Depressive symptom trajectories in older breast cancer survivors: the Thinking and Living with Cancer Study.
Breast cancer
Cancer survivorship
Depression
Frailty
Older adults
Social support
Journal
Journal of cancer survivorship : research and practice
ISSN: 1932-2267
Titre abrégé: J Cancer Surviv
Pays: United States
ID NLM: 101307557
Informations de publication
Date de publication:
04 Nov 2023
04 Nov 2023
Historique:
received:
14
07
2023
accepted:
21
10
2023
medline:
4
11
2023
pubmed:
4
11
2023
entrez:
4
11
2023
Statut:
aheadofprint
Résumé
To identify trajectories of depressive symptoms in older breast cancer survivors and demographic, psychosocial, physical health, and cancer-related predictors of these trajectories. Recently diagnosed nonmetastatic breast cancer survivors (n = 272), ages 60-98 years, were evaluated for depressive symptoms (Center for Epidemiological Studies Depression Scale, CES-D; scores ≥16 suggestive of clinically significant depressive symptoms). CES-D scores were analyzed in growth-mixture models to determine depression trajectories from baseline (post-surgery, pre-systemic therapy) through 3-year annual follow-up. Multivariable, multinomial logistic regression was used to identify baseline predictors of depression trajectories. Survivors had three distinct trajectories: stable (84.6%), emerging depressive symptoms (10.3%), and recovery from high depressive symptoms at baseline that improved slowly over time (5.1%). Compared to stable survivors, those in the emerging (OR = 1.16; 95% CI = 1.08-1.23) or recovery (OR = 1.26; 95% CI = 1.15-1.38) groups reported greater baseline anxiety. Greater baseline deficit accumulation (frailty composite measure) was associated with emerging depressive symptoms (OR = 3.71; 95% CI = 1.90-7.26). Less social support at baseline (OR = 0.38; 95% CI = 0.15-0.99), but greater improvement in emotional (F = 4.13; p = 0.0006) and tangible (F = 2.86; p = 0.01) social support over time, was associated with recovery from depressive symptoms. Fifteen percent of older breast cancer survivors experienced emerging or recovery depressive symptom trajectories. Baseline anxiety, deficit accumulation, and lower social support were associated with worse outcomes. Our results emphasize the importance of depression screening throughout the course of cancer care to facilitate early intervention. Factors associated with depressive symptoms, including lower levels of social support proximal to diagnosis, could serve as intervention levers.
Identifiants
pubmed: 37924476
doi: 10.1007/s11764-023-01490-2
pii: 10.1007/s11764-023-01490-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NCI NIH HHS
ID : K01 CA212056
Pays : United States
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Pilevarzadeh M, Amirshahi M, Afsargharehbagh R, Rafiemanesh H, Hashemi SM, Balouchi A. Global prevalence of depression among breast cancer patients: a systematic review and meta-analysis. Breast Cancer Res Treat. 2019;176:519–33.
doi: 10.1007/s10549-019-05271-3
Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12:160–74.
pubmed: 21251875
doi: 10.1016/S1470-2045(11)70002-X
Krebber AMH, Buffart LM, Kleijn G, Riepma IC, De Bree R, Leemans CR, et al. Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments. Psychooncology. 2014;23:121–30.
pubmed: 24105788
doi: 10.1002/pon.3409
Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A. Depression and anxiety in women with early breast cancer: five year observational cohort study. Br Med J. 2005;330:702.
doi: 10.1136/bmj.38343.670868.D3
Colleoni M, Mandala M, Peruzzotti G, Robertson C, Bredart A, Goldhirsch A. Depression and degree of acceptance of adjuvant cytotoxic drugs. Lancet. 2000;356:1326–7.
pubmed: 11073026
doi: 10.1016/S0140-6736(00)02821-X
Nyrop KA, Deal AM, Shachar SS, Basch E, Reeve BB, Choi SK, et al. Patient-reported toxicities during chemotherapy regimens in current clinical practice for early breast cancer. Oncologist. 2019;24:762–71.
pubmed: 30552158
doi: 10.1634/theoncologist.2018-0590
Satin JR, Linden W, Phillips MJ. Depression as a predictor of disease progression and mortality in cancer patients: A meta-analysis. Cancer. 2009;115:5349–61.
pubmed: 19753617
doi: 10.1002/cncr.24561
Wang X, Wang N, Zhong L, Wang S, Zheng Y, Yang B, et al. Prognostic value of depression and anxiety on breast cancer recurrence and mortality: a systematic review and meta-analysis of 282,203 patients. Mol Psychiatry. 2020;25:3186–97.
pubmed: 32820237
pmcid: 7714689
doi: 10.1038/s41380-020-00865-6
Clough-Gorr KM, Ganz PA, Silliman RA. Older breast cancer survivors: factors associated with change in emotional well-being. J Clin Oncol. 2007;25:1334–40.
pubmed: 17312327
doi: 10.1200/JCO.2006.09.8665
Taira N, Shimozuma K, Shiroiwa T, Ohsumi S, Kuroi K, Saji S, et al. Associations among baseline variables, treatment-related factors and health-related quality of life 2 years after breast cancer surgery. Breast Cancer Res Treat. 2011;128:735–47.
doi: 10.1007/s10549-011-1631-y
Avis NE, Levine BJ, Case LD, Naftalis EZ, Van Zee KJ. Trajectories of depressive symptoms following breast cancer diagnosis. Cancer Epidemiol Biomark Prev. 2015;24:1789–95.
doi: 10.1158/1055-9965.EPI-15-0327
Charles C, Bardet A, Larive A, Gorwood P, Ramoz N, Thomas E, et al. Characterization of depressive symptoms trajectories after breast cancer diagnosis in women in France. JAMA Netw Open. 2022;5:e225118.
pubmed: 35420663
pmcid: 9011125
doi: 10.1001/jamanetworkopen.2022.5118
Brandão T, Schulz MS, Matos PM. Psychological adjustment after breast cancer: a systematic review of longitudinal studies. Psychooncology. 2017;26:917–26.
pubmed: 27440317
doi: 10.1002/pon.4230
Nakamura ZM, Deal AM, Nyrop KA, Chen YT, Quillen LJ, Brenizer T, et al. Serial assessment of depression and anxiety by patients and providers in women receiving chemotherapy for early breast cancer. Oncologist. 2021;26:147–56.
pubmed: 32946156
doi: 10.1002/onco.13528
So WKW, Marsh G, Ling WM, Leung FY, Lo JCK, Yeung M, et al. Anxiety, depression and quality of life among Chinese breast cancer patients during adjuvant therapy. Eur J Oncol Nurs. 2010;14:17–22.
pubmed: 19734087
doi: 10.1016/j.ejon.2009.07.005
Andersen BL, DeRubeis RJ, Berman BS, Gruman J, Champion VL, Massie MJ, et al. Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. J Clin Oncol. 2014;32:1605–19.
pubmed: 24733793
pmcid: 4090422
doi: 10.1200/JCO.2013.52.4611
Nakamura ZM, Damone EM, Herrick HP, Nyrop KA, Deal AM, Brenizer AT, et al. Anticipating mental health needs after chemotherapy in early-stage breast cancer using patient-reported symptom screening. Support Care Cancer. 2022;30:3933–41.
pubmed: 35044483
pmcid: 8957600
doi: 10.1007/s00520-022-06827-8
Bluethmann SM, Mariotto AB, Rowland JH. Anticipating the “Silver Tsunami”: prevalence trajectories and co-morbidity burden among older cancer survivors in the United States. Cancer Epidemiol Biomark Prev. 2016;25:1029–36.
doi: 10.1158/1055-9965.EPI-16-0133
Miller KD, Nogueira L, Devasia T, Mariotto AB, Yabroff KR, Jemal A, et al. Cancer treatment and survivorship statistics, 2022. CA Cancer J Clin. 2022;72:409–36.
pubmed: 35736631
doi: 10.3322/caac.21731
Dunn LB, Cooper BA, Neuhaus J, West C, Paul S, Aouizerat B, et al. Identification of distinct depressive symptom trajectories in women following surgery for breast cancer. Health Psychol. 2011;30:683.
pubmed: 21728421
pmcid: 3217116
doi: 10.1037/a0024366
Dunn LB, Aouizerat BE, Langford DJ, Cooper BA, Dhruva A, Cataldo JK, et al. Cytokine gene variation is associated with depressive symptom trajectories in oncology patients and family caregivers. Eur J Oncol Nurs. 2013;17:346–53.
