Skip to main content

Advertisement

SpringerLink
Log in

Variations in supportive care needs of patients after diagnosis of localised cutaneous melanoma: a 2-year follow-up study

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

We aimed to describe variations in unmet supportive care needs of patients diagnosed with localised melanoma at high risk of recurrence and factors associated with initial and persisting moderate-to-high needs.

Methods

We ascertained 386 patients diagnosed with clinical stage IB-II melanoma and administered surveys every 6 months for 2 years. The proportion experiencing at least one moderate-to-high need was assessed among salient subgroups: 306 patients with no previous melanoma and 80 with previous melanoma at enrolment, 30 who experienced disease recurrence during follow-up and 31 who developed another primary. Baseline factors associated with (a) needs at enrolment and (b) persistent needs over 2 years (or as long as disease-free) were identified by logistic regression analyses.

Results

The proportion of patients with needs substantially declined over the first 6 months (if no previous melanoma, from 48 to 22 %, p < 0.001; previous melanoma, 35 to 17 %, p = 0.007), and in those remaining disease-free, needs declined further by 24 months (to 14 and 6 % respectively). By contrast, 50 % of those experiencing recurrence, and 39 % of those who developed another primary, reported needs. Stressful life events and anxiety were associated with needs at enrolment. At least one need, mainly fear of recurrence, persisted in 22 % of disease-free participants. Persistent needs were predicted by age, depression, anxiety and other stressful life events.

Conclusions

Melanoma patients’ needs peak when first diagnosed and if disease recurs. Younger people or those experiencing additional stressful events, anxiety or depression are more likely to experience persistent needs and may benefit from tailored support.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Erdmann F, Lortet-Tieulent J, Schüz J, Zeeb H, Greinert R, Breitbart EW, Bray F (2013) International trends in the incidence of malignant melanoma 1953-2008—are recent generations at higher or lower risk? Int J Cancer 132(2):385–400

    Article  CAS  PubMed  Google Scholar 

  2. Arnold M, Holterhues C, Hollestein LM, Coebergh JWW, Nijsten T, Pukkala E, Holleczek B, Tryggvadóttir L, Comber H, Bento MJ, Diba CS, Micallef R, Primic-Žakelj M, Izarzugaza MI, Perucha J, Marcos-Gragera R, Galceran J, Ardanaz E, Schaffar R, Pring A, de Vries E (2014) Trends in incidence and predictions of cutaneous melanoma across Europe up to 2015. J Eur Acad Dermatol Venereol 28(9):1170–1178

    Article  CAS  PubMed  Google Scholar 

  3. Green AC, Baade P, Coory M, Aitken JF, Smithers M (2012) Population-based 20-year survival among people diagnosed with thin melanomas in Queensland Australia. J Clin Oncol 30(13):1462–1467

    Article  PubMed  Google Scholar 

  4. Stucky C-CH, Gray RJ, Dueck AC, Wasif N, Laman SD, Sekulic A, Pockaj BA (2010) Risk factors associated with local and in-transit recurrence of cutaneous melanoma. Am J Surg 200(6):770–774

    Article  PubMed  Google Scholar 

  5. Committee on Quality Health Care in America - Institute of Medicine, Crossing the quality chasm: a new health system for the twenty-first century. 2001: Washington, D.C.

  6. Sanson-Fisher R, Girgis A, Boyes A, Bonevski B, Burton L, Cook P (2000) The unmet supportive care needs of patients with cancer supportive care review group. Cancer 88(1):226–237

    Article  CAS  PubMed  Google Scholar 

  7. Bird J, Coleman P, Danson S (2015) Coping with melanoma-related worry: a qualitative study of the experiences and support needs of patients with malignant melanoma. J Clin Nurs 24(7–8):937–947

    Article  PubMed  Google Scholar 

  8. Stamataki Z, Brunton L, Lorigan P, Green AC, Newton-Bishop J, Molassiotis A (2015) Assessing the impact of diagnosis and the related supportive care needs in patients with cutaneous melanoma. Support Care Cancer 23(3):779–789

    Article  PubMed  Google Scholar 

  9. Molassiotis A, Brunton L, Hodgetts J, Green AC, Beesley VL, Mulatero C, Newton-Bishop JA, Lorigan P (2014) Prevalence and correlates of unmet supportive care needs in patients with resected invasive cutaneous melanoma. Ann Oncol 25(10):2052–2058

