Top

Published in:

01-06-2020 | Colorectal Cancer

Risk factors for cancer-related distress in colorectal cancer survivors: one year post surgery

Authors: Claire J. Han, Biljana Gigic, Martin Schneider, Yakup Kulu, Anita R. Peoples, Jennifer Ose, Torsten Kölsch, Paul B. Jacobsen, Graham A. Colditz, Jane C. Figueiredo, William M. Grady, Christopher I. Li, David Shibata, Erin M. Siegel, Adetunji T. Toriola, Alexis B. Ulrich, Karen L. Syrjala, Cornelia M. Ulrich

Published in: Journal of Cancer Survivorship | Issue 3/2020

Abstract

Purposes

Cancer-related distress is known to persist long after completion of treatment. Factors related to distress are largely unexplored in colorectal cancer (CRC) survivors. We examined changes over time and risk factors for distress in CRC patients over the first year after surgery.

Methods

We included 212 CRC patients with data at 6 and 12 months post-surgery from the ColoCare Study in Heidelberg, Germany. Sociodemographic and lifestyle factors, social support, and health-related quality of life (HrQOL) prior to surgery were evaluated as predictors of cancer-related distress. Distress was measured with the Cancer and Treatment Distress instrument (CTXD). Linear regression analyses examined associations between risk factors and distress.

Results

Distress subscale scores varied significantly over time: health burden subscale score increased (P < .001), while finances (P = .004), medical demands (P < .001), and identity (P < .001) subscale scores decreased over time. Uncertainty and family strain subscale scores did not change. Younger age, lower income, advanced tumor stage, poorer social support, and poorer baseline HrQOL predicted higher level distress at 6 and 12 months.

Conclusion

Cancer-related distress continues unresolved after surgery. Although some risk factors are difficult to alter, those at highest risk can be identified earlier for possible preventive strategies.

Implications for Cancer Survivors

Screening for risk factors pre-surgery would allow for targeted interventions including strategies to improve resources for those with low support, thereby reducing long-term distress in CRC survivors.

Available only for authorised users

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7–30. https://doi.org/10.3322/caac.21442.CrossRefPubMed

Manitta V, Zordan R, Cole-Sinclair M, Nandurkar H, Philip J. The symptom burden of patients with hematological malignancy: a cross-sectional observational study. J Pain Symptom Manage. 2011;42(3):432–42. https://doi.org/10.1016/j.jpainsymman.2010.12.008.CrossRefPubMed

Miles A, McClements PL, Steele RJ, Redeker C, Sevdalis N, Wardle J. Perceived diagnostic delay and cancer-related distress: a cross-sectional study of patients with colorectal cancer. Psych Oncol. 2017;26(1):29–36. https://doi.org/10.1002/pon.4093.CrossRef

Averyt JC, Nishimoto PW. Psychosocial issues in colorectal cancer survivorship: the top ten questions patients may not be asking. J Gastrointest Oncol. 2014;5(5):395–400. https://doi.org/10.3978/j.issn.2078-6891.2014.058.CrossRefPubMedPubMedCentral

Holland JC, Andersen B, Breitbart WS, Buchmann LO, Compas B, Deshields TL, et al. NCCN clinical practice guidelines in oncology (NCCN) guidelines: distress management. J National Comprehensive Cancer Network. 2013;11(2):190–209.CrossRef

Bidstrup PE, Johansen C, Mitchell AJ. Screening for cancer-related distress: summary of evidence from tools to programmes. Acta Oncologica. 2011;50(2):194–204. https://doi.org/10.3109/0284186X.2010.533192.CrossRefPubMed

Smith SK, Loscalzo M, Mayer C, Rosenstein DL. Best practices in oncology distress management: beyond the screen. Am Soc Clin Oncol Educ Book. 2018;38:813–21. https://doi.org/10.1200/EDBK_201307.CrossRefPubMed

Abrahamson K. Dealing with cancer-related di stress. Am J Nurs. 2010;110(4):67–9. https://doi.org/10.1097/01.NAJ.0000370162.07674.f6.CrossRefPubMed

Deimling GT, Brown SP, Albitz C, Burant CJ, Mallick N. The relative importance of cancer-related and general health worries and distress among older adult, long-term cancer survivors. Psych Oncol. 2017;26(2):182–90. https://doi.org/10.1002/pon.4015.CrossRef

10.

Gibbons A, Groarke A, Sweeney K. Predicting general and cancer-related distress in women with newly diagnosed breast cancer. BMC Cancer. 2016;16(1):935.CrossRefPubMedPubMedCentral

11.

