Fear of disease progression in patients with gastrointestinal stromal tumors (GIST).

Abstract

10549 Background: GIST are rare tumors and before 2000 patients had a dismal prognosis when metastasized. Since the introduction of imatinib and other tyrosine kinase inhibitors overall survival has increased from less than 1 year before 2001 to more than 5 years now. Research on psychosocial consequences for this particular cancer type is scarce. This study focuses on quality of life and fear of disease progression in GIST patients. Methods: Eighty patients with locally advanced or metastatic GIST, being treated with imatinib or sunitinib, from the Radboud University Nijmegen Medical Centre in the Netherlands were asked to participate. Patients completed self-report questionnaires including the EORTC-QLQ-C30, the Cancer Worry Scale, and the Fear of Cancer Recurrence Inventory. Results: Fifty two patients (median age 64.2; range 22-84 years) completed the questionnaires. Two subgroups were identified: patients with locally advanced (n= 27) and metastatic GIST (n= 25). Overall, GIST patients demonstrate a good global quality of life (EORTC-QLQ-C30 mean global health 76.1). However, 50% of them (n= 26) experienced high levels of fear of cancer progression (CWS cut-off point ≥ 14). High levels of fear were not associated with age, gender or between patients with locally advanced or metastatic GIST. Subgroup analyses revealed that patients with high levels of fear of disease progression showed significantly higher levels of psychological distress related to fear of cancer progression and more functional impairments including domains that can be disturbed by fear of cancer progression (e.g. work, daily and social activities, the ability to make future plans or set life goals). Conclusions: Despite a good overall quality of life, a substantial percentage of GIST patients experience high levels of fear of cancer progression, experiencing more psychological distress and more functional impairments compared to patients with low levels of fear. No relation was found with demographic variables nor with stage of disease. This research demonstrates that it is necessary to focus on more specific rather than general quality of life of GIST patients.