SAN DIEGO, Sept. 24, 2017 /PRNewswire-USNewswire/
-- Psychological distress has long been associated with
negative health outcomes for cancer patients, though specific
reasons remain unclear. A new study finds that roughly half of all
patients who reported having severe distress, which the National
Comprehensive Cancer Network® (NCCN®)
describes as "a mix of anxiety and depressive symptoms,"
subsequently missed one or more radiation therapy appointments
and/or were admitted to the hospital during their treatment,
compared with fewer than 20 percent of patients who reported lower
levels of distress. The study will be presented today at the 59th
Annual Meeting of the American Society for Radiation Oncology
(ASTRO).
The emotional side effects of cancer, compared with physical
side effects, often are more difficult to diagnose and manage. The
NCCN® estimates that significant distress afflicts
roughly a third of cancer patients, leading to further
symptoms—such as loss of appetite, difficulty concentrating and
sleeplessness—that undermine patients' ability to fight their
diseases.
"Focusing on the 'whole patient' allows oncologists to deliver
the best possible treatment. We know that having cancer is
stressful, which means that we have a responsibility to consider a
patient's mental well-being when planning a course of action with
them," said Justin Anderson, lead
author of the study and a medical student at the Virginia Commonwealth University School of Medicine
in Richmond, Virginia.
"While distress does not directly impact a patient's disease, it
impacts how she or he copes with treatment, such as the ability to
follow a doctor's recommendations and adhere to a treatment plan.
Findings from this study also link higher levels of distress to
outcomes specific to radiation oncology, including missed radiation
therapy appointments and hospital admission during a course of
radiation."
Study findings are based on 54 patients who received external
beam radiation therapy with curative intent in the authors'
radiation oncology department during a one-year period between 2015
and 2016. The average patient age was 59 (range 32-85), and 58
percent of the patients were male.
Researchers evaluated patients' levels of distress with the NCCN
Distress Thermometer, a brief instrument that asks patients to rate
"how much distress [they] have been experiencing in the past week
including today," on a scale from 0 (No distress) to 10 (Extreme
distress), similar to common pain scales. Distress scores were
grouped into four categories: severe (scores of 7-10), moderate
(4-6), low (1-3) and none (0). Fifteen percent of the patients in
this study reported severe distress, 29 percent reported moderate
stress, 29 percent reported low distress and 25 percent reported no
distress.
Patients with higher distress scores were more likely to miss
appointments during their course of radiation therapy. More than
half (57%) of the patients with severe distress scores missed one
or more appointments, compared to 18 percent of patients with
moderate, low or no distress (p < 0.01).
Distressed patients also were more likely to be admitted to the
hospital during treatment. Half of the patients with severe
distress scores were admitted during treatment, compared with 11
percent of patients with moderate, low or no distress (p <
0.01).
Researchers also examined the influence of clinical and
demographic factors on levels of patient distress. Neither weight
loss during treatment nor duration of time between initial
consultation and start of treatment correlated significantly with
distress scores. The stage of a patient's cancer, however, was
positively associated with distress, such that each increase in
stage predicted an average increase of 0.8 points on a patient's
distress score (p < 0.05).
The study demonstrates that the NCCN Distress Thermometer or
similar instruments can be useful prognostic tools for radiation
oncologists to determine which patients may need additional support
during treatment, explained Mr. Anderson.
"Our field has made great advancements in treatments for
patients with cancer, but psychosocial factors influence a
patient's ability to receive the appropriate treatment without
delay or interruption. Our study demonstrates an association
between distress and radiation therapy-specific outcomes, adding to
the growing body of evidence emphasizing a need for an
interdisciplinary approach to cancer care," said Mr. Anderson.
"These findings underscore the importance of devising treatment
plans that address mental well-being and are unique to each
patient's individual needs. For example, if a patient is
experiencing severe distress—and therefore is at higher risk of
missing appointments or being admitted to the hospital—we can offer
transportation or housing support."
