Background: We aimed to systematically review the evidence on adverse mental health outcomes in breast cancer survivors (≥1 year) compared with women with no history of cancer. Methods: Studies were identified by searching MEDLINE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Social Sciences Citation Index, and through backward citation tracking. Two researchers selected the studies, extracted data, and assessed the risk of bias. Results: Sixty studies were included. Of 38 studies of depression, 33 observed more depression in breast cancer survivors; this was statistically significant in 19 studies overall, including six of seven where depression was ascertained clinically, three of four studies of antidepressants, and 13 of 31 that quantified depressive symptoms. Of 21 studies of anxiety, 17 observed more anxiety in breast cancer survivors, statistically significant in 11 studies overall, including two of four with clinical/prescription-based outcomes, and in eight of 17 of anxiety symptoms. Breast cancer survivors also had statistically significantly increased symptoms/frequency of neurocognitive dysfunction (18 of 24 studies), sexual dysfunctions (5 of 6 studies), sleep disturbance (5 of 5 studies), stress-related disorders/PTSD (2 of 3 studies), suicide (2 of 2 studies), somatisation (2 of 2 studies), and bipolar and obsessive-compulsive disorders (1 of 1 study each). Studies were heterogeneous in terms of participants' characteristics, time since diagnosis, ascertainment of outcomes, and measures reported. Approximately one-half of the studies were at high risk of selection bias and confounding by socio-economic status. Conclusions: There is compelling evidence of an increased risk of anxiety, depression and suicide, and neurocognitive and sexual dysfunctions in breast cancer survivors compared with women with no prior cancer. This information can be used to support evidence-based prevention and management strategies. Further population-based and longitudinal research would help to better characterize these associations.

/pdf/associations-between-breast-cancer-survivorship-and-adverse-1b6cpyawl3.pdf

Associations Between Breast Cancer Survivorship and Adverse Mental Health Outcomes: A Systematic Review.

Post-traumatic growth in stomach cancer survivors: Prevalence, correlates and relationship with health-related quality of life.

Recent studies have shown that cancer survivors experience severe psychological distress, but some also experience personal growth, known as posttraumatic growth (PTG). Help-seeking behavior (HSB) is critical for cancer survivors to better cope with stress and possibly experience PTG. The existing theoretical models of PTG and HSB assume that cancer survivors, regardless of their cultural background or personality, will receive benefit from actively interacting with others. The purpose of this review article is to critically examine this assumption and to propose that the roles of distal and proximate cultures need to be considered in further understanding the psychological mechanisms of PTG and HSB. Future studies should identify the culture-specific meanings and implications of experiencing PTG and engaging in HSB.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jpr.12105

A Review of Posttraumatic Growth and Help-Seeking Behavior in Cancer Survivors: Effects of Distal and Proximate Culture

