Abstract
BackgroundThe aim of this study was to analyze biopsychosocial factors affecting how patients cope with cancer and adjuvant treatment and to appraise psychological distress, coping, perceived social support, quality of life and SDM before and after adjuvant treatment in breast cancer patients compared to colon cancer patients.MethodsNEOcoping is a national, multicenter, cross-sectional, prospective study. The sample comprised 266 patients with colon cancer and 231 with breast cancer. The instruments used were the Brief Symptom Inventory (BSI), Mini-Mental Adjustment to Cancer (Mini-MAC), Multidimensional Scale of Perceived Social Support (MSPSS), Shared Decision-Making Questionnaire-Patient (SDM-Q-9) and Physician’s (SDM-Q-Doc), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ).ResultsBreast cancer patients reacted worse to the diagnosis of cancer with more symptoms of anxiety, depression, and somatization, and were less satisfied with their involvement than those with colon cancer (p = 0.003). Participants with colon cancer were older and had more physical symptoms and functional limitations at the beginning of adjuvant treatment, while there were scarcely any differences between the two groups at the end of adjuvancy, at which time both groups suffered greater psychological and physical effects and scored lower on coping strategies, except for anxious preoccupation.ConclusionsBreast cancer patients need more information and involvement of the oncologist in shared decision-making, as well as and more medical and psychological support when beginning adjuvant treatment. Both breast and colon cancer patients may require additional psychological care at the end of adjuvancy.
Highlights
The aim of this study was to analyze biopsychosocial factors affecting how patients cope with cancer and adjuvant treatment and to appraise psychological distress, coping, perceived social support, quality of life and shared decision-making (SDM) before and after adjuvant treatment in breast cancer patients compared to colon cancer patients
Based on the hypothesis that breast cancer patients have their own way of coping with the disease and treatment that does not depend on objective factors of severity, prognosis, or toxicity, we focus first on breast cancer patients and compare them to colon cancer patients
The proportion of patients who did not work was high in both groups, it was higher among patients with colorectal cancer mainly because, since they were older, more of them were retired, whereas among the breast cancer subjects, 38% were unemployed
Summary
The aim of this study was to analyze biopsychosocial factors affecting how patients cope with cancer and adjuvant treatment and to appraise psychological distress, coping, perceived social support, quality of life and SDM before and after adjuvant treatment in breast cancer patients compared to colon cancer patients. Indications for adjuvant treatment for cancer are gradually increasing and adjuvancy has a positive impact on reducing recurrence and mortality, albeit at the expense of greater risk of toxicity and a temporary or permanent negative impact on quality of life. It is widely assumed that individuals with certain types of cancer, such as breast cancer, cope differently than those with other types, which affects their quality of life and how they experience their situation [4] It is apropos the validity of these assumptions be determined and whether there are other variables that can improve patient-physician shared decision-making (SDM). It is essential that other factors be teased out that can contribute to better patients’ acceptance of their situation and the possible side effects of adjuvant treatment, so as not to lose out on the benefits it offers [5]
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