Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Supportive Care in Cancer
Published in: Supportive Care in Cancer 2/2011

01-02-2011 | Original Article

Gender, age and surgery as a treatment modality leads to higher distress in patients with cancer

Authors: Bejoy C. Thomas, V. NandaMohan, Madhvan K. Nair, Manoj Pandey

Published in: Supportive Care in Cancer | Issue 2/2011

Login to get access

Abstract

Introduction

Distress has been defined as a multidimensional construct that extends along a continuum, ranging from common normal feelings of vulnerability, sadness and fears to problems that can become disabling, such as depression, anxiety, panic, social isolation and existential and spiritual crisis. Several studies have pointed out the need to screen for distress in the cancer. Emotional distress has been found as a core indicator of a patient’s health and well-being and has installed it as the sixth vital sign. The aim of the present study was to identify the predictors of distress in cancer patients.

Patients and methods

For the present study, a total of 760 patients with cancer in a tertiary cancer centre were assessed using the Distress Inventory for Cancer Version 2 (DIC V2). A multivariate logistic regression was carried out to identify the predictors of distress and six subscales.

Results

Female patients under the age of 44 years scheduled to undergo surgery or those who had undergone surgery predicted significantly higher levels of overall distress. Composite disease stage other than stage IV metastatic disease and being a daily wage employee predicted significantly lower levels of overall distress.

Discussion

Higher distress among women undergoing surgery could imply distress associated with significant cosmetic disfigurement and feeling of loss of womanhood especially in those with breast or cervix cancer.