doi: 10.1016/j.ejon.2012.10.004
Bidstrup PE, Christensen J, Mertz BG, Rottmann N, Dalton SO, Johansen C. Trajectories of distress, anxiety, and depression among women with breast cancer: looking beyond the mean. Acta Oncol (Madr). 2015;54:789–96.
doi: 10.3109/0284186X.2014.1002571
Stanton AL, Wiley JF, Krull JL, Crespi CM, Hammen C, Allen JJB, et al. Depressive episodes, symptoms, and trajectories in women recently diagnosed with breast cancer. Breast Cancer Res Treat. 2015;154:105–15.
pubmed: 26420401
pmcid: 6453702
doi: 10.1007/s10549-015-3563-4
Nelson CJ, Cho C, Berk AR, Holland J, Roth AJ. Are gold standard depression measures appropriate for use in geriatric cancer patients? A systematic evaluation of self-report depression instruments used with geriatric, cancer, and geriatric cancer samples. J Clin Oncol. 2010;28:348.
pubmed: 19996030
doi: 10.1200/JCO.2009.23.0201
Cataldo JK, Paul S, Cooper B, Skerman H, Alexander K, Aouizerat B, et al. Differences in the symptom experience of older versus younger oncology outpatients: a cross-sectional study. BMC Cancer. 2013;13:1–16.
doi: 10.1186/1471-2407-13-6
Kurtz M, Kurtz J, Stommel M, Given C, Given B. Predictors of depressive symptomatology of geriatric patients with colorectal cancer: a longitudinal view. Support Care Cancer. 2002;10:494–501.
pubmed: 12353129
doi: 10.1007/s00520-001-0338-8
Aarts JWF, Deckx L, van Abbema DL, Tjan-Heijnen VCG, van den Akker M, Buntinx F. The relation between depression, coping and health locus of control: differences between older and younger patients, with and without cancer. Psychooncology. 2015;24:950–7.
pubmed: 25644618
doi: 10.1002/pon.3748
Duc S, Rainfray M, Soubeyran P, Fonck M, Blanc JF, Ceccaldi J, et al. Predictive factors of depressive symptoms of elderly patients with cancer receiving first-line chemotherapy. Psychooncology. 2017;26:15–21.
pubmed: 26913707
doi: 10.1002/pon.4090
Hurria A, Li D, Hansen K, Patil S, Gupta R, Nelson C, et al. Distress in older patients with cancer. J Clin Oncol. 2009;27:4346.
pubmed: 19652074
pmcid: 2799049
doi: 10.1200/JCO.2008.19.9463
Cohen M. Depression, anxiety, and somatic symptoms in older cancer patients: a comparison across age groups. Psychooncology. 2014;23:151–7.
pubmed: 24038748
doi: 10.1002/pon.3383
Thomé B, Hallberg IR. Quality of life in older people with cancer–a gender perspective. Eur J Cancer Care (Engl). 2004;13:454–63.
pubmed: 15606713
doi: 10.1111/j.1365-2354.2004.00471.x
Weiss Wiesel TR, Nelson CJ, Tew WP, Hardt M, Mohile SG, Owusu C, et al. The relationship between age, anxiety, and depression in older adults with cancer. Psychooncology. 2015;24:712–7.
pubmed: 25099337
doi: 10.1002/pon.3638
Erlangsen A, Stenager E, Conwell Y. Physical diseases as predictors of suicide in older adults: a nationwide, register-based cohort study. Soc Psychiatry Psychiatr Epidemiol. 2015;50:1427–39.
pubmed: 25835959
doi: 10.1007/s00127-015-1051-0
Misono S, Weiss NS, Fann JR, Redman M, Yueh B. Incidence of suicide in persons with cancer. J Clin Oncol. 2008;26:4731.
pubmed: 18695257
pmcid: 2653137
doi: 10.1200/JCO.2007.13.8941
Mandelblatt JS, Small BJ, Luta G, Hurria A, Jim H, McDonald BC, et al. Cancer-related cognitive outcomes among older breast cancer survivors in the Thinking and Living With Cancer Study. J Clin Oncol. 2018;36:JCO1800140.
pubmed: 30281396
doi: 10.1200/JCO.18.00140
Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.
