Supportive Care in Cancer

, Volume 15, Issue 12, pp 1423–1428 | Cite as

Stress and long-term survivors of brain cancer

  • Stephen T. Keir
  • Jonas J. Swartz
  • Henry S. Friedman
Original Article

Abstract

Introduction

Adult brain tumor patients are joining the ranks of cancer survivors in increasing numbers in the United States. As a result, health care providers are faced with new challenges to address the need for psychosocial support in this population.

Methods

Using the Perceived Stress Scale and the National Comprehensive Cancer Network’s Distress Thermometer, levels of stress and cancer-related items of concern were assessed in adult long-term survivors of brain cancer.

Results

Sixty-one percent of the sample population experienced elevated levels of stress. Scores were not significantly associated with age, gender, treatment status, or tumor grade. Long-term survivors were just as likely to report being stressed (χ 2 = 0.032, NS), while reporting fewer numbers of items of concern (5.02, SD = 3.509), compared to brain tumor patients diagnosed 18 months (M = 6.82, SD = 3.737, t = 2.467, p  0.05).

Discussion/conclusion

Despite their long-term survival status, long-term survivors of brain cancer continue to experience elevated levels of stress. Predictors of stress in this population are related to familial, emotional, and practical concerns. While the scientific community continues to examine the specific impact of stress on both the physical and mental outcomes of cancer patients, understanding the sources of stress within cancer populations is key in designing targeted interventions to help patients manage the stress associated with this disease.

Implications for brain tumor survivors

This study provides a better understanding of the unique needs of long-term survivors of brain cancer. An awareness of the sources and levels of stress experienced by this population could lead to the development of effective supportive care interventions to improve the quality of life of the survivor.

