Describing and predicting psychological distress after colorectal cancer

Abstract

BACKGROUND. Psychological distress in cancer survivors can be detrimental to treatment adherence and self‐care tasks and is associated with poor health behaviors and decreased overall quality of life. The prevalence, course, and predictors of psychological distress after the diagnosis of colorectal cancer are to date not well described. METHODS. A prospective survey of 1822 colorectal cancer patients was undertaken assessing psychological distress and hypothesized predictors including optimism, cancer threat appraisal, social support, and physical activity at 6 and 12 months postdiagnosis. Logistic regression identified correlates of psychological distress at 12 months postdiagnosis. RESULTS. The prevalence of global psychological distress was low: 8.3% and 6.7% at 6 and 12 months postdiagnosis, respectively. When baseline measures of independent variables were included in a logistic regression model, distress at 6 months postdiagnosis (odds ratio [OR] = 10.84), comorbidities (OR = 1.64), optimism (OR = 0.93), cancer threat appraisal (OR = 0.92), and social support (OR = 0.94) were significantly associated with distress at 12 months postdiagnosis. A second logistic regression model that included concurrent measures of cancer threat appraisal, social support, and physical activity found that distress at 6 months postdiagnosis (OR = 12.49), comorbidities (OR = 1.64), optimism (OR = 0.94), and concurrent cancer threat appraisal (OR = 0.85) were significantly associated with distress at 12 months postdiagnosis. CONCLUSIONS. Distress screening at regular intervals is needed to efficiently detect colorectal cancer patients who require in‐depth psychological intervention. Threat appraisal is a modifiable variable that should be included in interventions for colorectal cancer survivors. Further research is needed to investigate the potential for physical activity to reduce distress after cancer. Cancer 2008. © 2008 American Cancer Society.

Cancer survivorship: Advancing the concept in the context of colorectal cancer

“…Although heavy smoking or alcohol intake among CRC survivors is infrequent, many survivors fail to meet physical activity, body mass index and fruit and vegetable intake recommendations (Chambers et al, 2012a(Chambers et al, , 2012bGrimmett et al, 2011;Hawkes et al, 2008;James et al, 2006;Johnson et al, 2009;Lynch et al, 2007aLynch et al, , 2008cMcGowan et al, 2013;Peddle et al, 2008aPeddle et al, , 2008bPullar et al, 2012;SpeedAndrews et al, 2012SpeedAndrews et al, , 2013Thraen-Borowski et al, 2013;Wijndaele et al, 2009). Achieving recommended levels of physical activity may be difficult if the survivor is experiencing chronic effects of CRC, treatment or co-morbidities (Anderson et al, 2013;Chambers et al, 2009;Hawkes et al, 2008;Lynch et al, 2007aLynch et al, , 2008cPalmer et al, 2013).…”

“…Achieving recommended levels of physical activity may be difficult if the survivor is experiencing chronic effects of CRC, treatment or co-morbidities (Anderson et al, 2013;Chambers et al, 2009;Hawkes et al, 2008;Lynch et al, 2007aLynch et al, , 2008cPalmer et al, 2013). Changes in diet are as much to do with attaining a sense of control over bowel function or ostomy output, as it is to control the disease trajectory, and prevent recurrence (Anderson et al, 2013;Esplen et al, 2007;Grant et al, 2011;McMullen et al, 2008;Nikoletti et al, 2008;Palmer et al, 2013;Pullar et al, 2012;Sun et al, 2015).…”

“…Fear of recurrence, depression, anxiety and distress are enduring issues for some survivors, heightened around the time of clinical appointments (Appleton et al, 2013;Chambers et al, 2012b;Dunn et al, 2013;Esplen et al, 2007;Faul et al, 2012;Krouse et al, 2009;Lawsin et al, 2007;Loi, 2011;Lynch et al, 2008c;McCaughan et al, 2012;Milbury et al, 2013;Nikoletti et al, 2008;Phipps et al, 2008;Ristvedt and Trinkaus, 2009;Schneider et al, 2007;Shun et al, 2011;Stein et al, 2009;Thong et al, 2013). The physical effects of CRC treatment, including bowel dysfunction and peripheral neuropathy had significant negative effects on CRC survivors' psychological well-being, body image, and adaption to survivorship (Bailey et al, 2015;Desnoo and Faithfull, 2006;Ho et al, 2015;McMullen et al, 2008;Padman et al, 2015;Palmer et al, 2013;Phipps et al, 2008;Schneider et al, 2007;Serpentini et al, 2011;Thong et al, 2011b;Tofthagen, 2010).…”

After the Treatment Phase of Colorectal Cancer Care: Survivorship and Follow-Up

“…Specifically, CRC survivors may experience psychosocial distress related to a progressive decline in anorectal function (including increased stool frequency, more fecal incontinence and decreased rectal compliance) and having an ostomy which leads to reduced social, emotional, sexual and occupational functioning. A survey of CRC survivors revealed that 7% of patients still suffered from psychosocial distress at 12 months post-diagnosis [65]. In this particular study, initial distress at six months post-diagnosis, multiple comorbidities, and the lack of social supports were found to be associated with increased distress at 12 months.…”

Psychological distress among adult cancer survivors: importance of survivorship care plan

“…Prior research has shown that a significant percentage of cancer survivors are at increased risk of psychological sequelae [7][8][9][10], such as depression, anxiety, overall psychological distress, and post-traumatic stress disorder. These sequelae, if left untreated, can lead to reduced quality of life, suicide ideation, and increased cancer mortality [11][12][13].…”