Syrowatka A, Motulsky A, Kurteva S, Hanley JA, Dixon WG, Meguerditchian AN, et al. Predictors of distress in female breast cancer survivors: a systematic review. Breast Cancer Res Treat. 2017;165(2):229–45. https://doi.org/10.1007/s10549-017-4290-9.CrossRefPubMedPubMedCentral

12.

Graves KD, Arnold SM, Love CL, Kirsh KL, Moore PG, Passik SD. Distress screening in a multidisciplinary lung cancer clinic: prevalence and predictors of clinically significant distress. Lung Cancer. 2007;55(2):215–24. https://doi.org/10.1016/j.lungcan.2006.10.001.CrossRefPubMed

13.

Howes J, Simpson J, McLeod D, Digout C, Spencer J, Maginley D, et al. Best practice guideline for the management of cancer-related distress in adults. Supportive Care Cancer Site Team, Cancer Care Nova Scotia 10/30/2014.

14.

Occhipinti S, Chambers SK, Lepore S, Aitken J, Dunn J. A longitudinal study of post-traumatic growth and psychological distress in colorectal cancer survivors. PLoS One. 2015;10(9):e0139119. https://doi.org/10.1371/journal.pone.0139119.CrossRefPubMedPubMedCentral

15.

Worster B, Holmes S. The preoperative experience of patients undergoing surgery for colorectal cancer: a phenomenological study. Eur J Oncol Nurs. 2008;12(5):418–24. https://doi.org/10.1016/j.ejon.2008.05.007.CrossRefPubMed

16.

Taylor C. Body image concerns after colorectal cancer surgery. Br J Nurs. 2015;24(10):8-S14. https://doi.org/10.12968/bjon.2015.24.Sup10.S8.CrossRef

17.

Behrenbruch C, Shembrey C, Paquet-Fifield S, Mølck C, Cho HJ, Michael M, et al. Surgical stress response and promotion of metastasis in colorectal cancer: a complex and heterogeneous process. Clin Exp Metastasis. 2018;35(4):333–45. https://doi.org/10.1007/s10585-018-9873-2.CrossRefPubMed

18.

Pereira MG, Figueiredo AP, Fincham FD. Anxiety, depression, traumatic stress and quality of life in colorectal cancer after different treatments: a study with Portuguese patients and their partners. Eur J Oncol Nurs. 2012;16(3):227–32. https://doi.org/10.1016/j.ejon.2011.06.006.CrossRef

19.

Jakobsson J, Idvall E, Kumlien C. The lived experience of recovery during the first 6 months after colorectal cancer surgery. J Clin Nurs. 2017;26(23–24):4498–505. https://doi.org/10.1111/jocn.13780.CrossRefPubMed

20.

Syrjala KL, Sutton SK, Jim HS, Knight JM, Wood WA, Lee SJ, et al. Cancer and treatment distress psychometric evaluation over time: A BMT CTN 0902 secondary analysis. Cancer. 2017;123(8):1416–23. https://doi.org/10.1002/cncr.30454.CrossRefPubMed

21.

Kuba K, Esser P, Scherwath A, Schirmer L, Schulz-Kindermann F, Dinkel A, et al. A cancer-and-treatment–specific distress and its impact on posttraumatic stress in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Psych Oncol. 2017;26(8):1164–71. https://doi.org/10.1002/pon.4295.CrossRef

22.

Mosher CE, Winger JG, Given BA, Helft PR, O'Neil BH, Mosher CE, et al. Mental health outcomes during colorectal cancer survivorship: a review of the literature. Psych Oncol. 2016;25(11):1261–70. https://doi.org/10.1002/pon.3954.CrossRef

23.

Lynch BM, Steginga SK, Hawkes AL, Pakenham KI, Dunn J. Describing and predicting psychological distress after colorectal cancer. Cancer. 2008;112(6):1363–70. https://doi.org/10.1002/cncr.23300.CrossRefPubMed

24.

Landsbergen KM, Prins JB, Brunner HG, Van Duijvendijk P, Nagengast FM, Van Krieken JH, et al. Psychological distress in newly diagnosed colorectal cancer patients following microsatellite instability testing for Lynch syndrome on the pathologist’s initiative. Familial Cancer. 2012;11(2):259–67. https://doi.org/10.1007/s10689-012-9510-1.CrossRefPubMedPubMedCentral

25.

