An Exploration of Breast Cancer Survivors’ Greatest Worries and Concerns and Lifestyle Changes Posttreatment

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Fear that cancer will return has been known to motivate breast cancer survivors to adopt health-oriented lifestyle changes posttreatment (Costanzo, Lutgendorf, & Roeder, 2011). The purpose of this archival study was to investigate female breast cancer survivors' (N = 166) greatest worries and concerns, and lifestyle changes, in association with levels of anxiety, distress, pain, fatigue, education, and body mass index (BMI) one month posttreatment and one year posttreatment. Codebook development and mixed methods were used to explore themes that emerged from open-ended survey questions. Whereas the number of survivors' greatest concerns decreased over time, the concerns themselves remained relatively consistent. Distress and pain are important considerations one month posttreatment for survivors who reported medical and psychological concerns other than cancer recurrence. Results further indicated survivors who received chemotherapy and survivors who reported recurrence concerns were more likely to have clinical levels of distress one year posttreatment. Survivors who reported an increase in exercise had less distress, pain, and fatigue. Survivors who reported healthy dietary changes had less fatigue. Findings suggest that asking survivors about their greatest concerns may help to identify those with greater medical and psychological adjustment needs, including those with clinically significant symptoms of fatigue, distress, anxiety, and pain. Increased interdisciplinary collaboration among oncology treatment teams may foster customized treatments plans that are better tailored to survivors' unique constellations of symptoms, concerns, and adjustment needs. Specific mental health, fitness, and dietary interventions will likely assist survivors to increase health and well-being posttreatment.

Degree Name

Doctor of Philosophy in Clinical Psychology (PhD)

First Advisor

Nolty, Anne Turk

Document Type





Breast, Cancer, Diet therapy, Exercise therapy, Rehabilitation, Cancer pain, Anxiety in women




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