Do psychosocial factors influence the course of breast cancer? A review of recent literature, methodological problems and future directions (original) (raw)
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Psychosocial factors in the development and progression of breast cancer
Breast Cancer Research and Treatment, 1994
The factors responsible for the genesis of breast cancer remain unclear. Emerging, although controversial, evidence suggests that factors related to life-style, such as dietary fat or alcohol intake, or exposure to various forms of stressors, are associated with mammary tumorigenesis. The possible role of life-style factors in breast cancer is important in light of the fact that mortality to this disease is increasing in most countries and that development of curative therapies for breast cancer has not been forthcoming. Thus, determining the role of life-style factors in the onset and progression of breast cancer, particularly among individuals genetically vulnerable to breast cancer or women with breast cancer in remission, is critical to prevent this disease. We will review the three main hypotheses which have been suggested to link psychosocial factors to the etiology of cancer, emphasizing data obtained through animal models. Interpretation of the existing data suggests that the number of stressful life-events does not predict vulnerability to develop breast cancer or survival from it; a certain level of stress appears to protect from malignancies. The crucial factor affecting tumor growth is the interaction among stress, an individual's personality, and available psychosocial support, and the effect of this interaction on an individual's ability to cope with stress. In addition, other risk factors for breast cancer known to be closely associated with psychosocial factors, namely dietary fat and alcohol consumption, may interact with the effects of psychosocial factors on breast cancer.
Baseline psychosocial predictors of survival in localised breast cancer
British Journal of Cancer, 2006
Despite the large number of studies on the impact of psychosocial factors on breast cancer progression, there is no certainty about the contributing factors or processes involved. We investigated the relative impacts of socioeconomic, psychological, and psychosocial factors on survival in breast cancer. A consecutive sample of 102 patients (participation 82%) under 72 years of age with locoregional breast cancer completed validated questionnaires on coping with cancer, emotional expression (anger), perceived available support, noncancer life stresses, and quality of life 3À4 months after diagnosis. Survival times were measured from the date of diagnosis to the date of relapse and further to the date of death or date of last follow-up. Cumulative Cox regression analyses were carried out. After controlling for biological prognostic factors, age, and baseline treatment, longer survival was predicted by a long education and a minimising-related coping, while shorter survival was predicted by emotional defensiveness (antiemotionality), behavioural-escape coping, and a high level of perceived support. A shorter event-free time was also predicted by unemployment and depressive symptoms. Cancer survival is affected by a complex combination of psychosocial factors, among which minimising predicts a favourable prognosis and anger nonexpression and escape behaviour an unfavourable prognosis. Higher socioeconomic status is associated with longer survival. High scores in well-being scales may reflect emotional nonexpression.
European Journal of Cancer, 2005
The possibility that psychological response within a few weeks of a breast cancer diagnosis can influence the outcome of the disease is a contentious issue. Psychological response, including helplessness/hopelessness, fighting spirit and depression was assessed in early-stage breast cancer patients between 1 and 3 months post-diagnosis, in order to ascertain effect on cancer prognosis. Patients were followed up for a period of 10 years in order to clarify the effect of psychological response on disease outcome. After 10 years, there is a continuing effect of helplessness/hopelessness on disease-free survival (adjusted hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.11-2.11) but not of depression (adjusted HR for overall survival for ÔcasesÕ 2.43, 95% CI 0.97-6.10). Longer follow-up also indicates that a high fighting spirit confers no survival advantage. The results showed that, in patients who were disease-free at 5 years, their baseline helpless/hopeless response still exerted a significant effect on disease-free survival beyond 5 (and up to 10) years. The effect is therefore maintained for up to 10 years of follow-up. Clinicians may wish to screen for helplessness around the time of diagnosis in order to target psychological care resources. Further large studies, with similarly prolonged follow-up, are needed to replicate this effect and clarify its mechanism of action.
Women's Psychological Behaviour in Breast Cancer
Women affected by breast cancer deal with a range of psychological and medical issues. The aim of this review article is to determine the extent to which the psychological distress is associated with cancer prevention practices. The results indicate that psychological distress was directly associated with an increased likelihood of daily smoking, physical inactivity and obesity amongst physiologically distressed adults which supports the need for integration of cancer prevention and related mental health interventions to reduce specific cancer risk in severe patients. The article also includes the basic idea of cancer, its signs and symptoms, causes, the different types with their respective causes and treatments, the patient characteristics that may influence psychological outcomes for breast cancer, the predictable responses that women may have at each stage of breast cancer making note of the meaning that breast cancer may hold for those influenced.
Psychosocial Factors Associated with Breast Cancer Patients
Journal of Social Work Education & Practice, 2019
Breast Cancer is the most complex treatment in the present scenario. When the patient is diagnosed with breast cancer, it affects patients' psychosocial condition. During the treatment process, patients suffer from depression, loss of hope, stress and other associated psychological issues. This study suggests that psychosocial factors are highly significant for persons with breast cancer. This paper also discusses the methodology of the study, level of psychological factors and provide recommendations for the health care institution and health care professionals focusing on patients' mental health aspects.
A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors
Psychology & Health, 2012
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Psychobiological Factors Predicting the Course of Breast Cancer
Journal of Personality, 1987
Drawing on a ciirefully controlled sample of 52 women with a history of breast carcinoma and 34 healthy controls, this prospective study examined empirical associations between psychological factors and the progression of neoplastic disorders over a follow-up penod averaging 624 days Psychological vanables were psychometncally assessed by self-report measures A multiple regression analysis which controlled for disease stage at onginal diagnosis, age, total length of disease course, hematological factors, and blood chemistries measured at study onset showed neoplastic spread to be associated with a repressive personality style, reduced expression of negative affect, helplessness-hopelessness, chronic stress, and comforting daydreaming The identified model of medical and psychological vanables accounted for 56% of the observed vanance A psychobiological model of brain-body disregulation provided the best account of the observed associations between psychological functioning and the progression of disease Future research is necessary to examine the role which psychological functioning may exert upon health-relevant behaviors that might blunt the benefits of professional health care This article is based on a dissertation submitted to the Graduate School of Yale University The author gratefully acknowledges the assistance of Professor Jerome L Singer, thesis sponsor, and the members of the committee (Professors Irving Jams,