Coping, Emotional Processing, and Cancer-Related Symptoms in Breast Cancer Survivors: Cross-Sectional Secondary Analysis of the REPAT Study

Objective: As survival rates from breast cancer increase, the post-treatment period poses several challenges, including a high burden of cancer-related symptoms that interfere with quality of life. This study aims to provide a better understanding of the relationship between coping (approach and avoidance), emotional processing (emotional awareness and acceptance of emotions), and cancer-related symptoms. Methods: This is a cross-sectional, secondary analysis of baseline data from a randomized controlled trial entitled “The Role of Emotional Processing in Art Therapy” (REPAT) study. Participants included 179 breast cancer survivors 6.1 months on average after completing primary treatment. Participants completed questionnaires measuring approach and avoidance coping, acceptance of emotions, cancer-related symptoms (depression, fatigue, and pain), and the Level of Emotional Awareness a performance scale. Hierarchical linear regressions were performed while adjusting for background variables. Results: Participants experienced significant depressive symptoms (51.7%), fatigue (78.8%), pain interference (78%), and pain intensity (66%). There were strong correlations between depression, cancer-related fatigue, and pain. After adjusting for confounders, acceptance of emotions was negatively associated with depression, and avoidance coping was positively associated with depression, cancer-related fatigue, and pain interference. Emotional awareness and approach coping were not associated with cancer-related symptoms, but both were significantly associated with acceptance of emotions. Conclusions: Breast cancer survivors' post-treatment period presents the challenge of dealing with elevated cancer-related symptoms. Regardless, breast cancer survivors with high acceptance of emotions and low avoidance coping experienced fewer cancer-related symptoms.