Research on the psychosocial aspects of cancer and practice to counteract those effects are no longer addenda to clinical work and research in oncology. The opening up of research into rehabilitation, late effects and the entire concept of survivorship [1] has extended the concept of cancer [2]. Gone are the days when psychological support was claimed to prolong the life of cancer survivors [3]; the claim has little credence, and the data do not support it [4]. Research on survivorship has followed much more productive alleys, leading to studies on co-morbidity, the prevention, detection and treatment of late effects, their timing and the effective elements of rehabilitation for cancer patients [5]. Authorities such as the Institute of Medicine [6] and the National Comprehensive Cancer Network [7] in the USA, the World Cancer Report [8] and numerous other national and international organizations and publications [9] concur that cancer survivors require interventions, not only pharmaceutically and with narrow tumor-oriented treatment, but also treatment of the person experiencing cancer. A person with a spouse has to discover how to restore marital life [10], a cancer survivor may lose her or his job [11], and daily care is needed for the symptoms and other problems that are late effects of cancer treatment [12]. In the European Union, the number of cancer survivors was estimated to be 17.8 million in 2008 [13], and this number is growing. Therefore, public health policies are needed to defi ne and direct services to these survivors, many of whom will become part of the population of long-term survivors. Unlike cancer patients in earlier times, those who survive today may not only have had a cancer but often have one, two and more concurrent chronic diseases, such as diabetes, cardiovascular disease or thyroid dysfunction. Integrated treatment decisions and management structures are required for these more complex cases. The specialization of medical services over the past 50 years benefi ts patients by ensuring the availability of expertise but tends to leave integration of treatment in a ‘ no man ’ s land ’ . Integration of treatment will be essential in the decades to come, especially with the advent of more targeted, individualized treatment trajectories for each cancer patient. The ‘ one size fi ts all ’ approach must give way to assessment and management of individual tumor burden, co-morbidity and perhaps even the patient ’ s own preferences. These factors call for a shift in our caring culture, to a focus on recovery, coping with late effects and self-management. In principle, a public health system works on the basis that citizens take care of themselves and contact the health system if they recognize symptoms; at that point, citizens expect proper action by the health system. This balance between self-management and rapid health system action in the case of symptoms works for citizens who are healthy and are not chronically ill. For such survivors, including those who survive after treatment for cancer, public health systems have instituted a time-consuming, expensive, labor-intensive follow-up system, the function of which is now being questioned. The aim of this huge follow-up program, which involves millions of encounters between cancer survivors and specialists across Europe, is the detection of recurrence and secondary cancer. Concern has been raised, however, that these large programs are draining too many resources from the core activity of specialized clinicians. Nurse practitioners in several cancer hospitals in the USA are qualifi ed to perform most follow-up activities, including referrals and prescriptions for the management of late effects of cancer treatment, under the supervision of Acta Oncologica, 2013; 52: 191–194

New paradigms in planning cancer rehabilitation and survivorship.

Introduction: Traumatic events such as breast cancer along with negative effects on patients also have positive effects. These cases have been studied less in Iran. Therefore, this study was conducted with the aim of explanation of positive changes after breast cancer by using a qualitative approach. Materials and Methods: This qualitative study was conducted in 2012 in one of the specialized centers for cancer affiliated to Isfahan University of Medical Sciences. In this study, it was interviewed with 19 women with breast cancer about positive changes after cancer by using individual, open and deep methods. The interviews were analyzed with conventional content analysis method. Results: The titles of the three major categories were included as behavioral changes to maintain and promote health (acquisition of health information and adopting promoting health behaviors), spiritual development (attention to the God and sense of meaning in life, revising the values and priorities, strengthening moral and behavioral traits) and personal growth and flourish (feeling empowerment, confidence and efforts to achieve the goals and desires). These three categories have led to emerge themes in this study as the Awakening after cancer. Conclusions: The results of this study indicated positive changes after breast cancer. Considering such changes while providing care and consulting to patients with breast cancer in addition to facilitate and accelerate positive changes will be prompted to provide care and proper and influential consulting to promote patient health.

Positive changes after breast cancer: A qualitative study

Background. Although breast cancer (BC) may have negative psychological sequelae, it may also be experienced as an existential challenge, which can derive personal growth. Only one study has been conducted, however, on whether women with BC experience more post-traumatic growth (PTG) than BC-free women. We examined PTG in women with and without BC and whether the characteristics and treatment of BC were associated with PTG. Material and methods. We used data from the questionnaire administered in the Diet, Cancer and Health cohort and included 774 women with BC and 666 randomly sampled BC-free women aged 63–81 years. PTG was measured with the PTG inventory, for which the women identified their own traumatic or life-changing event. Linear regression was used to compare PTG in women with and without BC and to examine the association between BC characteristics and treatment and PTG. Results. Although women with BC experienced significantly more PTG in the domains ‘appreciation of life’ and ‘relating ...

https://informahealthcare.com/doi/pdf/10.3109/0284186X.2012.744878

Post-traumatic growth among elderly women with breast cancer compared to breast cancer-free women.

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Post-traumatic growth among elderly women with breast cancer compared to breast cancer-free women.