Cancer Control Research
5R03CA072554-02
Mortimer, Joanne E.
CLINICAL & PSYCHOSOCIAL FACTORS IN BREAST CANCER
AbstractDESCRIPTION (Applicant's Description) Over the past 20 years, the management
of primary breast cancer has evolved from a purely surgical treatment of the
primary cancer to include acceptance of lumpectomy followed by radiation
therapy and adjuvant therapy in many patients. The addition of
postoperative chemotherapy and/or hormone therapy has improved overall
survival in breast cancer patients. Depending on the type of therapy
selected, patients may experience psychological trauma due to hair loss,
weight gain, lethargy, and premature menopause. The psychological
literature has focused principally on the impact of the primary surgery on
the patient's quality of life and emotional adjustment. The additional
psychological traumas related to adjuvant therapy have been insufficiently
studied, to date. We propose to study the interrelationships amongst
clinical, psychological, and social determinants of quality of life in women
receiving adjuvant treatment for localized breast cancer. Changes will be
studied at initiation of adjuvant therapy, and 2, 6, and 12 months after
initiation of adjuvant therapy. For purposes of this proposal, quality of
life includes: general quality of life, cancer specific quality of life,
psychological adjustment, marital satisfaction, and sexual functioning. The
needs for psychosocial support in these women change over the first year
following localized surgical treatment of the primary cancer. We hope to
systematically explore those changes to meet the following specific aims:
1. Develop an on-going needs assessment of support in coping with breast
cancer and its treatment at key points during the first 12 months after
surgery of the primary breast cancer. 2. Characterize the patient's
changes in quality of life and related factors, including general quality of
life, cancer-specific quality of life, psychological adjustment, marital
satisfaction and sexual function during the 12 months following initiation
of adjuvant therapy. 3. Characterize changes in clinical, psychological,
and social influences on quality of life and related factors during the 12
months following initiation of adjuvant therapy. 4. Characterize changes
in relationships, both new and old, as the patients' needs for clinical,
psychological, and social support are altered during the 12 months after
surgery for primary breast cancer. 5. Characterize how changes in
clinical, psychological, and social support impact on the patient's outcome
as measured by quality of life.
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