Abstract
Introduction
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).
Results
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.
Conclusions
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.
Similar content being viewed by others
References
Society BT. Professional resources, brain tumor facts and statistics. In. 2008.
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.
DeAngelis LM. Brain tumors. The New England Journal of Medicine 2001;344:114–23. doi:10.1056/NEJM200101113440207.
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.
Medscape. Brain Cancer Incidence and Survival. In: WebMD. 2008.
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.
Reardon DA, Rich JN, Friedman HS, Bigner DD. Recent advances in the treatment of malignant astrocytoma. Journal of Clinical Oncology 2006;24:1253–65. doi:10.1200/JCO.2005.04.5302.
Reardon DA, Wen PY. Therapeutic advances in the treatment of glioblastoma: rationale and potential role of targeted agents. The Oncologist 2006;11:152–64. doi:10.1634/theoncologist.11-2-152.
Feuerstein M, Hansen JA, Calvio LC, Johnson L, Ronquillo JG. Work productivity in brain tumor survivors. Journal of Occupational and Environmental Medicine 2007;49:803–11. doi:10.1097/JOM.0b013e318095a458.
Keir ST, Guill AB, Carter KE, Friedman HS. Stress and intervention preferences of patients with brain tumors. Supportive Care in Cancer 2006;14:1213–9. doi:10.1007/s00520-006-0087-9.
Edvardsson T, Ahlstrom G. Illness-related problems and coping among persons with low-grade glioma. Psycho-Oncology 2005;14:728–37. doi:10.1002/pon.898.
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.
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.
Zebrack BJ, Chesler MA. Quality of life in childhood cancer survivors. Psycho-Oncology 2002;11:132–41. doi:10.1002/pon.569.
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.
Stuber ML, Kazak AE, Meeske K, Barakat L, Guthrie D, Garnier H, et al. Predictors of posttraumatic stress symptoms in childhood cancer survivors. Pediatrics 1997;100:958–64. doi:10.1542/peds.100.6.958.
Bosma I, Vos MJ, Heimans JJ, Taphoorn MJB, Aaronson NK, Postma TJ, et al. The course of neurocognitive functioning in high-grade glioma patients. Neuro-Oncology 2007;9:53–62. doi:10.1215/15228517-2006-012.
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.
Pelletier G, Verhoef MJ, Khatri N, Hagen N. Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues. Journal of Neuro-Oncology 2002;57:41–9. doi:10.1023/A:1015728825642.
Krex D, Klink B, Hartmann C, von Deimling A, Pietsch T, Simon M, et al. Long-term survival with glioblastoma multiforme. Brain 2007;130:2596–606. doi:10.1093/brain/awm204.
Correa DD. Cognitive functions in brain tumor patients. Hematology/Oncology Clinics of North America 2006;20:1363–76. doi:10.1016/j.hoc.2006.09.012.
Carlson LE, Bultz BD. Benefits of psychosocial oncology care: Improved quality of life and medical cost offset. Health and Quality of Life Outcomes 2003;1:8. doi:10.1186/1477-7525-1-8.
Carlson LE, Bultz BD. Cancer distress screening. Needs, models, and methods. Journal of Psychosomatic Research 2003;55:403–9. doi:10.1016/S0022-3999(03)00514-2.
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.
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.
NCCN practice guidelines for the management of psychosocial distress. National Comprehensive Cancer Network. Oncology. 1999;13:113–147. Williston Park.
Akizuki N, Akechi T, Nakanishi T, Yoshikawa E, Okamura M, Nakano T, et al. Development of a brief screening interview for adjustment disorders and major depression in patients with cancer. Cancer 2003;97:2605–13. doi:10.1002/cncr.11358.
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.
Trask PC, Paterson A, Riba M, Brines B, Griffith K, Parker P, et al. Assessment of psychological distress in prospective bone marrow transplant patients. Bone Marrow Transplantation 2002;29:917–25. doi:10.1038/sj.bmt.1703557.
Almeida DM, Kessler RC. Everyday stressors and gender differences in daily distress. Journal of personality and social psychology 1998;75:670–80. doi:10.1037/0022-3514.75.3.670.
Emslie C, Fuhrer R, Hunt K, Macintyre S, Shipley M, Stansfeld S. Gender differences in mental health: evidence from three organisations. Social Science & Medicine 2002;54:621–4. doi:10.1016/S0277-9536(01)00056-9.
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.
Curren JR. Support needs of brain tumour patients and their carers: the place of a telephone service. International Journal of Palliative Nursing 2001;7:331–7.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Keir, S.T., Farland, M.M., Lipp, E.S. et al. Distress persists in long-term brain tumor survivors with glioblastoma multiforme. J Cancer Surviv 2, 269–274 (2008). https://doi.org/10.1007/s11764-008-0069-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11764-008-0069-7