Persistent symptoms among survivors of Hodgkin's disease: An explanatory model based on classical conditioning

Persistent symptoms of nausea, distress, and vomiting triggered by reminder s of cancer treatment were examined among 273 Hodgkin's disease survivors, 1 to 20 years posttreatment. Prevalence rates were high for distress and na usea but low for vomiting. Retrospective report of anticipatory symptoms du ring treatment was the strongest predictor of persistent symptoms, suggesti ng that treatment-induced symptoms are less likely to persist if conditioni ng does not occur initially. Time since treatment was also a significant pr edictor, with patients more recently treated more likely to experience pers istent symptoms. Thus, an explanatory model based on classical conditioning theory successfully predicted presence of persistent symptoms. Symptoms al so were associated with ongoing psychological distress, suggesting that qua lity of life is diminished among survivors with persistent symptoms. Recomm endations for prevention and treatment of symptoms are discussed.