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  “Through this project, we hope to intervene during this critical time by addressing coping and adjustment needs early.”

  Robin Lally

  Assistant Professor of Nursing

By SARA SALDI

Published: May 16, 2011

The breast cancer pretreatment period—the time during which a woman is diagnosed, meets with physicians and awaits initial treatment—can be extremely distressing, lonely and confusing. Research demonstrates that approximately one-third of women diagnosed with breast cancer will develop such symptoms as depression and post-traumatic stress at some point in the course of their illness. These symptoms may continue for up to 20 years after diagnosis.

According to Robin Lally, assistant professor in the UB School of Nursing, giving women tools to support their adjustment to breast cancer early after diagnosis is believed to be the key to reduce this psychological burden.

Lally has received a American Cancer Society (ACS) Mentored Research Scholar Grant of more than $700,000 to develop and pilot test a tailored, Internet-based education program to help support the initial psychological adjustment to breast cancer during the pretreatment period.

The ACS Mentored Research Scholar Grant, which will fund Lally’s research, mentoring and training from 2011-16, provides support to full-time junior faculty with the goal of encouraging beginning investigators to become independent researchers as either clinician scientists or cancer control-and-prevention researchers.

Lally’s mentors for this project are Jean Brown, dean of the UB School of Nursing; Karen Meneses, associate dean for research, University of Alabama School of Nursing; and Deborah Erwin, director of cancer health disparities research, Roswell Park Cancer Institute.

For the past 13 years, Lally has been studying the way women think after receiving a breast cancer diagnosis. In 2005, her research began to focus on developing a theory regarding the thought processes and behaviors associated with early psychological adjustment to breast cancer in the highly distressing days and weeks immediately following diagnosis.

“My work focuses on the stressful period just following receipt of a breast cancer diagnosis,” Lally says. “Since many women receive their diagnosis from a mammography center or their general practitioner and then must identify a clinic and wait to see a breast surgeon, they are often left alone to deal with their anxiety. Through this project, we hope to intervene during this critical time by addressing coping and adjustment needs early,” she says.

The Internet-based system she will be developing has distinct advantages for delivering the information these patients may need, Lally explains. The Internet-based format will ensure women are reached as soon as possible after a diagnosis, as well as allowing the patient to control the rate at which she acquaints herself with the diagnosis and related information. The patient receives the information in a manner that supports her emotional well-being—in private and in a consistent, tailored and repeatable way.

While it is unclear why some women have more difficulty adjusting to breast cancer than others, Lally says studies suggest that processing and assimilating the experience is associated with a better mental outlook rather than avoidance and shutting down, which are associated with greater distress.

What is important, she says, is that this ACS-funded education program is an opportunity to reach patients psychologically at a time when research has demonstrated that their emotional needs often are overlooked.

Lally will carry out the project in four phases: content development and evaluation for the Internet-based program; site prototypes that allow for patient feedback; evaluations from focus groups of culturally diverse breast cancer survivors; and the actual pilot study, which will pre- and post-test women newly diagnosed with early-stage disease.

“It is my hope that this program will prove to enhance the psychosocial care that radiologic diagnostic centers, and nurses and physicians in busy clinic settings are able to provide to women soon after informing them they have breast cancer,” Lally says.