Prevalence of distress in cancer patients undergoing chemotherapy

Aim: Feeling distressed is often a normal reaction to the diagnosis of cancer and cancer treatment. However, if excessive, distress may lead to more disabling conditions such as depression and anxiety. The aims of the study were to determine the prevalence and level of distress in patients with cancer who were undergoing chemotherapy and to examine the associated factors related to psychological distress in these patients. Methods: Adult patients with confirmed cancer who were undergoing out-patient chemotherapy at the Clinical Oncology Unit, Universiti Malaya Medical Centre were invited to participate in the study. They were assessed on their sociodemographic profiles, clinical history, distress level as measured using the ‘Distress Thermometer’, and problems checklist on practical, family, emotional and physical symptoms. The Hospital Anxiety Depression Scale (HADS) was used by patients to report anxiety and depression. Results: One hundred and sixty-eight patients with mean age of 50 years participated in the study. The prevalence of psychological distress determined by the ‘Distress Thermometer’ was 51%. HADS found the prevalence of depression/anxiety to be 32%. There was no significant association between distress and the primary site of cancer, the phase of chemotherapy and the sociodemographic profiles except for age (r = −0.21, P = 0.007). Distress was significantly associated with practical, family and emotional problems. Some of the physical problems such as appearance, breathing, changes in urination, constipation, eating, fatigue, getting around, memory/concentration, nausea, pain and sleep were also significantly associated with distress. Conclusion: Cancer patients undergoing chemotherapy experienced high level of distress. This finding should alert oncologists that some patients exhibiting these signs of distress may need referral to the mental health team.