Screening for Distress in Routine Oncological Care—A Survey in 520 Melanoma Patients

Abstract

IntroductionDespite the increasing incidence of melanoma little is known about patients' emotional distress associated with this disease. Supplemented by the problem list (PL), the distress thermometer (DT) is a recommended screening instrument to measure psychosocial distress in cancer patients. Our objective was to explore the acceptance and the feasibility of the DT and PL as a concise screening tool in an ambulatory setting for routine care and to elucidate determinants of distress in melanoma patients with regard to sociodemographic and clinical variables.MethodsConsecutive melanoma outpatients were asked to complete the DT with the PL prior to their scheduled consultation. Demographic and clinical data were obtained from the patients' charts. Clinical data included melanoma stage, time since diagnosis, previous treatment, current treatment, and other cancer disease.ResultsOut of 734 patients recruited into the study, 520 patients (71%) completed both the DT and the PL. Forty-seven percent met the ≥5 cut-off score for distress. Younger and employed patients reported higher distress than older and retired patients. A cut-off score of ≥5 was closely associated with self-reported emotional sources of distress, with practical problems, especially at work, family problems (dealing with the partner), and physical problems like pain, appearance, getting around, and nausea. Apart from higher distress under current systemic treatment, no associations were found between distress and clinical data.ConclusionThe DT together with the PL seems to be an economically reasonable screening tool to measure psychosocial distress in melanoma patients. In particular, younger melanoma patients who are currently employed are prone to experience distress at some point after diagnosis, but there appears to be almost no association between clinical data and the extent of distress. To characterize the impact of distress on disease outcome and quality of life in melanoma patients, further research is needed.

Guiding Lay Navigation in Geriatric Patients With Cancer Using a Distress Assessment Tool

“…2–9 The National Comprehensive Cancer Network (NCCN) recommends use of the distress thermometer or similar tools as a method for consistent measurement of distress for cancer patients. 10 In 2015, the Commission on Cancer (CoC) began a phased-in program to screen for distress as part of its certification requirements.…”

“…3–5,9,16 Increased distress is associated with reduced quality of life, increased mortality, and higher healthcare expenditures. 15,17,18 In geriatric patients, 14–40% report depression and over 40% report significant distress.…”

Psychoeducational intervention for people at high risk of developing another melanoma: a pilot randomised controlled trial

“…In addition, people with melanoma often experience intense fear that the disease could spread and become untreatable. Studies have reported that 30%–50% of melanoma survivors experience heightened emotional distress2 and that many report unmet needs for information and psychological support 4–6. Australian clinical practice guidelines for the management of melanoma highly recommended that psychoeducational support be made widely available to people with melanoma 7.…”

“…Studies have reported that 30%-50% of melanoma survivors experience heightened emotional distress 2 and that many report unmet needs for information and psychological support. [4][5][6] Australian clinical practice guidelines for the management of melanoma highly recommended that psychoeducational support be made widely available to people with melanoma. 7 German guidelines extend this by recommending implementation of regular psycho-oncological screening to identify and offer psychological care to people with melanoma experiencing difficulties adjusting to their disease.…”

Prevalence of pain among melanoma patients

“…It may evolve with cancer wounds and consequently social isolation, solitude and fear. All these aspects are directly related to the complexity of melanoma patients' pain [5][6][7] . The etiology of melanoma pain may be associated to different factors, such as the presence of an injury, local inflammatory reactions in tumor or other tissues and chronic compression of adjacent tissues.…”