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CC BY-NC-ND 4.0 · South Asian J Cancer
DOI: 10.1055/s-0042-1756184
Original Article

Assessment of Psychological Distress Among Indian Adolescents and Young Adults with Solid Cancer Using the National Comprehensive Cancer Network Distress Thermometer

Shiv Prasad Shrivastava
1   Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
,
Aditya Elhence
1   Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
,
Prutha Jinwala
1   Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
,
Shashank Bansal
1   Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
,
Prakash Chitalkar
1   Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
,
Shweta Bhatnagar
2   Department of Radiology, CHL Hospital, Indore, Madhya Pradesh, India
,
Rajesh Patidar
1   Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
,
Vikas Asati
1   Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
,
Pradeep Kumar Reddy
3   Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
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Abstract

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Shiv Prasad Shrivastava

Purpose The incidence of cancer has increased in India with a visible impact on the young population (aged 15–39 years). The present study aims to evaluate psychological distress among Indian adolescents and young adults (AYAs) with solid cancer using the National Comprehensive Cancer Network (NCCN) distress thermometer.

Methods The demographic and clinical characteristics of AYAs patients (age 15–39 years) with cancer were recorded. Assessment of psychological distress of patients using the NCCN distress thermometer was performed at three time points over a period of 3 months. Distress thermometer scale and a self-administered questionnaire in English and Hindi languages was handed over to participants at three time points: at treatment commencement (T1), at 1 month, and 3 months (T2 and T3, respectively) into therapy.

Results Of the 259 patients, 63% were women and 37% men; the median age was 34 years. In total, 71 (27%) were ≤ 24 years old and 188 (73%) were>24 years old. Bone sarcoma (39%) was common cancer in AYA patients aged ≤ 24 years and breast cancer (21%) in >24 years of age. The distress scores in both the groups were the highest at diagnosis (T1) followed by that measured at 1 (T2) and 3 months (T3) after diagnosis. The distress score in the age ≤ 24 years was the highest (6.7) at T1, followed by those measured at T2 (2.6) and T3 (1.1) and among age>24 years was the highest (6.6) at T1, followed by those measured at T2 (2.6) and T3 (1.2). Among AYA patients>24 years old, worry, nervousness, sadness, transportation, and sleep were the top five identified problems and in ≤ 24 years old, the top identified problems were worry, financial support, sleep, nervousness, and sadness.

Conclusion Adolescents and young adults experience some level of distress associated with the cancer diagnosis, effects of the disease, treatment regardless of the stage and various transitions throughout the trajectory of the disease. The distress thermometer is an easy and useful tool for the assessment of psychological distress in AYA cancers. Early identification of distress burden with the distress thermometer leads to effective interventions in patients with cancer which could improve outcomes including survival in AYAs with cancer in India.

Keywords

adolescent and young adults - AYAs - Indian - NCCN distress thermometer - psychological distress


