Abstract 5023: Pretreatment blame, physical symptoms, and distress in patients undergoing radiotherapy for head and neck cancer

Abstract

Abstract INTRODUCTION: Head and Neck Cancer (HNC) patients report higher rates of psychiatric morbidity than other cancer patients, suggesting that psychological adjustment is an important component of their quality of life. One factor contributing to patients’ distress is the degree to which they experience physical symptom morbidity. Given that HNC is often attributed to unhealthy lifestyle factors (i.e., tobacco, alcohol, and risky sexual behaviors resulting in HPV), another possible contributor, that has not been studied, is patients’ attributions of self-blame regarding their disease cause. The objective of this study was to explore the associations between lifestyle factors, symptoms, self-blame, and distress in this population. Understanding these potential interactions may provide targets for future psychosocial interventions. METHODS: Data for this exploratory study was collected from a cross-sectional survey of 70 HNC patients (87 % male; 63% oropharyngeal) prior to the initiation of radiotherapy. RESULTS: In terms of lifestyle factors, 70% of patients had a tobacco history and 7% had screening scores indicative of alcohol dependence as measured by the AUDIT; 61 % of the oropharyngeal patients were HPV positive. Behavioral self-blame was significantly greater among patients with a history of tobacco use (t(66) = 2.52, p = 0.01) and characterological self-blame was highest among patients with HPV positive tumors (t(66) = 2.28, p = 0.03). Although patient distress (BSI-18) was significantly associated with higher levels of cancer symptom severity (p = 0.0001) and interference (p = 0.0001), as measured by the MDASI-HN, the association of distress with blame also approached significance (p < 0.10). CONCLUSION: Results suggest that blame is prevalent in head and neck cancer patients and is related to lifestyle factors that may have caused the disease. The finding that patient distress was associated with both symptom severity and self-blame is interesting and suggests that psychosocial interventions should not only address patients’ current level of symptoms but also their attributions of blame regarding the cause of their disease. Our future work will prospectively examine whether changes in symptoms and blame affect the course of distress in this vulnerable population. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5023. doi:10.1158/1538-7445.AM2011-5023