By Kathryn Doyle
NEW YORK (Reuters Health) - More than a decade after treatment, the average woman who has had breast cancer seems about as satisfied with her life as women who never had the disease, according to a new Canadian study.
"It's been recognized for a long time that in the very short term breast cancer can adversely affect quality of life," said senior author Dr. Pamela Goodwin of the University of Toronto.
Surgery, chemotherapy and radiation can lead to pain, nausea and fatigue, but researchers did not know how long those effects usually last, Goodwin told Reuters Heath.
She and her coauthors followed 535 women who filled out questionnaires on their quality of life when they were diagnosed with breast cancer and soon after, beginning between 1989 and 1996.
In 2005 to 2007, the 285 women who had survived cancer without a recurrence were brought back to answer the same questions, which addressed pain, sleep, appetite and general health, for example.
The researchers compared their answers to those from a group of women of a similar age with no history of breast cancer.
Among women with breast cancer, quality of life tended to improve in the year after diagnosis, and at the end of the study was largely equivalent to that of the comparison women, according to results published in the Journal of Clinical Oncology.
Women who had had breast cancer rated their cognitive functioning and financial situation somewhat lower than other women - by five and six percent, respectively, which is a small difference, Goodwin said.
"The majority of patients with early-stage breast cancer are long-term survivors with little impact on longevity," said Dr. Patricia Ganz, director of cancer prevention and control research at the University of California, Los Angeles Fielding School of Public Health.
Based on previous research, she said, it has been known for some time that the three million breast cancer survivors in the U.S. more than five years past diagnosis generally have a good quality of life. But positive outcomes like this tend not to be publicized as much as negative ones, Ganz, who was not involved in the new research, told Reuters Health.
"In general the average quality of life in our patients was pretty much the same as women without breast cancer," Goodwin said.
"But I want to really emphasize that we're talking about averages. I don't ever want to discount the small group of women who may have ongoing symptoms," such as pain, fatigue, swelling and severe body image issues, she said.
The proportion of women who experience persistent pain or swelling in the arm or chest wall is getting smaller over time as treatments improve, she added.
Women in both study groups rated their overall quality of life at a bit over 80 percent.
The difference in financial satisfaction might relate to employment, since some women choose to work less or stop working when diagnosed with breast cancer, or may even be laid off, Goodwin said.
Since the study was conducted in Canada, the actual financial cost of cancer treatment would have been almost negligible, she said, compared to the U.S. where cancer treatment can leave survivors deeply in debt.
Women with a history of breast cancer also rated their memory and ability to organize and plan activities slightly lower than their peers, which could be due to long-term effects of chemotherapy or might be a flaw in the questionnaire, researchers said. Breast cancer survivors tend to score as well as other women on direct cognition tests.
The post-breast cancer group reported less overall pain than the comparison group, possibly because the cancer patients adapted to higher levels of pain during treatment, Goodwin said.
Quality of life improved significantly over the first year after diagnosis, so women may not have to wait too long to see positive changes, which she said is reassuring.
"To me it's remarkable that the majority of women find ways to adapt and come out the other end quite strong," she said.
SOURCE: http://bit.ly/143343r Journal of Clinical Oncology, online August 26, 2013.