What Do We Know About Psychological Outcomes of Lymphoma in Adults?

Abstract

Abstract. The goal of this review is to present the results of research on the influence of lymphoma on patients’ emotional status and cognitive functioning. A literature search was conducted to identify articles in English that investigated short- and long-term psychological outcomes of lymphoma and lymphoma treatment. Studies published prior to July 2016 were located by an electronic search using relevant databases such as ScienceDirect and PubMed. The search terms used included both medical subject headings and keywords such as “Hodgkin lymphoma,” “non-Hodgkin lymphoma,” “therapy,” “treatment,” “malignant,” “psychology,” “cognitive function,” “emotion,” “psychological adaptation,” “depression,” and “anxiety.” The retrieved publications were independently evaluated by two reviewers. Articles were selected based on the applicable titles and abstracts. The lists of eligible publications were compared and disagreements were resolved by discussion. Of the 1,418 articles identified in the search, we chose 39 publications, which in our opinion could be interesting or useful for psychologists. Studies show that lymphoma and its treatment lead to severe distress. Thirty-six percent of patients manifest symptoms of anxiety and depression, which are most often associated with the so-called “B-symptoms,” which mark poor prognosis or with side effects of chemotherapy such as nausea or vomiting. Reports also indicate that lymphoma patients may develop mild to severe cognitive decline. Its manifestations may range from benign problems with attention, thinking, and memory to severe cognitive impairment, that is, subcortical dementia. The etiology of intellectual deterioration in lymphoma has not been well described yet, but it may be related to the disease process or to the treatment. Additionally, literature demonstrates that lymphoma may lead to adverse changes in patient’s professional life such as resignation or early retirement.

Care After Lymphoma (CALy) trial: A phase II pilot pragmatic randomised controlled trial of a nurse-led model of survivorship care

“…With improved remission rates, quality of life and well-being can be impacted by long-term and late effects (Leeuwen and Ng, 2017;Sarker et al, 2017). These can include persistent physical effects such as fatigue and cognition impairment (de Lima et al, 2017;Krolak et al, 2017;Leeuwen and Ng, 2017;Linendoll et al, 2016); psychosocial effects such as fear of recurrence, depression, anxiety and distress (Hall et al, 2016;van de Wal et al, 2016); along with practical concerns such as employment and finances (Arboe et al, 2017;Mojs et al, 2017). Survivors also have an increased risk of developing other diseases such as cardiovascular disease (Leeuwen and Ng, 2017) and second cancers (Leeuwen and Ng, 2017;Schaapveld et al, 2015), therefore survivors need an awareness of these potential risks to ensure timely follow-up occurs (Ng et al, 2011).…”

Factors of emotional distress in lymphoma: A systematic review

“…Diagnosis and staging of lymphoma may involve several tests including PET (positron emission tomography) scan and CT (computerised tomography) scan, and bone marrow biopsy; and lymphoma treatments can range from watchful waiting to intensive treatments including chemotherapy, radiation therapy, novel treatments and/or stem cell transplant 2 . Indeed, psychological distress is recognised as a prevalent issue among cancer patients/survivors 7 and emerging research suggests that lymphoma patients/survivors can have significantly impaired psychological wellbeing and health‐related quality of life (HRQOL) 8–13 …”

“…], which may be confounded by patients' willingness to report distress. Reviews suggest that many patients develop short‐term symptoms but some patients/survivors continue to develop severe symptoms over time 12,13 . This highlights the need to identify risk factors of distress in this population.…”

“…For example, one of the findings from Leak and colleagues' review 8 was that older NHL survivors had worse physical but better mental QOL compared to their younger counterparts. Of the reviews that did discuss factors of distress, conclusions are often drawn across a limited number of studies, ranging from 1 to 3 studies per factor 10,12,13 . Although risk factors of distress have been identified for various cancers more broadly, 19,20 to the authors' knowledge, no review has specifically examined factors of distress in this population.…”

Real-world costs of illness of Hodgkin and the main B-Cell Non-Hodgkin lymphomas in France

“…The active treatment phase is characterized by high toxicity with important magnitude of Adverse Events (AEs) 8 . The diagnosis, treatments and AEs may lead to important physical and psychological vulnerability 8,9 . Thus, the high consumption of care and the resulting number of hospitalizations lead to a significant cost supported by the social health insurance which should be assessed through a Cost-Of-Illness (COI) study.…”