Changes Over Time in Occurrence, Severity, and Distress of Common Symptoms During and After Radiation Therapy for Breast Cancer  Kristin Hofsø, RN, Tone Rustøen, RN, PhD, Bruce A. Cooper, PhD, Kristin Bjordal, MD, PhD, Christine Miaskowski, RN, PhD, FAAN  Journal of Pain and Symptom Management  Volume 45, Issue 6, Pages 980-1006 (June 2013) DOI: 10.1016/j.jpainsymman.2012.06.003 Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 1 Observed (open circles) and predicted (filled circles) trajectories for the probability of occurrence of a) lack of energy, b) worrying, c) difficulty sleeping, d) feeling drowsy, e) sweats, and f) pain across the six months of the study. Journal of Pain and Symptom Management 2013 45, 980-1006DOI: (10.1016/j.jpainsymman.2012.06.003) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 2 Observed (open circles) and predicted (filled circles) trajectories for the probability of lack of energy across the six months for occurrence in patients who a) did not have and b) did have an ALND, for higher vs. lower severity ratings for patients who c) did not have and d) did have an ALND, and for higher vs. lower distress ratings for patients who e) did not have and f) did have an ALND. Severity ratings are plotted as observed (open symbols) and predicted (filled symbols) for none vs. slight to very severe, none/slight vs. moderate to very severe, none to moderate vs. severe/very severe, and none to severe vs. very severe. Distress ratings are plotted as observed (open symbols) and predicted (filled symbols) for did not have vs. not at all to very severe, did not have/not at all vs. mild to very severe, did not have to mild vs. moderate to very severe, did not have to moderate vs. severe/very severe, and did not have to severe vs. very severe. ALND=axillary lymph node dissection. Journal of Pain and Symptom Management 2013 45, 980-1006DOI: (10.1016/j.jpainsymman.2012.06.003) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 3 Observed (open circles) and predicted (filled circles) trajectories for the probability of lack of energy across the six months for occurrence in patients who a) had not and b) had received CTX, for higher vs. lower severity ratings for patients who c) had not and d) had received CTX, and for higher vs. lower distress ratings for patients who e) had not and f) had received CTX. Severity ratings are plotted as observed (open symbols) and predicted (filled symbols) for none vs. slight to very severe, none/slight vs. moderate to very severe, none to moderate vs. severe/very severe, and none to severe vs. very severe. Distress ratings are plotted as observed (open symbols) and predicted (filled symbols) for did not have vs. not at all to very severe, did not have/not at all vs. mild to very severe, did not have to mild vs. moderate to very severe, did not have to moderate vs. severe/very severe, and did not have to severe vs. very severe. CTX=chemotherapy. Journal of Pain and Symptom Management 2013 45, 980-1006DOI: (10.1016/j.jpainsymman.2012.06.003) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 4 Observed and predicted trajectories for the probability of a higher vs. a lower severity rating for a) lack of energy, b) worrying, c) difficulty sleeping, d) feeling drowsy, e) sweats, and f) pain across the six months of the study. Severity ratings are plotted as observed (open symbols) and predicted (filled symbols) for none vs. slight to very severe, none/slight vs. moderate to very severe, none to moderate vs. severe/very severe, and none to severe vs. very severe. Journal of Pain and Symptom Management 2013 45, 980-1006DOI: (10.1016/j.jpainsymman.2012.06.003) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 5 Observed and predicted trajectories for the probability of a higher vs. a lower distress rating for a) lack of energy, b) worrying, c) difficulty sleeping, d) feeling drowsy, e) sweats, and f) pain across the six months of the study. Distress ratings are plotted as observed (open symbols) and predicted (filled symbols) for did not have vs. not at all to very severe, did not have/not at all vs. mild to very severe, did not have to mild vs. moderate to very severe, did not have to moderate vs. severe/very severe, and did not have to severe vs. very severe. Journal of Pain and Symptom Management 2013 45, 980-1006DOI: (10.1016/j.jpainsymman.2012.06.003) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 6 Observed (open circles) and predicted (filled circles) trajectories for the probability of feeling drowsy across the six months for occurrence in patients who a) had not and b) had received CTX, for higher vs. lower severity ratings for patients who c) had not and d) had received CTX, and for higher vs. lower distress ratings for patients who e) had not and f) had received CTX. Severity ratings are plotted as observed (open symbols) and predicted (filled symbols) for none vs. slight to very severe, none/slight vs. moderate to very severe, none to moderate vs. severe/very severe, and none to severe vs. very severe. Distress ratings are plotted as observed (open symbols) and predicted (filled symbols) for did not have vs. not at all to very severe, did not have/not at all vs. mild to very severe, did not have to mild vs. moderate to very severe, did not have to moderate vs. severe/very severe, and did not have to severe vs. very severe. CTX=chemotherapy. Journal of Pain and Symptom Management 2013 45, 980-1006DOI: (10.1016/j.jpainsymman.2012.06.003) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 7 Observed and predicted trajectories for the probability of reporting a higher vs. a lower distress score for pain across the six months in patients who a) did not and b) did receive CTX. Distress ratings are plotted as observed (open symbols) and predicted (filled symbols) for did not have vs. not at all vs. mild to very mild, did not have/not at all vs. mild to very severe, did not have to mild vs. moderate to very severe, did not have to moderate vs. severe/very severe, and did not have to severe vs. very severe. CTX=chemotherapy. Journal of Pain and Symptom Management 2013 45, 980-1006DOI: (10.1016/j.jpainsymman.2012.06.003) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions