Psychological response to cancer diagnosis and disease outcome in patients with breast cancer and lymphoma

Abstract

Abstract The relationship between psychological response (PRD) to cancer diagnosis measured three months post‐diagnosis and disease outcome up to five years later was studied prospectively in a consecutive series of 107 women with early (T 0 – 2 , N 0 – 1 , M 0 ) breast cancer and a consecutive series of 61 men and women with Hodgkin's and Non‐Hodgkin's lymphoma. It was only possible to assign 138 patients (88 breast cancer and 50 lymphoma) to single psychological response categories. In those who could be so categorised a significant trend of worsening prognosis as response varied from ‘fighting spirit’ or ‘denial’ through ‘anxious preoccupation’ to ‘stoic acceptance’ or ‘hopelessness/helplessness’, was demonstrated for both overall survival (χ 2 = 5.49; p = 0.02) and recurrence‐free survival (χ 2 = 6.09; p = 0.015). Male lymphoma patients who had died by five years tended to have higher scores on the suppression of anger scales of the Courtauld Emotional Control Scale and the‘Powerful Others Scale’ of the Mental Health Locus of Control Scale; they more often reported avoiding seeking information or‘keeping busy’ as a way of avoiding thinking about their diagnosis. The relative values of psychological test scores and semi‐structured interview data in the study are discussed.