Geue K, Rieckhof S, Buttstaedt M, Singer S. Do cancer patients with high levels of distress benefit more than less distressed patients from outpatient art therapy? Eur J Oncol Nurs. 2017;30:1–7. https://doi.org/10.1016/j.ejon.2017.07.004.CrossRefPubMed

26.

Gigic B, Boeing H, Toth R, Böhm J, Habermann N, Scherer D, et al. Associations between dietary patterns and longitudinal quality of life changes in colorectal cancer patients: the ColoCare study. Nutr Cancer. 2018;70(1):51–60. https://doi.org/10.1080/01635581.2018.1397707.CrossRefPubMed

27.

Liesenfeld DB, Grapov D, Fahrmann JF, Salou M, Scherer D, Toth R, et al. Metabolomics and transcriptomics identify pathway differences between visceral and subcutaneous adipose tissue in colorectal cancer patients: the ColoCare study. Am J Clin Nutr. 2015;102(2):433–43. https://doi.org/10.3945/ajcn.114.103804.CrossRefPubMedPubMedCentral

28.

Ulrich CM, Gigic B, Böhm J, Ose J, Viskochil R, Schneider M, et al. The ColoCare study - a paradigm of transdisciplinary science in colorectal cancer outcomes. Cancer Epidemiol Biomark Prev. 2018;28(3):591–601. https://doi.org/10.1158/1055-9965.EPI-18-0773.CrossRef

29.

Vaglio J, Conard M, Poston WS, O'Keefe J, Haddock CK, House J, et al. Testing the performance of the ENRICHD social support instrument in cardiac patients. Health Qual Life Outcomes. 2004;2:24.CrossRefPubMedPubMedCentral

30.

Investigators ENRICHD. Enhancing recovery in coronary heart disease (ENRICHD) study intervention: rationale and design. Psychosom Med. 2001;63(5):747–55.

31.

Cordes A, Herrmann-Lingen C, Büchner B, Hessel A. Repräsentative Normierung des ENRICHD- Social-Support-Instrument (ESSI) – Deutsche Version. 2009;2:16–32.

32.

Scott N, Fayers P, Aaronson N, Bottomley A, de Graeff A, Groenvold M, et al. EORTC QLQ-C30. Reference values. Brussels: Belgium EORTC; 2008.

33.

Jocham HR, Dassen T, Widdershoven G, Halfens R. Reliability and validity of the EORTC QLQ-C30 in palliative care cancer patients. Cent Eur J Med. 2009;4(3):348–57. https://doi.org/10.2478/s11536-009-0032-7.CrossRef

34.

Syrjala KL, Yi JC. SL Langer. SL. Psychometric properties of the cancer and treatment distress (CTXD) measure in hematopoietic cell transplantation patients. Psych Oncol. 2016;25(5):529–35. https://doi.org/10.1002/pon.3861.CrossRef

35.

Rischer J, Scherwath A, Zander AR, Koch U, Schulz-Kindermann F. Sleep disturbances and emotional distress in the acute course of hematopoietic stem cell transplantation. Bone Marrow Transplant. 2009;44(2):121–8. https://doi.org/10.1038/bmt.2008.CrossRefPubMed

36.

Knight JM, Syrjala KL, Majhail NS, Martens M, Le-Rademacher J, Logan BR, et al. Patient-reported outcomes and socioeconomic status as predictors of clinical outcomes after hematopoietic stem cell transplantation: a study from the blood and marrow transplant clinical trials network 0902 trial. Biol Blood Marrow Transplant. 2016;22(12):2256–63. https://doi.org/10.1016/j.bbmt.2016.08.016.CrossRefPubMedPubMedCentral

37.

Carrera PM, Kantarjian HM, Blinder VS. The financial burden and distress of patients with cancer: understanding and stepping-up action on the financial toxicity of cancer treatment. CA Cancer J Clin. 2018;68(2):153–65. https://doi.org/10.3322/caac.21443.CrossRefPubMedPubMedCentral

38.

Burgoyne MJ, Bingen K, Leuck J, Dasgupta M, Ryan P, Hoffmann RG. Cancer-related distress in young adults compared to middle-aged and senior adults. J Adolesc Young Adult Oncol. 2015;4(2):56–63. https://doi.org/10.1089/jayao.2014.0005.Epub.CrossRefPubMed

39.

Kavitha R, Jayan C. Role of social support on cancer distress among breast cancer patients. Behavioral Social Sciences. 2014;2(1):247–51.

40.

