Skip to main content

Advertisement

SpringerLink
Log in

Illness intrusiveness and subjective well-being in patients with glioblastoma

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Glioblastoma (GBM) is the most common adult CNS malignancy but its impact on quality of life (QOL) is poorly understood. In other patient populations, illness intrusiveness (the extent to which disease and treatment disrupts valued activities and interests) is associated with low subjective well-being, after controlling for disease and treatment variables. In this cross-sectional cohort study, we examined the relations among illness intrusiveness, disease burden, and subjective well-being in GBM. 73 GBM patients completed validated self-report measures of depression, positive affect, illness intrusiveness, and health-related QOL. Responses were compared to data from six other cancer groups using repeated measures analyses of variance. Hierarchical multiple-regression analyses tested the hypothesis that illness intrusiveness accounts for well-being after controlling for the effects of disease burden. GBM patients reported less positive affect, more depression, and more illness intrusiveness than people with other cancers. Illness intrusiveness correlated with depression and (low) positive affect. Associations among cancer symptoms, depression, and positive affect decreased when illness intrusiveness was added to regression equations. Good performance status and high cancer-symptom burden were associated with illness intrusiveness and depression. GBM patients report greater distress, lower positive affect, and more illness intrusiveness than people with other cancers. Subjective well-being is mediated in part by illness intrusiveness in this population. In addition to medical treatment, efforts to help patients remain engaged in valued activities and interests may help preserve QOL after the diagnosis of a GBM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. CBTRUS. CBTRUS Statistic Report: primary brain and central nervous system tumors diagnosed in the United States in 2004–2006. Hinsdale, IL: Central Brain Tumor Registry of the United States, 2010

  2. Liu R, Page M, Solheim K, Fox S, Chang SM (2009) Quality of life in adults with brain tumors: current knowledge and future directions. Neuro Oncol 11(3):330–339

    Article  PubMed Central  PubMed  Google Scholar 

  3. Stupp R, Hegi ME, Mason WP et al (2009) Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 10(5):459–466

    Article  CAS  PubMed  Google Scholar 

  4. Hart MG, Grant R, Garside R, Rogers G, Somerville M, Stein K (2008) Temozolomide for high grade glioma. Cochrane Database Syst Rev 4:Cd007415

    PubMed  Google Scholar 

  5. Hart MG, Garside R, Rogers G, Stein K, Grant R (2013) Temozolomide for high grade glioma. Cochrane Database Syst Rev 4:Cd007415

    PubMed  Google Scholar 

  6. Taphoorn MJ, Stupp R, Coens C et al (2005) Health-related quality of life in patients with glioblastoma: a randomised controlled trial. Lancet Oncol 6(12):937–944

    Article  PubMed  Google Scholar 

  7. Henriksson R, Asklund T, Poulsen HS (2011) Impact of therapy on quality of life, neurocognitive function and their correlates in glioblastoma multiforme: a review. J Neurooncol 104(3):639–646

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Armstrong TS, Mendoza T, Gning I et al (2006) Validation of the M.D. Anderson symptom inventory brain tumor module (MDASI-BT). J Neurooncol 80(1):27–35

    Article  CAS  PubMed  Google Scholar 

  9. Armstrong TS, Vera-Bolanos E, Gning I et al (2011) The impact of symptom interference using the MD Anderson symptom inventory-brain tumor module (MDASI-BT) on prediction of recurrence in primary brain tumor patients. Cancer 117(14):3222–3228

    Article  PubMed  Google Scholar 

  10. Armstrong TS, Vera-Bolanos E, Acquaye AA, Gilbert MR, Ladha H, Mendoza T (2015) The symptom burden of primary brain tumors: evidence for a core set of tumor and treatment-related symptoms. Neuro Oncol. doi:10.1093/neuonc/nov166

    Google Scholar 

  11. Lee JH, Jung TY, Jung S et al (2013) Performance status during and after radiotherapy plus concomitant and adjuvant temozolomide in elderly patients with glioblastoma multiforme. J Clin Neurosci 20(4):503–508

    Article  PubMed  Google Scholar 

  12. Chaichana KL, Halthore AN, Parker SL et al (2011) Factors involved in maintaining prolonged functional independence following supratentorial glioblastoma resection. Clinical article. J Neurosurg 114(3):604–612

    Article  PubMed Central  PubMed  Google Scholar 

  13. Jones LW, Cohen RR, Mabe SK et al (2009) Assessment of physical functioning in recurrent glioma: preliminary comparison of performance status to functional capacity testing. J Neurooncol 94(1):79–85

