Physical symptoms/side effects during breast cancer treatment predict posttreatment distress

Ann Behav Med. 2007 Oct;34(2):200-8. doi: 10.1007/BF02872674.


Background: Studies suggest that the period following completion of treatment can be distressing for cancer patients. One potentially important predictor of distress is physical symptoms/side effects during treatment.

Purpose: A longitudinal, observational design was used to examine whether the number of physical symptoms/side effects experienced during treatment was a correlate of cancer-related distress and general distress 4 months after treatment completion, as measured by the Impact of Events Scale and the Mental Health subscale of the Short Form-36, respectively.

Methods: Participants were 151 women who had completed chemotherapy and/or radiotherapy for ductal carcinoma in situ or stage 1 or 2 breast cancer. Hierarchical multiple regression was conducted with relevant sociodemographic, clinical, and psychiatric variables entered as controls.

Results: Greater physical symptoms/side effects predicted greater total cancer-related distress, intrusive thoughts, and general distress. Physical symptoms/side effects did not significantly predict avoidance. Follow-up analyses indicated that the relationship between physical symptoms/side effects and general distress was mediated by both total cancer-related distress and intrusive thoughts.

Conclusions: These results suggest that patients who experience greater physical symptoms/side effects during treatment are at greater risk for later cancer-related distress and, in turn, general distress. Future research should evaluate whether early intervention with these patients is effective in preventing or reducing distress in the posttreatment period.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / toxicity*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / psychology*
  • Breast Neoplasms / radiotherapy
  • Carcinoma, Intraductal, Noninfiltrating / drug therapy
  • Carcinoma, Intraductal, Noninfiltrating / psychology*
  • Carcinoma, Intraductal, Noninfiltrating / radiotherapy
  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Radiotherapy / adverse effects*
  • Radiotherapy / psychology
  • Risk Factors
  • Sick Role
  • Stress Disorders, Traumatic / diagnosis
  • Stress Disorders, Traumatic / psychology*