Vanessa L Beesley1, B Mark Smithers2, Kiarash Khosrotehrani3,4, Mohsina Khatun5, Peter O'Rourke5, Maria Celia B Hughes6, Maryrose K Malt6, Mark J Zonta7, Gerard J Bayley2,8, Andrew P Barbour2, Lee J Brown9, Justin D'Arcy10, Christopher P Allan2,11, Adèle C Green6,12. 1. Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. 2. Queensland Melanoma Project, Discipline of Surgery, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia. 3. Experimental Dermatology Group, Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia. 4. Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia. 5. Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. 6. Cancer and Population Studies group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. 7. The Townsville Hospital, Townsville, QLD, Australia. 8. Phoenix Plastic Surgery Institute, Brisbane, QLD, Australia. 9. Kawana Private Hospital, Sunshine Coast, QLD, Australia. 10. Nambour General Hospital, Nambour, QLD, Australia. 11. Mater Health Services, Brisbane, QLD, Australia. 12. Institute of Inflammation and Repair, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Abstract
OBJECTIVE: The aim of this paper is to determine levels of supportive care needs, anxiety, depression and symptoms amongst patients newly diagnosed with localised invasive primary melanoma and if these varied amongst patients who had a sentinel lymph node biopsy (SLNB). We also considered quality of life compared with general population norms. METHODS: Patients newly diagnosed with clinical stage IB-II invasive melanoma were ascertained through Queensland hospitals, specialist clinics and pathology laboratories. Validated surveys measured 46 need items (Supportive Care Needs Survey-Short Form + melanoma subscale), anxiety and depression (Hospital Anxiety and Depression Scale) and quality of life and symptoms (Functional Assessment of Cancer Therapy-Melanoma). Regression models compared outcomes according to whether or not participants had a SLNB. RESULTS: We surveyed 386 patients, 155 before and 231 after wide local excision, of whom 46% reported ≥1 moderate-level or high-level unmet need. The three highest needs were for help with fears about cancer spreading (17%), information about risk of recurrence (17%) and outcomes when spread occurred (16%). Those who had a SLNB were more likely to report a moderate or high unmet need for help with uncertainty about the future or with lymphoedema (p < 0.05). Overall, 32% of participants had anxiety and 15% had depression regardless of performance of SLNB. Melanoma-specific symptoms were worse in SLNB patients (p = 0.03). Compared with the general population, emotional well-being was lower amongst melanoma patients. CONCLUSIONS: A substantial proportion of newly diagnosed patients with localised invasive melanoma need further melanoma-specific information and support with psychological concerns. Patients who have a SLNB clear of disease may need help with symptoms after surgery.
OBJECTIVE: The aim of this paper is to determine levels of supportive care needs, anxiety, depression and symptoms amongst patients newly diagnosed with localised invasive primary melanoma and if these varied amongst patients who had a sentinel lymph node biopsy (SLNB). We also considered quality of life compared with general population norms. METHODS:Patients newly diagnosed with clinical stage IB-II invasive melanoma were ascertained through Queensland hospitals, specialist clinics and pathology laboratories. Validated surveys measured 46 need items (Supportive Care Needs Survey-Short Form + melanoma subscale), anxiety and depression (Hospital Anxiety and Depression Scale) and quality of life and symptoms (Functional Assessment of Cancer Therapy-Melanoma). Regression models compared outcomes according to whether or not participants had a SLNB. RESULTS: We surveyed 386 patients, 155 before and 231 after wide local excision, of whom 46% reported ≥1 moderate-level or high-level unmet need. The three highest needs were for help with fears about cancer spreading (17%), information about risk of recurrence (17%) and outcomes when spread occurred (16%). Those who had a SLNB were more likely to report a moderate or high unmet need for help with uncertainty about the future or with lymphoedema (p < 0.05). Overall, 32% of participants had anxiety and 15% had depression regardless of performance of SLNB. Melanoma-specific symptoms were worse in SLNB patients (p = 0.03). Compared with the general population, emotional well-being was lower amongst melanomapatients. CONCLUSIONS: A substantial proportion of newly diagnosed patients with localised invasive melanoma need further melanoma-specific information and support with psychological concerns. Patients who have a SLNB clear of disease may need help with symptoms after surgery.
Authors: David Levy; Haryana M Dhillon; Anna Lomax; Michael Marthick; Catriona McNeil; Steven Kao; Judith Lacey Journal: Support Care Cancer Date: 2018-09-04 Impact factor: 3.603
Authors: Lahiru Russell; Anna Ugalde; Donna Milne; Meinir Krishnasamy; Eric O Seung Chul; David W Austin; Richard Chambers; Liliana Orellana; Patricia M Livingston Journal: Trials Date: 2018-04-13 Impact factor: 2.279
Authors: Tavis Read; Scott Webber; Janine Thomas; Michael Wagels; Helmut Schaider; H Peter Soyer; B Mark Smithers Journal: BMJ Open Date: 2017-10-06 Impact factor: 2.692
Authors: Vanessa L Beesley; B Mark Smithers; Peter O'Rourke; Monika Janda; Kiarash Khosrotehrani; Adèle C Green Journal: Support Care Cancer Date: 2016-08-25 Impact factor: 3.603