Advances have improved survival among breast cancer (BC) patients and 89% can expect >5 year survival. The price for this survival, however, may be physical and psychosocial symptoms that persist many years into the survivorship trajectory. Unmet needs for symptom management and the relationships between unmet needs, symptom burden, and psychosocial adaptation remain unclear. We examined these relationships among longer term BC survivors.
Eligibility included non-metastatic BC survivors diagnosed > 3 years prior and attendance at a survivorship-focused appointment. Nineteen common symptoms of disease and treatment were evaluated and participants reported unmet need for assistance for each symptom they experienced. Psychosocial adaptation was assessed through the Hospital Anxiety and Depression Scale (HADS).
103 primarily white (72%), middle aged (M=62.7 yrs) BC survivors were recruited. Participants were, on average, 11.4 yrs from diagnosis and most (78.2%) reported Stage I or II BC. Participants reported an average of 9.2 symptoms, most commonly fatigue (67%), joint pain (66%), weight gain (60%), decreased sexual drive (55%), and insomnia (52%). Participants reported an average of 2.8 unmet needs for assistance with symptoms, most commonly joint pain (29%), fatigue (25%), weight gain (23%), and difficulty with memory (21%). Overall levels of depressive (M=2.45) and anxiety (M=4.89) symptoms were low, and elevated depressive and anxiety symptoms were reported by 3% and 18% of the sample, respectively. Number of symptoms and anxiety were unrelated to any demographic, disease or treatment variables. Depressive symptoms and unmet needs were related younger age (p < .05) and depressive symptoms were further related to not having received radiotherapy (p < .05). Number of symptoms experienced and unmet needs were moderately related to both depressive (all r > 0.49, p < .001) and anxiety symptoms (all r > 0.31, p < .01).
Among long term BC survivors symptoms are common, while unmet need and symptoms of anxiety and depression are more modest. However, both symptoms and unmet need are associated with symptoms of depression and anxiety and represent a potentially missed opportunity for improving outcomes among BC survivors.
Citation Format: Palmer SC, Blauch AN, Pucci DA, Jacobs LA. Symptom burden, unmet need for assistance, and psychosocial adaptation among longer term breast cancer survivors [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-13-12.