Abstract
Objectives:
Psychological distress, including anxiety and depressive symptoms, is prevalent among newly diagnosed cancer patients. Greater distress may be related to poorer health-related quality of life (HRQOL). Here we describe a sample of newly diagnosed patients who reported on anxiety, depressive symptoms, and HRQOL upon initial presentation to a multidisciplinary head and neck clinic.
Methods:
Retrospective medical record review (October 2012 - February 2013) yielded 43 patients (33 male) who provided data of interest. This cohort completed screening measures of anxiety and depressive symptoms (HADS), and health-related social and physical quality of life (UW-QOL). These data were provided during the initial clinic visit, prior to initiation of adjuvant treatment. Average age was 61.8 years (SD=13.6). Eighteen (41.9%) patients had oral cavity/laryngeal cancers. Squamous cell pathology was noted in 28 (65%) cases. Many patients (n=19, 44.2%) scored above clinical cutoff for distress. A moderate impact to social-emotional and physical QOL was also noted. Younger patients had significantly greater anxiety symptoms (r=-.373, P = .015), and patients with more advanced cancer reported poorer social-emotional QOL (r=-.330, P = .040). Greater depressive symptoms were related to poorer physical QOL (r=-.454; P = .003), especially for those who scored above the clinical cutoff (F(1,42)=7.54; P = .009).
Results:
Relationships between psychological distress and HR-QOL are evident at the time of diagnosis, particularly for patients reporting clinically significant distress. Distress that begins with diagnosis and continues with treatment is also linked with circadian, endocrine, and immune disruption.
Conclusions:
These pathways are intriguing, as they may mediate relationships to HR-QOL highlighted here, and warrant further study.
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