UCSF

ABSTRACTAssociations Between Demographic, Clinical, and Symptom Characteristics and Stress in Oncology Patients Receiving Chemotherapy By Tara Stacker Most patients diagnosed with cancer and undergoing treatment experience global stress and cancer-specific stress; both types of stress are associated with a higher symptom burden. Initial cancer diagnosis is regarded as a disease-specific traumatic event capable of provoking PTSD symptoms. In this cross-sectional study, we used a comprehensive set of demographic, clinical, and symptom characteristics to evaluate for their relative contribution to measures of global and cancer-specific stress. Patients (n=941) completed self-report study questionnaires a total of six times over two cycles of chemotherapy. Consistent with our a priori hypothesis, we found both common and unique characteristics associated with higher levels of global stress and cancer-specific stress. A significant proportion of our patients had scores indicating clinically meaningful subsyndromal PTSD (29.4%) or scores suggestive of syndromal PTSD (13.9%). Four of the five stepwise linear regression analyses performed for various stress measures explained between 41.6% and 54.5% of the total variance. Compared to various demographic and clinical characteristics, many of the common symptoms associated with cancer and its treatments uniquely explained a higher percentage of the variance in the various stress measures. Symptoms of depression made the largest unique contribution to the percentage of total explained variance across all our stress measures. Based on our findings clinicians can choose to assess for global stress, cancer-specific stress, and depression early after cancer diagnosis. Additionally, patients would likely benefit from integrative interventions (e.g., mindfulness-based stress reduction, cognitive behavioral therapy, acupuncture) that simultaneously address stress and symptoms commonly associated with cancer and its treatments.