The abstract, "The long-lasting relationship of distress on
radiation oncology specific clinical outcomes," will be presented
in detail during a news briefing and an oral abstract session at
ASTRO's 59th Annual Meeting in San
Diego (full details below). To schedule an interview with
Mr. Anderson and/or outside experts, contact ASTRO's media
relations team on-site at the San
Diego Convention Center, September 24
through 27, by phone at 703-286-1600 or by email at
press@astro.org.
ATTRIBUTION TO THE AMERICAN SOCIETY OF RADIATION ONCOLOGY
(ASTRO) ANNUAL MEETING REQUESTED IN ALL COVERAGE.
This news release contains additional and/or updated
information from the study author(s). Full original abstract
and author disclosures available from press@astro.org or at
www.astro.org/annualmeeting.
Study Presentation Details
- Scientific Session: Sunday, September
24, 1:15 – 2:45 p.m. Pacific
time, San Diego Convention
Center, room 7A/B
- News Briefing: Tuesday, September
26, 1:00 – 2:00 p.m. Pacific
time, San Diego Convention
Center, room 24C, webcast: http://www.bit.do/astro17-3
Resources on Cancer and Radiation Therapy
- Video: An Introduction to Radiation Therapy (Spanish
version)
- ASTRO's clinical practice statements and guidelines
- Additional brochures, videos and information on radiation
therapy from RTAnswers.org
ABOUT ASTRO'S ANNUAL MEETING
ASTRO's 59th Annual
Meeting, the world's largest scientific meeting in radiation
oncology, will be held September 24-27,
2017, at the San Diego
Convention Center. The 2017 Annual Meeting is expected to attract
more than 11,000 attendees from across the globe, including
oncologists from all disciplines and members of the entire
radiation oncology team. More than 2,800 abstracts sharing results
from clinical trials and other research studies will be presented
in conjunction with educational sessions and keynote addresses that
underscore the meeting's theme, "The Healing Art and Science of
Radiation Oncology." Led by ASTRO President Brian Kavanagh, MD, MPH, FASTRO, the 2017
meeting will feature keynote addresses from Richard D. Zane, MD, FAAEM, Chief Innovation
Officer for the University of Colorado
Health System; Lucy Kalanithi, MD, FACP, widow of Paul Kalanithi,
MD, the best-selling author of "When Breath Becomes Air," with
Heather Wakelee, MD, Paul's
oncologist; and Vinay K. Prasad, MD,
MPH, an assistant professor of medicine at the Oregon Health &
Science University. During the four-day meeting, more than 200
exhibitors will demonstrate cutting-edge technology and medical
device innovations for radiation oncology. Visit us online for more
information about ASTRO's 59th Annual Meeting or
press opportunities at the meeting.
ABOUT ASTRO
The American Society for Radiation
Oncology (ASTRO) is the world's largest radiation oncology society,
with more than 10,000 members who are physicians, nurses,
biologists, physicists, radiation therapists, dosimetrists and
other health care professionals who specialize in treating patients
with radiation therapies. The Society is dedicated to improving
patient care through professional education and training, support
for clinical practice and health policy standards,
advancement of science and research, and advocacy. ASTRO
publishes three medical journals, International Journal of
Radiation Oncology • Biology • Physics
(www.redjournal.org), Practical Radiation Oncology
(www.practicalradonc.org) and Advances in
Radiation Oncology (www.advancesradonc.org);
developed and maintains an extensive patient website, RT Answers
(www.rtanswers.org); and created the Radiation
Oncology Institute (www.roinstitute.org), a nonprofit
foundation to support research and education efforts around the
world that enhance and confirm the critical role of radiation
therapy in improving cancer treatment. To learn more about ASTRO,
visit www.astro.org and follow us on our
blog, Facebook and
Twitter.
Contact: Liz
Gardner
703-286-1600
liz.gardner@astro.org
Leah Kerkman
Fogarty
703-839-7336
leah.fogarty@astro.org
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SOURCE American Society for Radiation Oncology