LIFE AFTER BREAST-CANCER - UNDERSTANDING WOMENS HEALTH-RELATED QUALITY-OF-LIFE AND SEXUAL FUNCTIONING

Purpose: To describe the health related quality of life (HRQL), partne r relationships, sexual functioning, and body image concerns of breast cancer survivors (BCS) in relation to age, menopausal status, and typ e of cancer treatment. Patients and Methods: A cross-sectional sample of BCS in two large metropolitan areas was invited to participate in a survey study that included the following standardized measures: the R AND 36-item Health Survey; the Centers for Epidemiologic Studies-Depre ssion Scale (CES-D); the Dyadic Adjustment Scale (DAS): the Breast Can cer Prevention Trial (BCPT) Symptom Checklist; the Watts Sexual Functi oning Questionnaire (WSFQ); and subscales from the Cancer Rehabilitati on Evaluation System (CARES). Results: Eight hundred sixty-four BCS co mpleted the survey RAND Health Survey scores were as good or better th an those of healthy, age-matched women, and the frequency of depressio n was similar to general population samples. Marital/partner adjustmen t was similar to normal healthy samples, and sexual functioning mirror ed that of healthy, age-matched postmenopausal pausal women. However, these BCS reported higher rates of physical symptoms (eg, joint pains, headaches, and hot flashes) than healthy women. Sexual dysfunction oc curred more frequently in women who had received chemotherapy (all age s), and in younger women who were no longer menstruating. In women gre ater than or equal to 50 years, tamoxifen therapy was unrelated to sex ual functioning. Conclusion: BCS report more frequent physical and men opausal symptoms than healthy women, yet report HRQL and sexual functi oning comparable to that of healthy, age-matched women. Nevertheless, some survivors still experience poorer functioning, and clinicians sho uld inquire about common symptoms to provide symptomatic management or counseling for these women. (C) 1998 by American Society of Clinical Oncology.