Symptom incidence, distress, cancer‐related distress, and adherence to chemotherapy among African American women with breast cancer

• Published in: Cancer 2017-06, Vol.123 (11), p.2061-2069
• Main Authors: Yee, Melissa K., Sereika, Susan M., Bender, Catherine M., Brufsky, Adam M., Connolly, Mary C., Rosenzweig, Margaret Q.
• Format: Article
• Language: English
• Subjects: Adhesion; Adult; African Americans; African Americans - psychology; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Body Image - psychology; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - psychology; Cancer; Chemotherapy; Correlation analysis; Deterioration; distress; Emotions; Fatigue - chemically induced; Fatigue - epidemiology; Fatigue - psychology; Female; Gastrointestinal Diseases - chemically induced; Gastrointestinal Diseases - epidemiology; Gastrointestinal Diseases - psychology; Humans; Incidence; Medication Adherence - psychology; Middle Aged; Oncology; racial disparity; Randomized Controlled Trials as Topic; Sleep Initiation and Maintenance Disorders - chemically induced; Sleep Initiation and Maintenance Disorders - epidemiology; Sleep Initiation and Maintenance Disorders - psychology; Stress, Psychological - psychology; symptoms; Women - psychology
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.30575

BACKGROUND There is a persistent racial survival disparity between African American (AA) and white women with breast cancer. There is evidence that symptom incidence, associated distress, and overall cancer‐related distress may be unexplored, important contributing factors. The purpose of the current study was to: 1) describe and compare the number of chemotherapy‐related symptoms and associated distress among AA women with breast cancer over the course of chemotherapy at 3 time points (at baseline before initiating chemotherapy, midpoint, and at the completion of chemotherapy); and 2) to describe the relationship between the number of chemotherapy‐related symptoms and overall cancer distress compared with the ability to receive at least 85% of the prescribed chemotherapy within the prescribed timeframe. METHODS Descriptive, comparative, and correlational analyses of symptom incidence, symptom distress, cancer‐related distress, and prescribed chemotherapy dose received among a cohort of AA women receiving chemotherapy for breast cancer were performed. RESULTS AA women (121 women) experienced worsening symptoms from baseline to midpoint in chemotherapy and then stabilized for the duration of therapy. The inability to receive 85% of the prescribed chemotherapy within a prescribed time point was found to be significantly correlated with midpoint symptom distress. CONCLUSIONS The main findings of the current study were that AA women experience a deterioration in symptom distress over the course of chemotherapy from baseline (before chemotherapy) to the midpoint, which was found to be associated with less adherence to chemotherapy overall. Thus, the incidence and management of physical and emotional symptoms, as measured through a multidimensional symptom measurement tool, may be contributing to breast cancer dose disparity and should be explored further. Cancer 2017;123:2061–2069. © 2017 American Cancer Society. In the current study, African American women are found to experience a deterioration in overall symptom incidence, particularly over the course of chemotherapy from baseline (before chemotherapy) to the midpoint, which appears to be associated with less adherence to chemotherapy overall. Thus, the incidence and management of chemotherapy‐related symptoms may be contributing to breast cancer dose disparity and should be explored further.