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Correlation between Cancer Pain and Psychological Health Problems in Breast Cancer Patients: A Preliminary Study
abstracts
Annals of Oncology
P3 195
Cancer as a trauma? Predictors of development of posttraumatic stress disorder (PTSD) in patients with cancer
Gabriel Banik1, Lubos Drgona2, Vladimir Malec3, Viktor Rosenberg4, Lucia Vasilkova5 Institute of Psychology, Faculty of Arts, University of Presov in Presov, Slovakia, 2 Department of Oncohematology, Faculty of Medicine, Comenius University in Bratislava and National Oncology Institute, 3Department of Oncology, Faculty Hospital A. D. Roosevelt in Banska Bystrica, 4Department of Radiation Oncology, Faculty Hospital J. A. Reiman in Presov, 5Psychological ambulance, National Oncology Institute
borderline, and 10% had depression. The correlation between CM and anxiety is r ¼ 0.358 (p-value ¼0.356). The correlation between CM and depression is r ¼0.581 (p-value ¼0.340). Conclusion: Most patients with adaptive and maladaptive CM had normal psychological health. Therefore, we can conclude that CM does not correlate with psychological health in breast cancer patients. There are many factors that may affect those problems. It is necessary to include other factors and more sample in order to obtain a more accurate Result.
P3 197
Association Between Performance Status and Quality of Life in Breast Cancer Patients: A Preliminary Study
Regina Nathania1, Julang Fahman1, Olivia J.d.a. Saroso1, Wilson M. Raffaello1, Helenia Putri1, Felix Wijovi1, Fernando Dharmaraja1, Friecelie Natalie1, Natasya Reina1, Andree Kurniawan2 1 Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia, 2 Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia
1
Background: Experiencing cancer is a highly stressful (traumatic) life-event which can lead to development of PTSD. PTSD can evolve after trauma in predisposed individuals, after being triggered by risk factors. The aim of this paper is to analyze the level of PTSD in patients with cancer in the context of other potential risk factors. Methods: Three path models were analyzed in a sample of patients with cancer (N ¼ 216). The models were focused on development of PTSD (PCL-5) in the context of psychological distress (SCL-90), personality traits (EPQ-R), perceived cognitive deficit (FACT-Cog), social support (BSSS), stressful life events, and selected socio-demographic, anamnestic, and medical variables. Mediation and moderation effects were also examined in the tested models. Results: Two models explained 63% of the variation in PTSD, while one model explained 60% of the PTSD variation as well as 23% of the variation in perceived cognitive deficits. All 3 models revealed that neuroticism and psychological distress had a statistically significant positive influence on the level of PTSD. In all 3 models, it was found that neuroticism influenced PTSD directly and also indirectly by means of a higher level of psychological distress. Specifically, it was found that this relation depends on the time passed since the patients were diagnosed with cancer and also on the history of mental disorders. In patients with history of mental disorders and in the patients with a lower level of social support, a statistically significant positive influence of stressful life events on PTSD was found. Conclusion: The Results draw attention to the possible mechanisms of the PTSD development under different combinations of individual risk factors. These findings offer not only new suggestions for the future research but provide also valuable implications for clinical practice.
P3 196
Relationship of Mechanism of Coping and Psychological Problems in Breast Cancer Patients 1
1
1
1
Angeline Tancherla , Elizabeth Celine , Fernando Dharmaraja , Friecelie Natalie , Helenia Putri1, Regina Nathania1, Andree Kurniawan2 1 Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia, 2 Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia Background: Cancer patients (including Breast Cancer) are faced with health problems and chemotherapy side effects, that can cause psychological problems (anxiety and depression). Coping mechanism (CM) helps prevent psychological problems. Patients can develop adaptive or maladaptive CM. The aim of the study is to evaluate the correlation between CM and the psychological problems in breast cancer patients. Methods: We conducted a cross-sectional study in General Hospital in Tangerang, from October 2018-February 2019. The samples are breast cancer patients that have undergone mastectomy and adjuvant chemotherapy. Data were collected using Cancer Coping Questionnaire (CCQ-21) and Hospital Anxiety Depression Scale. Baseline characteristics were presented using descriptive statistics. Correlation between both variables was analyzed with Somersd using SPSS version 24.0. Result: Samples are 29 breast cancer patients with a mean age of 49.93 611.473. 19 (65.5%) had adaptive CM, and 10 (34.5%) had maladaptive CM. Out of 19 patients with adaptive CM, 47.4% do not have anxiety, 26.3% in borderline, and 26.3% had anxiety; while, 57.9% do not have depression, 42.1% are in borderline, and none had depression. Out of 10 patients with maladaptive CM, 60% do not have anxiety, 30% in borderline, and 10% had anxiety; meanwhile, 80% do not have depression, 10% is in
