Two Years Out: How's Your Emotional Health

Once upon a time no one studied breast cancer survivors' emotional health.  Not enough survived; both doctors and patients assumed survivors should be grateful and move on with their lives. 

Now that 89% of breast cancer patients live at least five years, researchers are starting to look at survival issues.  In an Australian study researchers looked at the emotional health of women two years after their breast cancer diagnosis.  They found that survivors' wellbeing was "only modestly lower" than in women who had not had breast cancer.  So most women were coping pretty well two years after their cancer diagnosis.

Among those who were still struggling two years later, they found that women who were well-educated and women who lived alone were more likely to have "lower levels of overall wellbeing."  Researchers Susan R. Davis and Robin Bell concluded that doctors should make sure that women in these two groups get adequate emotional support as part of their follow-up care.

It would be interesting to know more about the women who lived alone in this study.  Some women live along by choice, valuing their independence while maintaining strong social connections.  Did these women, when faced with a crisis like breast cancer, find their social network insufficient to keep them going?  Or were the women living alone not so much by choice as by divorce or the death of family members?  In that group breast cancer would be an emotional trauma added to previous pain.

As to why educational level seemed to be a factor, researchers theorized, "More educated women are likely to be the best informed about their breast cancer and treatment, and their lower wellbeing results may reflect greater anxiety over decision making and their difficulty coping with a sense loss of control over their health and wellbeing."

The trend in recent years has been to make patients partners with their doctors.  We frequently see patients write in to Health Central saying, "My doctor has given me the choice between Treatment A and Treatment B.  What should I do?"

One important aspect of education is teaching people how to research, find facts, and apply them in daily life.  Women who are accustomed in their work life to making important decisions expect to do the same with their health care.  Education encourages people to believe that they are in charge of their lives, that hard work and information make a difference.   A cancer diagnosis is a reminder that much in life is beyond our control.

This study suggests that the stress of all that decision-making takes an emotional toll.  The saying, "The lawyer who represents himself has a fool for a client" expresses a truth that applies to many professions.  Professional judgments need some distance.  Doctors do not treat their own family members.  Asking the patient to be in charge of her own life and death decisions may not always be the best idea.