Psychological factors and quality of life in lymphoma patients treated with oral chemotherapy

Author/s Sara Larice, Ada Ghiggia, Luciana Bergui, Francesco Cattel, Matilde Scaldaferri, Elisa Sciorsci, Giulia Valinotti, Lorys Castelli
Publishing Year 2019 Issue 2019/3
Language Italian Pages 21 P. 77-97 File size 299 KB
DOI 10.3280/PDS2019-003005
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The aim of the study was to carry out a longitudinal evaluation of anxious-depressive symptomatology and quality of life in onco-hematological patients in treatment with oral chemotherapies. The project was conducted at the Integrated Oral Chemotherapy Service, in the Subalpine Onco-Hematological Center of the "Città della Salute e della Scienza" University Hospital of Turin. Thirty patients with lymphoma were evaluated with three measurements on psychological distress (Hospital Anxiety and Depression Scale HADS and the Distress Thermometer - DT) and quality of life (Functional Assessment of Cancer Therapy Scale-General, FACT-G). The psychological assessment was taken at the start of chemotherapy (T0) and after 3 cycles of treatment (T1), during outpatient hematological visits. A secondary aim was to evaluate the subjective patients’ opinion about the quality of the service and the level of concern about the therapy’s management, only at T1. Results of the psychological questionnaires showed the maintenance of distress and anxious-depressive symptomatology levels be-low the threshold of clinical relevance. Regarding the quality of life, our data showed a statistically significant decrease on the total score. What is more, patients have positively evaluated the presence of the pharmacist in the clinic, as a competent and supportive figure for the man-agement of chemotherapy treatment.

Keywords: Oral chemotherapy, lymphoma, anxiety, depression, emotional distress, quality of life

  1. Rao A. and Cohen H.J. (2004). Symptom management in the elderly cancer patient: fatigue, pain, and depression. J Natl Cancer Inst Monogr, 32: 150-157.
  2. Akechi T., Okuyama T., Uchida M., Nakaguchi T., Sugano K., Kubota Y., Ito Y., Kizawa Y. and Komatsu H. (2012). Clinical indicators of depression among ambulatory cancer patients undergoing chemotherapy. Japanese Journal of Clinical Oncology, 42(12): 1175-1180.
  3. Arber A., Odelius A., Williams P., Lemanska A. and Faithfull S. (2017). Do patients on oral chemotherapy have sufficient knowledge for optimal adherence? A mixed method study. European Journal of Cancer Care, 26(2): e12413.
  4. Bárez M., Blasco T., Fernández-Castro J. and Viladrich C. (2009). Perceived control and psychological distress in women with breast cancer: a longitudinal study. Journal of Behavioral Medicine, 32(2): 187.
  5. Barzelloni M.L., Mogavero A., Carnicelli P., Izzo R. e Crivaro V. (2012). Studio sperimentale prospettico conoscitivo di valutazione della relazione della percezione di fatigue e depressione tra caregiver, equipe curante e pazienti oncologici in trattamento chemioterapico con terapie somministrate per via orale verso terapie somministrate per via sistemica Studio Equipe-Caregivers 10 (Studio Equi-Car 10). G Ital Med Lav Ergon, 34(2 Suppl B): B29-37.
  6. Bjelland I., Dahl A.A., Haug T.T. and Neckelmann D. (2002). The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of Psychosomatic Research, 52(2): 69-77. DOI: 10.1016/S0022-3999(01)00296-
  7. Borner M., Scheithauer W., Twelves C., Maroun J. and Wilke H. (2001). Answering patients’ needs: oral alternatives to intravenous therapy. The Oncologist, 6(Supplement 4): 12-16.
  8. Brown L.F. and Kroenke K. (2009). Cancer-related fatigue and its associations with depression and anxiety: a systematic review. Psychosomatics, 50(5): 440-447. DOI: 10.1016/S0033-3182(09)70835-
  9. Cella D.F., Tulsky D.S., Gray G., Sarafian B., Linn E., Bonomi A., Silberman M., Yellen S.B., Winicour P. and Brannon J. (1993). The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. Journal of Clinical Oncology, 11(3): 570-579.
