Article

Psychological stress and melanoma: Are we meeting our patients' psychological needs?

School of Women's and Children's Health, Faculty of Medicine, University of New South Wales. Old CCIA Building, Level 0, Sydney Children's Hospital, High Street, Randwick, NSW 2031, Australia. Electronic address: .
Clinics in dermatology (Impact Factor: 2.47). 01/2013; 31(1):41-6. DOI: 10.1016/j.clindermatol.2011.11.005
Source: PubMed

ABSTRACT

Approximately 30% of all patients diagnosed with melanoma report levels of psychological distress indicative of the need for clinical intervention. Despite this, the psychological and emotional needs of patients frequently go undetected and unmet. This contribution aims to provide clinicians and researchers with a succinct update on our understanding of the psychosocial challenges faced by individuals with melanoma. There is now strong evidence that psychological interventions can improve psychosocial outcomes for patients with melanoma, including reductions in general mood disturbance, depression, and anxiety. Further prospective cohort studies are required for a better understanding of the impact of psychological stress on melanoma survival and recurrence, as well as the potential psycho-neuro-immunological mechanisms involved.

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    • "The most commonly reported psychological comorbidities in melanoma patients are anxiety and depression [39] [40] [41]. Even though the true association between psychological stress, coping and melanoma survival or recurrence is uncertain [42], psychological distress in general has been related with patient delay in seeking medical advice [43] [44] decreased adherence to treatment regimes [45], lower health-related quality of life [46], greater medical costs [47] [48] and reduced engagement in post-treatment screening and preventive behaviours [49]. In the surveyed sub-cohort of melanoma patients, anxiety, depression and QoL mean scores were found to be comparable to the general population. "
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    ABSTRACT: Patient numbers requiring long-term melanoma surveillance are constantly rising. Surveillance is costly and guideline recommendations vary substantially. In this German nationwide study, information on surveillance and treatment of patients diagnosed with melanoma and melanoma in situ (MMis) between April and June 2008 was prospectively collected over four years. Additionally, patient self-report questionnaires were evaluated to assess anxiety, depression, health-related quality of life, socio-demographic information and use of disease specific health information sources at year 4 after primary diagnosis. Complete data was available for 668 patients from 67 centres, of whom 96.0% were in regular melanoma surveillance. In year 3-4 of surveillance, only 55.6% of locoregionary metastases were detected during surveillance visits. Only 33.3% were self-detected by the patient even though 69.4% were documented as being clinically visible or palpable. Costs of 4year surveillance of 550 patients without tumour recurrence (stage I-IIC and MMis) accumulated to 228,155.75 €. Guideline-adherence for follow-up frequency, lymph node ultrasound, S100 serum level tests and diagnostic imaging recommendations was approximately 60% in year 3-4 of surveillance. Multivariate regression analysis showed that certain patient/tumour characteristics and regional differences were significantly associated with guideline deviations. The percentage of patients who exceeded published cut-off scores indicating clinically relevant symptoms of anxiety and depression were significantly increased. Patients frequently reported lack of psychosocial support and education but ascribed great importance to these. We recommend further reduction of melanoma follow-up in low-risk melanoma patients and improvement of psycho-social support and patient education for all melanoma patients. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Jan 2015 · European journal of cancer (Oxford, England: 1990)
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    • "The most commonly reported psychological comorbidities in melanoma patients are anxiety and depression [39] [40] [41]. Even though the true association between psychological stress, coping and melanoma survival or recurrence is uncertain [42], psychological distress in general has been related with patient delay in seeking medical advice [43] [44] decreased adherence to treatment regimes [45], lower health-related quality of life [46], greater medical costs [47] [48] and reduced engagement in post-treatment screening and preventive behaviours [49]. In the surveyed sub-cohort of melanoma patients, anxiety, depression and QoL mean scores were found to be comparable to the general population. "
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    ABSTRACT: BACKGROUND: Patient numbers requiring long-term melanoma surveillance are constantly rising. Surveillance is costly and guideline recommendations vary substantially. METHODS: In this German nationwide study, information on surveillance and treatment of patients diagnosed with melanoma and melanoma in situ (MMis) between April and June 2008 was prospectively collected over four years. Additionally, patient self-report questionnaires were evaluated to assess anxiety, depression, health-related quality of life, socio-demographic information and use of disease specific health information sources at year 4 after primary diagnosis. RESULTS: Complete data was available for 668 patients from 67 centres, of whom 96.0% were in regular melanoma surveillance. In year 3-4 of surveillance, only 55.6% of locoregionary metastases were detected during surveillance visits. Only 33.3% were self-detected by the patient even though 69.4% were documented as being clinically visible or palpable. Costs of 4year surveillance o
    Full-text · Article · Jan 2015 · European Journal of Cancer
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    ABSTRACT: The aim of this study was to examine the quality of life (QoL) in 40 Croatian metastatic melanoma patients who had completed at least first-line treatment and to see if there was a correlation between QoL parameters and serum lactate dehydrogenase (LDH). LDH levels were measured and all patients clinically examined between April and September 2013. Two QoL questionnaires were used for patient self-evaluation: the European Organization for Research and Treatment of Cancer Quality of life Questionnaire (EORTC QLQ-C30) and the Dartmouth Primary Care Cooperative Re-search Network and the World Organization of National Colleges, Academies, and Academic Associations of General Practitioners/Family Physicians (COOP/WONCA) charts. The average EORTC QLQ-C30 score for global health status (GHS) was 41.204. The average scores for functional scales were high, with the exception of emotional functioning (65.02). Blood LDH levels positively correlated with the Eastern Cooperative Oncology Group (ECOG) status (r=0.415; p<0.01) and pain (r=0.345; p<0.05), but not with any functional or COOP/WONCA scores. Global health status (GHS) positively correlated with patient age at the time of evaluation (r=0.386; p<0.05) and age at the time when metastatic disease had been diagnosed (r=0.366; p<0.05). Quality of life for the studied group of metastatic melanoma patients in Croatia can be considered generally weak, with the exception of emotional functioning and symptoms of fatigue, dispnoea, insomnia, and financial difficulties.
    Full-text · Article · Mar 2014 · Collegium antropologicum
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