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Purpose: Patients with cancer suffer from a wide range of psychological distress. Nevertheless, in the literature low utilization rates of psychooncological services are reported. Various factors may influence the utilization of professional support during inpatient care. Up to now it is unclear to what extent patients' attitude towards psychooncological support and physicians' recommendation for psychooncological care may influence the utilization. Methods: In a multicenter longitudinal observational study in Comprehensive Cancer Centers Germany, 1398 patients with mixed cancer diagnoses were assessed at baseline during their hospital stay with respect to psychooncological distress and the need for and use of psychooncological services. Results: Psychooncological support was used by almost 28.4% of patients up to this time. A positive attitude towards psychooncological support was reported by 41.6%. A recommendation of psychooncological support by a physician was received by 16.2%. These patients reported a significant higher level of distress compared to patients who did not received a recommendation. Multivariable logistic regression detected that the utilization rate was 3.79 times higher among patients with positive attitude towards psychooncological support (OR, 3.79; 95% CI 2.51–5.73, p < 0.001). Utilization was 4.21 times more likely among patients who received a physician´s recommendation (OR, 4.21; 95% CI 2.98–5.95, p < 0.001). Conclusion: The results of the study provide evidence of the relevance of giving more attention to psychooncological distress and attitudes towards psychooncological care. To reduce reservations, patients need low-threshold information about the psychooncological services offered. [ABSTRACT FROM AUTHOR]

Purpose: Anxiety is an accompanying symptom in cancer patients that can have a negative impact on patients. The aim of the present analyses is to determine the prevalence of anxiety, taking into account sociodemographic and medical variables, and to determine the odds ratio for the occurrence of anxiety in cancer patients compared to general population. Methods: In this secondary analyses, we included 4,020 adult cancer patients during and after treatment from a multi-center epidemiological study from 5 regions in Germany in different treatment settings and a comparison group consisting of 10,000 people from the general population in Germany. Anxiety was measured with the Generalized Anxiety Disorder (GAD-7) questionnaire. In multivariate analyses adjusted for age and sex, we calculated the odds of being anxious. Results: The prevalence of anxiety was observed to be 13.8% (GAD-7 ≥ 10). The level of anxiety was significant higher for patients in rehabilitation, compared to patients during inpatient and outpatient treatment (p =.013). Comparison with the general population yielded a 2.7-fold increased risk for anxiety among cancer patients (95% CI 2.4–3.1; p <.001). Patients with bladder cancer (OR, 5.3; 95% CI 3.0–9.4) and testicular cancer (OR, 5.0; 95% CI 2.1–12.1) showed the highest risk of having high levels of anxiety. Conclusion: The results highlight the importance of identifying anxiety in cancer patients. [ABSTRACT FROM AUTHOR]

Background: Cytogenetic testing (CGT) in uveal melanoma patients reveals prognostic information about the individual risk of developing distant metastasis with dismal prognosis. There is currently no medical intervention strategy with proven effect on the prognosis, rendering the result of the cytogenetic testing purely informative. We explored patients' socio-demographic backgrounds, psychological preconditions, coping strategies, external influences, and concerns about "knowing their fate" to study their possible interactions with decision-making for CGT.Methods: Uveal melanoma patients were asked to complete questionnaires on their interest in undergoing CGT for prognostication and the factors influencing their decision. Data were collected on socio-demographics, baseline anxiety (GAD-7), depression (PHQ-9), coping strategies (Brief COPE), and assumed future concerns regarding the CGT result. Data were analyzed by using multiple ordinal logistic regression and exploring estimated marginal effects.Results: Questionnaires were returned by 121 of 131 (92.4%) patients. Fifty-two patients (43%) had no interest in CGT, 34 (28.1%) were undecided, and 35 (28.9%) were interested. We observed no significant differences regarding age, sex, partnership, education, occupation, baseline anxiety, or depression. Decision-making favoring CGT was influenced by the treating physicians, internet resources, and level of baseline anxiety. Patients were likely to reject CGT when they worried that "knowing the result will have an unintended influence" on their life.Conclusion: Decision-making about CGT for prognostication in uveal melanoma is burdensome to many patients and in general not guided by medical advice regarding further treatment and screening procedures. The psychological impact of the decision is therefore unique and requires careful support by psycho-oncologists considering the patient's fears and expectations. [ABSTRACT FROM AUTHOR]