  10. Cheng K.K.F. and Yeung R. M.W. (2013). Impact of mood disturbance, sleep disturbance, fatigue and pain among patients receiving cancer therapy. European Journal of Cancer Care, 22(1): 70-78.
  11. Costantini M., Musso M., Viterbori P., Bonci F., Del Mastro L., Garrone O., Venturini M. and Morasso G. (1999). Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale. Supportive Care in Cancer, 7(3): 121-127.
  12. Cramer J.A., Roy A., Burrell A., Fairchild C.J., Fuldeore M.J., Ollendorf D.A. and Wong P.K. (2008). Medication compliance and persistence: terminology and definitions. Value in Health, 11(1): 44-47.
  13. DiMatteo M.R., Lepper H.S. and Croghan T.W. (2000). Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160(14): 2101-2107.
  14. Drost F.M., Mols F., Kaal S.E.J., Stevens W.B.C., Graaf W.T.A., Prins J.B. and Husson O. (2016). Psychological impact of lymphoma on adolescents and young adults: not a matter of black or white. Journal of Cancer Survivorship, 10(4): 726-735.
  15. Fallowfield L., Atkins L., Catt S., Cox A., Coxon C., Langridge C., Morris R. and Price M. (2005). Patients’ preference for administration of endocrine treatments by injection or tablets: results from a study of women with breast cancer. Annals of Oncology, 17(2): 205-210.
  16. Findley P.A., Shen C. and Sambamoorthi U. (2012). Depression treatment patterns among elderly with cancer. Depression Research and Treatment, 2012: 1-9. DOI: 10.1155/2012/67678
  17. Forconi F., Fabbri A., Lenoci M., Sozzi E., Gozzetti A., Tassi M., Raspadori D. and Lauria F. (2008). Low‐dose oral fludarabine plus cyclophosphamide in elderly patients with untreated and relapsed or refractory chronic lymphocytic Leukaemia. Hematological Oncology, 26(4): 247-251.
  18. Foulon V., Schöffski P. and Wolter P. (2011). Patient adherence to oral anticancer drugs: an emerging issue in modern oncology. Acta Clinica Belgica, 66(2): 85-96. DOI: 10.2143/ACB.66.2.206252
  19. Gatwood J., Gatwood K., Gabre E. and Alexander M. (2017). Impact of clinical pharmacists in outpatient oncology practices: A review. American Journal of Health-System Pharmacy, 74(19): 1549-1557.
  20. Gebbia V., Bellavia G., Ferraù F. and Valerio M.R. (2012). Adherence, compliance and persistence to oral antineoplastic therapy: a review focused on chemotherapeutic and biologic agents. Expert Opinion on Drug Safety, 11(sup1): S49-S59. DOI: 10.1517/14740338.2011.64580
  21. Grassi L., Johansen C., Annunziata M.A., Capovilla E., Costantini A., Gritti P., Torta, R., Bellani M. and Italian Society of Psycho-Oncology Distress Thermometer Study Group (2013). Screening for distress in cancer patients. Cancer, 119(9): 1714-1721.
  22. Greer J.A., Park E.R., Prigerson H.G. and Safren S.A. (2010). Tailoring cognitive-behavioral therapy to treat anxiety comorbid with advanced cancer. Journal of Cognitive Psychotherapy, 24(4): 294. DOI: 10.1891/0889-8391.24.4.29
  23. Hlubocky F.J., Webster K., Beaumont J., Cashy J., Paul D., Abernethy A., Syrjala K.L., Von Roenn J. and Cella D. (2013). A preliminary study of a health-related quality of life assessment of priority symptoms in advanced lymphoma: the National Comprehensive Cancer Network-Functional Assessment of Cancer Therapy–Lymphoma Symptom Index. Leukemia & Lymphoma, 54(9): 1942-1946. DOI: 10.3109/10428194.2012.76297
  24. Iop A., Manfredi A.M. and Bonura S. (2004). Fatigue in cancer patients receiving chemotherapy: an analysis of published studies. Annals of Oncology, 15(5): 712-720.
