Under Toad Days: Surviving the Uncertainty of Cancer Recurrence

McKinley, Elizabeth D.

doi:10.7326/0003-4819-133-6-200009190-00019

Cited by 47 publications

(50 citation statements)

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“…Instead, mean distress scores declined, and the decline was significant for intrusive thoughts. These results are perplexing given the multitude of personal anecdotes (Mullan, 1985;McKinley, 2000), clinical observations (Rowland and Holland, 1990;Schnipper, 2001), and information collected via structured interview (Ward et al, 1992;Beisecker et al, 1997), suggesting that the post-treatment period is marked by distress, anxiety, transition, and disruption. However, results are consistent with a previous empirical investigation of breast cancer survivors (Deshields et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

“…The completion of adjuvant treatment (chemotherapy and/or radiation therapy) may be one such period. Case studies and other anecdotal evidence in the literature suggest that the months immediately following the end of adjuvant treatment is a time of disruption, transition, and increased distress (Ward et al, 1992;Lethborg et al, 2000;McKinley, 2000;Schnipper, 2001).…”

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confidence: 99%

“…Much of the evidence regarding disrupted adjustment during the months following treatment completion is anecdotal (Mullan, 1985;McKinley, 2000), and health-care providers have also described clinical observations of increased distress during this time (Rowland and Holland, 1990;Schnipper, 2001). Other studies have obtained information regarding distress via structured interviews of small patient samples.…”

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confidence: 99%

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Adjusting to life after treatment: distress and quality of life following treatment for breast cancer

et al. 2007

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Clinical and anecdotal findings suggest that the completion of cancer treatment may be marked by heightened distress and disrupted adjustment. The present study examined psychological adjustment during the 3 months following treatment among 89 women with stages 0 -III breast cancer. Participants completed measures of depression, cancer-related anxiety, cancer concerns, and quality of life at three time points: during treatment, 3 weeks following the end of treatment, and 3 months post-treatment. Post-treatment scores were suggestive of good psychological adjustment among the majority of women. Moreover, distress did not increase following treatment; longitudinal analyses showed no significant changes in depression or recurrence worry, while intrusive thoughts decreased, and quality of life improved. Younger age predicted greater distress across measures. A history of depression or anxiety predicted greater depressive symptomatology, while more extensive treatment predicted greater cancer-related anxiety. Despite the lack of distress endorsed on general depression and anxiety indices, participants reported moderate distress associated with cancer-related concerns, including physical problems, fear of cancer recurrence, and resuming normal life. In sum, while breast cancer survivors demonstrate good adjustment on general distress indices following treatment, some women are at risk for sustained distress. Moreover, significant cancer-related concerns are prevalent and may be important intervention targets.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Adjusting to life after treatment: distress and quality of life following treatment for breast cancer

et al. 2007

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“…Twenty years ago, Dr. Fitzhugh Mullan, Chief Medical Officer of the Office of Medical Applications of Research at the National Institutes of Health, wrote about his own experience with cancer and what he called the "reentry" phase. 10,11 The themes Dr. Mullan described in his process of the resumption of life as an active adult 10 are remarkably similar to those that were identified by other cancer survivors, 12,13 healthcare professionals, 9,[12][13][14][15] and qualitative researchers 16 -19 over the next 2 decades. An important point made by those writers was that the challenges faced during reentry often are unanticipated and leave the individual feeling ill-prepared to manage them.…”

Section: The Adaptive Tasks Of Reentrymentioning

confidence: 93%

“…An important point made by those writers was that the challenges faced during reentry often are unanticipated and leave the individual feeling ill-prepared to manage them. 12 Instead of being able to predict the challenges, many patients and their intimate others hold expectancies that we may describe as the "myths of treatment completion" (see Table 1). …”

Section: The Adaptive Tasks Of Reentrymentioning

confidence: 99%

Promoting adjustment after treatment for cancer

Stanton

Ganz

Rowland

et al. 2005

Cancer

183

157

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The transition from the period of diagnosis and medical treatment of cancer to survivorship (i.e., the reentry phase) is an understudied phase in the cancer trajectory. The objectives of this report were 1) to illustrate several adaptive tasks of the reentry phase, 2) to provide examples of research on factors that predict positive adjustment during this phase, and 3) to discuss interventions that address the adaptive tasks of early cancer survivorship. Although the pertinent empirical literature is scarce, accounts from cancer survivors, healthcare professionals, and qualitative researchers converge to suggest several themes in adaptive tasks during reentry. Drawing from the authors' work and that of others, the authors have described common expectancies held by many individuals approaching reentry (e.g., "I shouldn't need support"), typical concerns during this phase (e.g., concern over cancer recurrence), and personal and contextual factors that can facilitate and

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Testing a model of symptoms, communication, uncertainty, and well-being, in older breast cancer survivors

2006

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Among older, long-term breast cancer survivors, symptoms from previous treatment can generate uncertainty about whether they represent co-morbid conditions, recurrence, or normal aging. This uncertainty can result in emotional distress and thoughts of recurrence. Communication with health care providers may help women reduce uncertainty and improve both emotional and cognitive well-being. To assess the influence of symptoms, uncertainty, and communication with providers on well-being, data from 203 Caucasian and African American survivors, 5-9 years post treatment, were tested using structural equation modeling. Symptoms, age, and uncertainty had the strongest influence on well-being, regardless of race. There was an unexpected positive association between patient-provider communication and thoughts of recurrence. Descriptive analysis revealed that 52% of women were unable to achieve their desired decision-making role with health care providers.

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Under Toad Days: Surviving the Uncertainty of Cancer Recurrence

Cited by 47 publications

References 0 publications

Adjusting to life after treatment: distress and quality of life following treatment for breast cancer

Adjusting to life after treatment: distress and quality of life following treatment for breast cancer

Promoting adjustment after treatment for cancer

Testing a model of symptoms, communication, uncertainty, and well-being, in older breast cancer survivors

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