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Psychological Reactions to Progression of Metastatic Breast Cancer-An Interview Study

Svensson, Helene PhD(c), RN; Brandberg, Yvonne PhD; Einbeigi, Zakaria MD, PhD; Hatschek, Thomas MD, PhD; Ahlberg, Karin PhD, RN

doi: 10.1097/01.NCC.0000343374.09270.ff
Articles

Knowledge about how patients experience their situation at the point of disease progression after first-line chemotherapy is limited. It is important to investigate this area to better understand and support women with advanced-stage disease. The study explored psychological reactions and coping on disease progression after first-line chemotherapy among women with metastatic breast cancer. Interviews were held with 20 patients with breast cancer who were included in a randomized study of first-line chemotherapy for metastatic breast cancer. Three themes emerged. "Before the information": Most of the women reported symptoms related to the disease progression before information about treatment failure. Thus, they were not surprised by the information. "Immediate after information": A range of psychological reactions were described. Most patients experienced sadness, disappointment, and setback in view of disease progress. Anxiety and worry about the future were reported. "Life after being informed of disease progression": Various strategies to cope with their situation were used, for example, work, social support, and church attendance. All women had disease progression. Worry was the most common emotional response. A number of strategies were used to cope with the situation. Most of the women responded with acceptance.

Authors' Affiliations: Institute of Health and Care Sciences, The Sahlgrenska Academy, Göteborg University, Göteborg, Sweden (Ms Svensson and Dr Ahlberg); Division of Selected Clinical Specialities, Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden (Ms Svensson and Dr Einbeigi); and Department of Oncology-Pathology, Radiumhemmet, Karolinska University Hospital, Stockholm, Sweden (Ms Brandberg and Dr Hatschek).

This research was funded by the King Gustav V Jubilee Clinic Cancer Research Foundation, the Swedish Cancer Society, and the Swedish Breast Cancer Association.

Corresponding author: Helene Svensson, PhD(c), RN, Department of Oncology, Sahlgrenska University Hospital, SE 413 45 Gothenburg, Sweden (helene.m.svensson@vgregion.se).

Accepted for publication July 1, 2008.

© 2009 Lippincott Williams & Wilkins, Inc.