Melanoma

2021 ◽  
pp. 155-161
Author(s):  
Nadine A. Kasparian ◽  
Iris Bartula
Keyword(s):  
Psychological Distress ◽  
Clinical Care ◽  
Cancer Recurrence ◽  
Clinical Intervention ◽  
Multidisciplinary Care ◽  
Fear Of Cancer Recurrence ◽  
Risk And Resilience ◽  
Diagnostic Uncertainty ◽  
Effective Interventions ◽  
Fear Of Cancer

Comprehensive psychological care of people with melanoma spans all phases of the disease trajectory, including risk assessment, diagnosis, treatment, recovery, and survivorship, as well as the transition from curative to palliative care, death, and bereavement. At least one-third of people with melanoma report levels of psychological distress indicative of a need for clinical intervention, and over 70% report high levels of fear of cancer recurrence or progression. Many patients experience the period of diagnostic uncertainty between detection of a suspicious lesion and receipt of biopsy results as particularly stressful. High psychological distress is associated with reduced participation in cancer screening, treatment and risk management recommendations, delays in seeking medical advice, lower satisfaction with clinical care, higher health care costs, poorer social functioning, greater morbidity and mortality, and poorer overall quality of life. Screening for distress in people with melanoma is strongly recommended as part of routine, multidisciplinary care, followed by a stepped approach to psychological support and treatment, based on patient risk and resilience factors, needs, values, and preferences. A range of psychotherapeutic and psychoeducational interventions, delivered via a variety of modalities, are effective in reducing psychological distress in people with melanoma in the short and longer term. Cutting-edge research is focused on harnessing technology to bring effective interventions to scale.

scholarly journals 1041 Sleep Quality Mediates The Relationship Between Fear Of Cancer Recurrence And Psychological Distress In Young Adults With Cancer

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A395-A396
Author(s):  
L C Daniel ◽  
S Garland ◽  
E Zhou ◽  
K Chalifour ◽  
G Eaton ◽  
...  
Keyword(s):  
Young Adults ◽  
Psychological Distress ◽  
Young Adult ◽  
Sleep Quality ◽  
Cancer Recurrence ◽  
Fear Of Cancer Recurrence ◽  
Young Adult Cancer Survivors ◽  
Adult Cancer Survivors ◽  
Fear Of Cancer ◽  
Young Adult Cancer

Abstract Introduction Fear of cancer recurrence is common in young adults with cancer and also related to poorer psychological outcomes. Sleep may be disrupted by anxious thoughts about cancer, causing long-term psychological distress. Thus, the current study tests sleep as a putative mediator of the association between fear of cancer recurrence and overall psychological distress in young adult cancer survivors. Methods In a national cross-sectional survey of Canadians, 436 young adults diagnosed with cancer between the ages of 15-39 (current age range 20-39, m=32.39, SD=4.70; 88% female) completed the Pittsburgh Sleep Quality Index, the Fear of Cancer Recurrence Inventory—Short Form, and the Kessler 10 Distress Inventory. Mediation was estimated using PROCESS. Age, sex, and on/off treatment status were entered into models as covariates. Results In the current sample, average fear of cancer recurrence was above the clinical cut-point (m=22.92, SD=6.84), psychological distress was high (m=25.18, SD=7.81), and sleep quality was poor (m=9.11, SD=3.95). Females reported significantly higher fear of cancer recurrence than males [F(1, 435)=15.49, p <.001]. Patients on treatment reported significantly higher fear of cancer recurrence [F(1,435)=11.43, p=.001], poorer sleep quality [F(1,435)=6.48, p=.011], and greater psychological distress [F(1,435)=4.73, p <.001] than patients off treatment. Using a bootstrapping model with covariates, higher fear of cancer recurrence was related to poorer sleep quality and, in turn, higher psychological distress as indicated by the indirect effect’s confidence interval not containing 0 (indirect effect=.13; 95%CI=0.081, 0.189). Conclusion Sleep quality may play an important role in connecting the common experience of fear of cancer recurrence to psychological distress in young adult cancer survivors. Future longitudinal research is needed to examine this possible mediator of young adult cancer patients’ psychological distress outcomes over time. Support This research was supported by a grant from the Newfoundland and Labrador Support for People and Patient-Oriented Research and Trials (NL-SUPPORT) Unit. Sheila Garland is supported by a Scotiabank New Investigator Award from the Beatrice Hunter Cancer Research Institute (BHCRI).

