Distress persists in long-term brain tumor survivors with glioblastoma multiforme
Glioblastoma multiforme (GBM) is the most common and aggressive type of primary brain tumor. The prognosis for GBM patients is extremely poor with an estimated median survival of 12 months. Despite this statistic, a number of GBM patients are living longer than in the past as new detection and treatment approaches are used. However, little is known about the psychological correlates of this disease. To address this issue we investigated distress and its sources in long-term survivors (LTS) of this disease.
Materials and methods
Participants were asked to complete the National Comprehensive Cancer Network’s (NCCN) Distress Thermometer, a single-item rapid screening tool for distress. Participants were also asked to designate sources of distress from a 34-item list developed by the NCCN. Distress scores and sources of distress for long-term GBM survivors (>18 months) were compared to patients diagnosed within the last 18 months (<18 months).
Eight-three brain tumor patients participated in this study. Fifty-nine percent of LTS met the ≥ 4 cut-off score for distress (M = 4.61, SD 3.12) as compared to 49% of patients diagnosed less than 18 months (M = 3.93, SD = 2.21; x2 = 0.406, NS), LTS reported fewer items of concern while more LTS reported being distressed.
This study indicates that LTS of GBM report experiencing distress at similar levels to other brain tumor patients. Level of distress for LTS is directly related to the total number of concerns in both emotional and physical domains.
Implications for cancer survivors
Regardless of LTS status, distress continues to be a part of the disease trajectory for many GBM patients. As such, attention to distress in these survivors of a major life threatening disease is warranted in follow up surveillance visits.
KeywordsDistress Long-term survivors Brain tumors
- 1.Society BT. Professional resources, brain tumor facts and statistics. In. 2008.Google Scholar
- 2.Jemal A, Siegel R, Ward E, Murray T, Xu J, Smigal C, et al. CA: a Cancer Journal for Clinicians. Cancer Statistics 2006;56:106–30.Google Scholar
- 4.Shaw EG, Seiferheld W, Scott C, Coughlin C, Leibel S, Curran W, et al. Reexamining the radiation therapy oncology group (RTOG) recursive partitioning analysis (RPA) for glioblastoma multiforme (GBM) patients. International Journal of Radiation Oncology, Biology, Physics 2003;57:S135–S6. doi: 10.1016/S0360-3016(03)00843-5.Google Scholar
- 5.Medscape. Brain Cancer Incidence and Survival. In: WebMD. 2008.Google Scholar
- 6.Ozols RF, Herbst RS, Colson YL, Gralow J, Bonner J, Curran WJ Jr, et al. Clinical cancer advances 2006: major research advances in cancer treatment, prevention, and screening—a report from the American society of clinical oncology. Journal of Clinical Oncology 2007;5:46–162. doi: 10.1200/JCO.2006.09.7030.Google Scholar
- 12.Mainio A, Hakko H, Timonen M, Niemela A, Koivukangas J, Rasanen P. Depression in relation to survival among neurosurgical patients with a primary brain tumor: a 5-year follow-up study. Neurosurgery 2005;56:1234–41. doi: 10.1227/01.NEU.0000159648.44507.7F, discussion 41-2.PubMedCrossRefGoogle Scholar
- 13.Keir ST, Calhoun-Eagan RD, Swartz JJ, Saleh OA, Friedman HS. Screening for distress in patients with brain cancer using the NCCN’s rapid screening measure. Psychooncology 2007.Google Scholar
- 15.Varni JW, Katz E. Stress, social support and negative affectivity in children with newly diagnosed cancer: a prospective transactional analysis. Psycho-Oncology 1997;6:267–78. doi: 10.1002/(SICI)1099-1611(199712)6:4<267::AID-PON277>3.0.CO;2-O.PubMedCrossRefGoogle Scholar
- 18.Patterson H. Nobody can afford a brain tumor: the financial impact of brain tumors on patients and families. A summary finding. San Francisco, CA; 2007.Google Scholar
- 24.Sellick SM, Crooks DL. Depression and cancer: an appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions. Psycho-Oncology 1999;8:315–33. doi: 10.1002/(SICI)1099-1611(199907/08)8:4<315::AID-PON391>3.0.CO;2-G.PubMedCrossRefGoogle Scholar
- 25.Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psycho-Oncology 2001;10:19–28. doi: 10.1002/1099-1611(200101/02)10:1<19::AID-PON501>3.0.CO;2-6.PubMedCrossRefGoogle Scholar
- 26.NCCN practice guidelines for the management of psychosocial distress. National Comprehensive Cancer Network. Oncology. 1999;13:113–147. Williston Park.Google Scholar
- 28.Roth AJ, Kornblith AB, Batel-Copel L, Peabody E, Scher HI, Holland JC. Rapid screening for psychologic distress in men with prostate carcinoma: a pilot study. Cancer 1998;82:1904–8. doi: 10.1002/(SICI)1097-0142(19980515)82:10<1904::AID-CNCR13>3.0.CO;2-X.PubMedCrossRefGoogle Scholar
- 32.Friedman H, Szalavitz M. What is "hope" for a patient with a deadly brain tumor? cerebrum. The Dana Farber Forum on Brain Science 2003;5:7–18.Google Scholar