Purpose: Despite promising achievements in precision cancer medicine (PCM), participating patients are still faced with manifold uncertainties, especially regarding a potential treatment benefit of molecular diagnostics (MD). Hence, MD poses considerable challenges for patient information and communication. To meet these challenges, healthcare professionals need to gain deeper insight into patients' subjective experiences. Therefore, this qualitative study examined information aspects of MD programs in cancer patients. Methods: In two German Comprehensive Cancer Centers, 30 cancer patients undergoing MD participated in semi-structured interviews on information transfer and information needs regarding MD. Additionally, patients provided sociodemographic and medical data and indicated their subjective level of information (visual analogue scale, VAS, 0–10). Results: On average patients had high levels of information (mean = 7, median = 8); nevertheless 20% (n = 6) showed an information level below 5 points. Qualitative analysis revealed that patients show limited understanding of the complex background of MD and have uncertainties regarding their personal benefit. Further, patients described unmet information needs. Existential threat in awaiting the results was experienced as burdensome. To withstand the strains of their situation, patients emphasized the importance of trusting their physician. Conclusion: The challenges in PCM consist in providing unambiguous information, especially concerning treatment benefit, and providing guidance and support. Therefore, psycho-oncology needs to develop guidelines for adequate patient communication in order to help healthcare providers and cancer patients to handle these challenges in the developing field of PCM. [ABSTRACT FROM AUTHOR]

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Background: Patients with peritoneal metastases suffer from physical and psychological distress. The aim of our investigation was to identify highly distressed patients, collect demographic data, and examine correlations between distress score and clinical outcome. Methods: This retrospective analysis included all patients who were treated for peritoneal surface malignancies with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in our department. Psycho-oncological screening was conducted preoperatively. Results: From a total of 213 patients, 105 (49.3%) participated in the psycho-oncological screening. Women had a higher score (6.2 ± 2.6) compared to men (4.8 ± 3.4; p = 0.02). Age (p = 0.15) and Peritoneal Cancer Index (p = 0.90) had no significant influence on the score. The postoperative rate for surgical (19/73) or non-surgical complications (20/73) in highly distressed patients was comparable to patients with low distress (9/31, 11/31; p = 0.46, p = 0.28). Psychological problems due to sadness (Odds Ratio [OR] 2.69; p = 0.009), sleeplessness (OR 3.01; p = 0.004), and the physical ability to get around (OR 2.65; p = 0.01) were identified as having the greatest impact on distress scores. Conclusion: The mean distress score in patients with peritoneal surface malignancies is high (5.4 ± 2.7), is not related to the medical prognosis of the patients due to their underlying disease, and showed no correlation to the complication rate. Sadness and problems with sleep and getting around have a major influence on this score. [ABSTRACT FROM AUTHOR]

Copyright of Der Onkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: Delivering palliative/supportive cancer care (PSCC) early in the course of cancer care can enhance patients' and caregivers' quality of life, reduce anxiety and depression, and prolong patients' lives. However, their support needs are analyzed insufficiently from viewpoints other than their own. The goal of this study was to explore the perspectives of healthcare professionals on desirable standards of support for tumor patients and caregivers across the cancer treatment trajectory. It further aimed at identifying starting points for PSCC to address these needs.Methods: Nine healthcare professionals of varying disciplines in a large German university hospital each participated in one of two focus groups. The qualitative data was analyzed following the grounded theory methodology.Results: The healthcare professionals described it as desirable standards that tumor patients and caregivers receive support coping with tasks, accepting the situation, generating strength, feeling trust, and gaining clarity, thus increasing their sense of control. These support needs were seen as important throughout the whole cancer treatment trajectory of tumor patients and their caregivers.Conclusions: Team meetings, supervision, tailored education, and structural improvements may aid healthcare professionals to develop and implement ways to further support patients and caregivers. Also, patients' and caregivers' support needs should be screened regularly, e.g., when treatment phases change. This would complement healthcare professionals' subjective theories of relevant needs during a specific treatment phase. [ABSTRACT FROM AUTHOR]

Purpose: The diagnosis of cancer, the symptoms of the illness and its treatment have an influence on how patients and their caregivers experience distress. However, data focusing on caregivers and their cancer-related distress in the outpatient setting is sparse. This study aimed to compare cancer-related distress of caregivers and patients and to derive implications for the system of outpatient psycho-oncological care.Methods: One hundred thirty-eight patients and 102 caregivers receiving psycho-oncological counseling completed a standardized interview based on a self-assessment questionnaire (Questionnaire on Stress in Cancer Patients, FBK).Results: Group comparisons for cancer-related distress revealed one statistically significant difference for the subscale 'Fear' of the FBK, Z = 2.308, p = .021, and d = .44. Caregivers showed higher cancer-related fear (M = 2.76, SD = 1.14) than patients (M = 2.41, SD = 1.29). There were no differences in 'psychosomatic complaints', 'information deficit', 'restrictions in everyday life', 'social strains', or the total score of the FBK.Conclusions: Caregivers seem to experience cancer-related distress equal to or even more severely than patients themselves. Results suggest that there is a need for more low-threshold offers of outpatient psycho-oncological counseling for caregivers. [ABSTRACT FROM AUTHOR]