Distress varies in level of intensity depending on severity of disease as well as phase of treatment (Simonton & Sherman, 1998). The greater levels of distress are positively associated with greater severity of disease (Maunsell, Brisson & Deschenes, 1992; Schag, Ganz, Polinsky, Fred, Hirji, & Peterson, 1993). Further, a patient’s phase of life has a significant impact on adjustment: younger patients demonstrate greater levels of distress than older patients (Simonton & Sherman, 1998; Vinokur, Threatt, Vinokur-Kaplan, & Satariano, 1990). In breast cancer patients, advanced age has been associated with increased social activities and contacts, with better mental health, perceived quality of life, and functioning (Vinokur et al., 1989)
