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

Abstract

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.

Qualitative and quantitative analysis of the defensive profile in breast cancer women: A pilot study

“…Recent findings have shown that defense mechanisms are associated with various physical and psychological symptoms (Di Giuseppe et al, 2019a), cancer progression (Ollonen and Eskelinen, 2007), and survival probability (Beresford et al, 2006). Anxiety and depression are two psychiatric disorders commonly associated with BC (Anderson et al, 2018) and their presence is also related to higher levels of immature defense mechanisms (Hyphantis et al, 2013a; Lueboonthavatchai, 2007). However, only a few studies have used observer-rated methods and applied measures assessing the whole hierarchy of defense mechanisms (Andruccioli et al, 2009; Perry et al, 2015).…”

Metabolite Biomarkers of Prolonged and Intensified Pain and Distress in Head and Neck Cancer Patients Undergoing Radio- or Chemoradiotherapy by Means of NMR-Based Metabolomics—A Preliminary Study

“…If the resolution of uncertainty is not possible, the ongoing brain-energy crisis leads to an allostatic load that contributes to systemic and brain pathology called “toxic stress” [ 57 ]. Such toxic distress, both as an acute and chronic condition, has a significant negative impact on the course and outcome of the oncological treatment [ 58 ]. That is why monitoring of the oncological patients, their psychological support and effective management of the distress are so important and highly desirable.…”

Psychiatric comorbidities and quality of life in breast cancer patients undergoing radiation treatment: Risk and protective factors

“…Despite these benefits, some reports have suggested that RT is also linked to higher levels of psychological distress, and patients with higher distress scores are reportedly more likely to miss appointments and to be admitted to the hospital during the RT course. 3 In addition, RT may be responsible for short-term memory loss and long-term declines in academic success due to its central nervous system toxicity. 4,5 These psychopathological comorbidities have significant impacts on patients' quality for life, self-care, and adaptation to treatment; over the course of time, they may affect cancer severity and prognosis as well as the response to treatment.…”