Journal of Genetic Counseling

, Volume 18, Issue 3, pp 265–274 | Cite as

Reactions to and Desire for Prognostic Testing in Choroidal Melanoma Patients

  • Tammy M. Beran
  • Tara A. McCannelEmail author
  • Annette L. Stanton
  • Bradley R. Straatsma
  • Barry L. Burgess
Original Research


To determine if choroidal melanoma patients want cytogenetic prognostic information. Ninety-nine choroidal melanoma patients completed a questionnaire regarding their opinions about receiving prognostic information. The perceived usefulness of prognostic information was evaluated in patients who had undergone cytogenetic testing. Depressive symptoms, quality of life, and interest in supportive counseling during test receipt were assessed. Ninety-seven percent of respondents reported that they would have wanted prognostic information at the time of their treatment and 98% of respondents reported that supportive counseling should be offered when prognostic information is given. Patients who had received a more favorable prognostic result were more likely to endorse the usefulness of cytogenetic testing than were patients who had received a less favorable prognostic result. Psychological status did not vary significantly as a function of cytogenetic test result. Prognostic information was important to patients with choroidal melanoma, even in the absence of prophylactic measures which might improve prognosis.


Choroidal melanoma Prognostic testing Patient preferences Cytogenetic testing Psychological adjustment Chromosome 3 Monosomy 3 Disomy 3 



The authors wish to thank all of those who participated in this study as well as Lorna Kwan, MPH, Jonsson Comprehensive Cancer Center, for her statistical consultation and assistance. This research was supported by a Jonsson Comprehensive Cancer Center Pre-Doctoral Fellowship and a UCLA Graduate Division Dissertation Year Fellowship to Tammy M. Beran and by Jonsson Comprehensive Cancer Center funding to Annette L. Stanton.

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.


