Cancer patient distress - roles of gender, family and psychological care

Abstract

Introduction
Cancer burden is rising worldwide, with 20 million new diagnoses annually. Psychological needs of cancer patients are increasingly recognised, and psycho-oncology teams are developing. We aimed to assess distress among cancer patients in the oncology day-ward of a large urban hospital in Ireland.

Methods
Cross-sectional observational study of patient-rated distress at cancer diagnosis and treatment. We assessed distress among 142 patients using an existing survey tool.

Results
Women reported more extreme distress during cancer diagnosis and treatment, with 39 (46.4%) reporting ‘extreme’ distress at diagnosis and 82 (21.2%) during treatment, compared to 8 (17.8%) men at diagnosis and 43 (4.7%) men during treatment. Patients were likely to perceive their families as more distressed than themselves. On multi-variable testing, female gender was independently associated with higher patient distress at diagnosis and treatment. Patients reported work, fatigue, and fear for the future as areas of life most extremely affected by cancer. Only 3 (2.6%) patients reported extreme difficulties with relationships.

Discussion
High rates of extreme distress for cancer patients, particularly women, and their families highlights the need for enhanced, gender-aware, family-oriented psychological supports during cancer diagnosis and treatment. Future research could usefully include family members, assess distress longitudinally, and evaluate the impact of psychological supports.