Impact of Life Events on Survival of Patients with Localized Melanoma

Lehto, Ulla-Sisko; Ojanen, Markku; Dyba, Tadeusz; Aromaa, Arpo; Kellokumpu‐Lehtinen, Pirkko

doi:10.1159/000334486

Cited by 7 publications

(13 citation statements)

References 57 publications

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“…We studied any first occurrence of these stressful life events from one year before cancer diagnosis onward, as recent events might better reflect a potential emotional burden among the patients (33). In the analysis of severe illness of a family member, we only considered newly diagnosed illnesses of the family members.…”

Section: Stressful Life Eventsmentioning

confidence: 99%

Psychologic Distress Is Associated with Cancer-Specific Mortality among Patients with Cervical Cancer

Andrae

Valdimarsdóttir

et al. 2019

Cancer Research

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Emerging evidence suggests a role of psychologic factors in the progression of different cancer types. However, it is unclear whether psychologic distress around the time of diagnosis of invasive cervical cancer places patients at a higher risk of cancer-specific mortality, independently of tumor characteristics and treatment modalities. We conducted a nationwide cohort study, including 4,245 patients with newly diagnosed cervical cancer during 2002-2011 in Sweden. Psychologic distress was indicated by a clinical diagnosis of depression, anxiety, or stress reaction and adjustment disorders, or the experience of a stressful life event, including death or severe illness of a family member, divorce, or between jobs, from one year before cancer diagnosis and onwards. We calculated the HRs of cancer-specific mortality among the patients exposed to psychologic distress, compared with unexposed patients, controlling for socioeconomic characteristics and other known prognostic indicators such as tumor and treatment characteristics. We found that patients exposed to psychologic distress had an increased risk of cancer-specific mortality (HR 1.33; 95% CI, 1.14-1.54). The association was primarily driven by distress experienced within one year before or after diagnosis (HR 1.30; 95% CI, 1.11-1.52), but not thereafter (HR 1.12; 95% CI, 0.84-1.49). In summary, our study shows that psychiatric disorders and stressful life events around cancer diagnosis are associated with increased cancer-specific mortality among patients with cervical cancer, independent of tumor characteristics and treatment modality. Significance: These findings support the integration of psychologic screening and intervention in the clinical management of patients with cervical cancer, particularly around the time of cancer diagnosis.

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Section: Stressful Life Eventsmentioning

confidence: 99%

Psychologic Distress Is Associated with Cancer-Specific Mortality among Patients with Cervical Cancer

Andrae

Valdimarsdóttir

et al. 2019

Cancer Research

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“…The association between psychosocial factors and cancer survival has been convincingly demonstrated only during recent decades [1–12]. The psychological processes and constructs investigated have varied among studies [4, 8].…”

Section: Introductionmentioning

confidence: 99%

“…Studies suggest that some psychosocial factors, such as emotional expression and psychological stress, are more likely to have an effect on survival compared with other factors [4]. Specifically, emotional non-expression (“repression”) [6, 17–19], hopelessness [7, 20, 21], depression [1, 10, 11, 20], and stress-related psychological factors [8, 12, 20] have been suggested to predict a shorter survival, whereas social support [22] and denial or minimizing coping response to the cancer to predict a more favorable prognosis [2, 5–8, 12, 21]. Factors related to well-being and quality of life (QOL) have shown contradictory results [2, 5–7, 9, 23].…”

Section: Introductionmentioning

confidence: 99%

Early quality-of-life and psychological predictors of disease-free time and survival in localized prostate cancer

et al. 2018

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Purpose The constructs evaluated in investigating association between psychosocial factors and cancer survival has varied between studies, and factors related to quality of life (QOL) have shown contradictory results. We investigated the effect of socioeconomic and early QOL and psychological factors on disease-free time and survival in localized prostate cancer. Methods A consecutive sample of patients with localized prostate cancer (T1–3, N0, M0) treated with external beam radiotherapy completed validated questionnaires on coping with cancer (the Ways of Coping Questionnaire WOC-CA), anger expression (the Anger Expression Scale), life events (the Life Experience Survey), and various aspects of QOL (the Rotterdam Symptom Checklist, the Depression Scale DEPS, the EORTC QLQ-C30, the LENT-SOMA outcome measure) approximately 4.5 months after diagnosis. Cox regression analyses were used to determine the predictors of the disease-free and overall survival times measured from the date of diagnosis to the date of a PSA-relapse and date of death. Results After controlling for biological prognostic factors, age, and adjuvant hormonal therapies, moderate and high socioeconomic status and an increased level of pain predicted longer survival, whereas an increased level of prostate-area symptoms and fatigue and, especially, reports of no/few physical symptoms were predictors of a shorter survival time. A longer PSA-relapse-free time was predicted by Cognitive Avoidance/Denial coping, whereas problems in social functioning, hopelessness, and an excellent self-reported QOL predicted a shorter PSA-relapse-free time. Conclusions Higher socioeconomic status was prognostic for longer survival, as previously reported. Patients with a seemingly good QOL (few physical complaints, excellent self-reported QOL) had poorer prognoses. This association may due to the survival decreasing effect of emotional non-expression; patients with high emotional non-expression may over-report their wellbeing in simple measures, and thus actually be in need of extra attention and care.

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“…Non-cancer life stressors have been linked to disturbances in QOL in breast and prostate cancer, and melanoma patients [11, 15–16] as well as to melanoma patients’ survival [17]. Financial and economic stressors in particular have been associated with decreased QOL for low-income women with gynecologic and breast cancers [18].…”

Section: Introductionmentioning

confidence: 99%

Non-cancer life stressors contribute to impaired quality of life in ovarian cancer patients

Lutgendorf

Slavich

Degeest

et al. 2013

Gynecologic Oncology

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OBJECTIVES Diagnosis and treatment for a life threatening illness such as cancer is known to be psychologically impactful. However, little is known about the influence that non-cancer life stressors have on the quality of life (QOL) of ovarian cancer patients. The goal of the present study was to examine associations between non-cancer life stressors and QOL in 123 women with invasive epithelial ovarian cancer who were followed prospectively and longitudinally for one year. METHODS Mixed models for repeated measures were used to examine the relationship between life stressors and QOL pre-surgery and one year later, while adjusting for age, cancer stage, depressive symptoms, anxiety, and chemotherapy status (at one year). Prospective associations between QOL pre-surgery and one-year QOL were also examined. RESULTS Number and severity of life stressors were unrelated to QOL of participants before surgery. At one year, however, participants experiencing a greater number of life stressors reported poorer concurrent physical well-being (PWB) (p = 0.015), functional well-being (FWB) (p < 0.0001), social well-being (SWB) (p = 0.0003), and total QOL (p<0.0001). Similar effects were found for life event severity. Finally, experiencing a greater number of life stressors pre-surgery predicted poorer overall QOL one year post-diagnosis (p < 0.0001). CONCLUSIONS Non-cancer life stressors can substantially impact long-term QOL of ovarian cancer patients, adjusting for medical variables such as chemotherapy and cancer stage, thus highlighting the importance of evaluating the stress burden of patients in ongoing cancer care.

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Impact of Life Events on Survival of Patients with Localized Melanoma

Cited by 7 publications

References 57 publications

Psychologic Distress Is Associated with Cancer-Specific Mortality among Patients with Cervical Cancer

Psychologic Distress Is Associated with Cancer-Specific Mortality among Patients with Cervical Cancer

Early quality-of-life and psychological predictors of disease-free time and survival in localized prostate cancer

Non-cancer life stressors contribute to impaired quality of life in ovarian cancer patients

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