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- W2142532872 abstract "In this issue of the Journal, Tross et al. (7) report on an exceptionally fine study of the relationship between psychological distress and both disease-free and overall survival in women with stage II breast cancer. Their report is noteworthy not only for the rigor of its methods but especially for the open-minded and balanced way in which it is written. The authors found no relationship between psychological distress, as measured by the Symptom Check List-90-Revised (SCL-90-R), and recurrence of disease in or survival of patients with breast cancer. Their study was conducted on a large subsample of patients in the Cancer and Leukemia Group B (CALGB) national clinical trial of adjuvant therapy for stage II breast cancer. Two hundred eighty women, 31% of the total sample, were entered in the study. Even a casual examination of the survival curves for these women shows little support for the idea that distress, as measured by the SCL-90-R, is associated with longer or shorter disease-free or overall survival time. In their report, Tross et al. note the limitations of their study. Although their study was prospective in design, the psychosocial component was apparently retrospective, a useful add-on to an intervention trial. Another important issue is sample bias. The authors were able to assess fewer than a third of the total sample, although it was a sizable number of women. Some of the reasons for this subsample selection, i.e., patient refusal and attrition, might have restricted the range of distress found, thereby reducing the ability of the study to detect a relationship between variance in distress and survival. Indeed, Tross et al. noted that the sample of patients was relatively nondepressed. Being depressed might be a reason for refusal to fill out additional questionnaires. Other reasons, such as a tendency to be uncooperative, have been reported to be associated with longer survival (2). Thus, patients who participated in the study might be self-selected for lacking the depression that might predict poorer outcome or the feistiness that other authors (7,3) have found to predict better outcome." @default.
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- W2142532872 title "Psychological Distress and Disease Course for Women With Breast Cancer: One Answer, Many Questions" @default.
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