertinent empirical literature is scarce, accounts from cancer survivors, healthcare professionals, and qualitative researchers converge to suggest several themes in adaptive tasks during reentry. Drawing from the authors' work and that of others, the authors have described common expectancies held by many individuals approaching reentry (e.g., "I shouldn't need support"), typical concerns during this phase (e.g., concern over cancer recurrence), and personal and contextual factors that can facilitate and

Predictors of change in unmet supportive care needs in cancer

“…Patients experience a significant disruption in their global functioning and supportive care needs immediately following diagnosis however they continue to require assistance adapting to and coping with their cancer throughout the cancer trajectory [23,37]. Stanton et al [23] suggest that the realisation one has cancer may only become apparent over time, for example, when active coping strategies (e.g.…”

“…The change in care and support following treatment completion suggests that patient satisfaction and social support may be the important predictors of unmet supportive care needs over time. At the conclusion of treatment, medical care and support may decrease owing to the belief that the worst is over and that the patient does not require ongoing assistance [23]. Patients indicate some discomfort requesting information from medical providers as time since diagnosis increases and instead seek information from popular media [24].…”

Adjusting to life after treatment: distress and quality of life following treatment for breast cancer

“…First, women are still contending with the physical effects of treatment, including fatigue, hair loss, early menopausal symptoms, lymphoedema, and decreased libido. Many women become distressed because they had not anticipated ongoing treatment-related problems (Beisecker et al, 1997;Stanton et al, 2005). Second, cancer survivors no longer need to focus intensely on medical treatment, leaving room for a psychological struggle (Schnipper, 2001).…”

“…Interviews with breast cancer survivors after the end of treatment revealed that women were just beginning to reflect on fears and existential issues at this time (Lethborg et al, 2000). Third, loss of support from family and friends who may not realise that cancer survivors continued to struggle with cancer-related physical and psychological issues is another potential source of distress (Stanton et al, 2005). The loss of regular contact with health-care providers may also result in feelings of decreased support (Lethborg et al, 2000).…”

“…Once treatment is over, this active coping strategy is no longer available. Fear of a cancer recurrence, the primary concern for 39% of women enrolled in a post-treatment intervention study (Stanton et al, 2005), coupled with the loss of one's primary means for managing cancer, may be a particularly distressing combination for cancer survivors (Lethborg et al, 2000).…”