vi146 | Poster Session
Background Cancer patients with low performance status (PS) will have worst survival than patients with good PS. In elderly patients with low PS have lower quality of life (QoL) score. The study between PS and QoL in breast cancer patients is still limited. The purpose of this research is to find correlation between the QoL and PS in breast cancer patients. Method A cross-sectional study was done in our general hospital starting from October 2018 until February 2019. The patients included are those diagnosed with breast cancer and have undergone chemotherapy. QoL is assessed using Breast 23 (BR23) questionnaire which evaluates the functional and symptoms scale of the patient, 0% is the worst function and most symptoms and 100% is the best function and no symptoms. Eastern Cooperative Oncology Group (ECOG) was used to assess the patients PS. The ECOG has a scoring system (0-5) which 0 defines as fully active and 5 as dead. The correlation between both variables was analyzed with spearman using SPSS version 24.0. Result From 34 patients with mean age 47.0969.268, have mean symptoms 55.5168.36 and mean functional 86.22611.29. The PS data showed 50% of the patients are fully active. BR23 score mean symptoms 57.1%69.17% and mean functional 90.78%68.06% was found in fully active patients. Meanwhile, BR23 score with mean symptoms 53.92%67.4% and mean functional 81.66%612.4% was found in patients with restriction (p-value¼0.016). Conclusion There is significant association between PS and QoL in breast cancer patients. Fully active patients have better QoL.
P3 198
Correlation between Cancer Pain and Psychological Health Problems in Breast Cancer Patients: A Preliminary Study
Cindy Cindy1, Felix Wijovi1, Helenia Putri1, Michelle Octavia1, Natasya Reina1, Maria Claudia1, Andree Kurniawan2 1 Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia, 2 Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia Background Cancer pain in breast cancer patients is under-diagnosed and undertreated, as it rarely happens. Cancer management can cause physical and psychological changes. The two most common problems are anxiety and depression. A few studies have shown that psychological problems are related to cancer pain, but it is not clear to what extent the pain affects them. Therefore, the aim of this study is to know the correlation between cancer pain and psychological aspect in breast cancer patients. Methods A cross-sectional study was done at our general hospital, from October 2018February 2019. The sample is breast cancer patients that have undergone mastectomy and adjuvant chemotherapy. Brief Pain Inventory and Hospital Anxiety and Depression Scale questionnaire were used to evaluate the patients. BPI score ranges from 1, pain does not interfere with daily life, to 10, pain interferes. HADS has a total score of 21, where 0-7 is normal, 8-10 is the borderline, and 11-21 means anxiety and/ or depression is present. Baseline characteristics were presented using descriptive statistics. Correlation between both variables were analysed with Spearman correlation. Results 36 breast cancer patients, with a mean age of 50.19 6 11.089 years old, were included. Median pain on general activity, mood, walking, working, sleeping, relaxing, and interacting is 1, 2, 1, 1, 2, 1, and 1, consecutively, with a median of 1.29 (1-7.57). From 19 patients, 47.2% patients have no anxiety, 30.6% patients on borderline, and 22.2% patients have anxiety. Meanwhile, 66.7% patients have no depression, 30.6% patients on borderline, and 2.8% patients with depression. Correlation between pain and anxiety is r¼0.425 (p-value¼0.069), while between pain and depression is r¼0.229 (p-value¼0.265). Conclusion There is no correlation between cancer pain and psychological health problems. Further study with greater sample size is needed to confirm the Result.
Volume 30 | Supplement 6 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz343.134/5582937 by guest on 25 October 2019
Methods: We collected the stimulated saliva from 10 head and neck cancer patients who underwent radiotherapy and had xerostomia symptom and from 10 age- and sexmatched controls. The xerostomia was evaluated with xerostomia inventory short version. The average xerostomia score of the patient group is 11.5, and the normal group is 5.5. We separated the peptide from saliva specimens with a 10K cut off filter. The differential expression of the peptide was performed with MALDI-TOF/TOF Ultraflex mass spectrometer and plausible neural network pattern recognition software. Results: We found patients who receive radiotherapy lacks two major peaks of m/z 555.19 and 754.35. Those indicated the small fragment of the several possible peptides that lacking in the patient group and contribute to xerostomia symptom. Conclusion: In the future work, we will add the candidate peptides into artificial saliva and perform the in vivo study to evaluate the potential of the peptide as a new ingredient of saliva substitute.
