Assessment of anxiety and depression and selected psychosocial variables in cancer patients. / Ocena zwiazku leku i depresji oraz wybranych zmiennych psychospolecznych u pacjentów onkologicznych.

OBJECTIVES: Assessment of anxiety-depressive disorders in an oncologically ill patient may help in the treatment process and planning psycho-oncological care. The aim of the study was to assess the level of anxiety and depression and selected psychosocial variables in cancer patients. METHODS: The study group consisted of cancer patients eligible for causal treatment for at least 6 weeks. The HADS questionnaire was used to examine 537 patients aged 19 to 91 (average age: 53.5). RESULTS: Both during the first oncological treatment and in the relapse of the disease, patients more often show symptoms of anxiety than depression. These conditions occur with greater intensity in women than in men (p=0.000), moreover, the risk of depressive disorders increases with the patient's age (p=0.015). The highest intensity of symptoms of depression was observed in patients living in the countryside and in people on disability or retirement pension, and the lowest in small and medium-sized towns and in people who were economically active or on short sick leave. On the other hand, the simultaneous occurrence of anxiety and depression was distinctive for the patients with breast and reproductive organs cancers, which were least frequently reported by patients with urinary tract cancers. CONCLUSIONS: Tools for screening the risk of depression and anxiety disorders should be used routinely during regular medical consultations in a patient with cancer. This will allow for early detection of symptoms and initiation of therapeutic measures.

Assessment of quality of life in patients surgically treated for penile cancer: Impact of aggressiveness in surgery.

PURPOSE: Health-related quality of life (HRQoL) evaluations are being increasingly used for clinical assessment of cancer treatment outcomes. For a patient, not only is life expectancy important, but also a general sense of sustained global health. Intuitively, the more disfiguring the treatment, the more pronounced could be the deterioration in the QoL. We aimed to compare various aspects of QoL in three groups of patients surgically treated for penile cancer by local excision, partial penectomy, or total penectomy. METHODS: HRQoL was assessed in 51 patients surgically treated for penile cancer. Total penectomy, partial penectomy, or wide local excision was performed in 11, 27, and 13 patients, respectively. The EORTC QLQ-C30 questionnaire was used for HRQoL assessment. Relations between the patients and their partners were also assessed. RESULTS: Statistically significant negative correlation was found between aggressiveness of the surgical procedure and both, assessment of global health status (p = 0.04) and physical functioning (p = 0.047). The more aggressive the surgery, the lower was the patients' assessment of their QoL. Among the patients who maintained their partner relations postsurgery, 58.9% declared that their relations postoperatively were not inferior compared to those preoperatively. There was no statistically significant effect of the surgery type on relations with female partners (p = 0.619). CONCLUSION: The magnitude of disfigurement caused by surgical treatment of penile cancer had a significant impact on the selected QoL domains assessed by the EORTC QLQ C-30 questionnaire. There was no correlation between the scope of surgical intervention and partner relations.

Basic methods for the assessment of health-related quality of life in uro-oncological patients.

BACKGROUND: The evaluation of patients' expectations and quality of life in uro-oncology is considered an important outcome of treatment efficacy and satisfaction. Aim of this systematic review was to evaluate the most frequently adopted tools in uro-oncology to assess Health Related Quality of Life (HRQoL). EVIDENCE ACQUISITION: A systematic literature search until October 2015 was performed on MEDLINE, Cochrane Library, PubMed combining the following terms: "quality of life," "health-related quality of life," "kidney cancer," "bladder cancer," "prostate cancer." Additional references were obtained from the reference list of full-text manuscripts. Data were synthesized using meta-analytic methods conformed to the PRISMA statement. EVIDENCE SYNTHESIS: HRQoL is a fundamental step in evaluating treatment outcome in patients with urological cancers. HRQoL is mostly measured through several questionnaires, which are generally categorized in generic questionnaires, exploring the patient's well-being en bloc; specific questionnaires, assessing each single domain of health status; and uro-oncological specific questionnaires, mainly characterized by a modular approach. Although different questionnaires have been proposed and validated, the standard method to be adopted in urology is far from the solution and further studies should investigate the strength and weakness of the different questionnaires. CONCLUSIONS: HRQoL questionnaires should become a standard method to evaluate medical/surgical outcomes in uro-oncology. Their implementation may significantly improve patients' satisfaction and help physicians in the decision-making process and possibly reduce health care costs.

Quality of life in penile carcinoma patients - post-total penectomy.

