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ORIGINAL ARTICLES
Year : 2022  |  Volume : 5  |  Issue : 1  |  Page : 25-34

Assessment of psychological and physical distress among Indian adolescents and young adults with solid cancer using the NCCN Distress Thermometer and Rotterdam Symptom Checklist


1 Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
2 Department of Radiology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India

Correspondence Address:
Dr. Shiv Prasad Shrivastava
Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh 453555
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jco.jco_2_22

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Purpose: The incidence of cancer has increased in India with a visible impact on the young population (aged 15–39 years). The present study aims to evaluate psychological and physical distress and symptom burden in Indian adolescents and young adults (AYAs) with solid cancer using the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) and Rotterdam Symptom Checklist (RSCL). Materials and Methods: This prospective, cross-sectional (n = 259) study included AYAs (aged 15–39 years) with histological diagnosis of solid organ malignancy. Patients’ demographic and clinical information were collected. The symptom burden of patients was assessed using the NCCN DT score and RSCL over the trajectory of three time points. Results: Of the 259 patients, 63% were women and 37% men; the median age was 34 years. In total, 71 (27%) were ≤24 years old and 188 (73%) were >24 years old. Bone sarcoma (39%) and germ cell tumor (31%) were the common subtypes in AYA patients aged ≤24 years and breast cancer (21%) in >24 years of age. The distress scores in both the groups were highest at diagnosis (T1) followed by that measured at 1 (T2) and 3 months (T3) after diagnosis. Among AYA patients >24 years old, worry, nervousness, sadness, transportation, and sleep were the top 5 identified problems and in ≤24 years old, the top identified problems were worry, financial support, sleep, nervousness, and sadness. Conclusion: The principle factors related to distress that were identified in Indian AYAs with cancer were: worry, nervousness, sadness, and sleep. The DT and RSCL are useful screening tools for the assessment of psychological and physical distress in AYAs cancer. Early identification of distress burden with the DT and effective interventions in patients with cancer could improve outcomes including survival. Regular screening for psychological distress and substance-cessation counseling will aid in early interventions, thereby improving outcomes in AYAs with cancer in India.


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