Advertisement

Annals of Surgical Oncology

, Volume 26, Issue 10, pp 3204–3209 | Cite as

Distress: Characterizing What Causes the Thermometer to Shift in Patients with Newly Diagnosed Breast Cancer Attending a Multidisciplinary Clinic

  • Chelsey C. CiambellaEmail author
  • Charu Taneja
  • Don S. Dizon
  • Doreen L. Wiggins
  • Christine M. Emmick
  • Kara L. Leonard
  • Mary L. Lopresti
  • Sabrina Witherby
  • Diana Cabral
  • Serena Snow
  • Theresa A. Graves
Breast Oncology

Abstract

Background

A diagnosis of breast cancer (BC) can result in multifactorial stress. If not addressed, distress can have a negative impact on outcomes. The experience of patients with newly diagnosed BC has not been sufficiently investigated. This study characterizes distress among new patients in a multidisciplinary care (MDC) clinic. The study aimed to determine the degree of distress at presentation, to characterize the sources, and to evaluate the impact of an MDC visit.

Methods

A retrospective review was performed from January 2015 to November 2017. Charts were accessed for demographics, tumor characteristics, and treatment data. Distress scores (DS) and problems as captured using the National Comprehensive Cancer Network (NCCN) Distress Thermometer were completed before evaluation and in a subgroup after an MDC visit. Predictors of severe distress (DS ≥4) were investigated using multivariable logistic regression. The paired t test was used to determine the impact of an MDC visit.

Results

The mean initial DS (n = 474) was 4.98. The top four sources of distress were worry, anxiety, fears, and sadness. Age younger than 65 years was significantly associated with a higher DS at presentation (p < 0.003). Among the patients queried before and after MDC (n = 137), a significant reduction in distress was identified (5.58–2.94; p < 0.0005).

Conclusions

Severe distress was found in 66 % of the patients with a recent diagnosis of BC, with younger age related to higher distress scores at presentation. Emotional stressors were the predominant factors accounting for distress. A same-day MDC visit was associated with a significant reduction in DS. These data indicate the importance and feasibility of proactively screening patients. Our research lends support to the value of multidisciplinary evaluation in this setting.

Notes

Disclosures

There are no conflicts of interest.

