Document Type : Original Article
Authors
1
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine - Ain Shams University, Egypt.
2
Department of Neurology and Psychiatry - Faculty of Medicine - Ain Shams University, Egypt.
3
Department of Clinical Oncology and Nuclear Medicine, Egypt.
Abstract
Background: Follow-up care for cancer patients after definitive treatment, includes: routine follow up visits and surveillance imaging to detect recurrence, new primaries, and maintaining quality of life. Scans may cause emotional - distress, including anxiety and fear of recurrence, a condition called “scanxiety’, which may lead to poor quality of life.
Aim of work: To assess scanxiety and psychological distress associated with surveillance imaging at routine follow up visits among cancer patients, and different factors affecting its severity.
Patients and methods:Consecutive sample of (179) cancer patients attending outpatient clinic at oncology department at Ain Shams University Hospital in Cairo, Egypt, for surveillance imaging from the period between October 2019 to February 2020. The General Health Questionnaire (GHQ), was used as a screening tool for psychological distress; patients with score ≥ 7, were subjected to Hamilton Anxiety Rating Scale (HAM-A), to assess the severity of anxiety symptoms during the periodsurrounding imaging scans. Sociodemographic and clinical data were obtained from the patients and from the medical records.
Results: 179 Participants,with mean age of 52.64 (SD= 11.20), and 69.8% were females. Most of the patients had some degree of psychological distress during the time of follow up scans, as 60.9% of patients (n=109) found to have a score ≥ 7 at General Health Questionnaire. Using Hamilton Anxiety Scale,Mild degree of anxiety (HAM-A score ≤ 17) was found in 16.2% of patients, mild to moderate anxiety (score 18-24) in 14.0 %, moderate to severe anxiety (score 25-30) in 17.3%, and very severe anxiety (score 31-56) in 13.4%.Moderate to severe anxiety was the most common degree of anxiety in our patients (28.4 % of patients with anxiety). Significant relationship was found between high GHQ score: (≥ 7) and age of patients (mean age of: 50.7 and SD 11.16), Not having children,type of cancer, and years since diagnosis (median of 2 years). The highest prevalence of scan-associated distress in our study was found in patients with CNS tumor, skin cancer, sarcoma and head and neck cancer, and lowest prevalence in breast cancer.
Conclusion: Surveillance imaging scans can provoke anxiety and fear of recurrence in cancer patients, so these studies should be justified, and supported by high quality evidence and guidelines recommendations. And psychological care should be a part of follow up care for cancer patients.
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