Breast can­cer sur­vivors may have lin­ger­ing men­tal health ef­fects LISA RAPAPORT

Business Standard - - ECONOMY -

Breast can­cer sur­vivors may be more likely to ex­pe­ri­ence anx­i­ety, de­pres­sion, sleep trou­bles and other men­tal health is­sues than women who have not been di­ag­nosed with the dis­ease, a re­search re­view sug­gests.

The study team ex­am­ined data from 60 pre­vi­ously pub­lished stud­ies of women who had sur­vived breast can­cer that fo­cused on a va­ri­ety of psy­cho­log­i­cal is­sues as well as chal­lenges with cog­ni­tive and sex­ual func­tion one year or more af­ter treat­ment.

“We al­ready knew that women ex­pe­ri­ence sub­stan­tial psy­cho­log­i­cal dis­tress around the breast can­cer di­ag­no­sis and dur­ing the main treat­ment pe­riod,” said lead study au­thor He­lena Car­reira of the Lon­don School of Hy­giene & Trop­i­cal Medicine in the UK.

“There is a need for greater aware­ness that anx­i­ety, de­pres­sion and cog­ni­tive and sex­ual dys­func­tions are com­mon af­ter breast can­cer, and that treat­ments are avail­able,” Car­reira said by email. “Early de­tec­tion and treat­ment of any men­tal health is­sues that arise is likely to help women bet­ter cope with the dis­ease and its af­ter­math.”

Newer screen­ing, di­ag­no­sis and treat­ment op­tions have trans­formed breast can­cer from a fa­tal ill­ness into a chronic ill­ness for many women, leav­ing sur­vivors to con­tend with a wide range of phys­i­cal and men­tal health is­sues that may re­sult from the tu­mors or from treat­ments to de­stroy the tu­mors.

De­pend­ing on the type of breast can­cer and treat­ment women had, they may have an in­creased risk of blood clots, strokes, bone weak­ness, frac­tures, breath­ing dif­fi­cul­ties and sex­ual health prob­lems, pre­vi­ous re­search has found.

Dis­tress, de­pres­sion and anx­i­ety may also be on­go­ing prob­lems for breast can­cer sur­vivors, par­tic­u­larly if they were younger when they were di­ag­nosed or had a his­tory of men­tal ill­ness prior to the can­cer di­ag­no­sis, some prior stud­ies also sug­gest.

The cur­rent anal­y­sis, pub­lished in the Jour­nal of the Na­tional Can­cer In­sti­tute, takes a closer look at the po­ten­tial for a broad range of men­tal health is­sues to sur­face af­ter women get through breast can­cer treat­ment.

For ex­am­ple, breast can­cer sur­vivors had up to twice the odds of de­vel­op­ing anx­i­ety as women who never had can­cer in some of the smaller stud­ies that ex­am­ined this ques­tion.

Up to one in five breast can­cer sur­vivors had anx­i­ety in stud­ies that looked for this di­ag­no­sis in elec­tronic health records, while as many as half of them had anx­i­ety in stud­ies that as­sessed anx­i­ety by giv­ing women ques­tion­naires about anx­i­ety symp­toms, the cur­rent anal­y­sis found.

Breast can­cer sur­vivors also had up to twice the risk of de­pres­sion. One in 10 breast sur­vivors had de­pres­sion based on med­i­cal records look­ing for this di­ag­no­sis, while the fig­ure climbed to 30 per­cent in stud­ies that ques­tioned women about their symp­toms.

From 20 per­cent to 40 per­cent of breast can­cer sur­vivors ex­pe­ri­enced neu­rocog­ni­tive im­pair­ments like chal­lenges with mem­ory, the anal­y­sis also found.

Breast can­cer sur­vivors were also up to two times more likely to ex­pe­ri­ence sex­ual dys­func­tion than women who had not been di­ag­nosed with tu­mors.

One lim­i­ta­tion of the anal­y­sis is that re­searchers didn’t pool data across the smaller stud­ies to as­sess the po­ten­tial for men­tal cog­ni­tive, or sex­ual is­sues af­ter a breast can­cer di­ag­no­sis. The smaller stud­ies in the anal­y­sis also used a wide va­ri­ety of meth­ods to mea­sure out­comes like de­pres­sion.

The in­cluded stud­ies also fo­cused mostly on older women, and younger breast can­cer sur­vivors tend to have higher rates of anx­i­ety and de­pres­sion than their older coun­ter­parts, said Dr. Fre­monta Meyer of the Dana-Far­ber Can­cer Cen­ter in Bos­ton.

Breast can­cer sur­vivors may also find that their in­creased risk of men­tal health prob­lems is most pro­nounced in the first years af­ter their di­ag­no­sis, Meyer, who wasn’t in­volved in the anal­y­sis, said by email.

De­pres­sion and anx­i­ety may be on­go­ing prob­lems for breast can­cer sur­vivors


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