Pan-cancer analysis of fear of cancer recurrence in cancer survivors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24104-e24104
Author(s):  
Jacob J. Adashek ◽  
Zachary Thompson ◽  
Dina Martinez Tyson ◽  
Smitha Pabbathi
Keyword(s):  
Logistic Regression ◽  
Cancer Survivors ◽  
Odds Ratio ◽  
Clinical Care ◽  
Unmet Need ◽  
Cancer Recurrence ◽  
Clinic Visit ◽  
Fear Of Cancer Recurrence ◽  
Gastrointestinal Malignancies ◽  
Fear Of Cancer

e24104 Background: Fear of cancer recurrence (FCR) in cancer survivors is an understudied phenomenon estimated to one-third to over half of all cancer survivors. FCR has been shown to contribute to treatment noncompliance and portend a decrease in overall survival (OS). The purpose of this study was to examine factors associated with needs related to FCR among patients seen at a solid tumor survivorship clinic at a National Cancer Institute designated center. Methods: Data collected as part of a patients’ needs assessment that is administered to patients (n = 657) with solid tumors such as breast, genitourinary, gastrointestinal malignancies at their initial clinic visit were analyzed. Correlations between responses were calculated and univariable and multivariable logistic regression was used to identify predictors of met or unmet needs related to FCR. Results: There were a total of 657 patients included 442 (67.3%) female and 215 (32.7%) male. The majority of patients (84.5%) were white (n = 555), followed by 9.74% black (n = 64), the remaining patients identified as ‘other’ or Asian. The patients median age was 67 years, median age of diagnosis 55 years, and median years since diagnosis 10 years. 613 patients had recorded distress scores ranging from 0 (n = 214), 1-4 (n = 255), 5-7 (n = 106), or 8-10 (n = 38). Of 647 patients, 241 (37.2%) reported FCR was not a need and 386 (59.7%) reported FCR was a met need. According to univariate logistic regression gender had no impact on FCR (p = 0.8427) nor did years since diagnosis (p = 0.1014). Results of multivariable regression indicate the odds ratio of reporting FCR as an unmet need (vs not a need) decreases by 6% (p = 0.0023) for every year increase in age. For each unit increase in distress score the odds ratio of reporting FCR as an unmet need is increased by 32% (p = 0.0007). Conclusions: Our data suggests that patients reporting higher distress scores are more likely to report FCR as an unmet need. Therefore, survivors with high distress scores reported in clinic visits should be evaluated for FCR. FCR reported as an unmet in our study is significantly less. Further stratification of FCR can be helpful for providers caring for survivors to identify and address FCR more effectively in clinical care. Further study is needed to learn how survivors have come to identify the need as being met.

Randomized Trial of ConquerFear: A Novel, Theoretically Based Psychosocial Intervention for Fear of Cancer Recurrence

2017 ◽  
Vol 35 (36) ◽  
pp. 4066-4077 ◽  
Author(s):  
Phyllis N. Butow ◽  
Jane Turner ◽  
Jemma Gilchrist ◽  
Louise Sharpe ◽  
Allan Ben Smith ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Randomized Trial ◽  
Cancer Recurrence ◽  
Attention Control ◽  
Fear Of Cancer Recurrence ◽  
General Anxiety ◽  
Face To Face ◽  
Fear Of Cancer ◽  
The Impact ◽  
Post Therapy

Purpose Fear of cancer recurrence (FCR) is prevalent, distressing, and long lasting. This study evaluated the impact of a theoretically/empirically based intervention (ConquerFear) on FCR. Methods Eligible survivors had curable breast or colorectal cancer or melanoma, had completed treatment (not including endocrine therapy) 2 months to 5 years previously, were age > 18 years, and had scores above the clinical cutoff on the FCR Inventory (FCRI) severity subscale at screening. Participants were randomly assigned at a one-to-one ratio to either five face-to-face sessions of ConquerFear (attention training, metacognitions, acceptance/mindfulness, screening behavior, and values-based goal setting) or an attention control (Taking-it-Easy relaxation therapy). Participants completed questionnaires at baseline (T0), immediately post-therapy (T1), and 3 (T2) and 6 months (T3) later. The primary outcome was FCRI total score. Results Of 704 potentially eligible survivors from 17 sites and two online databases, 533 were contactable, of whom 222 (42%) consented; 121 were randomly assigned to intervention and 101 to control. Study arms were equivalent at baseline on all measured characteristics. ConquerFear participants had clinically and statistically greater improvements than control participants from T0 to T1 on FCRI total ( P < .001) and severity subscale scores ( P = .001), which were maintained at T2 ( P = .017 and P = .023, respectively) and, for FCRI total only, at T3 ( P = .018), and from T0 to T1 on three FCRI subscales (coping, psychological distress, and triggers) as well as in general anxiety, cancer-specific distress (total), and mental quality of life and metacognitions (total). Differences in FCRI psychological distress and cancer-specific distress (total) remained significantly different at T3. Conclusion This randomized trial demonstrated efficacy of ConquerFear compared with attention control (Taking-it-Easy) in reduction of FCRI total scores immediately post-therapy and 3 and 6 months later and in many secondary outcomes immediately post-therapy. Cancer-specific distress (total) remained more improved at 3- and 6-month follow-up.