Keywords

Stress Brain cancer Long-term cancer survivors 

References

  1. 1.
    Academies IoMoN (2005) Cancer survivorship facts and figures. In: Institute of Medicine of the National AcademiesGoogle Scholar
  2. 2.
    Hewitt M et al (2005) From cancer patient to cancer survivor: lost in transition. National Academies, Washington, DCGoogle Scholar
  3. 3.
    Brain Tumor Society (2004) Professional resources: brain tumor facts and statistics. http://www.tbts.org. Cited 12 Feb 2007
  4. 4.
    Jemal A, Siegel R, Ward E et al (2006) Cancer statistics, 2006. CA Cancer J Clin 56(2):106–130PubMedCrossRefGoogle Scholar
  5. 5.
    DeAngelis LM (2001) Brain tumors. N Engl J Med 344(2):114–123PubMedCrossRefGoogle Scholar
  6. 6.
    Medscape (2007) Brain cancer incidence and survival. In: WebMD. http://www.webmd.com. Cited 12 Feb 2007
  7. 7.
    Foundation TKH-GBT. Brain Tumor Facts and Information Sheet. The Kelley Heinz-Grundner Brain Tumor Foundation. http://www.khgfoundation.org. Cited 14 Feb 2007
  8. 8.
    Schmidinger M, Linzmayer L, Becherer A et al (2003) Psychometric- and quality-of-life assessment in long-term glioblastoma survivors. J Neurooncol 63(1):55–61PubMedCrossRefGoogle Scholar
  9. 9.
    Deimling GT, Kahana B, Bowman KF, Schaefer ML (2002) Cancer survivorship and psychological distress in later life. Psychooncology 11(6):479–494PubMedCrossRefGoogle Scholar
  10. 10.
    Friedman HS, Szalavitz M (2003) What is “hope” for a patient with a deadly brain tumor? Cerebrum: The Dana Forum on Brain Science 5(3):7–18Google Scholar
  11. 11.
    Keir ST, Guill AB, Carter KE, Friedman HS (2006) Stress and intervention preferences of patients with brain tumors. Support Care Cancer 14(12):1213–1219PubMedCrossRefGoogle Scholar
  12. 12.
    Edvardsson T, Ahlstrom G (2005) Illness-related problems and coping among persons with low-grade glioma. Psychooncology 14(9):728–737PubMedCrossRefGoogle Scholar
  13. 13.
    Mainio A, Hakko H, Timonen M, Niemela A, Koivukangas J, Rasanen P (2005) Depression in relation to survival among neurosurgical patients with a primary brain tumor: a 5-year follow-up study. Neurosurgery 56(6):1234-1241; discussion 41–42PubMedCrossRefGoogle Scholar
  14. 14.
    Zebrack BJ, Chesler MA (2002) Quality of life in childhood cancer survivors. Psychooncology 11(2):132–141PubMedCrossRefGoogle Scholar
  15. 15.
    Varni JW, Katz E (1997) Stress, social support and negative affectivity in children with newly diagnosed cancer: a prospective transactional analysis. Psychooncology 6(4):267–278PubMedCrossRefGoogle Scholar
  16. 16.
    Stuber ML, Kazak AE, Meeske K et al (1997) Predictors of posttraumatic stress symptoms in childhood cancer survivors. Pediatrics 100(6):958–964PubMedCrossRefGoogle Scholar
  17. 17.
    Correa DD (2006) Cognitive functions in brain tumor patients. Hematol Oncol Clin North Am 20(6):1363–1376PubMedCrossRefGoogle Scholar
  18. 18.
    Stanton AL (2003) Psychosocial concerns and interventions for cancer survivors. J Clin Oncol 24(32):5132–5137CrossRefGoogle Scholar
  19. 19.
    Carlson LE, Bultz BD (2003) Benefits of psychosocial oncology care: Improved quality of life and medical cost offset. Health Qual Life Outcomes 1(1):8PubMedCrossRefGoogle Scholar
  20. 20.
    Carlson LE, Bultz BD (2003) Cancer distress screening. Needs, models, and methods. J Psychosom Res 55(5):403–409PubMedCrossRefGoogle Scholar
  21. 21.
    Sellick SM, Crooks DL (1999) Depression and cancer: an appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions. Psychooncology 8(4):315–333PubMedCrossRefGoogle Scholar
  22. 22.
    Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psychooncology 10(1):19–28PubMedCrossRefGoogle Scholar
  23. 23.
    Antoni MH, Lutgendorf SK, Cole SW et al (2006) The influence of bio-behavioural factors on tumour biology: pathways and mechanisms. Nat Rev Cancer 6(3):240–248PubMedCrossRefGoogle Scholar
  24. 24.
    Lillberg K, Verkasalo PK, Kaprio J, Teppo L, Helenius H, Koskenvuo M (2003) Stressful life events and risk of breast cancer in 10,808 women: a cohort study. Am J Epidemiol 157(5):415–423PubMedCrossRefGoogle Scholar
  25. 25.
    Reiche EM, Nunes SO, Morimoto HK (2004) Stress, depression, the immune system, and cancer. Lancet Oncol 5(10):617–625PubMedCrossRefGoogle Scholar
  26. 26.
    Ben-Eliyahu S (2003) The promotion of tumor metastasis by surgery and stress: immunological basis and implications for psychoneuroimmunology. Brain Behav Immun 17:S27–S36PubMedCrossRefGoogle Scholar
  27. 27.
    Lutgendorf SK, Costanzo ES (2003) Psychoneuroimmunology and health psychology: an integrative model. Brain Behav Immun 17(4):225–232PubMedCrossRefGoogle Scholar
  28. 28.
    Lutgendorf SK, Cole S, Costanzo E et al (2003) Stress-related mediators stimulate vascular endothelial growth factor secretion by two ovarian cancer cell lines. Clin Cancer Res 9(12):4514–4521PubMedGoogle Scholar
  29. 29.
    Thaker PH, Han LY, Kamat AA et al (2006) Chronic stress promotes tumor growth and angiogenesis in a mouse model of ovarian carcinoma. Nat Med 12(8):939–944PubMedCrossRefGoogle Scholar
  30. 30.
    Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24(4):385–396PubMedCrossRefGoogle Scholar
  31. 31.
    Akizuki N, Yamawaki S, Akechi T, Nakano T, Uchitomi Y (2005) Development of an Impact Thermometer for use in combination with the Distress Thermometer as a brief screening tool for adjustment disorders and/or major depression in cancer patients. J Pain Symptom Manage 29(1):91–99PubMedCrossRefGoogle Scholar
  32. 32.
    Dabrowski M, Boucher K, Ward JH et al (2007) Clinical experience with the NCCN distress thermometer in breast cancer patients. J Natl Compr Canc Netw 5(1):104–111PubMedGoogle Scholar
  33. 33.
    Ransom S, Jacobsen PB, Booth-Jones M (2006) Validation of the Distress Thermometer with bone marrow transplant patients. Psychooncology 15(7):604–612PubMedCrossRefGoogle Scholar
  34. 34.
    Vachon M (2006) Psychosocial distress and coping after cancer treatment. How clinicians can assess distress and which interventions are appropriate—what we know and what we don’t. Am J Nurs 106(3 Suppl):26–31PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Stephen T. Keir
    • 1
  • Jonas J. Swartz
    • 1
  • Henry S. Friedman
    • 1
  1. 1.The Tug McGraw Research Center in The Preston Robert Tisch Brain Tumor Center at Duke Surgery Department, Division of Neuro-oncologyDuke University Medical CenterDurhamUSA

Personalised recommendations