[Sandy in Silicon Valley]

Hi, Becky & Saleboat,

I'm not ready to put much stock in this research, mainly because at least a third of the data was derived from self-reported history of trauma such as being sexually abused as a child, having been raped, life-threatening injury or suicide of a family member.

While these are "stressful events", they were a separate group in the 3-part study, and they had the shortest survival rate!!! It's not as though this kind of traumatic stress is something we can control for!!! So what good is it, even if there is a real correlation/ causality???

"Stressful events" included adoption (whose, the bc mets patient, or her child's?), a parent's death, living with a MIL, earthquake, divorce, imprisonment of a relative. Well, at least these are more measurable self-report events than just a Likert scale of how much stress is in one's life, but still...

I'd alternately hypothesize that the women in the trauma & stress history groups (no telling WHEN they experienced the trauma/stress event! in relation to when they were dx'd with bc or bcmets, or whether they'd received counseling or instrumental help with financial and other problems associated with the trauma, stress...) might, as a collective data source, have less motivation to aggressively seek dx and care for bcmets (due to lack of financial or social resources, lack of feelings of self-worth, being in a depressive state, etc.) or even to continue treatment, if the treatment added yet another layer of suffering to their plate. And we all know how important aggressively or assertively pursuing the best available oncological care and treatment often is, towards getting treatments that have the best shot at keeping us recurrence free!

So, I'm really skeptical - about the research design, data collection methods, and conclusions drawn. But if this research can be replicated with another set of about N=100 subjects, perhaps with more recent traumas/ and both good and bad stressful events - marriage, moving, job promotions, and caring for a new baby are all stressful life events that bring big changes requiring major adjustments - then I'd consider this an important line of inquiry warranting further investigation.

(((hugs)))
Sandy in Silicon Valley