Conclusion

The study once again demonstrate gender and age differences in distress and also highlights the importance of knowing that cancer is confined to one organ and has not spread.
Literature
1.
Rodin G, Mackay JA, Zimmermann C, Mayer C, Howell D, Katz M, Sussman J, Brouwers M (2009) Clinician–patient communication: a systematic review. Support Care Cancer 17:627–644PubMedCrossRef
2.
Fallowfield L, Ratcliffe D, Jenkins V, Saul J (2001) Psychiatric morbidity and its recognition by doctors in patients with cancer. Br J Cancer 84:1011–1015PubMedCrossRef
3.
Ford S, Fallowfield L, Lewis S (1996) Doctor-patient interactions in oncology. Soc Sci Med 42:1511–1519PubMedCrossRef
4.
Ford S, Fallowfield L, Lewis S (1994) Can oncologists detect distress in their out-patients and how satisfied are they with their performance during bad news consultations? Br J Cancer 70:767–770PubMedCrossRef
5.
Sollner W, DeVries A, Steixner E, Lukas P, Sprinzl G, Rumpold G, Maislinger S (2001) How successful are oncologists in identifying patient distress, perceived social support, and need for psychosocial counselling? Br J Cancer 84:179–185PubMedCrossRef
6.
Carlson LE, Angen M, Cullum J, Goodey E, Koopmans J, Lamont L, MacRae JH, Martin M, Pelletier G, Robinson J et al (2004) High levels of untreated distress and fatigue in cancer patients. Br J Cancer 90:2297–2304PubMed
7.
8.
Carpenter KM, Andersen BL, Fowler JM, Maxwell GL (2009) Sexual self schema as a moderator of sexual and psychological outcomes for gynecologic cancer survivors. Arch Sex Behav 38:828–841PubMedCrossRef
9.
Kim Y, Wellisch DK, Spillers RL (2008) Effects of psychological distress on quality of life of adult daughters and their mothers with cancer. Psychooncology 17:1129–1136PubMedCrossRef
10.
Kim Y, Kashy DA, Wellisch DK, Spillers RL, Kaw CK, Smith TG (2008) Quality of life of couples dealing with cancer: dyadic and individual adjustment among breast and prostate cancer survivors and their spousal caregivers. Ann Behav Med 35:230–238PubMedCrossRef
11.
Mystakidou K, Parpa E, Tsilika E, Athanasouli P, Pathiaki M, Galanos A, Pagoropoulou A, Vlahos L (2008) Preparatory grief, psychological distress and hopelessness in advanced cancer patients. Eur J Cancer Care (Engl ) 17:145–151CrossRef
12.
Schou I, Ekeberg O, Karesen R, Sorensen E (2008) Psychosocial intervention as a component of routine breast cancer care-who participates and does it help? Psychooncology 17:716–720PubMedCrossRef
13.
Sivesind D, Baile WF (2001) The psychologic distress in patients with cancer. Nurs Clin North Am 36:809–825, viiiPubMed
14.
Anderson B, Lutgendorf S (2000) Quality of life as an outcome measure in gynecologic malignancies. Curr Opin Obstet Gynecol 12:21–26PubMedCrossRef
15.
Kelly C, Ghazi F, Caldwell K (2002) Psychological distress of cancer and clinical trial participation: a review of the literature. Eur J Cancer Care (Engl ) 11:6–15CrossRef
16.
Salander P (2000) Using beliefs and magical thinking to fight cancer distress-a case study. Psychooncology 9:40–43PubMedCrossRef
17.
Epping-Jordan JE, Compas BE, Osowiecki DM, Oppedisano G, Gerhardt C, Primo K, Krag DN (1999) Psychological adjustment in breast cancer: processes of emotional distress. Health Psychol 18:315–326PubMedCrossRef
18.
Mehta P, Rodrigue J, Nejame C, Gaa R, Wingard JR (2000) Acquiescence to adjunctive experimental therapies may relate to psychological distress: pilot data from a bone marrow transplant center. Bone Marrow Transplant 25:673–676PubMedCrossRef
19.
de Leeuw L Jr, de Graeff GA, Ros WJ, Hordijk GJ, Blijham GH, Winnubst JA (2000) Negative and positive influences of social support on depression in patients with head and neck cancer: a prospective study. Psychooncology 9:20–28PubMedCrossRef
20.
Koopman C, Hermanson K, Diamond S, Angell K, Spiegel D (1998) Social support, life stress, pain and emotional adjustment to advanced breast cancer. Psychooncology 7:101–111PubMedCrossRef
21.
22.
Thomas CB, Duszynski KR (1974) Closeness to parents and the family constellation in a prospective study of five disease states: suicide, mental illness, malignant tumor, hypertension and coronary heart disease. Johns Hopkins Med J 134:251–270PubMed
23.
Worden JW, Weisman AD (1975) Psychosocial components of lagtime in cancer diagnosis. J Psychosom Res 19:69–79PubMedCrossRef
24.
Reynolds P, Kaplan GA (1990) Social connections and risk for cancer: prospective evidence from the Alameda County Study. Behav Med 16:101–110PubMedCrossRef
25.
Roberge C, Tran M, Massoud C, Poiree B, Duval N, Damecour E, Frout D, Malvy D, Joly F, Lebailly P et al (2000) Quality of life and home enteral tube feeding: a French prospective study in patients with head and neck or oesophageal cancer. Br J Cancer 82:263–269PubMedCrossRef
26.