doi: 10.1177/014662167700100306
Vilagut G, Forero CG, Barbaglia G, Alonso J. Screening for depression in the general population with the Center for Epidemiologic Studies Depression (CES-D): a systematic review with meta-analysis. PLoS One. 2016;11:e0155431.
pubmed: 27182821
pmcid: 4868329
doi: 10.1371/journal.pone.0155431
Stafford L, Judd F, Gibson P, Komiti A, Quinn M, Mann GB. Comparison of the Hospital Anxiety and Depression Scale and the Center for Epidemiological Studies Depression Scale for detecting depression in women with breast or gynecologic cancer. Gen Hosp Psychiatry. 2014;36:74–80.
pubmed: 24200105
doi: 10.1016/j.genhosppsych.2013.08.010
Spielberger CD. State-trait anxiety inventory for adults. 1983;
Carroll JE, Small BJ, Tometich DB, Zhai W, Zhou X, Luta G, et al. Sleep disturbance and neurocognitive outcomes in older patients with breast cancer: interaction with genotype. Cancer. 2019;125:4516–24.
pubmed: 31553501
doi: 10.1002/cncr.32489
Stewart A, Ware J, editors. Measuring functioning and well-being: the Medical Outcomes Study approach. Durham, NC: Duke University Press; 1992.
Hurria A, Gupta S, Zauderer M, Zuckerman EL, Cohen HJ, Muss H, et al. Developing a cancer-specific geriatric assessment. Cancer. 2005;104:1998–2005.
pubmed: 16206252
doi: 10.1002/cncr.21422
Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11:570–9.
pubmed: 8445433
doi: 10.1200/JCO.1993.11.3.570
Jenkinson C, Layte R, Jenkinson D, Lawrence K, Petersen S, Paice C, et al. A shorter form health survey: can the SF-12 replicate results from the SF-36 in longitudinal studies? J Public Health (Bangkok). 1997;19:179–86.
doi: 10.1093/oxfordjournals.pubmed.a024606
Cohen HJ, Smith D, Sun C, Tew W, Mohile SG, Owusu C, et al. Frailty as determined by a comprehensive geriatric assessment-derived deficit-accumulation index in older patients with cancer who receive chemotherapy. Cancer. 2016;122:3865–72.
pubmed: 27529755
doi: 10.1002/cncr.30269
Guida JL, Ahles TA, Belsky D, Campisi J, Cohen HJ, DeGregori J, et al. Measuring aging and identifying aging phenotypes in cancer survivors. J Natl Cancer Inst. 2019;111:1245–54.
pubmed: 31321426
pmcid: 7962788
doi: 10.1093/jnci/djz136
Mitnitski A, Rockwood K. Aging as a process of deficit accumulation: its utility and origin. Interdiscip Top Gerontol. 2015;40:85–98.
pubmed: 25341515
doi: 10.1159/000364933
Ram N, Grimm KJ. Methods and measures: Growth mixture modeling: a method for identifying differences in longitudinal change among unobserved groups. Int J Behav Dev. 2009;33:565–76.
pubmed: 23885133
pmcid: 3718544
doi: 10.1177/0165025409343765
Grimm KJ, Ram N, Estabrook R. Growth modeling: structural equation and multilevel modeling approaches. Guilford Publications; 2016.
Searle SD, Mitnitski A, Gahbauer EA, Gill TM, Rockwood K. A standard procedure for creating a frailty index. BMC Geriatr. 2008;8:1–10.
doi: 10.1186/1471-2318-8-24
Sjöberg L, Karlsson B, Atti A-R, Skoog I, Fratiglioni L, Wang H-X. Prevalence of depression: comparisons of different depression definitions in population-based samples of older adults. J Affect Disord. 2017;221:123–31.
pubmed: 28645024
doi: 10.1016/j.jad.2017.06.011
Mohebbi M, Agustini B, Woods RL, McNeil JJ, Nelson MR, Shah RC, et al. Prevalence of depressive symptoms and its associated factors among healthy community-dwelling older adults living in Australia and the United States. Int J Geriatr Psychiatry. 2019;34:1208–16.
pubmed: 30989707
pmcid: 6924573
doi: 10.1002/gps.5119
Champion VL, Wagner LI, Monahan PO, Daggy J, Smith L, Cohee A, et al. Comparison of younger and older breast cancer survivors and age-matched controls on specific and overall quality of life domains. Cancer. 2014;120:2237–46.
