Sleep Disturbance Among Breast Cancer Survivors & Education/Work for Survivors of Childhood Cancers

January 21, 2010

Breast Cancer Survivors' Sleep Disturbances

Breast cancer survivors often experience sleep-wake disturbances that disrupt and affect their quality of life in varying ways. Recently, research on this topic was conducted, and the results were published in the Journal of Pain and Symptom Management. The researchers looked at women who finished treatment for breast cancer, and they compared those women to women of similar age who had never been diagnosed with breast cancer. On average, the survivors were about 5.6 years beyond their completions of treatments. These survivors reported a higher prevalence of sleep disturbances when compared to the women who had not been diagnosed with breast cancer. Moreover, the breast cancer survivors reported poorer sleep quality than the women without cancer. However, in both the breast cancer survivor group and the breast cancer-free group, poor sleep and sleep disturbances were associated with depressive symptoms, hot flashes, and poor physical functioning. One stark difference in associated factors was observed. In breast cancer survivors, but not in the other women, minority race status was observed to be significantly associated with poor sleep quality.

So while breast cancer survivors seem to experience a higher prevalence of sleep disturbances, the risk factors (except being a cancer survivor) seem to be similar to the risk factors for sleep disturbances among other women. I write “seem” because this initial study of these factors doesn’t allow researchers to accurately determine risk. To determine the nature and level of these risk factors, a prospective study will have to be conducted. A prospective study is one in which women are enrolled and followed for a period of time to determine whether they will have sleep disturbances. While they are being followed, researchers gather information about their hypothesized risk factors (e.g., depressive symptoms and poor physical functioning).

What does this study mean for survivors who are experiencing poor sleep quality? Well, this study was conducted using breast cancer survivors as subjects, but there might be some basic lessons to be learned for all survivors. It seems, from this initial observational study, that poor sleep is linked to depressive symptoms and troubling quality of life issues like physical function. If you are experiencing poor sleep, discuss it with your doctor, and consider some of the possible underlying issues such as mental health issues and the physical late effects of cancer. This might be a tough nut to crack, but understanding that a sleep disturbance might be strongly linked to other effects and symptoms you are experiencing could be exactly what you need to get back on the right path. You can view the abstract of this study on pubmed by clicking here.

Long-term Effects of Childhood Cancer: Education and Income as Adults

A study of long-term effects of childhood cancer was published by the American Cancer Society in the journal, Cancer, this month. In Sweden, researchers studied 1716 adults over the age of 25 who were diagnosed with cancer before their 16^th birthdays. The researchers were particularly interested in how the diagnosis of cancer might have affected the survivors' educational attainment and income later in their lives. The basic findings of the research are telling. Survivors of central nervous system cancers were far more likely to report lower educational attainment than the general population, less likely to be employed than the general population, and more likely to have lower income than the general population. These estimates were still true when the investigators excluded individuals who receive economic disability compensation, so it seems these survivors are out in the “real world,” yet often they are working at a severe disadvantage. For the medical community, this certainly suggests a need for safer pediatric tumor treatment protocols, and for the survivor community, it undoubtedly calls for greater awareness of the issues survivors of pediatric central nervous system cancers are facing. Armed with the awareness that these issues could prove problematic, survivors and their support systems can seek out professional help to address and prevent the problem. You can view the abstract of this study on pubmed by clicking here.

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