Quality of Life in Long-Term, Disease-Free Survivors of Breast Cancer: a Follow-up Study

Ganz, Patricia A.; Desmond, Katherine A.; Leedham, Beth; Rowland, Julia H.; Meyerowitz, Beth E.; Belin, Thomas R.

doi:10.1093/jnci/94.1.39

Cited by 927 publications

(867 citation statements)

References 46 publications

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“…In the current research, 67% of partnered young women with breast cancer were sexually active in the early months after treatment, a proportion comparable to the 65% observed by Ganz and colleagues in their study of breast cancer survivors of all ages (Ganz et al, 1998b(Ganz et al, , 2002. The finding that sexual activity was more common among women with an unmarried partner than among married women also is consistent with the Ganz et al (1999) finding that women with new partners since their breast cancer diagnosis were more likely to be sexually active.…”

Section: Discussionsupporting

confidence: 81%

“…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%

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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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Section: Discussionsupporting

confidence: 81%

Section: Body Image Sexuality and Sexual Problemsmentioning

confidence: 99%

Body image and sexual problems in young women with breast cancer

et al. 2005

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“…Chemotherapy related to higher levels of distress emotion at follow-up, consistent with a prior relation of chemotherapy to ratings on a "ladder of life" (Ganz et al, 2002), but this effect was not significant in the multivariate analysis. Another medical vari- …”

Section: Demographic and Medical Variablessupporting

confidence: 61%

Optimistic Personality and Psychosocial Well-Being During Treatment Predict Psychosocial Well-Being Among Long-Term Survivors of Breast Cancer.

et al. 2005

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In considering well-being among survivors of life-threatening illnesses such as breast cancer, 2 important questions are whether there is continuity between initial adjustment and longer term adjustment and what role personality plays in long-term adjustment. In this research, a sample of 163 early stage breast cancer patients whose psychosocial adjustment was first assessed during the year after surgery completed the same measures 5-13 years after surgery. Initial reports of well-being were relatively strong predictors of follow-up well-being on the same measures. Initial optimism and marital status also predicted follow-up adjustment, even controlling for earlier adjustment, which exerted a substantial unique effect in multivariate analyses. In contrast, initial medical variables played virtually no predictive role. There is substantial continuity of subjective well-being across many years among survivors of breast cancer, rooted partly in personality and social connection.

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“…The fact of having cancer and late effects of surgical and systemic treatments may have had an impact on the health estimates (Broeckel et al, 2000;Ganz et al, 2002). All patients received Tam.…”

Section: Quality-adjusted Survivalmentioning

confidence: 99%

Quantifying trade-offs: quality of life and quality-adjusted survival in a randomised trial of chemotherapy in postmenopausal patients with lymph node-negative breast cancer

et al. 2004

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We evaluated quality of life (QL) and quality-adjusted survival in International Breast Cancer Study Group Trial IX, a randomised trial including 1669 eligible patients receiving tamoxifen for 5 years or three prior cycles of cyclophosphamide, methotrexate and 5-fluorouracil (CMF) followed by 57 months tamoxifen. During the time with CMF toxicity (Tox), without symptoms and toxicity (TWiST), and following relapse (Rel), patients scored their QL indicators and a utility indicator for subjective health estimation between 'perfect' and 'worst' health. Scores were averaged within Tox, TWiST and Rel and transformed to utilities. Mean durations for the three transition times were weighted with utilities to obtain mean quality-adjusted TWiST (Q-TWiST). Patients receiving CMF reported significantly worse scores for most QL domains at month 3, but less hot flushes. After completing chemotherapy, there were no differences by treatment groups. Benefits evaluated by Q-TWiST favoured the additional chemotherapy. CMF provided 3 more months of Q-TWiST for patients with ER-negative tumours, but CMF provided no benefit in Q-TWiST for patients with ERpositive tumours. Q-TWiST analysis based on patient ratings is feasible in large-scale cross-cultural clinical trials.

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Quality of Life in Long-Term, Disease-Free Survivors of Breast Cancer: a Follow-up Study

Cited by 927 publications

References 46 publications

Body image and sexual problems in young women with breast cancer

Body image and sexual problems in young women with breast cancer

Optimistic Personality and Psychosocial Well-Being During Treatment Predict Psychosocial Well-Being Among Long-Term Survivors of Breast Cancer.

Quantifying trade-offs: quality of life and quality-adjusted survival in a randomised trial of chemotherapy in postmenopausal patients with lymph node-negative breast cancer

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