Advanced Melanoma Increases Psychological Burden in Patients

Submitted by admin5 on Thu, 05/25/2017 - 16:56

Stage III and IV melanoma may have a profound impact on patients’ distress burden, which requires further intervention strategies, according to research that will be presented at the 2017 ASCO Annual Meeting (June 2-6, 2017; Chicago, IL).

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Limited data exists regarding the impact of melanoma on the psychological burden of patients. Previous research has shown some predictors of melanoma-related distress, such as female gender or young age. However, research has yet to evaluate stages of disease and its association with distress or distress in patients with melanoma under systemic treatment for metastases.

Andrea Forschner, MD, department of dermatology, Eberhard-Karls University of Tuebingen (Germany), and colleagues conducted a study to analyze the psychological burden of patients with melanoma at the outpatient clinic at the University of Tuebingen. A total of 820 patients 406 men, 414 women) underwent psycho-oncological screening between July and September 2016. Patients were subjected to complete the distress thermometer, supplemented by a problem list, before consulting their physicians. Researchers matched psycho-oncological data with tumor- and patient-specific data to examine influences on distress using logistic regression.

Researchers noted that distress thermometer scores 5 or higher were considered above-threshold, indicating the need for psycho-oncological intervention.

A total of 359 of the patients demonstrated advanced disease (stage III, n = 182; stage IV, n = 177). One hundred and twenty patients received systemic treatment for metastases (checkpoint inhibitors, n = 90; targeted therapy, n = 27; chemotherapy, n = 3).

Researchers found that 338 patients (41.2%) met the cut-off score for distress. Factors found to influence distress (P < .05) over the threshold included female gender, younger age, and stage III and IV disease.

Additionally, researchers acknowledged a lower risk for values above the threshold for patients who underwent systemic therapy, though not significant (P = .252). They believe this finding may be due to a closer relationship between these patients and their physicians.

Implications of this study include a need for further intervention strategies for patients with advanced-stage melanoma as well as those who undergo systemic therapy. “Departments that care for melanoma patients should therefore be fitted by a sufficient number of psycho-oncologists,” authors of the study wrote.—Zachary Bessette

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