Publication History

Article published online:
02 September 2022

© 2022. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 McDonald FEJ, Patterson P, Kim B, White K. Working beyond the patient and cancer for adolescents and young adults. Eur J Cancer Care (Engl) 2018; 27 (06) e12967
    CrossrefPubMedGoogle Scholar
  • 2 Singh R, Shirali R, Chatterjee S, Adhana A, Arora RS. Epidemiology of cancers among adolescents and young adults from a tertiary cancer center in Delhi. Indian J Med Paediatr Oncol 2016; 37 (02) 90-94
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Census of India. Population Enumeration Data; Five-Year Age Group Data C-14 Tables. Accessed January 20, 2022, at: http://www.censusindia.gov.in/2011census/C-series/C-14.html
    Google Scholar
  • 4 GBD 2019 Adolescent Young Adult Cancer Collaborators. The global burden of adolescent and young adult cancer in 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Oncol 2022; 23 (01) 27-52
    CrossrefPubMedGoogle Scholar
  • 5 Daniel CL, Emmons KM, Fasciano K, Fuemmeler BF, Demark-Wahnefried W. Needs and lifestyle challenges of adolescents and young adults with cancer. Clin J Oncol Nurs 2015; 19 (06) 675-681
    CrossrefPubMedGoogle Scholar
  • 6 Adolescents and Young Adults with Cancer; Types of Cancers in Young People.. Accessed January 20, 2022, at: https://www.cancer.gov/types/aya
  • 7 Chao C, Bhatia S, Xu L. et al. Incidence, risk factors, and mortality associated with second malignant neoplasms among survivors of adolescent and young adult cancer. JAMA Netw Open 2019; 2 (06) e195536
    CrossrefPubMedGoogle Scholar
  • 8 Lee JS, DuBois SG, Coccia PF, Bleyer A, Olin RL, Goldsby RE. Increased risk of second malignant neoplasms in adolescents and young adults with cancer. Cancer 2016; 122 (01) 116-123
    CrossrefPubMedGoogle Scholar
  • 9 Chao C, Xu L, Bhatia S. et al. Cardiovascular disease risk profiles in survivors of adolescent and young adult (AYA) cancer: the Kaiser Permanente AYA Cancer Survivors Study. J Clin Oncol 2016; 34 (14) 1626-1633
    CrossrefPubMedGoogle Scholar
  • 10 Olsson M, Enskär K, Steineck G, Wilderäng U, Jarfelt M. Self-perceived physical attractiveness in relation to scars among adolescent and young adult cancer survivors: a population-based study. J Adolesc Young Adult Oncol 2018; 7 (03) 358-366
    CrossrefPubMedGoogle Scholar
  • 11 Duan Y, Wang L, Sun Q. et al. Prevalence and determinants of psychological distress in adolescent and young adult patients with cancer: a multicenter survey. Asia Pac J Oncol Nurs 2021; 8 (03) 314-321
    CrossrefPubMedGoogle Scholar
  • 12 Bellizzi KM, Smith A, Schmidt S. et al; Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) Study Collaborative Group. Positive and negative psychosocial impact of being diagnosed with cancer as an adolescent or young adult. Cancer 2012; 118 (20) 5155-5162
    CrossrefPubMedGoogle Scholar
  • 13 Kent EE, Parry C, Montoya MJ, Sender LS, Morris RA, Anton-Culver H. “You're too young for this”: adolescent and young adults' perspectives on cancer survivorship. J Psychosoc Oncol 2012; 30 (02) 260-279
    CrossrefPubMedGoogle Scholar
  • 14 Holland JC, Bultz BD. National comprehensive Cancer Network (NCCN). The NCCN guideline for distress management: a case for making distress the sixth vital sign. J Natl Compr Canc Netw 2007; 5 (01) 3-7
    CrossrefPubMedGoogle Scholar
  • 15 Cruzado JA, Hernández-Blázquez M. Mental disorder screening on cancer patients before and after radiotherapy and at the 1-month follow-up. Support Care Cancer 2018; 26 (03) 813-821
    CrossrefPubMedGoogle Scholar
  • 16 Kwak M, Zebrack BJ, Meeske KA. et al. Trajectories of psychological distress in adolescent and young adult patients with cancer: a 1-year longitudinal study. J Clin Oncol 2013; 31 (17) 2160-2166
    CrossrefPubMedGoogle Scholar
  • 17 Pelayo-Alvarez M, Perez-Hoyos S, Agra-Varela Y. Reliability and concurrent validity of the Palliative Outcome Scale, the Rotterdam Symptom Checklist, and the Brief Pain Inventory. J Palliat Med 2013; 16 (08) 867-874
    CrossrefPubMedGoogle Scholar
