Article

Behavioral Symptoms in Patients With Breast Cancer and Survivors

University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA.
Journal of Clinical Oncology (Impact Factor: 18.43). 03/2008; 26(5):768-77. DOI: 10.1200/JCO.2007.14.3248
Source: PubMed

ABSTRACT Behavioral symptoms are a common adverse effect of breast cancer diagnosis and treatment and include disturbances in energy, sleep, mood, and cognition. These symptoms cause serious disruption in patients' quality of life and may persist for years after treatment. Patients need accurate information about the occurrence of these adverse effects as well as assistance with symptom management. This review considers four of the most common behavioral sequelae of breast cancer, namely fatigue, sleep disturbance, depression, and cognitive impairment. Research on the prevalence, mechanisms, and treatment of each symptom is described, concluding with recommendations for future studies.

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    • "For example, breast cancer patients with sleep disturbance display elevated levels of cortisol and norepinepherine, accompanied by increased SNS activity and increased 24- h metabolic rate, indicating physiological hyperarousal (Carlson et al., 2007a). Even though sleep disturbance is a persisting problem, it may not always be dealt with effectively in post-treatment cancer survivor care (Bower, 2008; Ancoli-Israel, 2009). As an alternative to conventional treatments for sleep disturbance in cancer patients and survivors (besides in many other clinical populations), non-pharmacological or behavioral interventions such as mind—body therapies have increasingly shown promise (Carlson and Bultz, 2008; Kwekkeboom et al., 2010). "
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    ABSTRACT: Cancer survivors experience high levels of distress, associated with a host of negative psychological states, including anxiety, depression, and fear of recurrence, which often lead to sleep problems and reduction in quality of life (QOL) and well-being. As a neuropeptide hormone associated with affiliation, calmness, and well-being, oxytocin may be a useful biological measure of changes in health outcomes in cancer survivors. In this exploratory study, which comprised a subset of participants from a larger study, we evaluated (a) the feasibility and reliability of salivary oxytocin (sOT) levels in cancer survivors and (b) the effects of 2 sleep-focused mind-body interventions, mind-body bridging (MBB) and mindfulness meditation (MM), compared with a sleep hygiene education (SHE) control, on changes in sOT levels in 30 cancer survivors with self-reported sleep disturbance. Interventions were conducted in 3 sessions, once per week for 3 weeks. Saliva samples were collected at baseline, postintervention (~1 week after the last session), and at the 2-month follow-up. In this cancer survivor group, we found that intra-individual sOT levels were fairly stable across the 3 time points, of about 3 months' duration, and mean baseline sOT levels did not differ between females and males and were not correlated with age. Correlations between baseline sOT and self-report measures were weak; however, several of these relationships were in the predicted direction, in which sOT levels were negatively associated with sleep problems and depression and positively associated with cancer-related QOL and well-being. Regarding intervention effects on sOT, baseline-subtracted sOT levels were significantly larger at postintervention in the MBB group as compared with those in SHE. In this sample of cancer survivors assessed for sOT, at postintervention, greater reductions in sleep problems were noted for MBB and MM compared with that of SHE, and increases in mindfulness and self-compassion were observed in the MBB group compared with those in SHE. The findings in this exploratory study suggest that sOT may be a reliable biological measure over time that may provide insight into the effects of mind-body interventions on health outcomes in cancer survivors. © The Author(s) 2015.
    Integrative Cancer Therapies 04/2015; 14(4). DOI:10.1177/1534735415580675 · 2.01 Impact Factor
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    • "A nivel mundial, el cáncer de mama es una amenaza para la salud de la mujer, por lo que se considera una prioridad en salud en los países desarrollados (Knaul et al., 2009). A pesar de los avances en el desarrollo de terapias más efectivas y menos invasivas, el diagnóstico de cáncer sigue siendo un reto debido las consecuencias psicológicas y comportamentales que los pacientes enfrentan aun después del tratamiento tales como: depresión, fatiga, trastornos del sueño y disfunción cognitiva, estas son las secuelas más comunes en las pacientes con cáncer de mama (Bower, 2008; Miller, Ancoli-Israel, Bower, Capuron y Irwin, 2008). Sin embargo, entre todos estos síntomas, la fatiga es el más comúnmente experimentado y es considerado uno de los principales problemas que afectan la calidad de vida de los pacientes con cáncer, ya que el 80% de ellos lo presentan en alguna fase de la enfermedad (Font, Rodríguez y Buscemi, 2004). "
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    ABSTRACT: El objetivo de este estudio fue evaluar la relación entre la fatiga, la sintomatología de depresión y la calidad de sueño con indicadores de cortisol y determinar cuáles son las variables que explican la fatiga en mujeres con cáncer de mama. Participaron 17 mujeres con cáncer de mama previo al tratamiento de quimioterapia, las cuales proporcionaron 12 muestras de saliva durante dos días consecutivos y respondieron las escalas de Fatiga (MFI), Depresión (BDI) y Calidad de Sueño (ICSP). Los resultados obtenidos muestran que la latencia de sueño explica en un 41.7% la reducción de la actividad y que la disfunción diurna explica en un 48.8% de la fatiga mental, lo que nos sugiere un enfoque de intervención en esta fase del proceso del cáncer.
    Anuario de Psicologia 01/2015; 45(1):101-113.
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    • "Therefore , future research will need to investigate IL - 6 ' s mechanistic role using standard mediation analysis techniques . Pain and depressive symptoms affect a significant portion of breast cancer survivors ( Bower , 2008 ; Gartner et al . , 2009 ; Mitchell et al . "
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    ABSTRACT: Objective Pain and depressive symptoms are commonly experienced by cancer survivors. Lower social support is linked to a variety of negative mental and physical health outcomes among survivors. Immune dysregulation may be one mechanism linking low social support to the development of pain and depressive symptoms over time. Accordingly, the goal of the present study was to examine the relationships among survivors’ social support, pain, depressive symptoms, and inflammation. Methods Breast cancer survivors (N = 164, stages 0-IIIA) completed two study visits, one before any cancer treatment and the other 6 months after the completion of surgery, radiation, or chemotherapy, whichever came last. Women completed self-report questionnaires assessing social support, pain, and depressive symptoms, and provided a blood sample at both visits. Results Survivors with lower social support prior to treatment experienced higher levels of pain and depressive symptoms over time than their more socially supported counterparts. Furthermore, women with lower pretreatment social support had higher levels of IL-6 over time, and these elevations in IL-6 predicted marginally larger increases in depressive symptoms. Conclusions The results of this study suggest that social support at the time of diagnosis predicts the post-treatment development of pain, depressive symptoms, and inflammation. Consequently, early interventions targeting survivors’ social networks could improve quality of life during survivorship.
    Psychoneuroendocrinology 04/2014; 42:38-44. DOI:10.1016/j.psyneuen.2013.12.016 · 5.59 Impact Factor
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