Neville K (1998) The relationships among uncertainty, social support, and psychological distress in adolescents recently diagnosed with cancer. J Pediatr Oncol Nurs 15:37–46PubMed
27.
Bultz BD, Carlson LE (2006) Emotional distress: the sixth vital sign–future directions in cancer care. Psychooncology 15:93–95PubMedCrossRef
28.
Carlson LE, Bultz BD (2004) Efficacy and medical cost offset of psychosocial interventions in cancer care: making the case for economic analyses. Psychooncology 13:837–849PubMedCrossRef
29.
Kristeller JL, Zumbrun CS, Schilling RF (1999) 'I would if I could': how oncologists and oncology nurses address spiritual distress in cancer patients. Psychooncology 8:451–458PubMedCrossRef
30.
Russak MS, Lederberg M, Fitchett G (1999) Special Issue: Spiritual and religious beliefs and coping with cancer. Psychooncology 8:375–466CrossRef
31.
Rebalance Focus Action Group (2005) A position paper: screening key indicators in cancer patients—pain as a 5th vital sign and emotional distress as a 6th vital sign. Can Strategy Cancer Control Bull 7(Supplement):4
32.
Thomas BC, Mohan VN, Thomas I, Pandey M (2002) Development of a distress inventory for cancer: preliminary results. J Postgrad Med 48:16–20PubMed
33.
Pandey M, Thomas BC, Ramdas K, Nandamohan V (2006) Factors influencing distress in Indian cancer patients. Psychooncology 15:547–550PubMedCrossRef
34.
Pandey M, Devi N, Thomas BC, Vinod KS, Krishnan R, Ramdas K (2007) Distress overlaps with anxiety and depression in patients with head and neck cancer. Psychooncology 16:582–586PubMedCrossRef
35.
Pandey M, Sarita GP, Devi N, Thomas BC, Hussain BM, Krishnan R (2006) Distress, anxiety, and depression in cancer patients undergoing chemotherapy. World J Surg Oncol 4:68PubMedCrossRef
36.
Thomas BC, Thomas I, Nandamohan V, Nair M, Pandey M (2008) Screening for distress can predict loss of follow-up and treatment in cancer patients: results of development and validity of the Distress Inventory for Cancer Version 2. Psychooncology 18:524–533
37.
Wong WS, Fielding R (2007) Change in quality of life in Chinese women with breast cancer: changes in psychological distress as a predictor. Support Care Cancer 15:1223–1230PubMedCrossRef
38.
Zeltzer LK, Lu Q, Leisenring W, Tsao JC, Recklitis C, Armstrong G, Mertens AC, Robison LL, Ness KK (2008) Psychosocial outcomes and health-related quality of life in adult childhood cancer survivors: a report from the childhood cancer survivor study. Cancer Epidemiol Biomarkers Prev 17:435–446PubMedCrossRef
39.
Ando N, Iwamitsu Y, Kuranami M, Okazaki S, Wada M, Yamamoto K, Todoroki K, Watanabe M, Miyaoka H (2009) Psychological characteristics and subjective symptoms as determinants of psychological distress in patients prior to breast cancer diagnosis. Support Care Cancer 17:1361–1370PubMedCrossRef
40.
Chen AM, Jennelle RL, Grady V, Tovar A, Bowen K, Simonin P, Tracy J, McCrudden D, Stella JR, Vijayakumar S (2009) Prospective study of psychosocial distress among patients undergoing radiotherapy for head and neck cancer. Int J Radiat Oncol Biol Phys 73:187–193PubMedCrossRef
41.
Hagedoorn M, Buunk BP, Kuijer RG, Wobbes T, Sanderman R (2000) Couples dealing with cancer: role and gender differences regarding psychological distress and quality of life. Psychooncology 9:232–242PubMedCrossRef
42.
Nolen-Hoeksema S, Rusting CL (1999) Gender differences in well-being. In: Kahneman D, Diener E (eds) Well-being: the foundations of Hedonic Psychology. Sage, New York
43.
Bredart A, Didier F, Robertson C, Scaffidi E, Fonzo D, Costa A, Goldhirsch A, Autier P (1999) Psychological distress in cancer patients attending the European Institute of Oncology in Milan. Oncology 57:297–302PubMedCrossRef
44.
Keller M, Henrich G (1999) Illness-related distress: does it mean the same for men and women? Gender aspects in cancer patients' distress and adjustment. Acta Oncol 38:747–755PubMedCrossRef
45.
Nolen-Hoeksema S, Rusting CL (1999) Gender differences in well-being. In: Kahneman D, Diener E (eds) Well-being: the foundations of Hedonic Psychology. Sage, New York
46.
Peleg-Oren N, Sherer M, Soskolne V (2003) Effect of gender on the social and psychological adjustment of cancer patients. Soc Work Health Care 37:17–34PubMedCrossRef
47.
Matthews BA (2003) Role and gender differences in cancer-related distress: a comparison of survivor and caregiver self-reports. Oncol Nurs Forum 30:493–499PubMedCrossRef
48.
Gilbar O (1999) Gender as a predictor of burden and psychological distress of elderly husbands and wives of cancer patients. Psychooncology 8:287–294PubMedCrossRef
49.
Morita T, Akechi T, Ikenaga M, Kizawa Y, Kohara H, Mukaiyama T, Nakaho T, Nakashima N, Shima Y, Matsubara T et al (2004) Communication about the ending of anticancer treatment and transition to palliative care. Ann Oncol 15:1551–1557PubMedCrossRef