    Article  CAS  PubMed  Google Scholar 

  10. Fischbeck S, Imruck BH, Blettner M, Weyer V, Binder H, Zeissig SR, Emrich K, Friedrich-Mai P, Beutel ME (2015) Psychosocial care needs of melanoma survivors: are they being met? PLoS One 10(8):e0132754–e0132754

    Article  PubMed  PubMed Central  Google Scholar 

  11. Bonevski B, Sanson-Fisher R, Hersey P, Paul C, Foot G (1999) Assessing the perceived needs of patients attending an outpatient melanoma clinic. J Psychosoc Oncol 17(3/4):101–118

    Google Scholar 

  12. Hetz SP, Tomasone JR (2012) Supportive care needs of Canadian melanoma patients and survivors. Can Oncol Nurs J 22(4):248–256

    Article  PubMed  Google Scholar 

  13. Palesh O, Aldridge-Gerry A, Bugos K, Pickham D, Chen JJ, Greco R, Swetter SM (2014) Health behaviors and needs of melanoma survivors. Support Care Cancer 22(11):2973–2980

    Article  PubMed  Google Scholar 

  14. Beesley VL, Smithers BM, Khosrotehrani K, Khatun M, O’Rourke P, Hughes MC, Malt MK, Zonta MJ, Bayley GJ, Barbour AP, Brown LJ, D’Arcy J, Allan CP, Green AC (2015) Supportive care needs, anxiety, depression and quality of life amongst newly diagnosed patients with localised invasive cutaneous melanoma in Queensland Australia. Psychooncology 24(7):763–770

    Article  PubMed  Google Scholar 

  15. Boyes A, Girgis A, Lecathelinais C (2009) Brief assessment of adult cancer patients’ perceived needs: development and validation of the 34-item supportive care needs survey (SCNS-SF34). J Eval Clin Pract 15(4):602–606

    Article  PubMed  Google Scholar 

  16. McElduff P, Boyes A, Zucca A, Girgis A (2004) Supportive care needs survey: a guide to administration, scoring and analysis. The University of Newcastle, Newcastle, Australia

    Google Scholar 

  17. Australian Institute of Health and Welfare, Rural, regional and remote health: a guide to remoteness classifications. 2004, AIHW Canberra: AIHW

  18. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370

    Article  CAS  PubMed  Google Scholar 

  19. Ibrahim JG, Molenberghs G (2009) Missing data methods in longitudinal studies: a review. Test (Madrid, Spain) 18(1):1–43

    Google Scholar 

  20. Griesser AC, Vlastos G, Morel L, Beaume C, Sappino AP, Haller G (2011) Socio-demographic predictors of high support needs in newly diagnosed breast cancer patients. Eur J Cancer Care (Engl) 20(4):466–474

    Article  Google Scholar 

  21. McDowell ME, Occhipinti S, Ferguson M, Dunn J, Chambers SK (2010) Predictors of change in unmet supportive care needs in cancer. Psychooncology 19(5):508–516

    Article  CAS  PubMed  Google Scholar 

  22. Goldstein D, Bennett BK, Webber K, Boyle F, de Souza PL, Wilcken NRC, Scott EM, Toppler R, Murie P, O’Malley L, McCourt J, Friedlander M, Hickie IB, Lloyd AR (2012) Cancer-related fatigue in women with breast cancer: outcomes of a 5-year prospective cohort study. J Clin Oncol 30(15):1805–1812

    Article  PubMed  Google Scholar 

  23. Armes J, Crowe M, Colbourne L, Morgan H, Murrells T, Oakley C, Palmer N, Ream E, Young A, Richardson A (2009) Patients’ supportive care needs beyond the end of cancer treatment: a prospective, longitudinal survey. J Clin Oncol 27(36):6172–6179

    Article  PubMed  Google Scholar 

  24. Brédart, A., O. Merdy, B. Sigal-Zafrani, C. Fiszer, S. Dolbeault, and J.B. Hardouin 2015 Identifying trajectory clusters in breast cancer survivors’ supportive care needs, psychosocial difficulties, and resources from the completion of primary treatment to 8 months later. Support Care Cancer