Annals of Oncology
P3 195
Cancer as a trauma? Predictors of development of posttraumatic stress disorder (PTSD) in patients with cancer
Gabriel Banik1, Lubos Drgona2, Vladimir Malec3, Viktor Rosenberg4, Lucia Vasilkova5 Institute of Psychology, Faculty of Arts, University of Presov in Presov, Slovakia, 2 Department of Oncohematology, Faculty of Medicine, Comenius University in Bratislava and National Oncology Institute, 3Department of Oncology, Faculty Hospital A. D. Roosevelt in Banska Bystrica, 4Department of Radiation Oncology, Faculty Hospital J. A. Reiman in Presov, 5Psychological ambulance, National Oncology Institute
borderline, and 10% had depression. The correlation between CM and anxiety is r ¼ 0.358 (p-value ¼0.356). The correlation between CM and depression is r ¼0.581 (p-value ¼0.340). Conclusion: Most patients with adaptive and maladaptive CM had normal psychological health. Therefore, we can conclude that CM does not correlate with psychological health in breast cancer patients. There are many factors that may affect those problems. It is necessary to include other factors and more sample in order to obtain a more accurate Result.
P3 197
Association Between Performance Status and Quality of Life in Breast Cancer Patients: A Preliminary Study
Regina Nathania1, Julang Fahman1, Olivia J.d.a. Saroso1, Wilson M. Raffaello1, Helenia Putri1, Felix Wijovi1, Fernando Dharmaraja1, Friecelie Natalie1, Natasya Reina1, Andree Kurniawan2 1 Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia, 2 Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia
1
Background: Experiencing cancer is a highly stressful (traumatic) life-event which can lead to development of PTSD. PTSD can evolve after trauma in predisposed individuals, after being triggered by risk factors. The aim of this paper is to analyze the level of PTSD in patients with cancer in the context of other potential risk factors. Methods: Three path models were analyzed in a sample of patients with cancer (N ¼ 216). The models were focused on development of PTSD (PCL-5) in the context of psychological distress (SCL-90), personality traits (EPQ-R), perceived cognitive deficit (FACT-Cog), social support (BSSS), stressful life events, and selected socio-demographic, anamnestic, and medical variables. Mediation and moderation effects were also examined in the tested models. Results: Two models explained 63% of the variation in PTSD, while one model explained 60% of the PTSD variation as well as 23% of the variation in perceived cognitive deficits. All 3 models revealed that neuroticism and psychological distress had a statistically significant positive influence on the level of PTSD. In all 3 models, it was found that neuroticism influenced PTSD directly and also indirectly by means of a higher level of psychological distress. Specifically, it was found that this relation depends on the time passed since the patients were diagnosed with cancer and also on the history of mental disorders. In patients with history of mental disorders and in the patients with a lower level of social support, a statistically significant positive influence of stressful life events on PTSD was found. Conclusion: The Results draw attention to the possible mechanisms of the PTSD development under different combinations of individual risk factors. These findings offer not only new suggestions for the future research but provide also valuable implications for clinical practice.
P3 196
Relationship of Mechanism of Coping and Psychological Problems in Breast Cancer Patients 1
1
1
1
Angeline Tancherla , Elizabeth Celine , Fernando Dharmaraja , Friecelie Natalie , Helenia Putri1, Regina Nathania1, Andree Kurniawan2 1 Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia, 2 Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia Background: Cancer patients (including Breast Cancer) are faced with health problems and chemotherapy side effects, that can cause psychological problems (anxiety and depression). Coping mechanism (CM) helps prevent psychological problems. Patients can develop adaptive or maladaptive CM. The aim of the study is to evaluate the correlation between CM and the psychological problems in breast cancer patients. Methods: We conducted a cross-sectional study in General Hospital in Tangerang, from October 2018-February 2019. The samples are breast cancer patients that have undergone mastectomy and adjuvant chemotherapy. Data were collected using Cancer Coping Questionnaire (CCQ-21) and Hospital Anxiety Depression Scale. Baseline characteristics were presented using descriptive statistics. Correlation between both variables was analyzed with Somersd using SPSS version 24.0. Result: Samples are 29 breast cancer patients with a mean age of 49.93 611.473. 19 (65.5%) had adaptive CM, and 10 (34.5%) had maladaptive CM. Out of 19 patients with adaptive CM, 47.4% do not have anxiety, 26.3% in borderline, and 26.3% had anxiety; while, 57.9% do not have depression, 42.1% are in borderline, and none had depression. Out of 10 patients with maladaptive CM, 60% do not have anxiety, 30% in borderline, and 10% had anxiety; meanwhile, 80% do not have depression, 10% is in
