Predictors of distress and quality of life in patients undergoing cancer therapy: impact of treatment type and decisional role.
OBJECTIVE
The purpose of this secondary investigation was to examine the impact of the type of treatment received and the perceived role in treatment decision making in predicting distress and cancer-specific quality of life in patients newly diagnosed with breast or prostate cancer.


METHODS
Participants included 1057 newly diagnosed breast and prostate cancer patients from four Canadian cancer centers who partook in a randomized controlled trial examining the utility of providing patients with an audio-recording of their treatment planning consultation. A MANCOVA was performed to predict distress and cancer-specific quality of life at 12 weeks post-consultation based on control variables (patient age, education, residence, tumor size (breast sample), gleason score (prostate sample), and receipt of an initial treatment consultation recording), predictor variables (treatment type--chemotherapy, hormone therapy, radiation therapy; decisional role--active, collaborative, passive), and interactions between these predictors.


RESULTS
Women who received chemotherapy and reported having played a more passive role in treatment decision making had significantly greater distress and lower cancer-specific quality of life at 12-week post-consultation. There were no statistically significant predictors of these outcomes identified for men with prostate cancer.


CONCLUSIONS
Receipt of chemotherapy places women with breast cancer at risk for distress and reduced quality of life, but only for the subset of women who report playing a passive role in treatment decision making. Prospective, longitudinal studies are needed to confirm the present findings and to explicate the antecedents, composition, and consequences of the 'passive' decisional role during the treatment phase of the cancer trajectory.
Hack
Thomas F
TF
Faculty of Nursing, University of Manitoba, Winnipeg, MB, Canada. thack@sbrc.ca
Pickles
Tom
T
Ruether
J Dean
JD
Weir
Lorna
L
Bultz
Barry D
BD
Mackey
John
J
Degner
Lesley F
LF
D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D003863:Depression / Q000209:etiology / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010358:Patient Participation / Q000523:psychology*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology; D013637:Tape Recording; D016896:Treatment Outcome
D000970:Antineoplastic Agents