Psychological Adjustment to Uncertain Outcomes: The Threat of Cancer Recurrence

Clinical impressions and anecdotal reports suggest that follow-up exams to detect cancer recurrence can be very stressful, yet recent research posits that most cancer patients recover emotionally from their diagnosis over the one to two years after diagnosis and treatment. The present study employed a limited, longitudinal design to describe the psychological responses of women in remission for a primary diagnosis of breast (n = 59) or colorectal (n = 20) cancer to follow-up exams, and to identify factors associated with differing levels of adjustment to the exams. Subjects were interviewed at three time points proximate to a follow-up exam: Approximately one month before, the night before, and two weeks after the exam was completed and results were known. In addition, physicians provided evaluations regarding prognosis and anxiety level for 67 of the subjects. Analysis of variance, Chi-square analysis, and Pearson product moment correlations revealed that subjects did indeed experience significant anxiety prior to the exams. However, disease site, stage of disease, months since diagnosis, and age of subjects were not related to reactions to the exam. How subjects conceptualized the time line of cancer (i.e., as a chronic/cyclic or acute disease) was the sole variable related to outcome measures of distress and coping. Those with a chronic/cyclic perspective were significantly more anxious, fearful of recurrence, depressed, and evaluated their social support network and medical care as less positive than those with an acute view of cancer. The theoretical issues regarding time line are discussed and clinical implications are suggested.

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Psychology

Grantor

University of Illinois at Urbana-Champaign

Year dc:date

2015

Author dc:creator

• Silverman, Cobie S.

Contributors dc:contributor

• Michael Andrykowski

• Health Sciences, Oncology

Language dc:language

eng

Identifier

(MiAaPQ)AAI9945000

OAI identifier oai:identifier

oai:www.ideals.illinois.edu:2142/82272