  25. Beesley VL, Price MA, Webb PM, O’Rourke P, Marquart L, Butow PN (2013) Changes in supportive care needs after first-line treatment for ovarian cancer: identifying care priorities and risk factors for future unmet needs. Psychooncology 22(7):1565–1571

    Article  PubMed  Google Scholar 

  26. Mitchell J, Callaghan P, Street J, Neuhaus S, Bessen T (2014) The experience of melanoma follow-up care: an online survey of patients in Australia. J Skin Cancer 2014:429149–429149

    Article  PubMed  PubMed Central  Google Scholar 

  27. Bultz BD, Carlson LE (2006) Emotional distress: the sixth vital sign—future directions in cancer care. Psychooncology 15(2):93–95

    Article  PubMed  Google Scholar 

  28. Carlson LE, Waller A, Mitchell AJ (2012) Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol 30(11):1160–1177

    Article  PubMed  Google Scholar 

  29. Dieng M, Kasparian NA, Morton RL, Mann GJ, Butow P, Menzies S, Costa DSJ, Cust AE (2015) The melanoma care study: protocol of a randomised controlled trial of a psycho-educational intervention for melanoma survivors at high risk of developing new primary disease. BMC Psychology 3(1):23–23

    Article  PubMed  PubMed Central  Google Scholar 

  30. van de Wal, M., L. van de Poll-Franse, J. Prins, and M. Gielissen 2015 Does fear of cancer recurrence differ between cancer types? A study from the population-based PROFILES registry. Psychooncology.

  31. Hewitt M, Greenfield S, Stovall E (2005) From cancer patient to cancer survivor: lost in transition. Institute of Medicine and National Research Council, Washington, D.C.

    Google Scholar 

  32. Australian Cancer Network Melanoma Guidelines Revision Working Party, Clinical practice guidelines for the management of melanoma in Australia and New Zealand. 2008

Download references

Acknowledgments

We thank all study participants. We acknowledge the valuable contributions of our study staff Maria Celia Hughes, Maryrose Malt, Angela Carroll, Mohamed Lakhdar and Valerie Logan and clinical collaborators Drs. Mark Zonta (The Townsville Hospital and North Queensland Minimally Invasive Surgery), Gerard Bayley (Princess Alexandra Hospital and Phoenix Plastic Surgery, Greenslopes), Andrew Barbour (Princess Alexandra Hospital and Gastro Intenstinal and Soft Tissue Clinic, Greenslopes), Christopher Allan (Princess Alexandra Hospital and Mater Public and Private Hospital), Lee Brown (Coastal Plastic Surgery, Sunshine Coast), Justin D’Arcy (Nambour Hospital and Sunshine Coast Private Hospital Medical Centre), David Weedon (Sullivan Nicolaides Pathology), Dominic Wood (IQ Pathology) and Richard Williamson (Zenith Specialist Pathology).

VL Beesley and this study were funded by Australian National Health and Medical Research Council Program grants (Nos. 552429, 1073898). K Khosrotehrani was funded by a National Health and Medical Research Council fellowship (No 1023371).

Author information

Authors and Affiliations

  1. Population Health Department, QIMR Berghofer Medical Research Institute, Locked Bag 2000 Royal Brisbane Hospital, Brisbane, QLD, 4029, Australia

    Vanessa L. Beesley, Peter O’Rourke & Adèle C. Green

  2. Queensland Melanoma Project, Discipline of Surgery, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia

    B. Mark Smithers

  3. Institute for Health and Biomedical Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia

    Monika Janda

  4. Experimental Dermatology Group, UQ Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia

    Kiarash Khosrotehrani

  5. The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia

    Kiarash Khosrotehrani

  6. Cancer Research UK Manchester Institute, University of Manchester, Manchester, UK

    Adèle C. Green

Authors
  1. Vanessa L. Beesley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Mark Smithers
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter O’Rourke
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Monika Janda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kiarash Khosrotehrani
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Adèle C. Green
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vanessa L. Beesley.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Beesley, V.L., Smithers, B.M., O’Rourke, P. et al. Variations in supportive care needs of patients after diagnosis of localised cutaneous melanoma: a 2-year follow-up study. Support Care Cancer 25, 93–102 (2017). https://doi.org/10.1007/s00520-016-3378-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-016-3378-9

Keywords

Search

Navigation