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The
incidence of breast cancer in the United States has steadily increased
since the 1970's, as have survival rates. For many women, breast
cancer has become a chronic disease to be managed over many years.
The scope of concern about cancer has changed from adjustment to disease
onset to encompass issues of long-term adjustment, quality of life, and
survivorship. Roughly a quarter of the women diagnosed with breast cancer
are under the age of 50. Some studies report that age has little
influence on adjustment, while other studies have found that younger women
are at greater risk for psychological distress and have a somewhat different
set of challenges and needs than older women. Most interventions
provided to women with breast cancer have been targeted toward the initial
diagnosis and treatment period. Accumulating research suggests that
distress and cancer concerns may increase in prevalence at the time when
adjuvant treatment ends.
To address these issues, an earlier research study, the Breast Cancer Recovery Project (BCRP), randomly assigned younger women, within 2 months of having completed non-hormonal adjuvant treatment to a 3-arm intervention, consisting of a control arm, an education arm, and a nutrition arm. The results of the earlier phase of the BCRP showed that participants assigned to the two intervention arms had significantly fewer depressive symptoms and better physical functioning by the 13-month follow-up. The results also showed that the effects of the interventions were becoming stronger across time, rather than staying the same or becoming weaker as is the case with most intervention studies. In addition, the study found that there were important mediational pathways (intrusive thoughts, self-concept, self-efficacy, and concerns about cancer recurrence and mortality) underlying the intervention effects. |
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The primary objective of this pilot project is to establish the feasibility of collecting long term follow-up data on the group of women that had earlier participated in the Breast Cancer Recovery Project. This will be done by demonstrating that the earlier participants can be re-contacted, that the planned protocol is acceptable and re-consent can be obtained, and to begin the data collection. Participants in the pilot study will complete the same psychosocial interview to be used in the follow-up study, one that is closely modeled on the interview questionnaire used in the earlier phases. They will also complete salivary cortisol sampling, actigraphy, and hip and waist measures. Additional funding for a two-phase follow-up up study of the earlier participants is being sought from the National Institutes of Health. Findings from the pilot study will be used to substantiate our ability to successfully recruit and re-consent previous participants into the survivor follow-up study. This research utilizes key elements of the Pittsburgh Mind-Body Center's psychobiological model, and should provide us with information on the long-term effects of breast cancer diagnosis and treatment as well as on the long-term effects of psychosocial interventions.
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| 12/20/2005 tc |
