title: Noncancer life stresses in newly diagnosed cancer.
abstract: OBJECTIVE
  Noncancer life stresses affect psychosocial stress processes and have an impact on quality of life (QOL) of the patients. However, investigating life stresses in cancer is a recent development. We evaluated the life stresses of newly diagnosed melanoma, breast cancer, and prostate cancer patients in detail and investigated their impact on QOL outcomes after localized cancer diagnosis.
  
  
  METHODS
  Life change events from the previous year (negative events, positive events, total impact of events, impacts of the negative events, and impacts of loss events) and chronic ongoing life strains were measured with the Life Experience Survey and the Chronic Strains Survey in newly diagnosed patients 3 months after the diagnosis. Also, perceived symptoms and QOL were measured, and in melanoma and breast cancer, these were repeated up to 2 years later.
  
  
  RESULTS
  Noncancer life stress was common in newly diagnosed cancer patients: Both acute and chronic life stresses were experienced by four-fifths. Loss events (fateful negative events or social loss events) were reported by one-third. Many patients had a preceding chronic illness. Along with the cancer and treatment stresses, the noncancer life stresses predicted poorer QOL, particularly psychological and depressive symptoms. Different life stresses predicted slightly different domains of QOL, and depressive symptoms tended to be predicted by several kinds of life stresses. Baseline life stresses had impact also on later QOL in breast cancer.
  
  
  CONCLUSIONS
  Noncancer life stresses are common among newly diagnosed cancer patients and have impact on QOL, and thus they should be taken into account in cancer care. Screening for noncancer life stresses may offer means to enhance QOL outcomes in cancer.
authors.affiliation: Department of Oncology, Medical School, University of Tampere, Finland.
authors.forename: Ulla-Sisko
authors.initials: US
authors.lastname: Lehto
authors.forename: Markku
authors.initials: M
authors.lastname: Ojanen
authors.forename: Anna
authors.initials: A
authors.lastname: Väkevä
authors.forename: Arpo
authors.initials: A
authors.lastname: Aromaa
authors.forename: Pirkko
authors.initials: P
authors.lastname: Kellokumpu-Lehtinen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D008297:Male; D008545:Melanoma / Q000175:diagnosis; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D011471:Prostatic Neoplasms / Q000175:diagnosis; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology; D012878:Skin Neoplasms / Q000175:diagnosis; D013315:Stress, Psychological / Q000209:etiology*