Abstract
PurposeIt is known that the diagnosis of breast cancer often causes anxiety and depression. Radiotherapy of the breast as an obligatory part of a breast-conserving treatment concept can markedly increase these psychological symptoms in many, but not all patients. In this clinical observational study, we aimed at identifying cognitive, health-related and social factors that may either enhance or reduce the emergence of anxiety and depression.MethodsUsing a longitudinal study design with 25 women (mean age: 52.9 years; SD = 10.6; age range 29–70 years) with a first diagnosis of nonmetastatic breast cancer, measures of anxiety, depression, situational emotional states, intelligence, and aspects of social frameworks were assessed before, during, and after radiotherapy of the breast. At 4 time-points, standard and self-constructed questionnaires were used to assess the course of anxiety and depressive symptoms across the radiotherapy intervention.ResultsWe found that anxiety is highest immediately before the start of radiation therapy, while the anxiety level was lowest on the day that therapy was completed. Anxiety and depression were enhanced in women with a lifetime history of chronic diseases at all time points of measurement. Moreover, women with high intelligence and low social support had stronger symptoms of depression than women with low intelligence and a stable family background at some time points of measurement. The degree of anxiety was neither related to intelligence nor to social support.ConclusionFor the first time, we demonstrate empirical pilot data on cognitive and social modulators of anxiety and depression in women with breast cancer over the course of radiotherapy. Our results may help to optimize clinical procedures and thereby reduce symptoms of anxiety and depression in these patients.
Highlights
Breast cancer is the most common type of cancer and a leading cause of cancer death in women [1]
Anxiety and depression were enhanced in women with a lifetime history of chronic diseases
Our data suggest that medical anamnesis of patients with breast cancer who will be treated with radiotherapy should include details of the individual social situation, measures of intelligence, and further cognitive capacities
Summary
Breast cancer is the most common type of cancer and a leading cause of cancer death in women [1]. Every eighth woman will develop breast cancer in the course of her life; the treatment of breast cancer is a burden for numerous women. It is known that the diagnosis of breast cancer often causes anxiety and depression. Fear of future becomes a main problem after diagnosis and during the treatment of breast cancer [3, 4]. Tsaras et al reported prevalences of depression and anxiety of 38.2% and 32.2% in breast cancer patients [5]. In a study performed by Civilotti et al, even 52.1% of patients affected by breast cancer showed anxiety symptoms [4]. The levels of anxiety and depression frequently increase due to the expectation of progression of the disease, pain, and suffering from cancer treatment [4]. It has been shown that depression or other emotional distress like stressful life experiences may exert negative effects on cancer mortality and cancer survival [6]
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