Abstract P6-05-37: Comparing Changes in Depression and Anxiety Levels of Breast Cancer Patients throughout a Course of Radiation Therapy
Authors: Beiner Corina , Zhao Jenny , Mustafa Muhammad , Hirsch Ariel 
Published: March 2023

An estimated 32.2% and 41.9% of breast cancer patients experience depression and anxiety, respectively. However, due to differences in the understanding of radiotherapy and variability in the severity of side effects, responses of patients with breast cancer receiving radiation therapy may vary at different time points and differ in comparison to other patients with breast cancer. This study sought to describe the changes in levels of depression and anxiety experienced by English and Spanish-speaking patients throughout a course of radiation therapy for breast cancer along with the impact of different variables on these levels to better understand and quantify potential gaps.

Eligibility criteria included English and Spanish-speaking females, ages 18 or older, undergoing radiation therapy treatment for breast cancer at Boston Medical Center. Pre- and post-treatment surveys were completed before and after delivery of radiation therapy. Survey included sociodemographic questions along with the standardized PHQ-4 questionnaire, which uses a maximum total score of 12, to assess anxiety and depression. Results were analyzed using a least means square procedure.

A total of 60 participants completed pre- and post- treatment surveys. Total baseline distress mean (BDM) was 3.32 (SD= 3.55) and final distress mean (FDM) was 3.22 (SD= 3.78). English-speaking patients comprised 70% (n=42) of the sample and had a BDM of 3.40 with an adjusted change mean (ACM) decrease of 0.48. Spanish-speaking patients comprised 30% (n=18) of the sample, with a BDM of 3.11 and an ACM increase of 0.79, differences in ACM trended toward significance with a p-value of 0.083. Sociodemographic characteristics included: race, ethnicity, marital status, education level and longest residency. Additional variables surrounding social determinants of health included housing and food insecurity, which showed statistically significant increasing distress with increased insecurity at baseline.

While our study showed a higher BDM among English-speaking patients in comparison to Spanish-speaking patients, results showed that Spanish-speakers’ distress increased throughout treatment as opposed to English-speakers. Most of our patient population was English-speaking, though approximately one third Spanish-speaking and our participants were also primarily Black, non-Hispanic, never married, had a high school or associate level education, and had their longest residence in the US. Although the majority did not report housing or food insecurity, both had increasing DM with increased insecurity, with statistically significant results. As the number of Spanish-speakers in the US continues to increase, it will be important to continue assessing potential differences in cancer care. In addition, an understanding of the changes of distress throughout radiation treatment could help inform future interventions that address these disparities.

Baseline distress values and adjusted change in overall score by sociodemographic factors

Citation Format: Corina Beiner, Jenny Zhao, Muhammad Mustafa, Ariel Hirsch. Comparing Changes in Depression and Anxiety Levels of Breast Cancer Patients throughout a Course of Radiation Therapy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-37.