As a result of ongoing advances in early detection and treatment for breast cancer, interest has shifted increasingly to include the prevention and treatment of long-term and late effects of the disease. Consistent with this, a large body of research has documented the prevalence and severity of menopausal symptoms and their impact on quality of life in breast cancer survivors (BC+ survivors). Urinary incontinence (UI), or the involuntary leakage of urine, is a genitourinary symptom commonly associated with the menopausal transition. Previous studies of BC+ survivors indicate that between 28% and 55% of BC+ survivors report some symptom of UI. Studies have also demonstrated a relationship between UI and poorer health-related quality of life in survivorship. However, previous studies have been limited conceptually and methodologically and likely are an underestimate of the prevalence, severity and impact of UI on quality of life in BC+ survivors. Given that UI may significantly impact survivors'quality of life and may worsen over time if not treated, failure to assess and treat these symptoms may have long-term implications for the health and well-being of BC+ survivors. As well, the dearth of information available on UI outcomes, the impact of these outcomes on BC+ survivors'daily lives, and survivors'efforts to manage symptoms means that interventions to address UI in survivorship are likely to be incomplete and ineffective. To address the limitations of prior research and to advance our understanding of UI in BC+ survivors, we propose an innovative study of women with a history of breast cancer and an age-, race-, and ethnicity-matched comparison sample of women with no history of cancer (CA- participants). Participants will complete a battery of standardized, ecologically valid instruments designed to assess UI, UI outcomes and incontinence-related quality of life outcomes. Participants will also complete an assessment of self-management and help-seeking behaviors. These data will be used to address the following specific aims: 1) To estimate the prevalence of UI in women with a history of breast cancer compared to women with no history of cancer matched for age, race, and ethnicity;2) To explore the relationship between UI severity and other UI outcomes to quality of life in BC+ survivors and matched CA- participants;and 3) To identify the self- management and help-seeking behaviors used by BC+ survivors to manage UI. The proposed study is expected to yield results which are both theoretically and clinically significant. In terms of theoretical significance, the study is expected to yield a more complete understanding of UI in BC+ survivors, its impact on survivors'quality of life, and survivors'efforts to manage UI symptoms. It is also expected to provide support for the conduct of a prospective, longitudinal study of UI incidence in BC+ survivors. In terms of clinical significance, the study will yield the empirical evidence necessary to guide the development of an intervention to treat UI in BC+ survivors. Taken as a whole, the proposed study is expected to have significant implications for clinical care in survivorship by leading to the design of a randomized controlled trial of the intervention.
Urinary incontinence is increasingly recognized as a socially disabling condition that can have a profound impact on quality of life. Although there is preliminary evidence of the prevalence of urinary incontinence in breast cancer survivors, there is a dearth of information available on types of urinary incontinence in breast cancer survivors, the severity of urinary incontinence in survivors, its impact on survivors'quality of life, and survivors'efforts to manage symptoms. The proposed research plan is expected to have implications for public health by yielding a complete understanding of urinary incontinence in breast cancer survivors and its impact on survivors'quality of life so that interventions to address the condition are relevant and effective.
| Donovan, Kristine A; Boyington, Alice R; Judson, Patricia L et al. (2014) Bladder and bowel symptoms in cervical and endometrial cancer survivors. Psychooncology 23:672-8 |
| Donovan, Kristine A; Boyington, Alice R; Ismail-Khan, Roohi et al. (2012) Urinary symptoms in breast cancer: a systematic review. Cancer 118:582-93 |
