Influence of Treatment Caused Impairments on Anxiety and Depression in Patients with Cancer of the Esophagus or the Esophagogastric Junction

Overview

Journal J Gastrointest Cancer

Publisher Springer

Specialties Gastroenterology
Oncology

Date 2019 Jan 8

PMID 30613926

Citations 1

Authors

Thomas Kiefer

Dorothea Krahl

Carsten Hirt

Heinz Voller

Lorenz Volkel

Georg Daeschlein

Affiliations

Soon will be listed here.

Abstract

Purpose: After therapy of cancer of the esophagus or the esophagogastric junction, patients often suffer from anxiety and depression. Some risk factors for elevated anxiety and depression are reported, but the influence of steatorrhea, the frequency of which has only recently been reported, has not yet been investigated.

Method: Using the Hospital Anxiety and Depression Scale (HADS), we analyzed the correlation of anxiety and depression with steatorrhea, appetite, and weight loss in 72 patients with cancer of the esophagus or of the esophagogastric junction, who were treated at our rehabilitation clinic between January 2011 and December 2014. In addition, effectiveness of psychological interviews was analyzed.

Results: We have evaluable anxiety questionnaires from 51 patients showing a median anxiety value of 5 (range 0-13). As for the depression, results from evaluable questionnaires of 54 patients also showed a median value of 5 (range 0-15). Increased anxiety and depression values (> 7) were observed in 25.4% and 37.0% of the patients respectively. Patients who were admitted with steatorrhea for rehabilitation showed a statistically higher anxiety value (median 6.3 vs. 4.7, p < 0.05), reduced appetite, and a weight loss above 15 kg depicting a correlation to anxiety and depression. Psychological conversations helped lowering the depression but had no influence on anxiety.

Conclusions: Impairments after cancer treatment, such as steatorrhea, appetite loss, and weight loss, should be interpreted as an alarm signal and should necessitate screening for increased anxiety and depression. Psychological therapy can help improving the extent of the depression.

Citing Articles

Fear of cancer recurrence, anxiety and depressive symptoms in adolescent and young adult cancer patients.

Sun H, Yang Y, Zhang J, Liu T, Wang H, Garg S Neuropsychiatr Dis Treat. 2019; 15:857-865.

PMID: 31118635 PMC: 6498985. DOI: 10.2147/NDT.S202432.

References

Rutegard M, Charonis K, Lu Y, Lagergren P, Lagergren J, Rouvelas I . Population-based esophageal cancer survival after resection without neoadjuvant therapy: an update. Surgery. 2012; 152(5):903-10. DOI: 10.1016/j.surg.2012.03.025. View

Dunn L, Aouizerat B, Cooper B, Dodd M, Lee K, West C . Trajectories of anxiety in oncology patients and family caregivers during and after radiation therapy. Eur J Oncol Nurs. 2011; 16(1):1-9. PMC: 3115490. DOI: 10.1016/j.ejon.2011.01.003. View

Derogar M, Orsini N, Sadr-Azodi O, Lagergren P . Influence of major postoperative complications on health-related quality of life among long-term survivors of esophageal cancer surgery. J Clin Oncol. 2012; 30(14):1615-9. DOI: 10.1200/JCO.2011.40.3568. View

Mitchell A, Meader N, Symonds P . Diagnostic validity of the Hospital Anxiety and Depression Scale (HADS) in cancer and palliative settings: a meta-analysis. J Affect Disord. 2010; 126(3):335-48. DOI: 10.1016/j.jad.2010.01.067. View

McCorry N, Dempster M, Clarke C, Doyle R . Adjusting to life after esophagectomy: the experience of survivors and carers. Qual Health Res. 2009; 19(10):1485-94. DOI: 10.1177/1049732309348366. View

Bjelland I, Dahl A, Haug T, Neckelmann D . The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002; 52(2):69-77. DOI: 10.1016/s0022-3999(01)00296-3. View

Kiefer T, Krahl D, Osthoff K, Thuss-Patience P, Bunse J, Adam U . Importance of Pancreatic Enzyme Replacement Therapy after Surgery of Cancer of the Esophagus or the Esophagogastric Junction. Nutr Cancer. 2017; 70(1):69-72. DOI: 10.1080/01635581.2017.1374419. View

Rouvelas I, Zeng W, Lindblad M, Viklund P, Ye W, Lagergren J . Survival after surgery for oesophageal cancer: a population-based study. Lancet Oncol. 2005; 6(11):864-70. DOI: 10.1016/S1470-2045(05)70347-8. View

Dempster M, McCorry N, Brennan E, Donnelly M, Murray L, Johnston B . Psychological distress among survivors of esophageal cancer: the role of illness cognitions and coping. Dis Esophagus. 2011; 25(3):222-7. DOI: 10.1111/j.1442-2050.2011.01233.x. View

10.

Hulbert-Williams N, Neal R, Morrison V, Hood K, Wilkinson C . Anxiety, depression and quality of life after cancer diagnosis: what psychosocial variables best predict how patients adjust?. Psychooncology. 2011; 21(8):857-67. DOI: 10.1002/pon.1980. View

11.

Carlson L, Waller A, Groff S, Giese-Davis J, Bultz B . What goes up does not always come down: patterns of distress, physical and psychosocial morbidity in people with cancer over a one year period. Psychooncology. 2011; 22(1):168-76. DOI: 10.1002/pon.2068. View

12.

Hellstadius Y, Lagergren P, Lagergren J, Johar A, Hultman C, Wikman A . Aspects of emotional functioning following oesophageal cancer surgery in a population-based cohort study. Psychooncology. 2014; 24(1):47-53. DOI: 10.1002/pon.3583. View

13.

Wolf M, Zehentmayr F, Schmidt M, Holzel D, Belka C . Treatment strategies for oesophageal cancer - time-trends and long term outcome data from a large tertiary referral centre. Radiat Oncol. 2012; 7:60. PMC: 3364842. DOI: 10.1186/1748-717X-7-60. View

14.

Huddy J, Macharg F, Lawn A, Preston S . Exocrine pancreatic insufficiency following esophagectomy. Dis Esophagus. 2012; 26(6):594-7. DOI: 10.1111/dote.12004. View

15.

Hellstadius Y, Lagergren J, Zylstra J, Gossage J, Davies A, Hultman C . A longitudinal assessment of psychological distress after oesophageal cancer surgery. Acta Oncol. 2017; 56(5):746-752. DOI: 10.1080/0284186X.2017.1287945. View

16.

Ferlay J, Shin H, Bray F, Forman D, Mathers C, Parkin D . Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2011; 127(12):2893-917. DOI: 10.1002/ijc.25516. View

17.

Zigmond A, SNAITH R . The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983; 67(6):361-70. DOI: 10.1111/j.1600-0447.1983.tb09716.x. View

18.

Lloyd-Williams M, Friedman T . Depression in palliative care patients--a prospective study. Eur J Cancer Care (Engl). 2002; 10(4):270-4. DOI: 10.1046/j.1365-2354.2001.00290.x. View

19.

Bergquist H, Ruth M, Hammerlid E . Psychiatric morbidity among patients with cancer of the esophagus or the gastro-esophageal junction: a prospective, longitudinal evaluation. Dis Esophagus. 2007; 20(6):523-9. DOI: 10.1111/j.1442-2050.2007.00741.x. View

20.

Parker P, Baile W, de Moor C, Cohen L . Psychosocial and demographic predictors of quality of life in a large sample of cancer patients. Psychooncology. 2003; 12(2):183-93. DOI: 10.1002/pon.635. View