pubmed: 24891116
doi: 10.1002/cncr.28737
Götze H, Friedrich M, Taubenheim S, Dietz A, Lordick F, Mehnert A. Depression and anxiety in long-term survivors 5 and 10 years after cancer diagnosis. Support Care Cancer. 2020;28:211–20.
pubmed: 31001695
doi: 10.1007/s00520-019-04805-1
Kuswanto CN, Stafford L, Sharp J, Schofield P. Psychological distress, role, and identity changes in mothers following a diagnosis of cancer: a systematic review. Psychooncology. 2018;27:2700–8.
pubmed: 30289196
doi: 10.1002/pon.4904
Tiedtke C, de Rijk A, Dierckx de Casterlé B, Christiaens M, Donceel P. Experiences and concerns about ‘returning to work’for women breast cancer survivors: a literature review. Psychooncology. 2010;19:677–83.
pubmed: 19823971
doi: 10.1002/pon.1633
Crowley SA, Foley SM, Wittmann D, Jagielski CH, Dunn RL, Clark PM, et al. Sexual health concerns among cancer survivors: testing a novel information-need measure among breast and prostate cancer patients. J Cancer Educ. 2016;31:588–94.
pubmed: 26076657
doi: 10.1007/s13187-015-0865-5
Gorman JR, Su HI, Roberts SC, Dominick SA, Malcarne VL. Experiencing reproductive concerns as a female cancer survivor is associated with depression. Cancer. 2015;121:935–42.
pubmed: 25377593
doi: 10.1002/cncr.29133
Avis NE, Levine B, Naughton MJ, Case DL, Naftalis E, Van Zee KJ. Explaining age-related differences in depression following breast cancer diagnosis and treatment. Breast Cancer Res Treat. 2012;136:581–91.
pubmed: 23053661
doi: 10.1007/s10549-012-2277-0
Hannum SM, Clegg Smith K, Coa K, Klassen AC. Identity reconstruction among older cancer survivors: age and meaning in the context of a life-altering illness. J Psychosoc Oncol. 2016;34:477–92.
pubmed: 27715772
doi: 10.1080/07347332.2016.1221017
Huang G, Wu Y, Zhang G, Zhang P, Gao J. Analysis of the psychological conditions and related factors of breast cancer patients. Chinese-German J Clin Oncol. 2010;9:53–7.
doi: 10.1007/s10330-009-0135-2
Weyerer S, Eifflaender-Gorfer S, Köhler L, Jessen F, Maier W, Fuchs A, et al. Prevalence and risk factors for depression in non-demented primary care attenders aged 75 years and older. J Affect Disord. 2008;111:153–63.
pubmed: 18372049
doi: 10.1016/j.jad.2008.02.008
Oerlemans S, Issa DE, van den Broek EC, Nijziel MR, Coebergh JW, Mols F, et al. Impact of therapy and disease-related symptoms on health-related quality of life in patients with follicular lymphoma: results of the population-based PHAROS-registry. Eur J Haematol. 2014;93:229–38.
pubmed: 24702126
doi: 10.1111/ejh.12335
Perkins EA, Small BJ, Balducci L, Extermann M, Robb C, Haley WE. Individual differences in well-being in older breast cancer survivors. Crit Rev Oncol Hematol. 2007;62:74–83.
pubmed: 17240157
pmcid: 1911161
doi: 10.1016/j.critrevonc.2006.11.002
Nelson CJ, Weinberger MI, Balk E, Holland J, Breitbart W, Roth AJ. The chronology of distress, anxiety, and depression in older prostate cancer patients. Oncologist. 2009;14:891–9.
pubmed: 19738000
doi: 10.1634/theoncologist.2009-0059
Weinberger MI, Roth AJ, Nelson CJ. Untangling the complexities of depression diagnosis in older cancer patients. Oncologist. 2009;14:60–6.
pubmed: 19144682
doi: 10.1634/theoncologist.2008-0147
Magnuson A, Sattar S, Nightingale G, Saracino R, Skonecki E, Trevino KM. A practical guide to geriatric syndromes in older adults with cancer: a focus on falls, cognition, polypharmacy, and depression. Am Soc Clin Oncol Educ Book. 2019;39:e96–109.
