Adjuvant chemotherapy in Dukes' B and C colorectal cancer has only a minor influence on psychological distress

Abstract

The object of this cross-sectional study on psychological distress was to reveal such distress among patients treated for colorectal cancer (CRC). Between 1993 and 1996, 95 patients in northern Norway were included in the national study randomising Dukes' B and C CRC patients between adjuvant chemotherapy (ACT: 5-fluorouracil and levamisole) or follow-up following radical surgery. In April 1996, all 82 survivors were mailed the Impact-of-Event Scale (IES), to which 64 patients responded (78%). Less than one-third of the patients reported a moderate to high level of psychological distress. Scores predicting significant stress response syndrome were revealed in 14% of the patients. The mean score on the intrusion and avoidance scales were 6.1 and 7.7, respectively. Such variables as age, sex, tumour location (rectum/colon), Dukes' stage B/C and time of follow up did not significantly influence the scores. Patients receiving ACT reported only a slightly raised level on the intrusion (6.97 vs 5.17) and avoidance (8.48 vs 6.80) scales. This study indicates that ACT in CRC Dukes' B and C is not a stressful happening. All advantages in survival achieved by ACT have to be weighed against the "cost" in terms of physical and psychological side effects. This study indicates the weighting in terms of psychological distress may be minimal.

Demographic, medical, and psychosocial correlates to CAM use among survivors of colorectal cancer

“…In partial support of our hypotheses, intrusive thoughts, social support, and quality of life were significant correlates to CAM use; however, general psychological distress was not. Participants in this sample reported higher levels of cancer-specific distress compared to previous samples of CRC patients [13]. Perhaps the relationship between intrusive thoughts and participation in hypnosis or biofeedback may be interpreted as a means of managing these intrusive thoughts.…”

“…Participants could provide endorsement on a scale of 0= not at all to 3= often. Considering a maximum score of 45, clinically significant thresholds for the IES have been established as low (<8.5), medium (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19), and high (>19) for total distress [9].…”

A Systematic Overview of Chemotherapy Effects in Colorectal Cancer

“…Eighty-two survivors, of whom 64 (78%) responded, randomised to surgery alone or surgery and uorouracil plus levamisole for 12 months, were assessed using the Impact of Event Scale. Overall distress 0 -38 months after surgery was low with no difference between groups (36). Likewise, QoL did not differ between patients treated with surgery alone or surgery followed by adjuvant uorouracil plus leucovorin in an Italian study (37) during the rst two years of follow-up.…”

Prognostic significance of depth of invasion, vascular invasion and numbers of lymph node retrievals in combination for patients with stage II colorectal cancer undergoing radical resection

“…Patients who undergo radical resection of stage II primary CRC without lymph node metastasis are reported to have a 5-year survival rate of about 80% [7]. About 20% of these patients are known to develop sporadic distant metastases.…”

“…For all stage II patients, chemotherapy administration may be inappropriate and costly [7]. On the other hand, approximately 20% of patients who undergo radical resection of stage II CRC will ultimately develop metastasis to the liver or lungs associated with a poor prognosis [8,9].…”