scholarly journals Setting an International Research Agenda for Fear of Cancer Recurrence: An Online Delphi Consensus Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Joanne Shaw ◽  
Helen Kamphuis ◽  
Louise Sharpe ◽  
Sophie Lebel ◽  
Allan Ben Smith ◽  
...  
Keyword(s):  
Focus Group ◽  
Research Agenda ◽  
Clinical Care ◽  
Cancer Recurrence ◽  
Models Of Care ◽  
Mechanisms Of Action ◽  
Intervention Research ◽  
Fear Of Cancer Recurrence ◽  
Active Components ◽  
Fear Of Cancer

BackgroundFear of cancer recurrence (FCR) is common amongst cancer survivors. There is rapidly growing research interest in FCR but a need to prioritize research to address the most pressing clinical issues and reduce duplication and fragmentation of effort. This study aimed to establish international consensus among clinical and academic FCR experts regarding priorities for FCR research.MethodsMembers of the International Psycho-oncology Society (IPOS) Fear of Cancer Recurrence Special Interest Group (FORwards) were invited to participate in an online Delphi study. Research domains identified in Round 1 were presented and discussed at a focus group (Round 2) to consolidate the domains and items prior to presentation in further survey rounds (Round 3) aimed at gaining consensus on research priorities of international significance.ResultsThirty four research items were identified in Round 1 and 33 of the items were consolidated into six overarching themes through a focus group discussion with FCR experts. The 33 research items were presented in subsequent rounds of the delphi technique. Twenty one participants contributed to delphi round 1, 16 in round 2, and 25 and 29 participants for subsequent delphi rounds. Consensus was reached for 27 items in round 3.1. A further four research items were identified by panelists and included in round 3.2. After round 3.2, 35 individual research items were ratified by the panelists. Given the high levels of consensus and stability between rounds, no further rounds were conducted. Overall intervention research was considered the most important focus for FCR research. Panelists identified models of care that facilitate greater access to FCR treatment and evaluation of the effectiveness of FCR interventions in real world settings as the two research items of highest priority. Defining the mechanisms of action and active components across FCR/P interventions was the third highest priority identified.ConclusionThe findings of this study outline a research agenda for international FCR research. Intervention research to identify models of care that increase access to treatment are based on a flexible approach based on symptom severity and can be delivered within routine clinical care were identified as research areas to prioritize. Greater understanding of the active components and mechanisms of action of existing FCR interventions will facilitate increased tailoring of interventions to meet patient need.

scholarly journals Prevalence and correlates of psychological distress, unmet supportive care needs, and fear of cancer recurrence among haematological cancer patients during the COVID-19 pandemic

2021 ◽  
Author(s):  
Nienke Zomerdijk ◽  
Michelle Jongenelis ◽  
Camille E Short ◽  
Andrew Smith ◽  
Jane Turner ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Supportive Care ◽  
Perceived Risk ◽  
Unmet Needs ◽  
Cancer Recurrence ◽  
Supportive Care Needs ◽  
Fear Of Cancer Recurrence ◽  
Disruptive Effect ◽  
Care Needs ◽  
Fear Of Cancer

Abstract Background The COVID-19 pandemic has had a disruptive effect on people with haematological cancers, who represent a high-risk population due to the nature of their disease and immunosuppressive treatments. We aimed to identify the psychological impacts of the COVID-19 pandemic on haematology patients and identify correlated factors to inform the development of appropriate supportive interventions.Methods 394 respondents volunteered their participation in response to a study advertisement distributed online through established haematology groups. Participants completed a self-report online survey exploring well-being, psychological distress, unmet supportive care needs, and fear of cancer recurrence.Results At least 1 in 3 respondents (35%) reported clinical levels of distress and nearly 1 in 3 (32%) identified at least one unmet need. Among respondents in remission (n = 134), clinical fear of cancer recurrence was reported by nearly all (95%). Unmet needs, pre-existing health conditions, younger age, financial concerns, and perceived risk of contracting COVID-19 were the dominant factors contributing to psychological distress during the pandemic. Psychological distress, lost income, perceived inadequate support from care team, perceived risk of contracting COVID-19, and being a woman were significantly associated with unmet needs. Psychological distress and concern about the impact of COVID-19 on cancer management were significantly associated with fear of cancer recurrence among respondents in remission.Conclusion Results highlight the high psychological burden and unmet needs experienced by people with haematological cancers during the COVID-19 pandemic and indicate a need for innovative solutions to rapidly identify distress and unmet needs during, and beyond, pandemic times.

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