Cancer-related communications and symptom burden in couples coping with advanced lung cancer.
231 Background: Although effective communications regarding symptoms may decrease distress and patients and their spouses, families tend to experience barriers to open communication. The purpose of this cross-sectional survey study is to examine the role of cancer-related communications in symptom burden in families coping with advanced non-small cell lung cancer. Methods: Couples were approached while waiting for their routine visit at the thoracic center. 25 patients (58% female; 78% white; mean age: 62.7 years; 72% stage III; 2.3 months post diagnosis) and their spouses completed measures of cancer symptoms (ESAS), psychological distress (BSI), and illness communication (CCAT_PF). Results: Dyadic analyses using multi-level modeling revealed that patients generally rated their own symptom burden significantly lower compared to spouses rating patient symptoms (P < .0001). However, this discrepancy in perceptions of symptoms was a function of cancer communication (P < .001) so that the more couples communicate about cancer-related issues (e.g., treatment decision making) the more they agreed regarding symptom burden. Importantly, a discrepancy in symptoms ratings was significantly related to spouses’ depressive symptoms (P < . 01) so that the greater the discrepancy, the greater spouses depression. Lastly, more effective cancer communication was related to lower cancer symptoms in patients (P < .05) as well as depression (P < .01) and anxiety (P < .05) in both patients and spouses. Conclusions: These findings highlight the importance of effective cancer communication in reducing symptom burden in couples coping with advanced lung cancer. Behavioral interventions that target communication skills taining may improve symptom management in patients and reduce psychological distress in spouses.