Joanne Mortimer1, Carolyn E Behrendt. 1. 1 Division of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center , Duarte, California.
Abstract
BACKGROUND: The intensity and persistence of treatment-related symptoms among breast cancer survivors is incompletely understood. OBJECTIVE: The objective of the study was to estimate prevalence of severe symptoms well after initial treatment for breast cancer, to test whether symptom intensity diminishes with time or varies by treatment received. DESIGN, SETTING, SUBJECTS: This was a cross-sectional survey of female survivors of stage I-III invasive breast cancer, seen for routine follow-up a year or more after diagnosis. MEASUREMENTS: Data was derived from three validated questionnaires indicating physical and emotional domains. Symptoms rated in the top two levels of four- or five-item Likert scales were "severe." Associations with symptom intensity were tested using multivariate linear regression. RESULTS: Survey response was 68.5% (50/73). Respondents were age 55.4 (±9.1) years, median 2.2 (1.0-13.1) years since diagnosis; 64% were receiving endocrine therapy. Severe levels of hot flashes (42% of respondents), weight gain (32%), low libido (32%), and joint pain (30%) were common; (36%) of respondents rated sleep "fairly poor" or "very bad;" 30% were fatigued at least half the day. For 34%, health typically limited vigorous activities "a lot." Most (84%) respondents were experiencing at least one severe symptom. Symptom intensity did not vary with time since diagnosis. Of seven symptoms, three (hot flashes, weight gain, low libido) were more intense when systemic treatment had included endocrine therapy. Time in past month feeling down, nervous, or worn out increased with intensity of physical symptoms. CONCLUSIONS: Given their severity, persistence, and association with emotional burden, treatment-related symptoms among breast cancer survivors (BCS) merit greater attention toward clinical management, patient education, and longitudinal study.
BACKGROUND: The intensity and persistence of treatment-related symptoms among breast cancer survivors is incompletely understood. OBJECTIVE: The objective of the study was to estimate prevalence of severe symptoms well after initial treatment for breast cancer, to test whether symptom intensity diminishes with time or varies by treatment received. DESIGN, SETTING, SUBJECTS: This was a cross-sectional survey of female survivors of stage I-III invasive breast cancer, seen for routine follow-up a year or more after diagnosis. MEASUREMENTS: Data was derived from three validated questionnaires indicating physical and emotional domains. Symptoms rated in the top two levels of four- or five-item Likert scales were "severe." Associations with symptom intensity were tested using multivariate linear regression. RESULTS: Survey response was 68.5% (50/73). Respondents were age 55.4 (±9.1) years, median 2.2 (1.0-13.1) years since diagnosis; 64% were receiving endocrine therapy. Severe levels of hot flashes (42% of respondents), weight gain (32%), low libido (32%), and joint pain (30%) were common; (36%) of respondents rated sleep "fairly poor" or "very bad;" 30% were fatigued at least half the day. For 34%, health typically limited vigorous activities "a lot." Most (84%) respondents were experiencing at least one severe symptom. Symptom intensity did not vary with time since diagnosis. Of seven symptoms, three (hot flashes, weight gain, low libido) were more intense when systemic treatment had included endocrine therapy. Time in past month feeling down, nervous, or worn out increased with intensity of physical symptoms. CONCLUSIONS: Given their severity, persistence, and association with emotional burden, treatment-related symptoms among breast cancer survivors (BCS) merit greater attention toward clinical management, patient education, and longitudinal study.