Irèn Kossintseva1, David Zloty. 1. *Both authors are affiliated with the Department of Dermatology & Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
BACKGROUND: Patients undergoing Mohs micrographic surgery (MMS) exhibit anxiety relating to cancer cure or the expected cosmetic outcome. OBJECTIVE: To obtain quantitative measurements of perioperative cancer and cosmetic anxiety levels in first-time MMS patients. Parameters influencing anxiety and its natural course were assessed. METHODS: Prospective, single-blinded, questionnaire study of 173 patients undergoing MMS of the face. Anxiety levels were assessed using a visual analog scale preoperatively and postoperatively over 6 months. RESULTS: Mohs patients demonstrate a trend to greater or equal anxiety about cancer over cosmesis at all measured time points, but differences only reached statistical significance beginning 1 week postoperatively. Clinically relevant lowering of cancer anxiety levels is delayed until 3 months postoperatively. Cosmetic anxiety reaches a clinically relevant improvement by 1 week. The intuitive predictors of cosmetic anxiety, namely female gender and younger age, were quantitatively reinforced in this study. The predictor of cancer anxiety was the use of preoperative lorazepam. CONCLUSION: To maximize patient care, Mohs surgeons must be aware of covert patient anxieties and the parameters, which influence these anxieties. Identifying and anticipating the course of cancer- and cosmetic-related anxieties will reduce patient fears, improving their satisfaction with the MMS experience.
BACKGROUND:Patients undergoing Mohs micrographic surgery (MMS) exhibit anxiety relating to cancer cure or the expected cosmetic outcome. OBJECTIVE: To obtain quantitative measurements of perioperative cancer and cosmetic anxiety levels in first-time MMS patients. Parameters influencing anxiety and its natural course were assessed. METHODS: Prospective, single-blinded, questionnaire study of 173 patients undergoing MMS of the face. Anxiety levels were assessed using a visual analog scale preoperatively and postoperatively over 6 months. RESULTS: Mohs patients demonstrate a trend to greater or equal anxiety about cancer over cosmesis at all measured time points, but differences only reached statistical significance beginning 1 week postoperatively. Clinically relevant lowering of cancer anxiety levels is delayed until 3 months postoperatively. Cosmetic anxiety reaches a clinically relevant improvement by 1 week. The intuitive predictors of cosmetic anxiety, namely female gender and younger age, were quantitatively reinforced in this study. The predictor of cancer anxiety was the use of preoperative lorazepam. CONCLUSION: To maximize patient care, Mohs surgeons must be aware of covert patientanxieties and the parameters, which influence these anxieties. Identifying and anticipating the course of cancer- and cosmetic-related anxieties will reduce patient fears, improving their satisfaction with the MMS experience.
Authors: Ethan Walker; Yiqiao Liu; InYoung Kim; David L Wilson; James P Basilion; Daniel L Popkin; Mark Biro; Sukanya Raj Iyer; Harib Ezaldein; Jeffrey Scott; Miesha Merati; Rachel Mistur; Bo Zhou; Brian Straight; Joshua J Yim; Matthew Bogyo; Margaret Mann Journal: Cancer Res Date: 2020-03-04 Impact factor: 12.701
Authors: Mark Biro; InYoung Kim; Andrea Huynh; Pingfu Fu; Margaret Mann; Daniel L Popkin Journal: J Am Acad Dermatol Date: 2019-06-01 Impact factor: 11.527