INTRODUCTION: Total amputation, as a treatment for advanced penile cancer, significantly debilitates the patient's quality of life and sexual function. The aim of the study was to assess the quality of life in patients who had undergone total penectomy. MATERIAL AND METHODS: The questionnaires EORTC QLQ C-30, SES, CMNI, and a modified IIEF-15 questionnaire, were sent to 11 patients. RESULTS: A total of 10 patients returned the questionnaires completed. The results of the overall quality of life, the median result in individual domains, as assessed by the EORT QLQ C-30 questionnaire, were clearly lower than the reference results. There were statistically significant differences in the results of the QLQ C-30, concerning the role-functioning domain in relation to age (p = 0.008) and education (p = 0.032), in the domain of emotional functioning in relation to education (p = 0.008) and in the domains of physical functioning in relation to the partner relationship (p = 0.032). A significant number of patients were sexually inactive. Sexual activity as defined by touching the area of the pubic symphysis at the scars of the penis, touching and fondling perianal areas or the scrotum and watching things/people that cause excitement was observed in 2/10, 1/10 and 2/10 of patients respectively. In 5/6 of these patients, partnership relationships did not deteriorate, including one patient for whom the relationship actually improved. CONCLUSIONS: The results obtained indicate that total amputation of the penis significantly affects one's sex life and overall quality of life. However, this does not have negative implications in terms of partnership relations, self-assessment or the evaluation of masculinity.

Anxiety and depression and cognitive coping strategies and health locus of control in patients with ovary and uterus cancer during anticancer therapy.

AIM OF THE STUDY: The crisis associated with cancer may contribute to the development of anxiety and depressive disorders. Contemporary psycho-oncology focuses on the psychological determinants of the cancer patients functioning to find which disease-coping strategies help the healing process, facilitate the establishment of a good therapeutic relationship and the process of adapting to difficult situations. Aim of the study was assess the psychological functioning of patients with cancer of reproductive organs in the cancer-treating process. The practical aim was to develop guidelines for psychological care dedicated to this group of patients. MATERIAL AND METHODS: The study was conducted in the Reproductive Organs Cancer Clinic in Institute of Oncology in Warsaw using a questionnaire consisting of: Demographic, Hospital Anxiety and Depression Scale (HADS), Multidimentional Health Locus of Control (MHLC), Cognitive Emotions Regulations Questionaire (CERQ). RESULTS: Seventy-eight patients aged 22 to 82 (average 54) were examined. Investigation of relationships between anxiety and depression and coping strategies showed: positive correlation of anxiety with self blame and rumination, positive correlation of anxiety and depression with catastrophizing, positive correlation of depression with blaming others, negative correlation of anxiety and depression with acceptance and positive refocusing, negative correlation of depression with refocus of planning and putting into perspective. CONCLUSIONS: The results of this study indicate that there may be an indirect method of diagnosing anxiety and depression disorders in cancer patients by observing the coping strategies to cope with the difficult situation.

Anxiety and depression, cognitive coping strategies, and health locus of control in patients with digestive system cancer.

INTRODUCTION: Contemporary psycho-oncology focuses on the study of the psychological determinants of the functioning of cancer patients. Among the psychological factors that significantly affect the functioning of the patients are anxiety and depressive disorders. AIM: To assess the psychological functioning of patients with digestive system cancer in the cancer-treating process and to develop guidelines for psychological care dedicated to this group of patients based on the results of the study. MATERIAL AND METHODS: A total of 69 patients aged 23 to 91 (average 56) years with digestive system cancer treated in the Gastroenterology Cancer Clinic in the Institute of Oncology in Warsaw were examined using HADS, Mini-MAC, and MHLC. The results were analysed using statistical tests and correlation analysis. Another 532 patients from other wards formed the reference group. RESULTS: Measured HLC, anxiety, and depression did not differ significantly from the overall patient population. The investigation of the relationships between anxiety and depression and mental adjustment to cancer showed a positive correlation between anxiety and depression and anxious preoccupation and hopelessness-helplessness, and negative correlation between anxiety and depression and fighting spirit. CONCLUSIONS: The obtained research results on the correlation of anxiety and depression with health locus of control show that the lower the severity of anxiety and depression, the higher the severity of internal health locus of control. The results confirm the necessity of psychological support forcancer patients showing evidence of destructive attitudes and external health locus of control, so that the severity of anxiety-depressive disorders can indirectly be reduced.