Long-term survivors of adult cancers are almost twice as likely to report psychological distress severe enough to cause moderate to serious problems functioning in social, work or school situations, compared to the general population, according to a large, national study presented September 24, 2008, at the American Society for Therapeutic Radiology and Oncology’s 50th Annual Meeting in Boston.
Findings also show that younger long-term cancer survivors—those less than 65 years old—were more likely to experience severe psychological distress than survivors aged 65 and older. The study also found that there was no difference in the number of years since the cancer diagnosis and the increased risk of distress. Long-term cancer survivors are individuals who have lived 5 years or more beyond their initial cancer diagnosis.
“We hope these findings will raise awareness of the psychosocial needs of long-term cancer survivors and encourage routine psychological screening of these survivors,” Karen Hoffman, md, lead author of the study and a radiation oncologist at the Harvard Radiation Oncology Program at Harvard Medical School in Boston, said. “Quick, low-cost psychological screening tests are available that can and should be performed during clinic visits.”
12 Million US Survivors
There are an estimated 12 million cancer survivors living in the United States. These survivors may face many stresses as a result of their cancer experience, including adjustment to physical disabilities, changes in their social support system, and fear of the cancer returning or of dying from cancer. Researchers identified individuals with severe psychological distress based on how frequently they felt nervous, restless, hopeless, worthless, and that everything was an effort.
The study involved 4,712 long-term survivors of adult-onset cancer and 126,841 respondents never diagnosed with cancer using the 2002–2006 National Health Interview Survey, an in-person health survey of the US population. Among survivors, the mean age at cancer diagnosis was 47 years and the mean age at the interview time was 62 years. The majority were survivors of breast, gynecologic, male genitourinary, and colorectal cancer.
Cancer survivors were more likely to report severe psychological distress than adults never diagnosed with cancer. In addition to other findings, the investigation revealed that survivors who were not married or living with a partner, had less than a high school education, were uninsured, were current or former smokers, or had difficulty with instrumental activities of daily living were more likely to experience severe distress than those without these characteristics.
A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
