title: Living with metastatic breast cancer: a qualitative analysis of physical, psychological, and social sequelae.
abstract: Women with metastatic breast cancer face a wide range of medical, practical, and emotional challenges that impact their quality of life. Research to date, however, has not focused on the quality-of-life concerns of metastatic breast cancer patients with significant distress. The present study examined a range of concerns among distressed metastatic breast cancer patients, including physical and emotional distress, social functioning, and existential issues. Forty-four distressed women with metastatic breast cancer wrote their deepest thoughts and feelings regarding their illness. These essays were thematically analyzed for effects of the illness on quality of life. Three themes were identified in patients' essays. First, metastatic breast cancer and its treatment may result in a number of quality-of-life concerns, including physical symptom burden, emotional distress, body image disturbance, and disrupted daily activities. Second, social constraints on disclosure of cancer-related concerns may exacerbate patients' distress. Third, many women experience a heightened awareness of life's brevity and search for meaning in their cancer experience. Results highlight a range of quality-of-life concerns following a metastatic breast cancer diagnosis and suggest that addressing social constraints on cancer-related disclosure and the search for meaning may improve patients' psychological adjustment.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. cemosher@iupui.edu
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Mosher
authors.forename: Courtney
authors.initials: C
authors.lastname: Johnson
authors.forename: Maura
authors.initials: M
authors.lastname: Dickler
authors.forename: Larry
authors.initials: L
authors.lastname: Norton
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Massie
authors.forename: Katherine
authors.initials: K
authors.lastname: DuHamel
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000209:etiology; D000368:Aged; D001828:Body Image; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011788:Quality of Life