  1. Asch, D. A., Jedrziewski, M. K., & Christakis, N. A. (1997). Response rates to mail surveys published in medical journals. Journal of Clinical Epidemiology, 50(10), 1129–1136.CrossRefGoogle Scholar
  2. Bedikian, A. Y. (2006). Metastatic uveal melanoma therapy: current options. International Ophthalmology Clinics, 46(1), 151–166.CrossRefGoogle Scholar
  3. Ben-Zur, H., & Breznitz, S. (1997). Denial, anxiety and information processing. In M. S. Myslobodsky (Ed.), The mythomanias: The nature of deception and self-deception (pp. 225–243). Hillsdale: Lawrence Erlbaum.Google Scholar
  4. Bird, S. J. (1989). Genetic testing for neurologic diseases: a rose with thorns. Neurologic Clinics, 7(4), 859–870.CrossRefGoogle Scholar
  5. Charles, S., Kessler, L., Stopfer, J. E., Domchek, S., & Halbert, C. H. (2006). Satisfaction with genetic counseling for BRCA1 and BRCA2 mutations among African American women. Patient Education and Counseling, 63(1–2), 196–204.CrossRefGoogle Scholar
  6. Cook, S. A., Damato, B., Marshall, E., & Salmon, P. (2008). Psychological aspects of cytogenetic testing of uveal melanoma: preliminary findings and directions for future research. Eye, advanced online publication doi:
  7. Cruickshanks, K. J., Fryback, D. G., Nondahl, D. M., Robinson, N., Keesey, U., Dalton, D. S., et al. (1999). Treatment choice and quality of life in patients with choroidal melanoma. Archives of Ophthalmology, 117(4), 461–467.CrossRefGoogle Scholar
  8. Damato, B., Duke, C., Coupland, S. E., Hiscott, P., Smith, P. A., Campbell, I., et al. (2007). Cytogenetics of uveal melanoma: a seven-year clinical experience. Ophthalmology, 114(10), 1925–1931.CrossRefGoogle Scholar
  9. Dormandy, E., Michie, S., Hooper, R., & Marteau, T. M. (2005). Low uptake of prenatal screening for Down syndrome in minority ethnic groups and socially deprived groups: a reflection of women’s attitudes or a failure to facilitate informed choices? International Journal of Epidemiology, 34(2), 346–352.CrossRefGoogle Scholar
  10. Fertig, D. L., & Hayes, D. F. (2001). Considerations in using tumor markers: what the psycho-oncologist needs to know. Psychooncology, 10(5), 370–379.CrossRefGoogle Scholar
  11. Harbour, J. W. (2007). Molecular prognostic testing in uveal melanoma: has it finally come of age? Archives of Ophthlmology, 125(8), 1122–1123.CrossRefGoogle Scholar
  12. Hawkins, B. S. (2004). The Collaborative Ocular Melanoma Study (COMS) randomized trial of pre-enucleation radiation of large choroidal melanoma: IV. Ten-year mortality findings and prognostic factors COMS report number 24. American Journal of Ophthalmology, 138(6), 936–951.CrossRefGoogle Scholar
  13. Kujala, E., Makitie, T., & Kivela, T. (2003). Very long-term prognosis of patients with malignant uveal melanoma. Investigative Ophthalmology and Visual Science, 44(11), 4651–4659.CrossRefGoogle Scholar
  14. McLaughlin, C. C., Wu, X. C., Jemal, A., Martin, H. J., Roche, L. M., & Chen, V. W. (2005). Incidence of noncutaneous melanomas in the U.S. Cancer, 103(5), 1000–1007.CrossRefGoogle Scholar
  15. Meiser, B. (2005). Psychological impact of genetic testing for cancer susceptibility: an update of the literature. Psychooncology, 14(12), 1060–1074.CrossRefGoogle Scholar
  16. Midena, E., Bonaldi, L., Parrozzani, R., Tebaldi, E., Boccassini, B., & Vujosevic, S. (2006). In vivo detection of monosomy 3 in eyes with medium-sized uveal melanoma using transscleral fine needle aspiration biopsy. European Journal of Ophthalmology, 16(3), 422–425.CrossRefGoogle Scholar
  17. Miki, Y., Swensen, J., Shattuck-Eidens, D., Futreal, P. A., Harshman, K., Tavtigian, S., et al. (1994). A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science, 266(5182), 66–71.CrossRefGoogle Scholar
  18. Onken, M. D., Worley, L. A., Davila, R. M., Char, D. H., & Harbour, J. W. (2006). Prognostic testing in uveal melanoma by transcriptomic profiling of fine needle biopsy specimens. The Journal of Molecular Diagnostics, 8(5), 567–573.CrossRefGoogle Scholar
  19. Prescher, G., Bornfeld, N., Hirche, H., Horsthemke, B., Jockel, K. H., & Becher, R. (1996). Prognostic implications of monosomy 3 in uveal melanoma. Lancet, 347(9010), 1222–1225.CrossRefGoogle Scholar
  20. Radloff, L. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.CrossRefGoogle Scholar
  21. Robertson, D. M. (2008). Cytogenetics in the management of uveal melanoma: are we there yet? Archives of Ophthalmology, 126(3), 409–410.CrossRefGoogle Scholar
