Breast CancerWoman Health

How Women Cope With the Stress of Breast Cancer

“Today the dominant view about the experience of having breast cancer is that being diagnosed and treated constitute crises in the lives of women who experience them, but the experience spans a year by most women with the early stage of the disease (i.e., women with a favorable prognosis). However, some women may feel the diagnosis and treatment are more traumatic and display some symptoms of post-traumatic stress disorder.

These issues make unique contributions to predicting emotional distress, sexual disruption, and impairments in feelings of femininity in these women as well. In two separate groups of women, patients with early-stage breast cancer who expected to remain cancer free in the future reported less emotional distress.

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It also appears that there are significant ethnic differences in the concerns reported and the adverse reactions expressed by patients with breast cancer. Hispanic women report more intense concerns than do other women, as well as higher levels of emotional distress and social and sexual disruptions, whereas African American women report lower levels of distress and disruption in sense of femininity than the other groups.

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In addition to individual differences in adjustment that are attributable to ethnicity, we are also learning that specific personality and contextual factors may also predict how a woman will adjust during the breast cancer treatment experience. Personality factors involved in the ways the cancer experience is appraised may also affect adjustment and quality of life among women with breast cancer. One of these dimensions is optimism versus pessimism. This variable (which is assessed before surgery) predicts emotional distress at several points during the year after surgery in patients with breast cancer.

How does being optimistic protect women from being distressed? Evidence shows that the effects are a result of different coping strategies. Specifically, greater acceptance as a coping strategy predicts lower distress, whereas the use of disengagement predicts more distress after surgery. Disengagement also appears to mediate the effects of pessimism on the development of distress up to 6 months after surgery. These findings are similar to those from another study involving patients with breast cancer who were assessed before and after undergoing breast biopsies and 3 weeks after surgery.

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Together these studies suggest that certain kinds of coping responses are important in their own right, a conclusion supported by other recent prospective studies of coping in patients with breast cancer.
It also suggests that patients with cancer may benefit from the opportunity to modify cognitive appraisals (i.e., increase optimism and use of acceptance and positive reframing through cognitive restructuring and coping-skills training) in the context of a psychosocial intervention.”


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