title: Physical symptoms/side effects during breast cancer treatment predict posttreatment distress.
abstract: BACKGROUND
  Studies suggest that the period following completion of treatment can be distressing for cancer patients. One potentially important predictor of distress is physical symptoms/side effects during treatment.
  
  
  OBJECTIVE
  A longitudinal, observational design was used to examine whether the number of physical symptoms/side effects experienced during treatment was a correlate of cancer-related distress and general distress 4 months after treatment completion, as measured by the Impact of Events Scale and the Mental Health subscale of the Short Form-36, respectively.
  
  
  METHODS
  Participants were 151 women who had completed chemotherapy and/or radiotherapy for ductal carcinoma in situ or stage 1 or 2 breast cancer. Hierarchical multiple regression was conducted with relevant sociodemographic, clinical, and psychiatric variables entered as controls.
  
  
  RESULTS
  Greater physical symptoms/side effects predicted greater total cancer-related distress, intrusive thoughts, and general distress. Physical symptoms/side effects did not significantly predict avoidance. Follow-up analyses indicated that the relationship between physical symptoms/side effects and general distress was mediated by both total cancer-related distress and intrusive thoughts.
  
  
  CONCLUSIONS
  These results suggest that patients who experience greater physical symptoms/side effects during treatment are at greater risk for later cancer-related distress and, in turn, general distress. Future research should evaluate whether early intervention with these patients is effective in preventing or reducing distress in the posttreatment period.
authors.affiliation: Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL 33612, USA. Heather.Jim@moffitt.org
authors.forename: Heather S
authors.initials: HS
authors.lastname: Jim
authors.forename: Michael A
authors.initials: MA
authors.lastname: Andrykowski
authors.forename: Pamela N
authors.initials: PN
authors.lastname: Munster
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use / Q000633:toxicity*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011878:Radiotherapy / Q000009:adverse effects* / Q000523:psychology; D012307:Risk Factors; D012803:Sick Role; D040921:Stress Disorders, Traumatic / Q000175:diagnosis / Q000523:psychology*