The prevalence of altered body image in patients with primary brain tumors: an understudied population

Lindsay Rowe,Elizabeth Vera,Veeraj Shah,Ramya Antony,Jing Wu,Peter Mathen,Marta Penas‐Prado ,Christine Bryla,Yamini Vyas,Orwa Aboud,Kathleen Wall,Tito R Mendoza ,Alvina Acquaye,Christine Cordova,Kevin Camphausen,Mark R Gilbert ,Christine Siegel,Sonja Crandon,Nicole Leggiero,Jennifer Reyes,Boris Labar ,Eric Burton,Terri S Armstrong

doi:10.1007/s11060-020-03433-8

Abstract

PurposeBody image (BI) is an important issue for cancer patients, as patients with BI concerns are susceptible to depression, anxiety, difficulty coping, and poor quality of life (QoL). While this concern has been documented in patients with other malignancies, no data exists of this QoL issue in patients with primary brain tumors (PBT).MethodsA cross-sectional survey of 100 PBT patients was conducted on an IRB approved prospective protocol using structured questionnaires. Participants completed the body image scale (BIS), Appearance Scheme Inventory Revised (ASI-R), MD Anderson Symptom Inventory Brain Tumor (MDASI-BT), and Patient-Reported Outcomes Measurement Information System (PROMIS) Depression, Anxiety, and Psychosocial Impact Positive measures.ResultsThe prevalence of clinically significant body image dissatisfaction (BIS ≥ 10) was 28% (95% CI 19–37%), median BIS score was 5 (range 0–27). The median ASI-R composite score was 2.9 (range 1.5–4.7). BIS was significantly correlated with the ASI-R (r = 0.53, 95% CI 0.37 to 0.65). The mean PROMIS Depression score was 48.4 (SD = 8.9), PROMIS Anxiety score was 49.4 (SD = 9.9), and PROMIS Psychosocial Illness Impact Positive score was 48.9 (SD = 9.7). BIS was significantly correlated with age, and trended with BMI and sex. The PROMIS Psychosocial Illness Impact Positive and PROMIS Anxiety scores were the most strongly related to BIS.ConclusionsThis study, the first to explore altered body image in PBT patients, revealed clinically significant body image dissatisfaction in nearly 1/3 of patients, similar to other malignancies. These findings underscore the potential contribution of disease and treatment-related body image concerns on psychosocial wellbeing in patients with PBT.

Highlights

Body image is a multidimensional concept that includes one’s physical appearance and the cognitive, emotional, and relational elements that influence an individual’s sense of identity [1]
Patients enrolled on an Institutional Review Board approved protocol between December 2017 and April 2018 were screened and approached if eligible. This was a cross-sectional design at a single time point. and eligibility requirements were adult (≥ 18 years old) patients with histologically confirmed primary brain tumors (PBT), with intracranial only disease, who were proficient in English
Age was significantly correlated with body image scale (BIS) scores (r = − 0.24, 95% CI − 0.44, − 0.05, p = 0.015), with younger patients having increased body image dissatisfaction

Summary

Introduction

Body image is a multidimensional concept that includes one’s physical appearance and the cognitive, emotional, and relational elements that influence an individual’s sense of identity [1]. It includes objective and subjective factors such as perceptions, feelings, and attitudes toward the body, which can be significantly affected by disease. Resultant body image has been found to affect patients’ social and psychological outcomes, as well as general quality of life These consequences include higher rates of depression, anxiety, and difficulty coping [13, 14]

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