Sarah J Cunningham1, Michaela Patton2, Fiona Schulte2,3,4, Patricia A Richardson5,6, Lauren C Heathcote1. 1. Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA. 2. Department of Psychology, University of Calgary, Calgary, Alberta, Canada. 3. Department of Oncology, University of Calgary, Calgary, Alberta, Canada. 4. Alberta Children's Hospital, Calgary, Alberta, Canada. 5. Departments of Pediatric Psychology and Pediatric Pain and Palliative Medicine, Helen DeVos Children's Hospital, Grand Rapids, Michigan, USA. 6. Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, East Lansing, Michigan, USA.
Abstract
OBJECTIVE: Somatic symptoms (e.g., pain, fatigue) are common after childhood cancer and are associated with greater fear of cancer recurrence and poorer health-related quality of life (HRQoL). Qualitative studies indicate that survivors of childhood cancer (SCCs) worry about somatic symptoms as indicating cancer recurrence, which could in part explain associations between symptoms and poorer psychosocial outcomes. However, the prevalence, characteristics, and impact of symptom worry has not been quantitatively studied. METHODS: SCCs (N = 111; 52% female; Mage at study = 17.67 years, range = 8-25 years; Mage at diagnosis = 6.70 years) across a variety of diagnoses were recruited from a pediatric cancer center in Canada and completed self-report measures of symptom worry, symptom frequency, general anxiety, fear of cancer recurrence, and HRQoL. RESULTS: A majority (62%) of SCCs worried about at least one symptom as a sign of recurrence. Pain was the most worrisome symptom, but SCCs also reported worrying about symptoms that are rarely associated with cancer recurrence such as hunger, dizziness, and feeling cold. Symptom worry was more strongly associated with fear of cancer recurrence than the mere frequency of those symptoms, and this relationship held while controlling for treatment factors and general anxiety. Symptom worry and frequency each explained unique variance in HRQoL. CONCLUSIONS: Worry about somatic symptoms as a sign of cancer recurrence is common and may be impactful after childhood cancer. Excessive worry about somatic symptoms could be an important target to reduce fear of recurrence and increase HRQoL in SCCs.
OBJECTIVE: Somatic symptoms (e.g., pain, fatigue) are common after childhood cancer and are associated with greater fear of cancer recurrence and poorer health-related quality of life (HRQoL). Qualitative studies indicate that survivors of childhood cancer (SCCs) worry about somatic symptoms as indicating cancer recurrence, which could in part explain associations between symptoms and poorer psychosocial outcomes. However, the prevalence, characteristics, and impact of symptom worry has not been quantitatively studied. METHODS: SCCs (N = 111; 52% female; Mage at study = 17.67 years, range = 8-25 years; Mage at diagnosis = 6.70 years) across a variety of diagnoses were recruited from a pediatric cancer center in Canada and completed self-report measures of symptom worry, symptom frequency, general anxiety, fear of cancer recurrence, and HRQoL. RESULTS: A majority (62%) of SCCs worried about at least one symptom as a sign of recurrence. Pain was the most worrisome symptom, but SCCs also reported worrying about symptoms that are rarely associated with cancer recurrence such as hunger, dizziness, and feeling cold. Symptom worry was more strongly associated with fear of cancer recurrence than the mere frequency of those symptoms, and this relationship held while controlling for treatment factors and general anxiety. Symptom worry and frequency each explained unique variance in HRQoL. CONCLUSIONS: Worry about somatic symptoms as a sign of cancer recurrence is common and may be impactful after childhood cancer. Excessive worry about somatic symptoms could be an important target to reduce fear of recurrence and increase HRQoL in SCCs.
Keywords:
Psycho-Oncology; adolescent and young adult; cancer; cancer survivors; childhood cancer; fear of cancer recurrence; oncology; somatic symptoms; symptom burden
Authors: Perri R Tutelman; Christine T Chambers; Laura Cornelissen; Conrad V Fernandez; Annette Flanders; Julia MacLeod; Simon B Sherry; Sherry H Stewart; Robin Urquhart; Sitara de Gagne; Gregory M T Guilcher; Javeria Hashmi; Lauren C Heathcote; Melanie Noel; Fiona S M Schulte; Jennifer N Stinson; Maya Stern Journal: Pain Date: 2021-09-25 Impact factor: 7.926
Authors: Lauren C Heathcote; Sarah J Cunningham; Sarah N Webster; Vivek Tanna; Elia Mattke; Nele Loecher; Sheri L Spunt; Pamela Simon; Gary Dahl; Marta Walentynowicz; Elizabeth Murnane; Perri R Tutelman; Lidia Schapira; Laura E Simons; Claudia Mueller Journal: Psychooncology Date: 2022-04-25 Impact factor: 3.955