vi146 | Poster Session
Background Cancer patients with low performance status (PS) will have worst survival than patients with good PS. In elderly patients with low PS have lower quality of life (QoL) score. The study between PS and QoL in breast cancer patients is still limited. The purpose of this research is to find correlation between the QoL and PS in breast cancer patients. Method A cross-sectional study was done in our general hospital starting from October 2018 until February 2019. The patients included are those diagnosed with breast cancer and have undergone chemotherapy. QoL is assessed using Breast 23 (BR23) questionnaire which evaluates the functional and symptoms scale of the patient, 0% is the worst function and most symptoms and 100% is the best function and no symptoms. Eastern Cooperative Oncology Group (ECOG) was used to assess the patients PS. The ECOG has a scoring system (0-5) which 0 defines as fully active and 5 as dead. The correlation between both variables was analyzed with spearman using SPSS version 24.0. Result From 34 patients with mean age 47.0969.268, have mean symptoms 55.5168.36 and mean functional 86.22611.29. The PS data showed 50% of the patients are fully active. BR23 score mean symptoms 57.1%69.17% and mean functional 90.78%68.06% was found in fully active patients. Meanwhile, BR23 score with mean symptoms 53.92%67.4% and mean functional 81.66%612.4% was found in patients with restriction (p-value¼0.016). Conclusion There is significant association between PS and QoL in breast cancer patients. Fully active patients have better QoL.
P3 198
Correlation between Cancer Pain and Psychological Health Problems in Breast Cancer Patients: A Preliminary Study
Cindy Cindy1, Felix Wijovi1, Helenia Putri1, Michelle Octavia1, Natasya Reina1, Maria Claudia1, Andree Kurniawan2 1 Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia, 2 Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia Background Cancer pain in breast cancer patients is under-diagnosed and undertreated, as it rarely happens. Cancer management can cause physical and psychological changes. The two most common problems are anxiety and depression. A few studies have shown that psychological problems are related to cancer pain, but it is not clear to what extent the pain affects them. Therefore, the aim of this study is to know the correlation between cancer pain and psychological aspect in breast cancer patients. Methods A cross-sectional study was done at our general hospital, from October 2018February 2019. The sample is breast cancer patients that have undergone mastectomy and adjuvant chemotherapy. Brief Pain Inventory and Hospital Anxiety and Depression Scale questionnaire were used to evaluate the patients. BPI score ranges from 1, pain does not interfere with daily life, to 10, pain interferes. HADS has a total score of 21, where 0-7 is normal, 8-10 is the borderline, and 11-21 means anxiety and/ or depression is present. Baseline characteristics were presented using descriptive statistics. Correlation between both variables were analysed with Spearman correlation. Results 36 breast cancer patients, with a mean age of 50.19 6 11.089 years old, were included. Median pain on general activity, mood, walking, working, sleeping, relaxing, and interacting is 1, 2, 1, 1, 2, 1, and 1, consecutively, with a median of 1.29 (1-7.57). From 19 patients, 47.2% patients have no anxiety, 30.6% patients on borderline, and 22.2% patients have anxiety. Meanwhile, 66.7% patients have no depression, 30.6% patients on borderline, and 2.8% patients with depression. Correlation between pain and anxiety is r¼0.425 (p-value¼0.069), while between pain and depression is r¼0.229 (p-value¼0.265). Conclusion There is no correlation between cancer pain and psychological health problems. Further study with greater sample size is needed to confirm the Result.
Volume 30 | Supplement 6 | October 2019
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_6/mdz343.134/5582937 by guest on 25 October 2019
Methods: We collected the stimulated saliva from 10 head and neck cancer patients who underwent radiotherapy and had xerostomia symptom and from 10 age- and sexmatched controls. The xerostomia was evaluated with xerostomia inventory short version. The average xerostomia score of the patient group is 11.5, and the normal group is 5.5. We separated the peptide from saliva specimens with a 10K cut off filter. The differential expression of the peptide was performed with MALDI-TOF/TOF Ultraflex mass spectrometer and plausible neural network pattern recognition software. Results: We found patients who receive radiotherapy lacks two major peaks of m/z 555.19 and 754.35. Those indicated the small fragment of the several possible peptides that lacking in the patient group and contribute to xerostomia symptom. Conclusion: In the future work, we will add the candidate peptides into artificial saliva and perform the in vivo study to evaluate the potential of the peptide as a new ingredient of saliva substitute.