Influence of adjuvant radiotherapy on the psychological health in breast cancer patients treated with conservative surgery

Background: In literature there are only few informations about the influen ce of postoperative irradiation on the psychological health of breast cance r patients treated by breast conserving surgery. However, psychological dis tress and anxiety related to irradiation are often observed. Purpose of our study was the evaluation of the influence of radiotherapy-induced distress in these patients. Patients and Methods: Between October 1995 and June 1996 in 48 breast cance r patients (31 to 76 years old) treated by breast conserving surgery adjuva nt irradiation with or without systemic therapy was applicated. On the firs t and the last day of radiotherapy they were given a questionnaire (Table I ) which was designed together with psychologists. Covering different situat ions related to radiotherapy the construction of items are determined by fa ctors with possible influence on psychological distress and perception with regard to irradiation. Results: Most of the women (92%) stated to be well informed about the irrad iation and tried to obtain further information about this treatment (83%). 56% tried not to think about radiotherapy and/or to distract themselves (81 %). 40% were anxious about the fact to undergo irradiation. In the end of t reatment 77% reported to have been anxious only initially or never; only 19 % were anxious almost or most of the time. 35% were worried about the expec ted cosmetic alterations of their breast; only 30% observed acute cosmetic changes. With regard to situation-related distress all patients (100%) stat ed that the communication with the medical staff made it easier to stand th e irradiation treatment. Conclusions: In spite of theoretical considerations our results are explora tive in character. However, following statements seem to be important: 1. A large requirement exists to get information about radiotherapy. 2. The pat ients experience irradiation treatment more positive than initially expecte d by themselves. 3. With regard to radiotherapy anxiety is reduced during t he course of treatment. Here the psychosocial care of the medical staff is an important support for reduction of anxiety.