Biopsychosocial distress assessment among testicular cancer survivors (TCS) using electronic patient reported outcomes (PROs).

Abstract

204 Background: Distressis a frequently endorsed experience by cancer patients.Many organizations advocate formal distress screening as part of clinical care in order to better meet the “psychological, social, and/or spiritual needs of patients that may interfere with the ability to cope effectively with cancer, its physical symptoms, and its treatments.” The primary objective of this study is to characterize distress levels among TCS using electronic PROs via a modified version of the National Comprehensive Cancer Network Distress Thermometer (DT) and Patient Reported Outcomes Measurement System (PROMIS). Methods: Eligible TCS ( < 69 years at diagnosis, any treatments, not in active or maintenance stage of exercise behavior) enrolled onto a pilot study of an electronic, self-directed, individually tailored “EXercise for CAncer Patients” (EXCAP) program were offered iPad-based distress screening during routine medical oncology clinic visits. Screening consisted of a modified DT, where patients self-report distress on a scale of 1-10, wherein scores of greater than 4 refer to increased distress, as well as PROMIS domains for anxiety and depression, where scores range from 0-100, 50 is the average for the United States (US) general population, and higher values indicate more anxiety or depression. Results: A total of 18 TCS (median age 44) enrolled in the EXCAP study as of May 31, 2016. Among participants, 56%, 28% and 17% had stage I, II, and III testicular cancer, respectively. Treatment modality and median time from treatment to enrollment were: 78% orchiectomy, 23.5 months (range 1-204); 33% retroperitoneal lymph node dissection, 8 months (range 1-48); and 72% chemotherapy, 22 months (range 3-587). TCS completed a median of 2 distress screenings (range 1-8). The median DT score was 3 (range 1-8). Median PROMIS anxiety and depression scores were 52.88 (32.87-69.36) and 51.02 (34.17-6.65). Conclusions: TCS self-report low levels of distress on the DT and PROMIS scores for anxiety and depression that are comparable to the US general population. Future research will explore associations between patient- and disease-specific factors and distress in TCS.