[Cancer in addition....].

BACKGROUND

There is still controversy over the possible prognostic role of subjective and objective stress in patients with cancer. The present report is based on a six year follow-up study of a breast cancer patient cohort. We focus on the possible prognostic effects of behavioural variables recorded in an early phase of the disease, adjusting for known clinical prognostic factors.

METHODS

106 consecutive breast cancer patients stage I and II less than 71 years of age were investigated with interviews and questionnaires one day before and six weeks after surgery. Negative life events, impaired functioning and previous health parameters were recorded with standard questions. Coping style and emotional control were assessed with the Mental Adjustment to Cancer scale (MAC) and the Courtauld Emotional Control scale (CEC).

RESULTS

At six years, 79 patients were still alive, including seven patients with relapse. Among 27 deceased patients, two patients died from other causes. There was a significantly increased risk (Hazard Ratio 2.6; 95% CI 1.18-5.77) of cancer specific deaths in women who "had suffered from one or more serious illnesses of more than six months' duration over the past 10 years" compared to those without previous illnesses. There were no significant results found for scores on the MAC or CEC scales.

CONCLUSIONS

Comorbid chronic diseases in cancer patients represent a negative prognostic factor with important clinical and health service implications.