"Impact of Baseline Emotional Distress on Long-Term Quality of Life in " by Kimberly Oslin, Eric Adjei Boakye et al.
 

Document Type

Conference Proceeding

Publication Date

5-2024

Abstract

Introduction: Psychosocial symptoms (e.g., emotional distress, anxiety, and depression) are under-recognized and undertreated in patients diagnosed with cancer. Head and neck cancer (HNC) patients are particularly vulnerable to poor psychosocial health due to the often disfiguring and permanently life-altering nature of HNC treatment. Prior research suggests that psychosocial symptoms contribute to poor quality of life in HNC patients. However, the association between precancer treatment anxiety and depression on quality of life after HNC treatment is unknown. This study examined the associations between pre-treatment anxiety and depression and long-term quality of life among patients with HNC. Methods: This is a retrospective study of patients diagnosed with HNC (between 2015 and 2022) who engaged in psychosocial evaluation with psych-oncology at a tertiary care center in the Midwest prior to treatment. Data was collected through two surveys, the Hospital Anxiety and Depression Scale (HADS) and the Functional Assessment of Cancer Therapy – Head & Neck (FACT-HN). HADS is a self-reported screening questionnaire for emotional distress, and FACT-HN is a patient-reported instrument that assesses physical, social/family, emotional, and functional well-being as well as HNC-specific symptoms. The exposure variables were the two HADS 7-item subscales that measure depressive (HADS-D) and anxious (HADS-A) symptoms in the prior week, which were collected during the pretreatment evaluation. We classified the scores as normal (0–7) vs. mild/moderate/severe (8–21). The outcome variables were the FACT-HN subscales (i.e., social/familial, emotional, functional, and physical well-being) collected during follow-up (i.e., 2-3 years after cancer diagnosis). Mann-Whitney U tests were used to examine the association between HADS-D and HADS-A and each of the four FACT-HN subscales. Results: This study included 47 patients who presented for their two- or three-year follow-up with a median age of 65.5 years. Of the 47 patients, 12.8% reported mild to severe depressive symptoms and 23.4% mild to severe anxious symptoms prior to treatment. The median social/familial well-being score was 24.5 (IQR=21.0-26.0), emotional well-being was 19.0 (IQR=14.0-20.0), functional well-being was 21.0 (IQR=13.0-26.0) and physical well-being was 26.0 (IQR=20.0-28.0). In bivariate analyses, there were statistically significant associations between HADS-A and physical (P< 0.0001), emotional (P=0.0003), and functional (P=0.0098) well-being. Patients with mild to severe anxiety reported worse physical (median=18.0 vs. 27.0), emotional (12.0 vs. 19.6), and functional (13.0 vs. 22.5) well-being than those that reported no anxiety. HADS-D was significantly associated with physical (P=0.0067) and functional (P=0.0558) well-being. Patients who experienced mild to severe depression reported worse physical (19.0 vs. 27.0) and functional (10.0 vs. 22.0) well-being than those that reported no depression. Conclusions: Patients with higher anxiety and depression prior to HNC treatment were found to have worse self-reported physical and functional well-being even two or three years from the end of their treatment. Additionally, higher pretreatment anxiety was associated with poorer posttreatment emotional well-being. These results highlight the urgent need for psychosocial assessment and care to optimize HNC outcomes, such as quality of life, especially in patients identified to be at risk prior to treatment.

First Page

44

Last Page

45

Comments

American Head and Neck Society AHNS 2024 Annual Meeting, May 15-16, 2024, Chicago, IL

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