title: Symptom incidence, distress, cancer-related distress, and adherence to chemotherapy among African American women with breast cancer.
abstract: There is a persistent racial survival disparity between African American (AA) and white women with breast cancer. There is evidence that symptom incidence, associated distress, and overall cancer-related distress may be unexplored, important contributing factors. The purpose of the current study was to: 1) describe and compare the number of chemotherapy-related symptoms and associated distress among AA women with breast cancer over the course of chemotherapy at 3 time points (at baseline before initiating chemotherapy, midpoint, and at the completion of chemotherapy); and 2) to describe the relationship between the number of chemotherapy-related symptoms and overall cancer distress compared with the ability to receive at least 85% of the prescribed chemotherapy within the prescribed timeframe.
  
  
  
  Descriptive, comparative, and correlational analyses of symptom incidence, symptom distress, cancer-related distress, and prescribed chemotherapy dose received among a cohort of AA women receiving chemotherapy for breast cancer were performed.
  
  
  
  AA women (121 women) experienced worsening symptoms from baseline to midpoint in chemotherapy and then stabilized for the duration of therapy. The inability to receive 85% of the prescribed chemotherapy within a prescribed time point was found to be significantly correlated with midpoint symptom distress.
  
  
  
  The main findings of the current study were that AA women experience a deterioration in symptom distress over the course of chemotherapy from baseline (before chemotherapy) to the midpoint, which was found to be associated with less adherence to chemotherapy overall. Thus, the incidence and management of physical and emotional symptoms, as measured through a multidimensional symptom measurement tool, may be contributing to breast cancer dose disparity and should be explored further. Cancer 2017;123:2061-2069. © 2017 American Cancer Society.
authors.affiliation: Department of Medical Oncology at Dana-Farber/Brigham and Women's Cancer Center in clinical affiliation with South Shore Hospital, Harvard University, Cambridge, Massachusetts.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Yee
authors.affiliation: Department of Epidemiology, School of Nursing and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sereika
authors.affiliation: School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Bender
authors.affiliation: Department of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Brufsky
authors.affiliation: School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Connolly
authors.affiliation: Acute and Tertiary Care Department, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania.
authors.forename: Margaret Q
authors.initials: MQ
authors.lastname: Rosenzweig
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001828:Body Image / Q000523:psychology; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology*; D005221:Fatigue / Q000139:chemically induced / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D015994:Incidence; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced / Q000453:epidemiology / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology*; D014930:Women / Q000523:psychology*
keywords: breast cancer; chemotherapy; distress; racial disparity; symptoms