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Anxiety plagues breast cancer patients

19 Aug 2013

Assoc Prof Chan (left) and Ms Cheung conducted the study, the largest of its kind in Asia
Breast cancer is the most common cancer in women worldwide. Even though chemotherapy improves the outcome of the disease, the treatment can lead to physical and psychological side effects; however, little research has been done in this aspect especially in Asians. A Singapore study conducted by NUS investigators, the largest of its kind in Asia published in Supportive Care in Cancer, found that psychological distress such as anxiety affects one in five breast cancer patients.

The findings may help healthcare professionals to identify breast cancer patients at risk of experiencing anxiety during chemotherapy treatment such that psychosocial support can be provided to alleviate the problem.

Associate Professor Alexandre Chan from NUS’ Department of Pharmacy, together with postgraduate student Ms Cheung Yin Ting, studied 319 early-stage breast cancer patients in Singapore between August 2009 and January 2012.

The female subjects receiving treatment at the National Cancer Centre Singapore, where both researchers are affiliated with, were categorised into three groups based on their chemotherapy treatment status: pre-chemotherapy, during-chemotherapy and post-chemotherapy. Patients who were receiving concurrent chemotherapy at the point of assessment experienced more severe anxiety symptoms when compared to pre-chemotherapy and post-chemotherapy patients (29.8 per cent, 9.0 per cent and 20 per cent, respectively). The symptoms persisted from six months to two years after completion of the chemotherapy.

Analysis by the two researchers identified fatigue and the concurrent chemotherapy as the strongest factors associated with higher levels of anxiety, while the receipt of neuropsychiatric medicines was moderately associated. The results also suggest that chemotherapy toxicities (such as dizziness, numbness and tingling of the fingers) may have contributed to these anxiety symptoms.

Prevalence of anxiety in Asian breast cancer patients is lower compared to their Western counterparts - 20 per cent in Singapore, comparable with other smaller studies conducted in Thailand and Hong Kong. This shows that psychosocial issues are prevalent among Asian breast cancer patients, and researchers should develop novel strategies to address such unmet needs.

Assoc Prof Chan said the current research is part of a bigger epidemiology study that looks at multiple late effects of breast cancer treatment such as cognitive function and fatigue. The investigators have tied up with other hospitals such as KK Women’s and Children’s Hospital to further the work.