Understanding Women's Concerns and Coping with Worry of Breast Cancer Recurrence

Abstract

Worry of cancer recurrence is prevalent among survivors of breast cancer. It can persist for years and undermine women's psychological wellbeing and overall adjustment. Thus far, we have limited knowledge about the individual, treatment and psychosocial characteristics that account for variations in worry of recurrence and its influence on psychological adjustment p ost treatment. Such knowledge is needed to inform interventions directed at alleviating recurrence worry, and improving psychological functioning in breast cancer survivors. Prior research suggests that more recent time since diagnosis, younger age, chemotherapy and trait anxiety contributes to psychological wellbeing. Whether these factors also contribute to worry of recurrence remains to be determined. Moreover, little is known about how women's beliefs about their cancer, influence worry of recurrence, or how women manage their worry of recurrence, and whether some coping strategies are more effective than others. The current study aimed to address these research gaps by evaluating worry of recurrence, coping with cancer worry, psychological wellbeing and quality of life among breast cancer survivors. The Common Sense Model of Self-Regulation was used as the guiding theoretical framework. The project also included the design and pilot testing of a new measure, Coping with Worry of Cancer Recurrence . A sample of 143 women who were in remission from breast cancer were recruited through the New Zeal and Cancer registry. Participants completed two questionnaires, each a month apart; 97.9 % completed both questionnaires. Analyses revealed that younger age, higher trait anxiety, and receiving chemotherapy and hormonal treatment were associated with greater worry of recurrence. In relation to cancer beliefs, perceptions of a more chronic timeline, more severe consequences and experiencing more symptoms perceived as a recurrence, predicted higher levels of worry of recurrence. With regards to coping strategies, emotional expression and optimistic thinking predicted lower levels of concurrent worry, while optimistic thinking and spirituality predicted decreases in worry of recurrence over time. Conversely, avoidance and problem solving strategies were associated with greater concurrent worry of recurrence, with avoidance also predicting increases in worry over time. Overall, the findings elucidate various factors associated with worry of recurrence, including illness beliefs and coping strategies. These findings can inform the development of psychological treatment of distress, by highlighting targets for intervention. Moreover, they can inform medical professional 's communications with women with breast cancer by identifying information that may be beneficial in circumventing distress.