  22. Scholes, A. G., Damato, B. E., Nunn, J., Hiscott, P., Grierson, I., & Field, J. K. (2003). Monosomy 3 in uveal melanoma: correlation with clinical and histologic predictors of survival. Investigative Ophthalmology and Visual Science, 44(3), 1008–1011.CrossRefGoogle Scholar
  23. Scotto, J., Fraumeni, J. F. Jr., & Lee, J. A. (1976). Melanomas of the eye and other noncutaneous sites: epidemiologic aspects. Journal of the National Cancer Institute, 56(3), 489–491.CrossRefGoogle Scholar
  24. Shields, C. L., Ganguly, A., Materin, M. A., Teixeira, L., Mashayekhi, A., Swanson, L. A., et al. (2007a). Chromosome 3 analysis of uveal melanoma using fine-needle aspiration biopsy at the time of plaque radiotherapy in 140 consecutive cases: the Deborah Iverson, MD, Lectureship. Archives of Ophthalmology, 125(8), 1017–1024.CrossRefGoogle Scholar
  25. Shields, C. L., Materin, M. A., Teixeira, L., Mashayekhi, A., Ganguly, Al., & Shields, J. A. (2007b). Small choroidal melanoma with chromosome 3 monosomy on fine-needle aspiration biopsy. Ophthalmology, 114(10), 1919–1924.CrossRefGoogle Scholar
  26. Shields, J. A., Shields, C. L., Materin, M., Sato, T., & Ganguly, A. (2008). Role of cytogenetics in management of uveal melanoma. Archives of Ophthalmology, 126(3), 416–419.CrossRefGoogle Scholar
  27. Sisley, K., Rennie, I. G., Parsons, M. A., Jacques, K., Hammond, D. W., Bell, S. M., et al. (1997). Abnormalities of chromosomes 3 and 8 in posterior uveal melanoma correlate with prognosis. Genes, Chromosomes & Cancer, 19(1), 22–28.CrossRefGoogle Scholar
  28. Tschentscher, F., Prescher, G., Zeschnigk, M., Horsthemke, B., & Lohmann, D. R. (2000). Identification of chromosomes 3, 6, and 8 aberrations in uveal melanoma by microsatellite analysis in comparison to comparative genomic hybridization. Cancer Genetics and Cytogenetics, 122(1), 13–17.CrossRefGoogle Scholar
  29. Ware, J. E., & Gandek, B. (1994). The SF-36 Health Survey: development and use in mental health research and the IQOLA Project. International Journal of Mental Health, 23(2), 49–73.CrossRefGoogle Scholar
  30. Ware, J., & Sherbourne, C. (1992). The MOS 36-Item Short Form Health Survey (SF-36): conceptual framework and item selection. Medical Care, 30(6), 473–483.CrossRefGoogle Scholar
  31. Ware, J., Snow, K., Kosinski, M., & Gandek, B. (1993). SF-36 health survey manual and interpretation guide. Boston: The Health Institute, New England Medical Center.Google Scholar
  32. White, V. A., Chambers, J. D., Courtright, P. D., Chang, W. Y., & Horsman, D. E. (1998). Correlation of cytogenetic abnormalities with the outcome of patients with uveal melanoma. Cancer, 83(2), 354–359.CrossRefGoogle Scholar
  33. Williams, J. K., Schutte, D. L., Evers, C., & Forcucci, C. (1999). Adults seeking presymptomatic gene testing for Huntington disease. Image: Journal of Nursing Scholarship, 31(2), 109–114.Google Scholar
  34. Wooster, R., Bignell, G., Lancaster, J., Swift, S., Seal, S., Mangion, J., et al. (1995). Identification of the breast cancer susceptibility gene BRCA2. Nature, 378(6567), 789–792.CrossRefGoogle Scholar
  35. Young, T. A., Burgess, B. L., Rao, N. P., Gorin, M. B., & Straatsma, B. R. (2007a). High density genome array is superior to fluorescence in-situ hybridization analysis of monosomy 3 in choroidal melanoma fine needle aspiration biopsy. Molecular Vision, 21(13), 2328–2333.Google Scholar
  36. Young, T. A., Rao, N. P., Glasgow, B. J., Moral, J. N., & Straatsma, B. R. (2007b). Fluorescent in situ hybridization for monosomy 3 via 30-gauge fine-needle aspiration biopsy of choroidal melanoma in vivo. Ophthalmology, 114(1), 142–146.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2009

Open AccessThis is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License (, which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Authors and Affiliations

  • Tammy M. Beran
    • 1
    • 2
    • 3
  • Tara A. McCannel
    • 2
    • 3
    • 4
    • 6
    Email author
  • Annette L. Stanton
    • 1
    • 4
    • 5
  • Bradley R. Straatsma
    • 2
    • 3
    • 4
  • Barry L. Burgess
    • 2
    • 3
  1. 1.Department of PsychologyUCLALos AngelesUSA
  2. 2.Department of OphthalmologyUCLALos AngelesUSA
  3. 3.Jules Stein Eye InstituteUCLALos AngelesUSA
  4. 4.Jonsson Comprehensive Cancer CenterUCLALos AngelesUSA
  5. 5.Department of Psychiatry and Biobehavioral SciencesUCLALos AngelesUSA
  6. 6.UCLA JSEI-OphthalmologyLos AngelesUSA

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