Emotional concerns in cancer survivors not treated with chemotherapy.

Abstract

233 Background: Emotional concerns can impact quality of life in all cancer (CA) survivors, regardless of receipt of chemotherapy. Methods: Surgically treated CA survivors that were not treated with chemotherapy were identified in the 2010 LiveStrong Survey. Only patients that responded to all 9 categories of emotional concern questions were included (energy/fatigue, depression and mood, identity and grief/guilt, faith and spirituality, fear of recurrence, social anxiety, shame, concern for family, insecurity). A total emotional concern score was calculated (0-9) and independent t-tests or ANOVA identified factors that impacted the total score. After stratification by CA type, linear regression determined which factors, if any, were important predictors of having more emotional concerns. Results: Of 649 CA survivors, most were white (91.0%), insured (97.8%), employed/student (79.3%), married/domestic partner (76.2%), and had survived at least 5 years (69.8%); many were > 40 years old (62.8%). The median number of reported emotional concerns was 4 (mean 4.3, SD 2.0) with 3.1% of patients reporting no concerns. Patients with brain or head/neck CAs had the highest scores (5.3, SD 1.5-1.7), whereas those with other endocrine tumors or melanoma had the lowest scores (3.9, SD 2.0-2.1), (p = 0.001). Additionally, age < 40 at diagnosis, female gender, being employed, uninsured, having less education, and having received radiation (RT), hormone (HT), or other additional therapy all increased the emotional concern score (p < 0.05); race/ethnicity, marital status, and income did not impact the score. After stratification by CA type, only the following increased emotional concerns: receipt of HT for breast CA (B = 0.30), being employed (B = 0.82) or retired (B = 0.41) for thyroid CA, female gender (B = 0.51) or receiving RT (B = 0.38) for bone/soft tissue CA, age < 40 (B = 0.37) and receipt of other/HT (B = 0.31) for melanoma, and female gender for (B = 0.76) for other endocrine tumors. Conclusions: Significant emotional concerns are reported by surgically treated cancer survivors not treated with chemotherapy. These concerns are most influenced by cancer type and treatment, but not race/ethnicity, marital status, or income.