Psychological Stress and Coping Resources during Primary Systemic Therapy for Breast Cancer. Results of a Prospective Study

Abstract

ABSTR ACTIntroduction This prospective study reports on the impact of psychological factors on women with primary breast cancer undergoing neoadjuvant chemotherapy. These women are in a special situation, where they not only have to deal with the shock of the cancer diagnosis but also with the fact that the malignant tumor will not be removed immediately but only after completing chemotherapy. A situation like this is stressful and requires a personal strength which not every woman may have.Methods In a prospective study 53 patients were assessed using various psychological and psycho-oncological questionnaires which aimed to evaluate their psychological stress and their coping resources. The women were evaluated before starting systemic treatment (t-1) and again immediately after completing chemotherapy but prior to surgery (t-2). The patients were also asked about their coping strategies at t-1 and t-2. Using the Ulm Coping Manual (UCM) the interviews were rated by independent assessors blinded to the respective patientʼs medical data. Patients were followed up for 3.7-5.5 years after completing chemotherapy.

Biopsychosocial Correlates of Adjustment to Cancer during Chemotherapy: The Key Role of Health-Related Quality of Life

“…Our data showed that for chemotherapy patients to develop, or preserve, a strong determination to overcome the disease, the supportive capacities of their network and a positive thinking disposition are essential resources that, if strengthened, might help them to experience more control over cancer-related problems and maintain faith in treatment. Although some scholars have dismissed the idea that fighting spirit is associated with “hard” medical outcomes [ 66 ], there is also evidence that greater fighting spirit, before and during chemotherapy, predicts disease-free and overall survival [ 67 ]. Doubtless, the fighting spirit can reduce patients distress and helplessness during the disease [ 8 , 9 , 35 ].…”

Development and psychometric properties of the Stressors in Breast Cancer Scale

“…The diagnosis of cancer generates psychological stress related not only to treatment and its side effects but also to its impact on the person’s daily life and social and family roles ( Brocken et al, 2012 ). Breast cancer is no exception in this regard ( Dooley et al, 2017 ; Tschuschke et al, 2017 ; Borgi et al, 2020 ). Stress in people with cancer has been linked to high levels of anxiety, depression ( Burgess et al, 2005 ; Mehnert and Koch, 2008 ; Alagizy et al, 2020 ; O’Hea et al, 2020 ), sleep problems ( Schell et al, 2019 ; De la Torre-Luque et al, 2020 ), lower self-care ( Abdollahi et al, 2020 ), and low levels of satisfaction with life ( Cerezo et al, 2020 , 2022 ).…”

Psycho-oncology care in breast cancer centres: a nationwide survey

“…To what extent these structures are adequate from the patients’ perspective has to be subject to further research. There are indications that the support needs of specific groups of patients with breast cancer, for example, patients with an immigration background,12 patients with comorbidities,13 patients receiving neoadjuvant chemotherapy or showing passive-resigning coping skills,14 patients who are offered individualised treatment approaches based on molecular genetic methods,15 male patients with breast cancer, or patients’ partners or caregivers,16 17 have not yet been addressed adequately. Should subsequent studies reveal that disease-specific, treatment-related or target group-specific needs are not fully met, it will be necessary to examine the institutional determinants in order to derive specific measures for the underserved patient groups.…”