Many women who’ve been diagnosed with breast cancer feel angry, sad, tired, anxious, stressed, depressed -- a whole rollercoaster of emotions. These feelings are complex, resulting from and affected by many factors: the cancer diagnosis and treatment, aging, hormonal changes, life experiences, and genetics.
These feelings and challenges don’t end when treatment ends. Many women who’ve been diagnosed and treated for early-stage breast cancer say they have to cope with lingering physical and emotional symptoms once treatment is over, including:
- fear of recurrence (the cancer coming back)
- losing the safety net of almost constant contact with their doctors and other healthcare providers
- a lower level of support from family and friends
- returning to work
- restarting a social life
A Dutch study has found that a web-based tool called BREATH can help women feel less stressed and anxious after breast cancer treatment ends. Still, the effect only lasted as long as the program.
The research was published online on July 13, 2015 by the Journal of Clinical Oncology. Read the abstract of “BREATH: Web-Based Self-Management for Psychological Adjustment After Primary Breast Cancer -- Results of a Multicenter Randomized Controlled Trial.”
BREATH (Breast Cancer E-Health) is a 16-week online program that focuses on specific psychological issues that women diagnosed with early-stage breast cancer face in the first year after they finish treatment and are trying to develop their “new normal.”
The BREATH program is based on cognitive behavioral therapy, a specific type of short-term, goal-oriented therapy that takes a hands-on, practical approach to problem-solving. Its goal is to change the patterns of thinking or behavior that are behind the problems people are having, so that the way they feel changes.
Besides information, BREATH includes homework assignments, self-assessment tests, and videos. Each week, a new module is posted online and women are sent email reminders to complete the module.
This study involved 150 women who had been diagnosed with early-stage breast cancer and had finished their primary treatment (surgery plus chemotherapy and/or radiation therapy) 2 to 4 months earlier. The women were about 50 years old and most of them were treated with surgery plus chemotherapy and radiation therapy. About 66% of the women also were treated with hormonal therapy.
At the beginning the study, all the women were assessed for psychological and emotional distress, including fear of recurrence, fatigue, quality of life, valuing of life, empowerment, and fulfillment.
The researchers then randomly split the women into two groups:
- one group participated in the BREATH program and also received usual care (70 women)
- the other group received only usual care (80 women)
Usual care consisted of oncologist visits 3 times per month, as well as information and emotional support when requested by the woman or recommended by her doctor.
The women’s psychological and emotional distress was assessed at 4, 6, and 10 months after the study started.
At the 4-month assessment, the women who participated in the BREATH program reported less distress than the women who were in the usual care group. This difference was statistically significant, which means that it was likely because of the difference in programs and not just due to chance. Empowerment was about the same in the two groups.
The researchers found that more women in the BREATH program responded well to treatment compared to women in the usual care group:
- 39 of 70, or 56%, of women in the BREATH group responded well to treatment
- 32 of 80, or 40%, of women in the usual care group responded well to treatment
Still, at the 6- and 10-month assessments, women in both groups had similar levels of distress. This means that the effect of the BREATH program didn’t last past the 16 weeks of the program. The researchers said that it might have been better if the women in the BREATH group had access to the program for longer than 16 weeks so they could refer back to it.
While the results of this study are promising, more and larger studies need to be done to figure out how often the BREATH program should be done so women get the most benefits from it.
If you’re struggling to establish your new normal after breast cancer treatment and are feeling helpless or hopeless, battling depression or sadness, or having other symptoms of emotional distress, it’s important to tell your doctor about your feelings. Together you can explore treatment options, including medicines, such as antidepressants, and therapy to help you learn ways to cope with life’s challenging situations.
For more information, visit the Post-Traumatic Stress Disorder, Depression, Fatigue, and Anxiety pages in the Breastcancer.org Treatment Side Effects section. You also may want to visit the Breastcancer.org Discussion Board forum on Relationships, Emotional Crises, Anxiety, and Depression to connect with other people managing these issues.