  25. Jacobs J.M., Pensak N.A., Sporn N.J., MacDonald J.J., Lennes I.T., Safren S.A., Pirl W.F., Temel, J.S. and Greer J.A. (2017). Treatment Satisfaction and Adherence to Oral Chemotherapy in Patients with Cancer. Journal of Oncology Practice, 13(5): e474-e485. DOI: 10.1200/JOP.2016.01972
  26. Jacobsen P.B., Donovan K.A., Trask P.C., Fleishman S.B., Zabora J., Baker F. and Holland J.C. (2005). Screening for psychologic distress in ambulatory cancer patients. Cancer, 103(7): 1494-1502.
  27. Jensen R.E., Arora N.K., Bellizzi K.M., Rowland J.H., Hamilton A.S., Aziz N.M. and Potosky A.L. (2013). Health‐related quality of life among survivors of aggressive non‐Hodgkin lymphoma. Cancer, 119(3): 672-680.
  28. Johnston K.M., Bolbocean C., Connors J. and Peacock S. (2012). Cost–effectiveness of rituximab in follicular lymphoma. Expert Review of Pharmacoeconomics & Outcomes Research, 12(5): 569-577.
  29. Kopec J.A., Yothers G., Ganz P.A., Land S.R., Cecchini R.S., Wieand H.S. and Wolmark N. (2007). Quality of life in operable colon cancer patients receiving oral compared with intravenous chemotherapy: results from National Surgical Adjuvant Breast and Bowel Project Trial C-06. Journal of Clinical Oncology, 25(4): 424-430. DOI: 10.1200/JCO.2005.05.259
  30. Lonardi S., Bortolami A., Stefani M., Monfardini S. (2007). Oral Anticancer Drugs in the Elderly: an overview. Drugs Aging, 24(5): 395-410. DOI: 10.2165/00002512-200724050-0000
  31. Ma C.S. (2014). Role of pharmacists in optimizing the use of anticancer drugs in the clinical setting. Integrated Pharmacy Research and Practice, 3: 11-24. DOI: 10.2147/IPRP.S4042
  32. Maloney K.W. and Kagan S.H. (2011, May). Adherence and oral agents with older patients. Seminars in Oncology Nursing, 27, 2: 154-160.
  33. Marcus S.C. and Olfson M. (2010). National trends in the treatment for depression from 1998 to 2007. Archives of General Psychiatry, 67(12): 1265-1273.
  34. Mathes T., Antoine S.L., Pieper D. and Eikermann M. (2014). Adherence enhancing interventions for oral anticancer agents: a systematic review. Cancer Treatment Reviews, 40(1): 102-108.
  35. Mazzotti E., Sebastiani C. and Marchetti P. (2012). Patient perception of disease control and psychological distress. Cancer Management and Research, 4: 335. DOI: 10.2147/CMAR.S3506
  36. Mitchell A.J., Chan M., Bhatti H., Halton M., Grassi L., Johansen C. and Meader N. (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. The Lancet Oncology, 12(2): 160-174. DOI: 10.1016/S1470-2045(11)70002-
  37. Mustian K.M., Peppone L.J., Palesh O.G., Janelsins M.C., Mohile S.G., Purnell J.Q. and Darling T.V. (2009). Exercise and cancer-related fatigue. US Oncology, 5(2): 20.
  38. Noens L., Van Lierde M.A., De Bock R., Verhoef G., Zachée P., Berneman Z., Martiat P., Mineur P., Van Eygen K. and De Geest S. (2009). Prevalence, determinants, and outcomes of nonadherence to imatinib therapy in patients with chronic myeloid leukemia: the ADAGIO study. Blood, 113(22): 5401-5411.
  39. Oerlemans S., Mols F., Nijziel M.R., Lybeert M. and van de Poll-Franse L.V. (2011). The impact of treatment, socio-demographic and clinical characteristics on health-related quality of life among Hodgkin’s and non-Hodgkin’s lymphoma survivors: a systematic review. Annals of Hematology, 90(9): 993-1004.
  40. O’neill V.J. and Twelves C.J. (2002). Oral cancer treatment: developments in chemotherapy and beyond. British Journal of Cancer, 87(9): 933.
  41. Palaian S., Prabhu M. and Shankar P.R. (2006). Patient counseling by pharmacist-a focus on chronic illness. Pak J Pharm Sci, 19(1): 65-72.
  42. Partridge A.H., Avorn J., Wang P.S. and Winer E.P. (2002). Adherence to therapy with oral antineoplastic agents. Journal of the National Cancer Institute, 94(9): 652-661.
  43. Prieto J.M., Blanch J., Atala J., Carreras E., Rovira M., Cirera E. and Gastó C. (2006). Clinical factors associated with fatigue in haematologic cancer patients receiving stem-cell transplantation. European Journal of Cancer, 42(12): 1749-1755.
  44. Reeve B.B., Potosky A.L., Smith A.W., Han P.K., Hays R.D., Davis W.W., Arora N.K., Haffer S.C. and Clauser S.B. (2009). Impact of cancer on health-related quality of life of older Americans. Journal of the National Cancer Institute, 101(12): 860-868.
  45. Regnier Denois V., Poirson J., Nourissat A., Jacquin J.P., Guastalla J.P. and Chauvin F. (2011). Adherence with oral chemotherapy: results from a qualitative study of the behaviour and representations of patients and oncologists. European Journal of Cancer Care, 20(4): 520-527.
  46. Rosenstein D. L. (2011). Depression and end-of-life care for patients with cancer. Dialogues in Clinical Neuroscience, 13(1): 101.
  47. Sabaté E. (2003). Adherence to long-term therapies: evidence for action [Aderenza in terapie a lungo termine: evidenza per l’azione]. World Health Organization. Roma: Critical Medicine Publishing.
  48. Sanii Y., Torkamandi H., Gholami K., Hadavand N. and Javadi M. (2016). Role of pharmacist counseling in pharmacotherapy quality improvement. Journal of Research in Pharmacy Practice, 5(2): 132. DOI: 10.4103/2279-042X.17958
  49. Siegel R., Ward E., Brawley O. and Jemal A. (2011). Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA: A Cancer Journal for Clinicians, 61(4): 212-236.
  50. Simchowitz B., Brouillard D. and Weingart S.N. (2010). Perceptions and experiences of patients receiving oral chemotherapy. Clinical Journal of Oncology Nursing, 14(4): 447.
  51. Smith S.K., Zimmerman S., Williams C.S., Preisser J.S. and Clipp E.C. (2008). Post-traumatic stress outcomes in non-Hodgkin’s lymphoma survivors. Journal of Clinical Oncology, 26(6): 934-941. DOI: 10.1200/JCO.2007.12.341
  52. Smith S.K., Zimmerman S., Williams C.S., Benecha H., Abernethy A.P., Mayer D.K., Edwards L.J. and Ganz P.A. (2011). Post-traumatic stress symptoms in long-term non-Hodgkin’s lymphoma survivors: does time heal?. Journal of Clinical Oncology, 29(34): 4526. DOI: 10.1200/JCO.2011.37.263
  53. Smith S.K., Mayer D.K., Zimmerman S., Williams C.S., Benecha H., Ganz P.A., Edwards L.J. and Abernethy A.P. (2013). Quality of life among long-term survivors of non-Hodgkin lymphoma: a follow-up study. Journal of Clinical Oncology, 31(2): 272-279. DOI: 10.1200/JCO.2011.40.624
  54. Spichiger E., Muller-Frohlich C., Denhaerynck K., Stoll H., Hantikainen V. and Dodd M. (2011). Prevalence of symptoms, with a focus on fatigue, and changes of symptoms over three months in outpatients receiving cancer chemotherapy. Swiss Med Wkly, 141: w13303.
  55. Stein K.D., Syrjala K.L. and Andrykowski M.A. (2008). Physical and psychological long‐term and late effects of cancer. Cancer, 112(S11): 2577-2592.
  56. Swerdlow S.H., Campo E., Pileri S.A., Harris N.L., Stein H., Siebert R., Advani R., Ghielmini M., Salles G.A. Zelenetz A.D. and Jaffe E.S. (2016). The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood, 127(20): 2375-2390.
  57. Taylor P.R.A., White J.M., Prescott R.J., Angus B., Galloway M.J., Jackson G.H., Lessells, A.M., Lucraft H.H., Summerfield G.P., Proctor S.J. and on Behalf of The Scotland and Newcastle Lymphoma Group. (2006). The addition of oral idarubicin to a chlorambucil/dexamethasone combination has a significant impact on time to treatment failure but none on overall survival in patients with low grade non-Hodgkin’s lymphoma: Results of the Scotland and Newcastle Lymphoma Group randomized NHL VIII trial. Leukemia & Lymphoma, 47(11): 2321-2330. DOI: 10.1080/1042819060088125
  58. Thompson C.A., Charlson M.E., Schenkein E., Wells M.T., Furman R.R., Elstrom R. Ruan J., Martin P. and Leonard J.P. (2010). Surveillance CT scans are a source of anxiety and fear of recurrence in long-term lymphoma survivors. Annals of Oncology, 21(11): 2262-2266.
  59. Timmers L., Swart E.L., Boons C.C., Mangnus D., Van de Ven P.M., Peters G.J., Boven E. and Hugtenburg J.G. (2012). The use of capecitabine in daily practice: a study on adherence and patients’ experiences. Patient Prefer Adherence, 6: 741-748. DOI: 10.2147/PPA.S3675
  60. US National Institutes of Health (2015). “National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch. Surveillance, Epidemiology, and End Results (SEER)”. Program Research Data (1973-2008).
  61. Van Der Poel M.W.M., Oerlemans S., Schouten H.C., Mols F., Pruijt J.F.M., Maas H. and van de Poll-Franse L.V. (2014). Quality of life more impaired in younger than in older diffuse large B cell lymphoma survivors compared to a normative population: a study from the population-based PROFILES registry. Annals of Hematology, 93(5): 811-819.
  62. Verbrugghe M., Verhaeghe S., Lauwaert K., Beeckman D. and Van Hecke A. (2013). Determinants and associated factors influencing medication adherence and persistence to oral anticancer drugs: a systematic review. Cancer Treatment Reviews, 39(6): 610-621.
  63. Wei W., Sambamoorthi U., Olfson M., Walkup J.T. and Crystal S. (2005). Use of psychotherapy for depression in older adults. American Journal of Psychiatry, 162(4): 711-717.
  64. Weinberger M.I., Roth A.J. and Nelson C.J. (2009). Untangling the complexities of depression diagnosis in older cancer patients. The Oncologist,14(1): 60-66.
  65. Weingart S.N., Brown E., Bach P.B., Eng K., Johnson S.A., Kuzel T.M., Langbaum T.S., Leedy R.D., Muller R.J., Newcomer L.N. and O’Brien S. (2008). NCCN Task Force Report: oral chemotherapy. Journal of the National Comprehensive Cancer Network: JNCCN, 6(S1): 14.
  66. Wittmann M., Vollmer T., Schweiger C. and Hiddemann W. (2006). The relation between the experience of time and psychological distress in patients with hematological malignancies. Palliative & Supportive Care, 4(4): 357-363. DOI: 10.1017/S147895150606046
  67. Wood L. (2012). A review on adherence management in patients on oral cancer therapies. European Journal of Oncology Nursing, 16(4): 432-438.
  68. Xu S., Yang Y., Tao W., Song Y., Chen Y., Ren Y., Liu J. and Pang D. (2012). Tamoxifen adherence and its relationship to mortality in 116 men with breast cancer. Breast Cancer Research and Treatment, 136(2): 495-502.
  69. Zerillo J.A., Goldenberg B.A., Kotecha R.R., Tewari A.K., Jacobson J.O. and Krzyzanowska M.K. (2018). Interventions to improve oral chemotherapy safety and quality: a systematic review. JAMA Oncology, 4(1), 105-117.
  70. Ziegler L., Hill K., Neilly L., Bennett M.I., Higginson I.J., Murray S.A., Stark D. and Collaborative, COMPASS (2011). Identifying psychological distress at key stages of the cancer illness trajectory: a systematic review of validated self-report measures. Journal of Pain and Symptom Management, 41(3): 619-636.
  71. Zolnierek K.B.H. and DiMatteo M.R. (2009). Physician communication and patient adherence to treatment: a meta-analysis. Medical Care, 47(8): 826.

Sara Larice, Ada Ghiggia, Luciana Bergui, Francesco Cattel, Matilde Scaldaferri, Elisa Sciorsci, Giulia Valinotti, Lorys Castelli, Aspetti psicologici e qualità della vita in pazienti con linfoma in trattamento con chemioterapia orale in "PSICOLOGIA DELLA SALUTE" 3/2019, pp 77-97, DOI: 10.3280/PDS2019-003005