News | Radiation Therapy | September 26, 2017

Study finds tool that measures psychological state to be prognostic for treatment adherence and inpatient hospital admission during radiation therapy

Distress Associated With Missed Appointments and Hospital Admission During Cancer Treatment

September 26, 2017 — 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 was presented at the 59th Annual Meeting of the American Society for Radiation Oncology (ASTRO), which runs Sept. 24-27 in San Diego.

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 percent) 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 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 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.”

For more information: www.astro.org

Related Content

Clinical Trials and Cutting-Edge Radiation Oncology Research to Be Featured at ASTRO 2017


Related Content

News | Artificial Intelligence

June 11, 2024 — A new study led by researchers at Emory AI.Health, published in the Journal of Computers in Medicine and ...

Time June 11, 2024
arrow
News | Breast Imaging

June 7, 2024 — Scholars and studies funded by Susan G. Komen(R), the world’s leading breast cancer organization ...

Time June 07, 2024
arrow
News | Radiopharmaceuticals and Tracers

June 7, 2024 — Shine Technologies, LLC, a pioneer in next-generation fusion-based technology, today announced a new ...

Time June 07, 2024
arrow
News | Radiation Oncology

June 3, 2024 — The American Society for Radiation Oncology (ASTRO) published an updated clinical guideline that details ...

Time June 03, 2024
arrow
News | Oncology Information Management Systems (OIMS)

May 30, 2024 — RaySearch Laboratories AB announced the release of the latest version of RayCare, the next generation ...

Time May 30, 2024
arrow
News | Artificial Intelligence

May 22, 2024 — Lunit, a leading provider of AI-powered solutions for cancer diagnostics and therapeutics, recently ...

Time May 22, 2024
arrow
News | Oncology Information Management Systems (OIMS)

May 21, 2024 — RaySearch Laboratories AB announced that the oncology information system RayCare* 2024A has been ...

Time May 21, 2024
arrow
News | Proton Therapy

May 21, 2024 — IBA, a world leader in particle accelerator technology, announced that it has signed a contract with the ...

Time May 21, 2024
arrow
News | Radiology Business

May 20, 2024 — Associated Medical Professionals of NY (A.M.P.) announced that internationally recognized radiation ...

Time May 20, 2024
arrow
News | Radiation Therapy

May 16, 2024 — Today marks a significant milestone in cancer care with the introduction of bipartisan federal ...

Time May 16, 2024
arrow
Subscribe Now