Impact of Psychological and Socioeconomic Factors on Management of Bone Tumours with Custom-made Endoprosthesis Reconstruction

Abstract

Objectives: In the past few decades, the definitive treatment for bone tumours has evolved considerably. Resection followed by custom-made endoprosthesis reconstruction has become the standard of care. The main objective of this study is to analyse the psychological and socioeconomic factors impacting the treatment of bone tumours. Materials and Methods: Among the 53 patients who underwent bone resection with custom mega prosthesis (CMP) reconstruction between 2013 and 2022, 22 patients are in regular follow-up, 16 patients are lost in follow-up, and the remaining 15 are dead. We prepared a questionnaire which included 22 questions to assess the impact of psycho-social and economic factors on the treatment of bone tumours. Results: We included 22 patients in our study. The average total duration of disease before surgery was 95 days. The average days of in-hospital stay was 53 days. The average number of days of hospital stay after surgery was 14 days. The average amount spent during the hospital stay was about 240 Indian national rupees/day. The average loss of work was about 90 days. The average days of leave availed in school/college was 135 days. About 69.2% of patients had to go for a change of occupation. About 90.9% of patients had a fear of recurrence. About 77.2% of patients found it difficult to indulge themselves in recreational/sports activities. About 45.4% of patients felt it was difficult for their partner/family to empathise with their situation. About 59% of patients had sleep difficulties. About 36.3% of patients were well satisfied with their prosthesis. Conclusion: Being predominantly a disease of the young population, the need for comprehensive management, including psychological counselling and rehabilitation in addition to cancer treatment, seems to be the need of the hour. The fact of the high cost of non-treatment-related expenditure needs to be addressed. A frequent cancer survivor programme will aid these patients to regain their self-confidence.