References

  1. 1.
    SEER Cancer Stat Facts: Female Breast Cancer. National Cancer Institute, Bethesda MD, 2019.Google Scholar
  2. 2.
    Choi EK, Kim IR, Chang O, et al. Impact of chemotherapy-induced alopecia distress on body image, psychosocial well-being, and depression in breast cancer patients. Psychooncology. 2014;23:1103–10.CrossRefGoogle Scholar
  3. 3.
    Antoni MH, Wimberly SR, Lechner SC, et al. Reduction of cancer-specific thought intrusions and anxiety symptoms with a stress management intervention among women undergoing treatment for breast cancer. Am J Psychiatry. 2006;163:1791–7.CrossRefGoogle Scholar
  4. 4.
    Wenzel JA, Griffith KA, Shang J, et al. Impact of a home-based walking intervention on outcomes of sleep quality, emotional distress, and fatigue in patients undergoing treatment for solid tumors. Oncologist. 2013;18:476–84.CrossRefGoogle Scholar
  5. 5.
    Hegel MT, Collins ED, Kearing S, et al. Sensitivity and specificity of the Distress Thermometer for depression in newly diagnosed breast cancer patients. Psychooncology. 2008;17:556–60.CrossRefGoogle Scholar
  6. 6.
    Golden-Kreutz DM, Thornton LM, Wells-Di Gregorio S, et al. Traumatic stress, perceived global stress, and life events: prospectively predicting quality of life in breast cancer patients. Health Psychol. 2005;24:288–96.CrossRefGoogle Scholar
  7. 7.
    Hartl K, Engel J, Herschbach P, et al. Personality traits and psychosocial stress: quality of life over 2 years following breast cancer diagnosis and psychological impact factors. Psychooncology. 2010;19:160–9.CrossRefGoogle Scholar
  8. 8.
    Palesh O, Butler LD, Koopman C, et al. Stress history and breast cancer recurrence. J Psychosom Res. 2007;63:233–9.CrossRefGoogle Scholar
  9. 9.
    Lazenby M, Ercolano E, Grant M, et al. Supporting commission on cancer-mandated psychosocial distress screening with implementation strategies. J Oncol Pract. 2015;11:e413–20.CrossRefGoogle Scholar
  10. 10.
    Zebrack B, Kayser K, Bybee D, et al. A practice-based evaluation of distress screening protocol adherence and medical service utilization. J Natl Compr Cancer Netw. 2017;15:903–12.CrossRefGoogle Scholar
  11. 11.
    Jacobsen PB, Donovan KA, Trask PC, et al. Screening for psychologic distress in ambulatory cancer patients. Cancer. 2005;103:1494–502.CrossRefGoogle Scholar
  12. 12.
    Mitchell AJ. Short screening tools for cancer-related distress: a review and diagnostic validity meta-analysis. J Natl Compr Cancer Netw. 2010; 8: 487–494.CrossRefGoogle Scholar
  13. 13.
    Thalen-Lindstrom A, Larsson G, Hellbom M, et al. Validation of the Distress Thermometer in a Swedish population of oncology patients; accuracy of changes during six months. Eur J Oncol Nurs. 2013;17:625–31.CrossRefGoogle Scholar
  14. 14.
    National Comprehensive Network Cancer Network. NCCN clinical practice guidelines in oncology: distress management V.2. 2013. www.nccn.org. Accessed 5 Apr 2019.
  15. 15.
    Stafford L, Judd F, Gibson P, et al. Screening for depression and anxiety in women with breast and gynaecologic cancer: course and prevalence of morbidity over 12 months. Psychooncology. 2013;22:2071–8.CrossRefGoogle Scholar
  16. 16.
    Chiang AC, Buia Amport S, Corjulo D, et al. Incorporating patient-reported outcomes to improve emotional distress screening and assessment in an ambulatory oncology clinic. J Oncol Pract. 2015;11:219–22.CrossRefGoogle Scholar
  17. 17.
    Acquati C, Kayser K. Predictors of psychological distress among cancer patients receiving care at a safety-net institution: the role of younger age and psychosocial problems. Support Care Cancer. 2017;25:2305–12.CrossRefGoogle Scholar
  18. 18.
    Jorgensen L, Laursen BS, Garne JP, et al. Prevalence and predictors of distress in women taking part in surgical continuity of care for breast cancer: a cohort study. Eur J Oncol Nurs. 2016;22:30–6.CrossRefGoogle Scholar
  19. 19.
    Agarwal J, Powers K, Pappas L, et al. Correlates of elevated Distress Thermometer scores in breast cancer patients. Support Care Cancer. 2013;21:2125–36.CrossRefGoogle Scholar
  20. 20.
    McFarland DC, Shaffer KM, Polizzi H, et al. Prevalence of physical problems detected by the Distress Thermometer and problem list in patients with myeloproliferative disorders. J Natl Compr Cancer Netw. 2017;15:1503–8.CrossRefGoogle Scholar
  21. 21.
    Mertz BG, Bistrup PE, Johansen C, Dalton SO, Deltour I, Kehlet H. Psychological distress among women with newly diagnosed breast cancer. Eur J Oncol Nurs. 2012;16:439–43.CrossRefGoogle Scholar
  22. 22.
    Avis NE, Crawford S, Manuel J. Psychosocial problems among younger women with breast cancer. Psychooncology. 2004;13:295–308.CrossRefGoogle Scholar
  23. 23.
    Castellon S, Ganz PA. Neuropsychological studies in breast cancer: in search of chemobrain. Breast Cancer Res Treat. 2009;116:125–7.CrossRefGoogle Scholar
  24. 24.
    Robbeson C, Hugenholtz-Wamsteker W, Meeus M, et al. Screening of physical distress in breast cancer survivors: concurrent validity of the Distress Thermometer and problem list. Eur J Cancer Care Engl. 2019; 28:e12880.CrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Chelsey C. Ciambella
    • 1
    • 2
    Email author
  • Charu Taneja
    • 2
    • 3
  • Don S. Dizon
    • 2
    • 3
  • Doreen L. Wiggins
    • 2
    • 3
  • Christine M. Emmick
    • 2
    • 3
  • Kara L. Leonard
    • 2
    • 3
  • Mary L. Lopresti
    • 2
    • 3
  • Sabrina Witherby
    • 2
    • 3
  • Diana Cabral
    • 2
    • 3
  • Serena Snow
    • 2
    • 3
  • Theresa A. Graves
    • 2
    • 3
  1. 1.Department of SurgeryBrown University Warren Alpert Medical SchoolProvidenceUSA
  2. 2.Rhode Island HospitalProvidenceUSA
  3. 3.Lifespan Health SystemProvidenceUSA

Personalised recommendations