  • 18 Ma X, Zhang J, Zhong W. et al. The diagnostic role of a short screening tool–the distress thermometer: a meta-analysis. Support Care Cancer 2014; 22 (07) 1741-1755
    CrossrefPubMedGoogle Scholar
  • 19 Klaassen Z, Wallis CJD, Goldberg H. et al. The impact of psychiatric utilisation prior to cancer diagnosis on survival of solid organ malignancies. Br J Cancer 2019; 120 (08) 840-847
    CrossrefPubMedGoogle Scholar
  • 20 Massetti GM, Thomas CC, King J, Ragan K, Buchanan Lunsford N. Mental health problems and cancer risk factors among young adults. Am J Prev Med 2017; 53 (3S1): S30-S39
    CrossrefPubMedGoogle Scholar
  • 21 Smith AW, Parsons HM, Kent EE. et al; AYA HOPE Study Collaborative Group. Unmet support service needs and health-related quality of life among adolescents and young adults with cancer: the AYA HOPE study. Front Oncol 2013; 3 (75) 75
    PubMedGoogle Scholar
  • 22 Jörngården A, Mattsson E, von Essen L. Health-related quality of life, anxiety and depression among adolescents and young adults with cancer: a prospective longitudinal study. Eur J Cancer 2007; 43 (13) 1952-1958
    CrossrefPubMedGoogle Scholar
  • 23 Larsson G, Mattsson E, von Essen L. Aspects of quality of life, anxiety, and depression among persons diagnosed with cancer during adolescence: a long-term follow-up study. Eur J Cancer 2010; 46 (06) 1062-1068
    CrossrefPubMedGoogle Scholar
  • 24 Kaul S, Avila JC, Mutambudzi M, Russell H, Kirchhoff AC, Schwartz CL. Mental distress and health care use among survivors of adolescent and young adult cancer: a cross-sectional analysis of the National Health Interview Survey. Cancer 2017; 123 (05) 869-878
    CrossrefPubMedGoogle Scholar
  • 25 Zebrack BJ, Corbett V, Embry L. et al. Psychological distress and unsatisfied need for psychosocial support in adolescent and young adult cancer patients during the first year following diagnosis. Psychooncology 2014; 23 (11) 1267-1275
    CrossrefPubMedGoogle Scholar
  • 26 Chan A, Poon E, Goh WL. et al. Assessment of psychological distress among Asian adolescents and young adults (AYA) cancer patients using the distress thermometer: a prospective, longitudinal study. Support Care Cancer 2018; 26 (09) 3257-3266
    CrossrefPubMedGoogle Scholar
  • 27 Wang YH, Li JQ, Shi JF. et al. Depression and anxiety in relation to cancer incidence and mortality: a systematic review and meta-analysis of cohort studies. Mol Psychiatry 2020; 25 (07) 1487-1499
    CrossrefPubMedGoogle Scholar
  • 28 McFarland DC, Holland JC. The management of psychological issues in oncology. Clin Adv Hematol Oncol 2016; 14 (12) 999-1009
    PubMedGoogle Scholar
  • 29 Chen AY, Newacheck PW. Insurance coverage and financial burden for families of children with special health care needs. Ambul Pediatr 2006; 6 (04) 204-209
    CrossrefPubMedGoogle Scholar
  • 30 Moreno-Smith M, Lutgendorf SK, Sood AK. Impact of stress on cancer metastasis. Future Oncol 2010; 6 (12) 1863-1881
    CrossrefPubMedGoogle Scholar
  • 31 Cleeland CS. Symptom burden: multiple symptoms and their impact as patient-reported outcomes. J Natl Cancer Inst Monogr 2007; (37) 16-21
    CrossrefPubMedGoogle Scholar
  • 32 Smyth EN, Shen W, Bowman L. et al. Patient-reported pain and other quality of life domains as prognostic factors for survival in a phase III clinical trial of patients with advanced breast cancer. Health Qual Life Outcomes 2016; 14: 52
    CrossrefPubMedGoogle Scholar
  • 33 Hata M, Koike I, Miyagi E. et al. Radiation therapy for patients with bone metastasis from uterine cervical Cancer: its role and optimal radiation regimen for palliative care. Anticancer Res 2018; 38 (02) 1033-1040
    Google Scholar
  • 34 Chan A, Lim E, Ng T, Shih V, Quek R, Cheung YT. Symptom burden and medication use in adult sarcoma patients. Support Care Cancer 2015; 23 (06) 1709-1717
    CrossrefPubMedGoogle Scholar
  • 35 Tan CJ, Mah JJJ, Goh WL, Poon E, Harunal Rashid MF, Chan A. Self-reported cognitive outcomes among adolescent and young adult patients with noncentral nervous system cancers. Psychooncology 2020; 29 (08) 1355-1362
    CrossrefPubMedGoogle Scholar