Quality of Life at the End of Primary Treatment of Breast Cancer: First Results From the Moving Beyond Cancer Randomized Trial

Ganz, Patricia A.; Kwan, Lorna; Stanton, Annette L.; Krupnick, J.L.; Rowland, Julia H.; Meyerowitz, Beth E.; Bower, Julienne E.; Belin, Thomas R.

doi:10.1093/jnci/djh060

Cited by 442 publications

(355 citation statements)

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“…Ganz and colleagues [20][21][22] have shown that quality-of-life and functional outcome are decreased during and after treatment, but our data suggest a decrement in these parameters before treatment. Significant correlations were observed between reports of poor sleep and the FACT-B instrument, which measures the impact of acknowledging a cancer diagnosis on daily functioning.…”

Section: Discussioncontrasting

confidence: 74%

Fatigue, sleep, and circadian rhythms prior to chemotherapy for breast cancer

Ancoli‐Israel

Liu

Marler

et al. 2005

Support Care Cancer

267

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Goals-Previous investigations have shown that women undergoing chemotherapy for breast cancer experience both disturbed sleep and fatigue. However, most of the previous research examined women either during or after chemotherapy. This study examined sleep, fatigue, and circadian rhythms in women with breast cancer before the start of chemotherapy.Patients and methods-Eighty five women with Stages I-IIIA breast cancer who were scheduled to begin adjuvant or neo-adjuvant anthracycline-based chemotherapy participated. Each had sleep/ wake activity recorded with actigraphy for 72 consecutive hours and filled out questionnaires on sleep, fatigue, depression, and functional outcome.Main results-On average, the women slept for about 6 h a night and napped for over an hour during the day. Sleep was reported to be disturbed and fatigue levels were high. Circadian rhythms were robust, but women who were more phase-delayed reported more daily dysfunction (p<0.01). Conclusions-The data from the current study suggest that the women with breast cancer likely experience both disturbed sleep and fatigue before the beginning of chemotherapy. Although their circadian rhythms are robust, breast cancer patients with more delayed rhythms experience more daily dysfunction secondary to fatigue. These data suggest that strategies to improve disturbed sleep and to phase-advance circadian rhythms prior to initiation of chemotherapy may be beneficial in improving daily function in breast cancer patients.

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Section: Discussioncontrasting

confidence: 74%

Fatigue, sleep, and circadian rhythms prior to chemotherapy for breast cancer

Ancoli‐Israel

Liu

Marler

et al. 2005

Support Care Cancer

267

206

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“…During the first six months after treatment Ganz et al (2004) found that sexual functioning was worse for women who received chemotherapy than for those who did not, regardless of type of surgery. Yurek et al (2000) found sexual activity after treatment was predicted by the extent of treatment and menopausal status, as well as by prior frequency of intercourse and sexual self-schema.…”

Section: Body Image Sexuality and Sexual Problemsmentioning

confidence: 99%

“…The relationship of good body image with the resumption of sexual relations and sexual dysfunction is inconsistent. While the majority of studies have found this relationship (Carver et al, 1998;Beckmann et al, 1983;Steinberg et al, 1985;Pozo et al, 1992;Ganz et al, 2004;Yurek et al, 2000;Lee et al, 1992;Wolberg et al, 1989;Schain et al, 1994) a few have not (Ashcroft et al, 1985;Penman et al, 1986;Ganz et al, 1987;Goldberg et al, 1992).…”

Section: Body Image Sexuality and Sexual Problemsmentioning

confidence: 99%

“…Having sexual problems (or dysfunction) includes experiencing disturbances in sexual desire and physiological changes associated with loss of sexual desire and arousal, reduction in sexual pleasure, difficulty in achieving orgasm, anxiety about sexual performance, pain during intercourse, and not finding sex pleasurable (Laumann et al, 1994(Laumann et al, , 1999American Psychiatric Association, 1994;Greendale et al, 1996). Women treated for breast cancer by mastectomy and/or chemotherapy have also reported problems with sexual functioning (Ganz et al, 2004;Carpenter et al, 2002;Young-McCaughan, 1996;Ganz et al, 1998a) that is, those associated with treatmentrelated menopause (Ganz et al, 2003). Sexual problems and sexual functioning have been found to persist years after diagnosis with breast cancer (Ganz et al, 2002).…”

Section: Body Image Sexuality and Sexual Problemsmentioning

confidence: 99%

“…Sexual functioning declined during the first year after breast cancer treatment with chemotherapy in three studies (Ganz et al, 2004;Yurek et al, 2000;Arora et al, 2001). During the first six months after treatment Ganz et al (2004) found that sexual functioning was worse for women who received chemotherapy than for those who did not, regardless of type of surgery.…”

Section: Body Image Sexuality and Sexual Problemsmentioning

confidence: 99%

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Body image and sexual problems in young women with breast cancer

et al. 2005

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SUMMARYPurpose: The purpose of this study was to determine the frequency of body image and sexual problems in the first months after treatment among women diagnosed with breast cancer at age 50 or younger.Background: Breast cancer treatment may have severe effects on the bodies of younger women. Surgical treatment may be disfiguring, chemotherapy may cause abrupt menopause, and hormone replacement is not recommended.Methods: A multi-ethnic population-based sample of 549 women aged 22-50 who were married or in a stable unmarried relationship were interviewed within seven months of diagnosis with in situ, local, or regional breast cancer.Results: Body image and sexual problems were experienced by a substantial proportion of women in the early months after diagnosis. Half of the 546 women experienced two or more body image problems some of the time (33%), or at least one problem much of the time (17%). Among sexually active women, greater body image problems were associated with mastectomy and possible reconstruction, hair loss from chemotherapy, concern with weight gain or loss, poorer mental health, lower self-esteem, and partner's difficulty understanding one's feelings. Among the 360 sexually active women, half (52%) reported having a little problem in two or more areas of sexual functioning (24%), or a definite or serious problem in at least one area (28%). Greater sexual problems were associated with vaginal dryness, poorer mental health, being married, partner's difficulty understanding one's feelings, and more body image problems, and there were significant ethnic differences in reported severity.Conclusions: Difficulties related to sexuality and sexual functioning were common and occurred soon after surgical and adjuvant treatment. Addressing these problems is essential to improve the quality of life of young women with breast cancer.

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