Abstract
Treatment of patients with gynecological cancer is a serious challenge and causes severe trauma for patients, primarily if it is associated with surgical intervention. Even after cancer is successfully treated, psychological disorders stay and sometimes exacerbate, including those associated with an identity crisis.
The purpose of this study was to evaluate how informative the use of the NCCN distress thermometer is for detecting psychoemotional disorders in patients with malignant tumors of the female reproductive system after successful anticancer treatment.
Materials and methods. Forty-seven gynecological cancer patients were included in the study after surgical or combined (surgery + chemotherapy) treatment. They included 17 patients with cervical cancer, 18 with endometrial cancer, and 12 with ovarian cancer. Panhysterectomy was a component of surgical treatment in all patients. Eleven patients were examined shortly after the surgical treatment (after 12 to 14 days), and the remaining 36 patients were surveyed during the follow-up visit 6-12 months after the treatment. At the time of the visit, the absence of cancer progression signs was confirmed by X-ray imaging methods (CT, MRI) and clinically. All patients were asked to rate their level of distress over the past week using the NCCN Distress Thermometer questionnaire. Version 2.2022.
Results. Twenty-five patients (62%) had a level of distress above the threshold ≥ 4. Nine patients had a level of distress ≥ 7. The most frequent problems causing distress were excitement and anxiety (80%), fatigue (81.3%), sleep disturbances (58%), sadness/depression (36%), and fear (33%). Almost a third (27%) of female patients recognized relationship problems with their partner and the presence of sexual problems (22%). About 20% identified issues in understanding the meaning of life. Identified psychoemotional disorders did not depend on tumor localization.
Conclusions:
More than half of gynecological cancer patients were found to have psychoemotional disorders and a level of distress above the limit after the successful completion of cancer treatment.
2) NCCN DT is an effective screening tool used to identify psychoemotional disorders in patients after the successful treatment of gynecological cancer.
3) Testing may be performed not only immediately after the treatment but also in the long term (after 6 to 12 months) since psychoemotional manifestations of distress (identity crises) may exacerbate over time.