50.
Takesaka J, Crowley R, Casarett D (2004) What is the risk of distress in palliative care survey research? J Pain Symptom Manage 28:593–598PubMedCrossRef
51.
Hwang SS, Chang VT, Cogswell J, Alejandro Y, Osenenko P, Morales E, Srinivas S, Kasimis B (2004) Study of unmet needs in symptomatic veterans with advanced cancer: incidence, independent predictors and unmet needs outcome model. J Pain Symptom Manage 28:421–432PubMedCrossRef
52.
Zietman AL, Sacco D, Skowronski U, Gomery P, Kaufman DS, Clark JA, Talcott JA, Shipley WU (2003) Organ conservation in invasive bladder cancer by transurethral resection, chemotherapy and radiation: results of a urodynamic and quality of life study on long-term survivors. J Urol 170:1772–1776PubMedCrossRef
53.
Lam WW, Fielding R, Ho EY (2005) Predicting psychological morbidity in Chinese women after surgery for breast carcinoma. Cancer 103:637–646PubMedCrossRef
54.
Jim HS, Andrykowski MA, Munster PN, Jacobsen PB (2007) Physical symptoms/side effects during breast cancer treatment predict posttreatment distress. Ann Behav Med 34:200–208PubMedCrossRef
55.
Newell R, Ziegler L, Stafford N, Lewin RJ (2004) The information needs of head and neck cancer patients prior to surgery. Ann R Coll Surg Engl 86:407–410PubMedCrossRef
56.
Montgomery GH, Bovbjerg DH (2004) Presurgery distress and specific response expectancies predict postsurgery outcomes in surgery patients confronting breast cancer. Health Psychol 23:381–387PubMedCrossRef
57.
Ferrell BR, Grant M, Funk B, Garcia N, Otis-Green S, Schaffner ML (1996) Quality of life in breast cancer. Cancer Pract 4:331–340PubMed
58.
Geinitz H, Zimmermann FB, Thamm R, Keller M, Busch R, Molls M (2004) Fatigue in patients with adjuvant radiation therapy for breast cancer: long-term follow-up. J Cancer Res Clin Oncol 130:327–333PubMedCrossRef
59.
Lai YH, Chang JT, Keefe FJ, Chiou CF, Chen SC, Feng SC, Dou SJ, Liao MN (2003) Symptom distress, catastrophic thinking, and hope in nasopharyngeal carcinoma patients. Cancer Nurs 26:485–493PubMedCrossRef
60.
Berkman BJ, Sampson SE (1993) Psychosocial effects of cancer economics on patients and their families. Cancer 72:2846–2849PubMedCrossRef
61.
62.
Given BA, Given CW, Stommel M (1994) Family and out-of-pocket costs for women with breast cancer. Cancer Pract 2:187–193PubMed
63.
Guidry JJ, Aday LA, Zhang D, Winn RJ (1998) Cost considerations as potential barriers to cancer treatment. Cancer Pract 6:182–187PubMedCrossRef
64.
Guidry JJ, Aday LA, Zhang D, Winn RJ (1997) Transportation as a barrier to cancer treatment. Cancer Pract 5:361–366PubMed
65.
Palapattu GS, Haisfield-Wolfe ME, Walker JM, BrintzenhofeSzoc K, Trock B, Zabora J, Schoenberg M (2004) Assessment of perioperative psychological distress in patients undergoing radical cystectomy for bladder cancer. J Urol 172:1814–1817PubMedCrossRef
66.
Trask PC (2004) Quality of life and emotional distress in advanced prostate cancer survivors undergoing chemotherapy. Health Qual Life Outcomes 2:37PubMedCrossRef
67.
Norton TR, Manne SL, Rubin S, Carlson J, Hernandez E, Edelson MI, Rosenblum N, Warshal D, Bergman C (2004) Prevalence and predictors of psychological distress among women with ovarian cancer. J Clin Oncol 22:919–926PubMedCrossRef
68.
Barnett MM (2006) Does it hurt to know the worst?–psychological morbidity, information preferences and understanding of prognosis in patients with advanced cancer. Psychooncology 15:44–55PubMedCrossRef
Metadata
Title
Gender, age and surgery as a treatment modality leads to higher distress in patients with cancer
Authors
Bejoy C. Thomas
V. NandaMohan
Madhvan K. Nair
Manoj Pandey
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 2/2011
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-009-0810-4

Other articles of this Issue 2/2011

Supportive Care in Cancer 2/2011 Go to the issue

Original Article

Psychological distress and needs of cancer patients: a prospective comparison between the diagnostic and the therapeutic phase

Original Article

Impact of changes in reimbursement policies and institutional practice algorithm for utilization of erythropoietic-stimulating agents on treatment patterns and costs in anemic lymphoma patients

Original Article

A new concept for the differential diagnosis and therapy of anaemia in cancer patients

Original Article

Screening for psychological distress in patients with lung cancer: results of a clinical audit evaluating the use of the patient Distress Thermometer

Short Communication

Factors that influence the efficacy of bereavement life review therapy for spiritual well-being: a qualitative analysis

Original Article

Transitoriness in cancer patients: a cross-sectional survey of lung and gastrointestinal cancer patients
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits