A study by researchers at the Herbert Irving Comprehensive Cancer Center (HICCC) at NewYork-Presbyterian/Columbia University Medical Center, has found that nearly one in four women (23 percent) newly diagnosed with breast cancer reported symptoms consistent with post-traumatic stress disorder (PTSD) shortly after diagnosis, with increased risk among black and Asian women. The research has been e-published ahead of print in the Journal of the National Cancer Institute.
"This study is one of the first to evaluate the course of PTSD after a diagnosis of breast cancer," said lead author Alfred I. Neugut, MD, PhD, the Myron M. Studner Professor of Cancer Research, professor of medicine and epidemiology, at Columbia University's College of Physicians & Surgeons and Mailman School of Public Health, and a member of the HICCC.
"We analyzed interview responses from more than 1,100 women," said Dr. Neugut. "During the first two to three months after diagnosis, nearly a quarter of them met the criteria for PTSD, although the symptoms declined over the next three months. Younger women were more likely to develop symptoms of PTSD, and data suggest Asian and black women are at a more than 50 percent higher risk than white women."
The 1,139 research participants were part of the Breast Cancer Quality of Care Study (BQUAL). Between 2006 and 2010, women with newly diagnosed breast cancer, stages I to III, over the age of 20 were recruited from NewYork-Presbyterian/Columbia University Medical Center and Mount Sinai School of Medicine in New York City; the Henry Ford Health System in Detroit; and Kaiser-Permanente in Northern California. Each participant completed three phone interviews. The first was two to three months after diagnosis and before the third chemotherapy cycle, if the patient was receiving chemotherapy. The second interview was four months after diagnosis, and the third was six months after diagnosis.
"The ultimate outcome of this research is to find ways to improve the quality of patients' lives," said Dr. Neugut, who is also an oncologist at NewYork-Presbyterian Hospital/Columbia. "If we can identify potential risk factors for PTSD, when women are diagnosed with breast cancer, we could provide early prevention and intervention to minimize PTSD symptoms. This approach might also have an indirect impact on the observed racial disparity in breast cancer survival."
The research team believes that these findings may apply to patients with other cancer diagnoses as well. Dr. Neugut noted that in previous research, symptoms of PTSD have been reported following prostate cancer and lymphoma diagnoses.
The paper is titled "Racial Disparities in Posttraumatic Stress after Diagnosis of Localized Breast Cancer: The BQUAL Study." Additional contributors are Neomi Vin-Raviv, Grace Clarke Hillyer, Dawn Hershman, Sandro Galea, Nicole Leoce, and Wei-Yann Tsai (CUMC); Dana Bovbjerg (University of Pittsburgh); Lawrence Kushi, and Candyce Kroenke (Kaiser-Permanente); Lois Lamerato (Henry Ford Health System); Christine Ambrosone (Roswell Park Cancer Institute); Heiddis Valdimarsdottir, and Lina Jandorf (Mt. Sinai); and Jeanne Mandelblatt (Georgetown). In addition to Dr. Neugut, Drs. Hershman and Tsai are members of the HICCC.
The study was supported by the Department of Defense, the National Cancer Institute, Breast Cancer Foundation and Environmental Health Foundation fellowship (grant numbers: NCI R01 (CA100598), NCI R01 (CA124924 and 127617), U10 (CA84131) and KO5 (CA96940).
The authors declare no financial or other conflicts of interest.
The Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Medical Center encompasses pre-clinical and clinical research, treatment, prevention, and population-based education efforts in cancer. The Cancer Center was initially funded by the NCI in 1972 and became a National Cancer Institute (NCI)-designated comprehensive cancer center in 1979. Cancer Center researchers and physicians are dedicated to understanding the biology of cancer and to applying that knowledge to the design of cancer therapies and prevention strategies that reduce its incidence and progression and improve the quality of the lives of those affected by cancer. For more information, visit www.hiccc.columbia.edu.
Columbia University Medical Center provides international leadership in basic, pre-clinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia's College of Physicians and Surgeons was the first institution in the United States to grant the MD degree and is among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest in the United States. Its physicians treat patients at multiple locations throughout the tri-state area, including the NewYork-Presbyterian/Columbia campus in Washington Heights, the new ColumbiaDoctors Midtown location at 51 W. 51st St. in Manhattan, and the new ColumbiaDoctors Riverdale practice. For more information, visit www.cumc.columbia.edu or columbiadoctors.org.