Welche Krebspatienten brauchen psychoonkologische Unterstützung

Abstract

Objectives: Cancer patients have to cope with anxieties concerning their prognosis, potential recurrence/progression, and treatment-associated sequelae. Stress-related psychosocial factors influence survival and disease-related mortality in cancer patients. Despite improvements in diagnosis and treatment, bladder cancer (BC) remains characterized by high rates of recurrence and progression. We screened pre-therapeutically the stress level of BC patients stratified by gender, disease state, treatment, and other factors by self-administered validated questionnaires to integrate them into psychosocial support as needed. Methods: A cross-sectional analysis of distress and need of psychosocial care was done in 301 patients undergoing treatment for BC by 2 questionnaires (Distress Thermometer [DT] and Hornheider Screening Instrument). Results: Of the 301 patients, 230 patients underwent transurethral resection for a first diagnosis, 63 for recurrent disease, 37 had progressive disease, and 25 had advanced metastatic disease and eventually died of BC. The mean stress level in all patients was 4.6. Twenty-eight percent of the patients expressed a need for psychosocial support. In patients with progressive disease, significantly higher stress scores were seen as well as a higher need of psychosocial care (5.4 and 41%). Conclusions: The median DT-level of 4.6 indicates moderate psychosocial stress in BC patients. From a stress level of 5, the recommendations of a psycho-oncological supervision are pronounced, so that our study showed that early systematic evaluation of psychosocial needs in BC patients is important. © 2018 S. Karger AG, Basel Welche Krebspatienten brauchen psychoonkologische Unterstützung?