Adjuvant vs. neoadjuvant chemotherapy: quality of life and psychosocial variables in women with breast cancer

Health Psychol Rep. 2022 Oct 5;11(1):59-69. doi: 10.5114/hpr/152329. eCollection 2023.

Abstract

Background: A breast cancer diagnosis with all that it entails is a highly stressful moment for women. Chemotherapy is one of the main treatments for this type of cancer, and it also brings several side effects and physical changes that often lead to emotional distress and adjustment difficulties. This study aims to analyse the quality of life and psychosocial variables in women with breast cancer submitted to different chemotherapy procedures.

Participants and procedure: We used a convenience sample of 50 women with breast cancer submitted to adjuvant or neoadjuvant chemotherapy. Women were interviewed after obtaining their informed consent. The instruments used were: a sociodemographic and clinical questionnaire, Functional Assessment of Cancer Therapy-Breast, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-12-Item, Positive and Negative Affect Schedule, and Brief Resilient Coping Scale.

Results: Participants demonstrated reasonable levels of all dimensions analysed, except for resilient coping, which was relatively low. Neither treatment significantly improves quality of life or any other psychosocial variable more than the other. Most of the variables were correlated, especially quality of life.

Conclusions: The results show that the choice of treatment according to the most favourable objective criteria (e.g., stage, patients' characteristics) and multidisciplinary work with the integration of a psychologist are vital to achieve good outcomes and the best possible quality of life. Interesting insights were obtained, such as the need for health literacy to make informed decisions and the variation of needs during the cancer course. Future research could use a longitudinal approach and a more representative sample.

Keywords: cancer; health care; treatments; well-being.