Qolp-18. A Call to Action: Death Anxiety in Neuro-Oncology

Abstract

BACKGROUND Patients with primary brain tumors (PBT) are at increased risk for psychological distress given the certainty of tumor progression, lack of curative treatments, and poor prognoses. A specific type of distress, death anxiety, was recently identified as an area of concern among neuro-oncology patients. However, researchers have yet to fully examine the prevalence or risk-factors of death anxiety in this population, and, importantly, what evidence-based treatments may be available to alleviate symptoms. METHODS Adult PBT patients (N=81) completed validated questionnaires on symptoms of death anxiety, generalized anxiety, and depression. Item-level frequencies were run to determine prevalence rates. Analyses were then conducted (t-tests, ANOVAs, Pearson correlations, regressions) to determine whether certain demographic, disease-related variables, and/or symptoms of psychological distress put patients at higher risk for death anxiety. Literature on evidence-based treatment options was also reviewed. RESULTS Over half (50-64%) of our sample endorsed items related to fear of death, distressing thoughts about death, and fear of the future, with 35% scoring above the cut-off for death anxiety. Predictors of death anxiety included generalized anxiety symptoms, bilateral or right hemisphere tumor, and female gender (r2=0.367; F(3,77)=16.488, p< .05). Younger age, lower grade tumors, and heightened depressive symptoms were associated with higher death anxiety (p< .05). While interventions to reduce distress in advanced cancer populations are available, most have purposely excluded neurological cancers, thus limiting their generalizability in neuro-oncology. CONCLUSION The proportion of PBT patients who endorsed death anxiety aligns with other advanced cancer populations. However, item-level analysis suggests heightened concern in neuro-oncology and a need for targeted intervention. Moreover, specific demographic, disease-related, and psychological distress variables put certain PBT patients at increased risk. These findings highlight the need for routine screenings and monitoring, as well as inclusion of neuro-oncology patients in evidenced-based treatment trials for reducing distress, specifically death anxiety.