Can Neglect and Abuse as a Child Affect Quality of Life of Cancer Survivors?

The National Cancer Institute says the number of people with a history of cancer alive in the U.S. grew to 11.7 million by January 2007. With a number like that, issues of what happens during and after cancer treatment; assessing and providing needed emotional support for patients alongside curative treatment; the impact of that experience on health outcomes and quality of life of survivors, have become an increasing priority for researchers, for health experts, and for the American Cancer Society.

This week, one of our grantees in this area, Christopher P. Fagundes, Ph.D., an ACS postdoctoral fellow at the Institute for Behavioral Medicine Research at The Ohio State University, let us know about a study of his that has just been published in the European Journal of Cancer.

Dr. Fagundes caught the attention of bloggers a year ago with a study that found, essentially, that people who had strong negative feelings about their ex- after a breakup were less likely to be depressed. In his latest work, Dr. Fagundes turns to cancer survivorship to ask a provocative question: could a history of neglect or abuse make some cancer survivors more vulnerable to poorer quality of life after treatment?

He focused on child maltreatment because previous studies have found those who were abused or neglected as children are more susceptible to mental and physical health problems in adulthood, especially following a life-threatening experience. War veterans with a history of childhood abuse, for instance, have been found to be more likely to suffer from Post Traumatic Stress Disorder (PTSD).  And the most striking fact guiding this research: studies show about 50% of adults report having experienced some type of abuse or neglect as children.

Researchers led by Dr. Fagundes hypothesized that breast cancer survivors who experienced neglect or abuse as children would have poorer quality of life after breast cancer treatment. Indeed, the study found those who were abused or neglected as children experienced more cancer-specific psychological distress, more fatigue, and poorer physical, emotional, functional, and breast cancer specific well-being after treatment. Interestingly, those who were maltreated as children also reported receiving less social support, and those who had reported receiving less social support also had poorer quality of life across all of those components.

The authors point out that many breast cancer survivors report quality of life difficulties well after treatment-related problems subside. They say a better understanding of how child maltreatment contributes to breast cancer survivor quality of life will help in tailoring and therefore improving the success rates of interventions aimed at reducing post-treatment problems.

These are tough issues, and involve questions some may find uncomfortable. But the bottom line is we must do whatever we can to make sure patients receive the psychosocial care they need as an integral part of their cancer treatment, and that this support continues as needed throughout survivorship so that life after a cancer diagnosis is as positive as it can be.

About David Sampson

I am the director of medical and scientific communications for the American Cancer Society national home office.
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