Gender, age and surgery as a treatment modality leads to higher distress in patients with cancer

• Published in: Supportive care in cancer Vol. 19; no. 2; pp. 239 - 250
• Main Authors: Thomas, Bejoy C., NandaMohan, V., Nair, Madhvan K., Pandey, Manoj
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-02-2011; Springer; Springer Nature B.V
• Subjects: Adaptation, Psychological; Adult; Age; Age Factors; Analysis of Variance; Anxiety; Cancer; Cancer patients; Care and treatment; Depression, Mental; Female; Gender; Humans; India; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Neoplasms - psychology; Neoplasms - surgery; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Patients; Physician-Patient Relations; Psychiatric Status Rating Scales; Psychology; Regression Analysis; Rehabilitation Medicine; Risk Factors; Severity of Illness Index; Sex Factors; Social Support; Socioeconomic Factors; Stress; Stress, Psychological - diagnosis; Stress, Psychological - etiology; Surgery; India; Patient–practitioner communication; Distress; Social isolation; Surgery; Cancer
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-009-0810-4

Introduction
Distress has been defined as a multidimensional construct that extends along a continuum, ranging from common normal feelings of vulnerability, sadness and fears to problems that can become disabling, such as depression, anxiety, panic, social isolation and existential and spiritual crisis. Several studies have pointed out the need to screen for distress in the cancer. Emotional distress has been found as a core indicator of a patient’s health and well-being and has installed it as the sixth vital sign. The aim of the present study was to identify the predictors of distress in cancer patients.
Patients and methods
For the present study, a total of 760 patients with cancer in a tertiary cancer centre were assessed using the Distress Inventory for Cancer Version 2 (DIC V2). A multivariate logistic regression was carried out to identify the predictors of distress and six subscales.
Results
Female patients under the age of 44 years scheduled to undergo surgery or those who had undergone surgery predicted significantly higher levels of overall distress. Composite disease stage other than stage IV metastatic disease and being a daily wage employee predicted significantly lower levels of overall distress.
Discussion
Higher distress among women undergoing surgery could imply distress associated with significant cosmetic disfigurement and feeling of loss of womanhood especially in those with breast or cervix cancer.
Conclusion
The study once again demonstrate gender and age differences in distress and also highlights the importance of knowing that cancer is confined to one organ and has not spread.