Distress Levels and Cancer-Related Items of Concern in Brain Tumor Population

By Stephen T. Keir

Distress is a major concern for cancer patients. Patients with brain tumors are particularly at risk for elevated levels of stress because of the severe functional, cognitive and neuropsychological symptoms of the disease. Distress is defined as a mentally or emotionally disruptive condition that occurs in response to adverse external influences. It is capable of affecting the physical and emotional health of the individual. Research shows that distress can lead to worry, sadness, anxiety and depression. Physically, stress has been linked to headaches, heart palpitations, sleep disturbances, fatigue, sexual dysfunction, and lowered immune function.  A better understanding of the levels and sources of distress experienced by this population could lead to the development of effective interventions to improve survivor quality of life. 

A study at The Tug McGraw Research Center in the Preston Robert Tisch Brain Tumor Center at Duke University assessed brain tumor patients using the Distress Thermometer, a tool developed by the National Comprehensive Cancer Network (NCCN) to quickly identify the extent and cause of distress. The Distress Thermometer is a visual scale on which the patient indicates his level of distress from “0” (none) to “10” (extreme). The midpoint, “5” indicates moderate stress. Results showed that 48% of patients reported low distress intensity, 41% reported moderate, and 11% reported high.

Using a list of possible concerns, patients identified a number of common items including fatigue (56%), worry (49%), skin dry/itchy (37%), memory/cognition (36%).  changes in sleep (32%), nervousness (31%), sadness (27%), nose dry/congested (27%), and sexual problems (25%). This research can be used to guide the design of supportive care interventions to address these specific sources of distress.  In addition, brain tumor patients on average reported more concerns (5.8) than the general cancer population (4.7).  This again indicates that brain tumor patients may be at increased risk for experiencing distress as compared to the general cancer population.

Abstract presented at The Duke Comprehensive Cancer Center 2007 Annual Meeting in Durham, North Carolina.