Coping skills affect life after breast cancer

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Young women who are less able to cope with breast cancer and feel ill-prepared for the challenge tend to have a lower quality of life after their diagnosis, according to a review of studies on the topic.

U.S. researchers also found that young women in bad relationships fared worse with breast cancer than women in good relationship or without partners. Women who missed more time from work after their diagnosis also tended to have a lower sense of overall well being, the authors note.

"It’s how you cope with things in general” that appears to influence how you fare after learning you have breast cancer, study author Dr. Nancy E. Avis said.

For instance, if women believe they will beat cancer, deal well with it, and learn from the experience, they will likely do better, said Avis, who is based at Wake Forest University School of Medicine in Winston-Salem, North Carolina.

Previous research has shown that younger women tend to have a poorer quality of life after breast cancer than older women. Younger women may have a host of unique concerns, Avis and her team write in the Journal of Clinical Oncology, such as having young children and premature menopause leading to loss of fertility.

To investigate the influences upon young women’s overall quality of life after breast cancer, Avis and her team interviewed 202 women diagnosed with breast cancer at age 50 or younger, and asked them how they felt between 4 and 42 months after learning of their diagnosis.

They found that women with breast cancer had a lower overall quality of life than their counterparts without breast cancer and more than 7 out of 10 women with breast cancer said they experienced aches, pains and general unhappiness after being diagnosed.

Women who missed more work, had relationship problems, struggled with sexual problems, had a negative body image, and were less able to cope after being diagnosed all had a lower overall sense of well being.

In addition, feeling unprepared for living with breast cancer, having vaginal dryness, and continuing to undergo treatment appeared to influence some aspects of women’s quality of life.

Avis said that although women’s response to cancer is largely an “attitude thing,” doctors can help them deal with vaginal dryness and other symptoms of early menopause induced by chemotherapy, which may improve how they cope with cancer.

She added that women who stop working after learning they have breast cancer may be depressed, which could explain why not working is associated with a lower sense of well-being.

Avis stressed that there was “huge variety” in how women responded, and some coped quite well, but experts need to concentrate on those who don’t. “We need to figure out ways to help the women who have more trouble,” Avis noted.

SOURCE: Journal of Clinical Oncology, May 20, 2005.

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