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Breast Cancer Survivors Bounce Back Quickly

Only two weeks after treatment ends, most women adjust emotionally, researchers find

THURSDAY, Dec. 29, 2005 (HealthDay News) -- Despite the psychological and physical trauma of having breast cancer, most survivors recover their emotional stability quickly once treatment ends, a new study finds.

In fact, most women have adjusted well just two weeks after their last round of therapy, said Teresa L. Deshields, a psychologist and lead author of the study, published in the December issue of Supportive Care in Cancer.

"Most of the [medical] literature hasn't looked at people as quickly after treatment as we did," said Deshields, an assistant professor of medicine at Washington University School of Medicine, in St. Louis. "People tend to bounce back quickly."

While most everyone hit a rough spot, things got better, and they improved quickly, she said: "Most people are pretty resilient. They can deal with traumatic experiences, and come out OK. They can figure out a way to cope with it."

For the study, Deshields and her team surveyed 94 women drawn from patients of the radiation oncology practice at the Siteman Cancer Center at Washington University and the Barnes-Jewish Hospital. The women were, on average, 55 years old and had stage 0, I, II or III breast cancer at the start of the study. All were finishing the last of a six- to seven-week course of daily radiation treatment. Their other cancer treatments varied, including surgery, chemotherapy and hormonal therapy.

The team surveyed them five times: the first interviews were on the last day of radiation treatment, then two weeks later, then four to six weeks later and then at three and six months after treatment ended. The survey asked about their depressive symptoms and their quality of life, as well as their mood and level of anxiety.

Right after the end of the treatment, the women did report elevated levels of depression and a lower quality of life, although anxiety levels were low, the team found. But by two weeks after the end of the radiation treatment, depression decreased significantly and overall quality of life improved greatly.

"The bottom line is, the majority of patients are doing OK," said Deshields. "Most of the time [study] results are presented as who is not doing well."

Her research, for a change of pace, is more good news than bad, she said. Only 6 percent of all the women in the study scored above the clinical cut-off for depression at every time point, she said. And at each survey point, 75 percent of the patients were not clinically depressed.

Deshields said she has never seen the two-week timeframe in other studies measuring emotional recovery. And when the team was designing the study, she had to be talked into measuring mood and depression as early as two weeks after treatment, she said.

"I thought, why are we doing two weeks? One of my co-authors, Tiffany Tibbs, really pushed for two weeks," she added, noting now she is glad she did.

The study did not ask the women how they coped or what they did to feel better emotionally and reclaim their previous quality of life, said Deshields. She suspects, from her clinical experience, that the coping mechanisms involved an array of measures. "Some may have embraced their religion, some joined support groups, saw a counselor," she said.

When she counsels those with cancer, she asks them to recall how they dealt with other life difficulties and employ the same strategies.

The findings come as no surprise to Salvatore Maddi, a professor in the School of Social Ecology at the University of California, Irvine. "Radiation treatment itself is so undermining that once it's over, you are happy," he said.

Maddi said, however, that another of the findings was interesting: that some of the women were not depressed. "That finding needs to be followed up on," he said. By looking more closely at these people, he said, researchers might be able to predict who will and won't have trouble with depression after cancer treatment.

"There might be some way of training people [to be more resilient after cancer treatment]," he said. Maddi's area of research interest is "hardiness," which he defines as "existential courage." He looks at what makes some people more resilient, and he is certain that people can learn hardiness.

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SOURCES: Teresa L. Deshields, Ph.D., assistant professor, medicine, Washington University School of Medicine, St. Louis; Salvatore Maddi, Ph.D., professor, University of California Irvine's School of Social Ecology; December 2005 Supportive Care in Cancer
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