Lingering fatigue and symptom burden were found to increase cancer worry, or the fear that the disease would return, among a group of women who had survived breast cancer.
Prior research has indicated that more than a third of breast cancer survivors worry about their cancer recurring. The researchers distinguished cancer worry, an emotional reaction, from risk perception, a cognitive reaction. They hypothesized that a majority of cancer worry would be related to greater fatigue severity, more symptom burden and a greater perceived risk.
The researchers measured risk perception, cancer worry, symptom burden and fatigue severity in 202 women with stage 0 to stage II breast cancer. Self-reported measures were taken 3 years after the women had completed treatment for their disease.
About 66% of patients expressed a moderate level of breast cancer worry. This greater worry was more prevalent in patients who were younger (P<.01), had undergone chemotherapy (P<.01), and reported more fatigue (P<.01), greater perceived risk (P<.001) and greater symptom burden (P<.01). Researchers found no association between worry and race, education or stage of disease, nor was there an association between worry and whether patients had undergone hormone therapy or mastectomy.
After the researchers controlled the data for demographic and clinical factors, fatigue, symptom burden and risk perception accounted for 27% of the variance in cancer worry (P<.01). When demographic and clinical factors were included, all of these things combined accounted for 33% of variance in breast cancer worry.
“Clinicians should be aware that, 3 years after completing adjuvant treatment, breast cancer survivors who report experiencing fatigue and other symptoms may also be experiencing greater cancer worry than those who report less residual symptoms,” the researchers wrote. “Consideration should be given to referring survivors experiencing heightened worry to a mental health professional.”