) This project will examine quality of life (QOL) in adult long-term survivors of cancer (five years or more cancer-free). Given what is seen as a lack of good measures, the project's first goal is to develop a measure of QOL for this group, based on extensive interviews of long-term cancer survivors and on sound principles of test construction. After development of this measure, the second goal will be to assess QOL in a tri-ethnic (Hispanic, non-Hispanic White, and African American) sample of survivors of breast, prostate, colorectal cancers, and Hodgkin's disease, yielding information on normative experiences of long-term survivors, on possible ethnic differences, and on long-term impact of adjuvant therapies. We will also examine this group prospectively, testing factors that may influence further change in their QOL over time. Indeed, studying how differences in personality, social context, coping patterns, etc. influence long-term QOL is the project's third goal, taking advantage of the fact that we have been studying psychosocial adaptation to breast cancer for many years. Women who participated in those earlier studies completed measures of several resilience and vulnerability factors at the time of their cancer diagnosis. Now, 5 to 13 years later, we will return to these women, assess QOL, and use the measures collected earlier to prospectively predict current QOL. We will be able to examine several personal and contextual variables as prospective predictors in this way. The fact that we have this information available on large numbers of women who were treated for breast cancer also permits us to conduct a very different kind of study of survivorship. In particular, we will be able to test these variables (collected early in the cancer experience) as predictors of who survives free from cancer at particular lengths of time after treatment. The idea that psychosocial variables play a role in recurrence (or its absence) is controversial. We will examine several psychosocial variables from our data sets that are relevant as predictors of recurrence. Conducting this research at this time will allow us to make use of - and further solidify - a resource that has been years in building. There is a large cadre of survivors of breast cancer about whom we know a good deal, thanks to their earlier research involvement. These people can continue providing important information about the experience of cancer survivorship and what qualities make the process easier or harder.
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