Sharma A, Walker LG, Monson JR. Baseline quality of life factors predict long term survival after elective resection for colorectal cancer. Int J Surg Oncol. 2013;2013:269510. https://doi.org/10.1155/2013/269510.CrossRefPubMedPubMedCentral

41.

Seber GA, Lee AJ. Linear regression analysis. Vol. 329. John Wiley & Sons; 2012.

42.

Sharp L, Patel D, Clarke S. The relationship between body image disturbance and distress in colorectal cancer patients with and without stomas. J Psych Res. 2011;70(5):395–402. https://doi.org/10.1016/j.jpsychores.2010.11.003.CrossRef

43.

Neo J, Fettes L, Gao W, Higginson IJ, Maddocks M. Disability in activities of daily living among adults with cancer: a systematic review and meta-analysis. Cancer Treat Rev. 2017;61:94–106. https://doi.org/10.1016/j.ctrv.2017.10.006.CrossRefPubMed

44.

Rasmussen S, Larsen PV, Søndergaard J, Elnegaard S, Svendsen RP, Jarbøl DE. Specific and non-specific symptoms of colorectal cancer and contact to general practice. Fam Pract. 2015;32(4):387–94. https://doi.org/10.1093/fampra/cmv032.CrossRefPubMed

45.

Barber FD. Effects of social support on physical activity, self-efficacy, and quality of life in adult cancer survivors and their caregivers. In Oncol Nurs Forum. 2013;40(5):481–9. https://doi.org/10.1188/13.ONF.481-489.CrossRef

46.

Trunzo JJ, Pinto BM. Social support as a mediator of optimism and distress in breast cancer survivors. J Consult Clin Psychol. 2003;71(4):805–11. https://doi.org/10.1037/0022-006X.71.4.805.CrossRefPubMed

47.

Maisey NR, Norman A, Watson M, Allen MJ, Hill ME, Cunningham D. Baseline quality of life predicts survival in patients with advanced colorectal cancer. Eur J Cancer. 2002;38(10):1351–7. https://doi.org/10.1016/S0959-8049(02)00098-9.CrossRefPubMed

48.

Ahlberg KT, Ekman T, Gaston-Johansson F. Fatigue, psychological distress, coping resources, and functional status during radiotherapy for uterine cancer. In Oncol Nurs Forum. 2005;32(3):633–40. https://doi.org/10.1188/05.ONF.633-640.CrossRef

49.

Mitchell AJ. Short screening tools for cancer-related distress: a review and diagnostic validity meta-analysis. J Natl Compr Cancer Netw. 2010;8(4):487–94.CrossRef

50.

Savard J, Ivers H. The evolution of fear of cancer recurrence during the cancer care trajectory and its relationship with cancer characteristics. J Psychosom Res. 2013;74(4):354–60. https://doi.org/10.1016/j.jpsychores.2012.12.013.CrossRefPubMed

Title: Risk factors for cancer-related distress in colorectal cancer survivors: one year post surgery
Authors: Claire J. Han
Biljana Gigic
Martin Schneider
Yakup Kulu
Anita R. Peoples
Jennifer Ose
Torsten Kölsch
Paul B. Jacobsen
Graham A. Colditz
Jane C. Figueiredo
William M. Grady
Christopher I. Li
David Shibata
Erin M. Siegel
Adetunji T. Toriola
Alexis B. Ulrich
Karen L. Syrjala
Cornelia M. Ulrich
Publication date: 01-06-2020
Publisher: Springer US
Keywords: Colorectal Cancer
Colorectal Cancer
Published in: Journal of Cancer Survivorship / Issue 3/2020
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-019-00845-y

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

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purposes

Methods

Results

Conclusion

Implications for Cancer Survivors

Please log in to get access to this content

Other articles of this Issue 3/2020

Online social support among breast cancer patients: longitudinal changes to Facebook use following breast cancer diagnosis and transition off therapy

Clinical trajectories, healthcare resource use, and costs of long-term hematopoietic stem cell transplantation survivors: a latent class analysis

The value of immunotherapy for survivors of stage IV non-small cell lung cancer: patient perspectives on quality of life

Comparison of health behaviours between cancer survivors and the general population: a cross-sectional analysis of the Lifelines cohort

Do esophageal cancer survivors work after esophagectomy and do health problems impact their work? A cross-sectional study

Use of consumer wearable devices to promote physical activity among breast, prostate, and colorectal cancer survivors: a review of health intervention studies

Keynote webinar | Spotlight on antibody–drug conjugates in cancer