Illness-Related Distress in Women with Clinically Localized Cutaneous Melanoma
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Women may experience distress or changes in their quality of life following treatment for early-stage melanoma. In order to plan future interventions and identify areas of primary concern, we conducted a cross-sectional survey to describe the experiences of women treated for clinically localized melanoma.
We examined quality of life, levels of distress, appearance perceptions, body image, fear of recurrence, and reproductive concerns in 100 patients (age 21–90 years, M = 54.34 years). Most (61 %) had melanoma of the extremity, with a median depth of 1.1 mm (range, 0–10.5 mm).
Significant depressive symptomatology occurred in 10 % of patients, and 12 % reported a clinically established high level of intrusive thoughts related to melanoma. Quality-of-life scores indicated more disruption on psychological, compared with social and physical functioning. Also, 64 % of women rated their appearance as worse post-treatment; 23 % were unsatisfied with the appearance of the surgical site. Recurrence concerns indicated significant worry about health and death. Most patients (>85 %) were not concerned about fertility, but 52 % worried that future children would have an increased risk of cancer.
Some women treated for clinically localized melanoma reported high levels of distress associated with their altered body image and fear of recurrence. Improvements in patient education prior to surgical intervention may reduce the distress associated with the diagnosis and treatment of melanoma.
- Linos E, Swetter SM, Cockburn MG, Colditz GA, Clarke CA. Increasing burden of melanoma in the United States. J Invest Dermatol. 2009;129:1666–74. CrossRef
- Reyes-Ortiz CA, Goodwin JS, Freeman JL. The effect of socioeconomic factors on incidence, stage at diagnosis and survival of cutaneous melanoma. Med Sci Monit. 2005;RA11:163–72.
- Bleyer A, Budd T, Montello M. Adolescents and young adults with cancer: the scope of the problem and criticality of clinical trials. Cancer. 2006;107:1645–55. CrossRef
- Purdue MP, Freeman LE, Anderson WF, Tucker MA. Recent trends in incidence of cutaneous melanoma among US Caucasian young adults. J Invest Dermatol. 2008;128:2905–8. CrossRef
- Al-Shakhli H, Harcourt D, Kenealy J. Psychological distress surrounding diagnosis of malignant and nonmalignant skin lesions at a pigmented lesion clinic. Plast Reconstr Aesthest Surg. 2006;59:479–86. CrossRef
- Missiha SB, Solish N, From L. Characterizing anxiety in melanoma patients. J Cutan Med Surg. 2003;7:443–8. CrossRef
- Holterhues C, Cornish D, van de Poll-Franse LV, Krekels G, Koedijk F, Kuijpers D, et al. Impact of melanoma on patients’ lives among 562 survivors: a Dutch population-based study. Arch Dermatol. 2011;147:177–85. CrossRef
- Newton-Bishop JA, Nolan C, Turner F, McCabe M, Boxer C, Thomas JM, et al. A quality-of-life study in high-risk (thickness > = or 2 mm) cutaneous melanoma patients in a randomized trial of 1-cm versus 3-cm surgical excision margins. J Invest Dermatol Symp Proc. 2004;9:152–9. CrossRef
- Lichtenthal WG, Cruess DG, Clark VL, Ming ME. Investment in body image among patients diagnosed with or at risk for malignant melanoma. Body Image. 2005;2:41–51. CrossRef
- Oliveria SA, Shuk E, Hay JL, Heneghan MK, Panageas K, Geller AC, et al. Melanoma survivors: health behaviors, surveillance, psychosocial factors, and family concerns. Psychooncology. 2011. doi: 10.1002/pon.2059.
- Ferrell BR, Dow KH, Grant M. Measurement of the quality of life in cancer survivors. Qual Life Res. 1995;4:523–31. CrossRef
- Veit CT, Ware Jr. JE. The structure of psychological distress and well-being in general populations. J Consult Clinical Psychol. 1983;51:730–42. CrossRef
- Berwick DM, Murphy JM, Goldman PA, Ware Jr. JE, Barsky AJ, Weinstein MC. Performance of a five-item mental health screening test. Med Care. 1991;29:169–76. CrossRef
- Vickberg SM. The concerns about recurrence scale (CARS): a systematic measure of women’s fears about the possibility of breast cancer recurrence. Ann Behav Med. 2003;25:16–24. CrossRef
- Horowitz M, Wilner N, Alvarez W. Impact of event scale: a measure of subjective stress. Psychosom Med. 1979;41:209–18.
- Hopwood P, Fletcher I, Lee A, Al Ghazal S. A body image scale for use with cancer patients. Eur J Cancer. 2001;37:189–97. CrossRef
- Melia M, Moy CS, Reynolds SM, Cella D, Murray TG, Hovland KR, et al. Development and validation of disease-specific measures for choroidal melanoma: COMS-QOLS report no. 2. Arch Ophthalmol. 2003;121:1010–20. CrossRef
- Schover LR, Rybicki LA, Martin BA, Bringelsen KA. Having children after cancer: A pilot study of survivors’ attitudes and experiences. Cancer. 1999;86:697–709. CrossRef
- Weissman MM, Bland R, Joyce PR, Newman S, Wells JE, Wittchen H-U. Sex differences in rates of depression: cross-national perspectives. J Affect Disord. 1993;29:77–84. CrossRef
- Kroenke CH, Bennett GG, Fuchs C, Giovannucci E, Kawachi I, Schernhammer E, et al. Depressive symptoms and prospective incidence of colorectal cancer in women. Am J Epidemiol. 2005;162:839–48. CrossRef
- Bleiker EM, Pouwer F, van der Ploeg HM, Leer JW, Adèr HJ. Psychological distress two years after diagnosis of breast cancer: frequency and prediction. Patient Educ Couns. 2000;40:209–17. CrossRef
- Zhong T, McCarthy C, Min S, Zhang J, Beber B, Pusic AL, et al. Patient satisfaction and health-related quality of life after autologous tissue breast reconstruction: a prospective analysis of early postoperative outcomes. Cancer. 2012;118:1701–9. CrossRef
- Moncrieff MD, Bowen F, Thompson JF, Saw RP, Shannon KF, Spillane AJ, et al. Keystone flap reconstruction of primary melanoma excision defects of the leg—The end of the skin graft? Ann Surg Oncol. 2008;15:2867–73. CrossRef
- Illness-Related Distress in Women with Clinically Localized Cutaneous Melanoma
Annals of Surgical Oncology
Volume 20, Issue 2 , pp 675-679
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- 1. Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- 2. New York University School of Medicine, New York, NY, USA
- 3. Department of Surgery, Gastric and Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA