Quality of Life, Depression, and Anxiety in Patients with Uveal Melanoma: A Review

Abstract

The aim is to summarize current knowledge on both QoL and depressive/anxious symptoms in patients with UM, including studies on the effect on QoL and psychological status of genetic testing related to the risk of metastatic disease. A review from the last 25 years by using the databases “PsycInfo,” “Medline,” and “Science Direct” was performed. As a total result, eighteen papers were retrieved. Eight studies (44.4%) used a prospective design methodology: two were retrospective observations (11.1%), three were cross-sectional observational studies (16.6%), and three (16.6%) were naturalistic follow-up studies. One trial was conducted with a case-control design (5.5%), and one was a methodological paper (5.5%). The number of subjects included in the studies ranged widely, between 7 and 842 (mean: 152.1 ± 201.3), for a total of 2587 patients, 1306 males (50.5%) and 1281 females (49.5%). The mean age of subject enrolled was 61.3 ± 4.1 years. Twenty-six different scales, questionnaires, or interviews were utilized. No significant differences in QoL between radiotherapy and enucleation emerged. Genetic testing did not significantly affect QoL or psychological status.

The national comprehensive cancer network distress thermometer as a screening tool for the evaluation of quality of life in uveal melanoma patients

“…As the results of the Collaborative Ocular Melanoma Study (COMS) could prove no survival difference between globe-preserving treatment and enucleation in the long-term follow-up (COMS Group 2001), the effect of the treatment chosen on the quality of life (QoL) of the patients should be considered for treatment planning (Foss et al 2000). Recent findings within the literature on the development of QoL seem to show no overall treatment-related differences in QoL, (van Beek et al 2018;Miniati et al 2018) but enucleated patients have been reported to suffer more from vision related problems (van Beek et al 2018;Frenkel et al 2018).…”

Psychosocial impact of prognostic genetic testing in uveal melanoma patients: a controlled prospective clinical observational study

“…Yet a growing number of patients with UM request to receive information on their prognosis [8,9]. Primary reasons for this decision are better life-planning, a higher sense of control and hopefulness [8][9][10]. Nonetheless, prognostication is likely to be emotionally burdensome due to its dichotomous outcome (D3 = good prognosis, M3 = poor prognosis).…”

“…For instance, enucleation can result in some degree of visual loss, cosmetic changes, body image problems, or avoidance of social events [12,17,20]. Other studies, however, could not find relevant differences [10,12,20,21]. Overall, research on effects of treatment and genetic testing remains heterogeneous.…”

“…Moreover, UM patients show a large variety of unmet supportive care needs [26] and a wish for psychological counseling both before and after result announcement [9]. Therefore, offering psycho-oncological intervention is considered vital [10,27]. Overall, there still seems to be a lack of consensus in the area of genetic testing of UM patients [10].…”

“…Therefore, offering psycho-oncological intervention is considered vital [10,27]. Overall, there still seems to be a lack of consensus in the area of genetic testing of UM patients [10]. Which patients are opting for prognostic testing and how those patients are impacted by diagnostic results is largely unexplored.…”