Background
Cancer places a financial and economic burden on individuals, but relatively little is known about the consequences. We investigated associations between cancer-related financial stress and strain and psychological well-being.

Methods
Individuals >6 months post-diagnosis with breast, prostate and lung cancer, identified from the National Cancer Registry Ireland, completed a postal questionnaire. Financial stress was assessed by the impact of the cancer diagnosis on household ability to make ends meet, financial strain by feelings about household financial situation since the cancer diagnosis and psychological well-being (depression, anxiety and distress) by the Depression Anxiety Stress Scales-21. Logistic regression was used to identify associations between financial stress and strain and depression, anxiety and distress of (a) any severity and (b) severe or worse.

Results
The response rate was 54%. Of 654 respondents, 49% reported increased financial stress and 32% increased financial strain due to cancer. Depression, anxiety and distress were present in: 36%, 29% and 29%, respectively (any severity); and 14%, 13% and 13%, respectively (severe or worse). In adjusted analyses, depression risk was raised threefold in those reporting increased cancer-related financial stress (odds ratio (OR) = 2.79, 95%CI 1.87–4.17) and increased cancer-related financial strain (OR = 3.56, 95%CI 2.23–5.67). For severe or worse depression, the risk estimates were more pronounced (increased stress: OR = 4.36, 95%CI 2.35–8.10; increased strain: OR = 8.21, 95%CI 3.79–17.77). Similar associations were found for anxiety and distress.

Conclusions
Cancer-related financial stress and strain were consistently associated with increased risk of adverse psychological outcomes. If confirmed, these findings provide further rationale for initiatives to alleviate the financial burden of cancer. Copyright © 2012 John Wiley & Sons, Ltd.

Associations between cancer‐related financial stress and strain and psychological well‐being among individuals living with cancer

Anxiety, depression and quality of life among Chinese breast cancer patients during adjuvant therapy.

This paper aimed to obtain information on the levels of anxiety and depression among cancer patients in China. The factors influencing these psychological problems were also analyzed. A total of 1,217 cancer patients were interviewed, and each participant was asked to complete a self-administered questionnaire. The anxiety status, depression status, disease stage, tumor site, pain status, and performance status of the patients during the week prior to the interview were assessed. The anxiety and depression prevalence rates were 6.49 and 66.72 %, respectively. The prevalence rates of depression were 60.62 % for head and neck cancer, 77.19 % for lung cancer, 57.9 % for breast cancer, 75.81 % for esophagus cancer, 63.40 % for stomach cancer, 68.42 % for liver cancer, 54.37 % for colorectal cancer, and 71.13 % for cervix cancer. The factors influencing depression of patients were performance status (P < 0.0001), pain (P = 0.0003), age (P < 0.0001), and education level (P < 0.0001). The risk factors of anxiety were performance status (P = 0.0007), age (P < 0.0001), and gender (P < 0.0001). Depression was a more important psychological problem than anxiety in cancer patients. Compared with 3.8 % of the prevalence of depression in normal population, depression level was high among Chinese cancer patients. Patients with lung, esophagus, and cervix cancers were the high-risk groups for depression. Poor performance status, pain, old age, and low-level education were the predicting factors for depression.

https://www.mascc.org/assets/Pain_Center/2014_February/feb_2014-6.pdf

Prevalence of anxiety and depression and their risk factors in Chinese cancer patients.

Objective
The aim of this study was to explore the association between baseline social support, functional status, and change in health-related quality of life (HRQoL) in colorectal cancer patients and change in anxiety and depression measured by Hospital Anxiety and Depression Scale (HADS) at 1 year after surgery.

Methods
Consecutive patients who were due to undergo therapeutic surgery for the first time for colon or rectal cancer in 9 hospitals in Spain were eligible for the study. Patients completed the following questionnaires before surgery and 12 months afterward: 1 HRQoL instrument, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire; a social support questionnaire, the Duke-UNC Functional Social Support Questionnaire; the Barthel Index, to assess functional status; the HADS, to assess anxiety and depression; and questions about sociodemographic information. General linear models were built to explore the association between social support, functional status, and change in HRQoL and changes in anxiety and depression 12 months after surgery.

Results
A total of 947 colorectal cancer patients took part in the study. Patients' functional status, social support, and change in HRQoL were associated with changes in anxiety and depression. Greater social support and improvements in physical, cognitive, and social functioning and in insomnia resulted in improvements in anxiety and depression. No functionally independent patients were associated with lesser improvements in anxiety and depression.

Conclusions
Colorectal cancer patients who have more social support, are functionally independent and have higher improvements in HRQoL may have better results in anxiety and depression at 1 year after surgery, adjusting for age, gender, location, occupation, and baseline HADS scores.

Association between social support, functional status, and change in health-related quality of life and changes in anxiety and depression in colorectal cancer patients.

Cancer is a disease wherein abnormal cells divide without control and are able to attack other tissues. Most of the patients and their families face some degree of depression, anxiety, and fear when cancer becomes a part of their lives. They feel helpless and eager to find ways on how to get rid of it. The study focuses on anxiety among breast cancer patients. It aims at investigating cancer, its symptoms, and effects the disease has on the anxiety level of patients.

The effect of anxiety on breast cancer patients.

Purpose
The importance of the quality of life (QOL) and mental condition of patients being treated for cancer is now recognized. In this study, we evaluated QOL and mental condition in patients with cancer before and after radiotherapy.

Munefumi Shinbo

Papers

Evaluation of quality of life and psychological response in cancer patients treated with radiotherapy.