pubmed: 31099668
doi: 10.1200/EDBK_237641
Saracino RM, Weinberger MI, Roth AJ, Hurria A, Nelson CJ. Assessing depression in a geriatric cancer population. Psychooncology. 2017;26:1484–90.
pubmed: 27195436
doi: 10.1002/pon.4160
Mandelblatt JS, Cai L, Luta G, Kimmick G, Clapp J, Isaacs C, et al. Frailty and long-term mortality of older breast cancer patients: CALGB 369901 (Alliance). Breast Cancer Res Treat. 2017;164:107–17.
pubmed: 28364214
pmcid: 5479131
doi: 10.1007/s10549-017-4222-8
Williams GR, Deal AM, Sanoff HK, Nyrop KA, Guerard EJ, Pergolotti M, et al. Frailty and health-related quality of life in older women with breast cancer. Support Care Cancer. 2019;27:2693–8.
pubmed: 30484012
doi: 10.1007/s00520-018-4558-6
Wildiers H, Heeren P, Puts M, Topinkova E, Janssen-Heijnen MLG, Extermann M, et al. International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol. 2014;32:2595.
pubmed: 25071125
pmcid: 4876338
doi: 10.1200/JCO.2013.54.8347
Morley JE, Vellas B, Van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14:392–7.
pubmed: 23764209
pmcid: 4084863
doi: 10.1016/j.jamda.2013.03.022
Mandelblatt JS, Zhou X, Small BJ, Ahn J, Zhai W, Ahles T, et al. Deficit accumulation frailty trajectories of older breast cancer survivors and non-cancer controls: the thinking and living with cancer study. J Natl Cancer Inst. 2021;113:1053–64.
pubmed: 33484565
pmcid: 8328973
doi: 10.1093/jnci/djab003
Ahles TA, Schofield E, Li Y, Ryan E, Root JC, Patel SK, et al. Relationship between cognitive functioning and frailty in older breast cancer survivors. J Geriatr Oncol. 2022;13:27–32.
pubmed: 34366276
doi: 10.1016/j.jgo.2021.07.011
Hann DM, Oxman TE, Ahles TA, Furstenberg CT, Stuke TA. Social support adequacy and depression in older patients with metastatic cancer. Psychooncology. 1995;4:213–21.
doi: 10.1002/pon.2960040307
Chochinov HM. Depression in cancer patients. Lancet Oncol. 2001;2:499–505.
pubmed: 11905726
doi: 10.1016/S1470-2045(01)00456-9
Goldzweig G, Baider L, Andritsch E, Rottenberg Y. Hope and social support in elderly patients with cancer and their partners: an actor–partner interdependence model. Future Oncol. 2016;12:2801–9.
pubmed: 27712084
doi: 10.2217/fon-2016-0267
Courtens AM, Stevens FCJ, Crebolder H, Philipsen H. Longitudinal study on quality of life and social support in cancer patients. Cancer Nurs. 1996;19:162–9.
pubmed: 8674024
doi: 10.1097/00002820-199606000-00002
Rizalar S, Ozbas A, Akyolcu N, Gungor B. Effect of perceived social support on psychosocial adjustment of Turkish patients with breast cancer. Asian Pac J Cancer Prev. 2014;15:3429–34.
pubmed: 24870734
doi: 10.7314/APJCP.2014.15.8.3429
Cicero V, Lo Coco G, Gullo S, Lo VG. The role of attachment dimensions and perceived social support in predicting adjustment to cancer. Psycho-Oncology: Journal of the Psychological, Social and Behavioral Dimensions of. Cancer. 2009;18:1045–52.
Alfano CM, Day JM, Katz ML, Herndon JE, Bittoni MA, Oliveri JM, et al. Exercise and dietary change after diagnosis and cancer-related symptoms in long-term survivors of breast cancer: CALGB 79804. Psycho-Oncology: Journal of the Psychological, Social and Behavioral Dimensions of. Cancer. 2009;18:128–33.
Kornblith AB, Dowell JM, Herndon JE, Engelman BJ, Bauer-Wu S, Small EJ, et al. Telephone monitoring of distress in patients aged 65 years or older with advanced stage cancer: a cancer and leukemia group B study. Cancer: Interdisciplinary International Journal of the American Cancer. Society. 2006;107:2706–14.