Patient-reported distress and survival among patients receiving definitive radiation therapy

Habboush, Yacob; Shannon, Robert; Niazi, Shehzad K.; Hollant, Laeticia; Single, Megan Paige; Gaines, Katherine; Smart, Bridget; Chimato, Nicolette; Heckman, Michael G.; Buskirk, Steven J.; Vallow, Laura A.; Tzou, Katherine S.; Ko, Stephen; Peterson, Jennifer; Biers, Heather; Day, Atiya; Nelson, Kimberly; Sloan, Jeff A.; Halyard, Michele Y.; Miller, Robert C.

doi:10.1016/j.adro.2017.03.004

Cited by 27 publications

(20 citation statements)

References 29 publications

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“…Given the negative survival sequelae associated with distress in the HNC population and that mask anxiety is a well–identified contributor to distress, it is essential for patient care that cancer centres have an understanding of mask anxiety with the HNC population receiving RT . Our study is first to report the longitudinal severity and course of mask anxiety during RT for HNC.…”

Section: Discussionmentioning

confidence: 99%

“…Distress is a term that has been adopted to describe an unpleasant experience of a psychological, social, spiritual and/or physical nature . In the population with HNC, patient–reported distress before and after radiotherapy (RT) is prognostic for poorer survival, with long–term challenges associated with physical functioning, fatigue and reduced social supports contributing to distress . Furthermore, distress in the population with HNC has been found to be related to the use of the thermoplastic mask required to immobilise patients to ensure precision of RT treatment …”

Section: Introductionmentioning

confidence: 99%

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A prospective examination of mask anxiety during radiotherapy for head and neck cancer and patient perceptions of management strategies

Nixon

Brown

Pigott

et al. 2019

J of Medical Radiation Sci

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Introduction Distress related to wearing an immobilisation mask for radiotherapy treatment (RT) is a common experience for the person undergoing RT for head and neck cancer (HNC). Described as ‘mask anxiety’, there is little known about the patterns of this distress through the course of the treatment or what strategies are being used by people to help alleviate mask anxiety. Methods The study used a prospective cohort design to examine the patterns of patient–reported mask anxiety during the course of RT, using a modified Distress Thermometer (DT) and a survey to explore strategies patients used to assist their mask anxiety. Results Thirty‐five participants, who identified as experiencing mask anxiety, were followed throughout RT treatment. At baseline, females were more likely to experience higher mask anxiety (P = 0.03). Across the course of treatment, mask anxiety significantly (P < 0.001) reduced within the total cohort. In 72% of participants, the level of initial distress was found to reduce over time. Only 22% experienced mask anxiety that remained constant. Few (6%) experienced an increase in mask anxiety across the course of RT. Participants reported relying on intervention from health professionals, self–taught strategies, music, visualisation and medication to manage their mask anxiety. Conclusions Due to its high prevalence and variable patterns over time, it is recommended that routine screening for mask anxiety be implemented as standard care throughout the course of RT for HNC. Multiple, diverse strategies are being used by patients and studies are needed to develop effective interventions for managing mask anxiety.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A prospective examination of mask anxiety during radiotherapy for head and neck cancer and patient perceptions of management strategies

Nixon

Brown

Pigott

et al. 2019

J of Medical Radiation Sci

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“…One study found that high distress levels measured before and during radiation therapy (RT) prognostic with higher distress levels associated with decreased survival. 9 …”

Section: Introductionmentioning

confidence: 99%

“…Some efforts have been made to correlate distress with specific cancer outcomes. One study found that high distress levels measured before and during radiation therapy (RT) prognostic with higher distress levels associated with decreased survival 9 …”

Section: Introductionmentioning

confidence: 99%

The long-lasting relationship of distress on radiation oncology-specific clinical outcomes

Anderson

Slade

McDonagh

et al. 2019

Advances in Radiation Oncology

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Purpose The diagnosis and treatment of cancer can have significant mental health ramifications. The National Comprehensive Cancer Network currently recommends using a distress screening tool to screen patients for distress and facilitate referrals to social service resources. Its association with radiation oncology–specific clinical outcomes has remained relatively unexplored. Methods and materials With institutional review board approval, National Comprehensive Cancer Network distress scores were collected for patients presenting to our institution for external beam radiation therapy during a 1-year period from 2015 to 2016. The association between distress scores (and associated problem list items and process-related outcomes) and radiation oncology–related outcomes, including inpatient admissions during treatment, missed treatment appointments, duration of time between consultation and treatment, and weight loss during treatment, was considered. Results A total of 61 patients who received either definitive (49 patients) or palliative (12 patients) treatment at our institution and completed a screening questionnaire were included in this analysis. There was a significant association between an elevated distress score (7+) and having an admission during treatment (36% vs 11%; P = .04). Among the patients treated with definitive intent, missing at least 1 appointment (71% vs 26%; P = .03) and having an admission during treatment (57% vs 10%; P = .009) were significantly associated with our institutional definition of elevated distress. We found no correlation between distress score and weight loss during treatment or a prolonged time between initial consult and treatment start. Conclusions High rates of distress are common for patients preparing to receive radiation therapy. These levels may affect treatment compliance and increase rates of hospital admissions. There remains equipoise in the best method to address distress in the oncology patient population. These results may raise awareness of the consequences of distress among radiation oncology patients. Specific interventions to improve distress need further study, but we suggest a more proactive approach by radiation oncologists in addressing distress.

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“…2,3 All of these factors have the potential of increasing patient distress, and this has been shown to lead to decreased survival following cancer therapy. 4 What can medical physicists do to help? We are uniquely positioned to serve as an information resource for patients during a formalized meeting at the initial consult.…”

mentioning

confidence: 99%

Medical physicists should meet with patients as part of the initial consult

Schuller

Hendrickson

Rong

2018

J Applied Clin Med Phys

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Patient-reported distress and survival among patients receiving definitive radiation therapy

Cited by 27 publications

References 29 publications

A prospective examination of mask anxiety during radiotherapy for head and neck cancer and patient perceptions of management strategies

A prospective examination of mask anxiety during radiotherapy for head and neck cancer and patient perceptions of management strategies

The long-lasting relationship of distress on radiation oncology-specific clinical outcomes

Medical physicists should meet with patients as part of the initial consult

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