Πέμπτη, 26 Ιανουαρίου 2017

ANXIETY OF BREAST CANCER PARTNERS

Nearly half (42%) of the partners of young breast cancer survivors (diagnosed at age ≤40 years) experience anxiety, even years after their partner's diagnosis, according to a new survey of 289 such partners.
The partners were overwhelming male (98%), and those who used "less constructive" and "maladaptive" coping behaviors were twice as likely to experience anxiety as their peers in the survey, reported lead author, Nancy Borstelmann, MPH, MSW, director of social work at Dana-Farber Cancer Institute in Boston, Massachusetts.
Maladaptive coping includes behaviors such as emotional withdrawal, denial, drinking alcohol, blaming, and aggression, said Borstelmann, adding that this behavior was "strongly" associated with higher levels of anxiety.
The findings reinforce the need for greater caregiver support, she said.
"Caregivers' mental health and how they cope needs attention," Borstelmann said at a presscast that preceded the 2017 Cancer Survivorship Symposium, to be held later this week in San Diego, California, where the study will be presented.
"When partners of breast cancer patients take care of themselves, it really does benefit everyone," said Merry Jennifer Markham, MD, from the University of Florida, Gainesville, who moderated the presscast and is an American Society of Clinical Oncology expert.
Dr Markham acknowledged that caregivers often neglect themselves when a loved one gets a cancer diagnosis but, in that scenario, various troubles can follow.
Intervene early, she advised: "Ask partners how they are doing to bring them into the conversation." Helpful resources include support groups, information materials on cancer, and meetings with a social worker or psychologist.
In this study, partners filled out the survey a median of 62 months after their counterpart was diagnosed with breast cancer. The survey included the Brief COPE, a tool for assessing the coping strategies used in response to stress. The tool assesses use of such strategies as acceptance of diagnosis, positive reframing, planning, and emotional support.
Respondents, who had a median age of 43 years, were mostly white (93%), working full time (94%), and college educated (78%) and were parents of children younger than 18 years (74%).
A minority (29%) reported some financial stress, and one third (32%) reported at least a fair amount of relationship concern.
In univariable analyses, anxiety was associated (P < .05) with several factors, including having less than a college education, working full time, parenting concerns, insufficient social support, and maladaptive coping.
However, in the multivariable model, only maladaptive coping remained significantly associated with anxiety (odds ratio, 2.32; 95% confidence interval, 1.22 - 4.39; P < .01).
However, Borstelmann also said that having less than a college education was also "strongly associated" with anxiety.
Dr Markham addressed this demographic-associated risk, saying that such men tend to have lower incomes and less access to resources, and have not been socialized into the healthcare system. "They're hesitant to speak up," she said.
In a press statement, Borstelmann summed up the study results: "Cancer doesn't just happen to one person; it has an impact on the entire family." She also pointed out that a breast cancer prognosis may be worse for women under 40 because of more aggressive tumor types, which may add to partner stress.
2017 Cancer Survivorship Symposium. Abstract 184. To be presented January 28, 2017.

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