    Article  PubMed  Google Scholar 

  14. Recht L, Glantz M, Chamberlain M, Hsieh CC (2003) Quantitative measurement of quality outcome in malignant glioma patients using an independent living score (ILS). Assessment of a retrospective cohort. J Neurooncol 61(2):127–136

    Article  CAS  PubMed  Google Scholar 

  15. Aaronson NK, Ahmedzai S, Bergman B et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376

    Article  CAS  PubMed  Google Scholar 

  16. Osoba D, Aaronson NK, Muller M et al (1996) The development and psychometric validation of a brain cancer quality-of-life questionnaire for use in combination with general cancer-specific questionnaires. Qual Life Res 5(1):139–150

    Article  CAS  PubMed  Google Scholar 

  17. Weitzner MA, Meyers CA, Gelke CK, Byrne KS, Cella DF, Levin VA (1995) The functional assessment of cancer therapy (FACT) scale. Development of a brain subscale and revalidation of the general version (FACT-G) in patients with primary brain tumors. Cancer 75(5):1151–1161

    Article  CAS  PubMed  Google Scholar 

  18. Chow R, Lao N, Popovic M et al (2014) Comparison of the EORTC QLQ-BN20 and the FACT-Br quality of life questionnaires for patients with primary brain cancers: a literature review. Support Care Cancer 22(9):2593–2598

    Article  PubMed  Google Scholar 

  19. Wefel JS, Cloughesy T, Zazzali JL et al (2011) Neurocognitive function in patients with recurrent glioblastoma treated with bevacizumab. Neuro Oncol 13(6):660–668

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Meyers CA, Hess KR (2003) Multifaceted end points in brain tumor clinical trials: cognitive deterioration precedes MRI progression. Neuro Oncol 5(2):89–95

    PubMed Central  PubMed  Google Scholar 

  21. Meyers CA, Hess KR, Yung WK, Levin VA (2000) Cognitive function as a predictor of survival in patients with recurrent malignant glioma. J Clin Oncol 18(3):646–650

    CAS  PubMed  Google Scholar 

  22. Bradburn N (1969) The structure of psychological well-being. Aldine, Chicago

    Google Scholar 

  23. Devins GM (2010) Using the illness intrusiveness ratings scale to understand health-related quality of life in chronic disease. J Psychosom Res 68(6):591–602

    Article  PubMed  Google Scholar 

  24. Devins GM, Bezjak A, Mah K, Loblaw DA, Gotowiec AP (2006) Context moderates illness-induced lifestyle disruptions across life domains: a test of the illness intrusiveness theoretical framework in six common cancers. Psychooncology 15(3):221–233

    Article  PubMed  Google Scholar 

  25. Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655

    Article  CAS  PubMed  Google Scholar 

  26. Krull KR, Gioia G, Ness KK et al (2008) Reliability and validity of the Childhood cancer survivor study neurocognitive questionnaire. Cancer 113(8):2188–2197

    Article  PubMed Central  PubMed  Google Scholar 

  27. Radloff L (1977) The CES–D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401

    Article  Google Scholar 

  28. Costello C, Devins G (1988) Screening for stressful life events and chronic difficulties. Can JBehav Sci 20:85–92

    Article  Google Scholar 

  29. Cohen J, Cohen P, West S, Aiken L (2003) Applied multiple regression/correlation analysis for the behavioral sciences, 3rd edn. Lawrence Erlbaum Associates, Mahwah

    Google Scholar 

  30. Kanter C, Daniels M, Stone A, Edelstein K, D’Agostino N (2010) A demographic and thematic overview of the brain tumour patient and caregiver support groups at Princess Margaret Hospital. Psycho-Oncology 19(Suppl. 2):S231

    Google Scholar 

  31. Devins GM, Edworthy SM, Seland TP, Klein GM, Paul LC, Mandin H (1993) Differences in illness intrusiveness across rheumatoid arthritis, end-stage renal disease, and multiple sclerosis. J Nerv Ment Dis 181(6):377–381

    Article  CAS  PubMed  Google Scholar 

  32. Devins GM, Edworthy SM, Paul LC et al (1993) Restless sleep, illness intrusiveness, and depressive symptoms in three chronic illness conditions: rheumatoid arthritis, end-stage renal disease, and multiple sclerosis. J Psychosom Res 37(2):163–170

    Article  CAS  PubMed  Google Scholar 

  33. Snyder S, Foley FW, Farrell E, Beier M, Zemon V (2013) Psychological and physical predictors of illness intrusiveness in patients with multiple sclerosis. J Neurol Sci 332(1–2):41–44

    Article  PubMed  Google Scholar 

  34. Shawaryn MA, Schiaffino KM, LaRocca NG, Johnston MV (2002) Determinants of health-related quality of life in multiple sderosis: the role of illness intrusiveness. Mult Scler 8(4):310–318

    Article  CAS  PubMed  Google Scholar 

  35. Turpin KV, Carroll LJ, Cassidy JD, Hader WJ (2007) Deterioration in the health-related quality of life of persons with multiple sclerosis: the possible warning signs. Mult Scler 13(8):1038–1045

    Article  CAS  PubMed  Google Scholar 

  36. Poochikian-Sarkissian S, Sidani S, Wennberg RA, Devins GM (2008) Psychological impact of illness intrusiveness in epilepsy—comparison of treatments. Psychol Health Med 13(2):129–145

    Article  PubMed  Google Scholar 

  37. Klein M, Reijneveld JC, Heimans JJ (2008) Subjective ratings versus objective measurement of cognitive function: in regard to Van Beek et al. (Int J Radiat Oncol Biol Phys 2007; 68:986–991). Int J Radiat Oncol Biol Phys. United States, 70: 961–962; author reply 962

  38. Gehring K, Sitskoorn MM, Gundy CM et al (2009) Cognitive rehabilitation in patients with gliomas: a randomized, controlled trial. J Clin Oncol 27(22):3712–3722

    Article  PubMed  Google Scholar 

  39. Edelstein K, Bernstein LJ (2014) Cognitive dysfunction after chemotherapy for breast cancer. J Int Neuropsychol Soc 20(4):351–356

    Article  PubMed  Google Scholar 

  40. Hermelink K, Kuchenhoff H, Untch M et al (2010) Two different sides of ‘chemobrain’: determinants and nondeterminants of self-perceived cognitive dysfunction in a prospective, randomized, multicenter study. Psychooncology 19(12):1321–1328

    Article  PubMed  Google Scholar 

  41. Kelvin JF, Steed R, Jarrett J (2014) Discussing safe sexual practices during cancer treatment. Clin J Oncol Nurs 18(4):449–453

    Article  PubMed  Google Scholar 

  42. Surbeck W, Herbet G, Duffau H (2015) Sexuality after surgery for diffuse low-grade glioma. Neuro Oncol 17(4):574–579

    Article  PubMed  Google Scholar 

  43. Krychman ML, Amsterdam A, Carter J, Castiel M, DeAngelis L (2004) Brain cancer and sexual health: a case report. Palliat Support Care 2(3):315–318

    Article  PubMed  Google Scholar 

  44. Khan F, Amatya B, Ng L, Drummond K, Olver J (2013) Multidisciplinary rehabilitation after primary brain tumour treatment. Cochrane Database Syst Rev 1:Cd009509

    PubMed  Google Scholar 

  45. Addeo R, Perri F, Parlato C, Della Vittoria G (2014) ASCO 2013: bevacizumab and glioblastoma—a marriage dissolution? Curr Med Res Opin 30:1871–1873

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was funded in part by the Kirchmann Family Chair in Neuro-Oncology Research and the Ontario Ministry of Health and Long Term Care. The views expressed do not necessarily reflect those of the OMOHLTC.

Author information

Authors and Affiliations

  1. Pencer Brain Tumor Centre, Princess Margaret Cancer Centre, 610 University Ave, 18-716, Toronto, Canada

    Kim Edelstein, Natalie C. Jewitt & Warren P. Mason

  2. Psychosocial Oncology & Palliative Care, Princess Margaret Cancer Centre, Toronto, Canada

    Kim Edelstein & Gerald M. Devins

  3. Hematology Oncology, Princess Margaret Cancer Centre, Toronto, Canada

    Warren P. Mason

  4. Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada

    Christine Massey

  5. Psychiatry, University of Toronto, Toronto, Canada

    Kim Edelstein & Gerald M. Devins

  6. Neurology, University of Toronto, Toronto, Canada

    Warren P. Mason

  7. Medical Oncology, Mid-western Cancer Centre, University Hospital Limerick, Limerick, Ireland

    Linda Coate

Authors
  1. Kim Edelstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Linda Coate
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christine Massey
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Natalie C. Jewitt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Warren P. Mason
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gerald M. Devins
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kim Edelstein.

Ethics declarations

Conflicts of interest

The authors have no financial or other conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Edelstein, K., Coate, L., Massey, C. et al. Illness intrusiveness and subjective well-being in patients with glioblastoma. J Neurooncol 126, 127–135 (2016). https://doi.org/10.1007/s11060-015-1943-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-015-1943-6

Keywords

Search

Navigation