In a recent publication in the journal The Oncologist, researchers conducted a cross-sectional study involving adults newly diagnosed with indolent non-Hodgkin’s lymphomas and sought to evaluate the quality of life (QoL: Functional Assessment of Cancer Therapy—General), psychological symptoms (Hospital Anxiety and Depression Scale), coping (Brief-COPE), and perception of prognosis (Prognosis Awareness Impact Scale) in this patient cohort.
The authors wrote, “Indolent non-Hodgkin lymphomas (iNHL) are a heterogenous group of mostly incurable diseases with prolonged illness courses and prognostic uncertainty. Yet, studies evaluating coping and perception of prognosis are limited.”
The study’s primary objective was to describe baseline experiences of iNHL, the utilization of coping approaches, and the perception of prognosis. The researchers also noted that the secondary objective was to assess the correlation of perception of prognosis at diagnosis with baseline psychological distress and QoL.
The authors wrote, “To our knowledge, our study is among the first to detail perception of prognosis in patients newly diagnosed with iNHL.”
Between September 2021 and September 2022, 48 newly diagnosed patients with iNHL at a single academic center were enrolled. To measure the QoL, anxiety and depression symptoms, coping, and perception of prognosis, questionnaires were administered.
The average age was 66.9 years (SD = 10.5), and the majority were females (60.4% ), with 85.4% being Caucasian, 8.3% being Asian, and patients who were African American, American Indian, and Middle Eastern each comprised 2.1% of the patient population. The most common diagnoses included chronic lymphocytic leukemia/small lymphocytic lymphoma (39.6%) and follicular lymphoma (33.3%). Most patients underwent upfront active surveillance (62.5%), and a small percentage (12.5%) had limited-stage disease treated with curative intent radiation therapy.
The results revealed that at the time of diagnosis, an estimated 33.3% of patients reported any clinically significant symptom of psychological distress, including 27.1% reporting anxiety and 14.6% experiencing symptoms associated with post-traumatic stress disorder (PTSD).
The results also indicated that at diagnosis, patients substantially employed acceptance (56.2%), seeking emotional support (47.9%), and denial (47.9%) as coping strategies.
The authors wrote, “While 66.7% of patients recalled their oncologist assessment of illness as incurable, only 35.4% reported that the illness is unlikely to be cured. Overall, 45.8% indicated that they were worried about their prognosis, and 31.2% reported perseverating on their prognosis.”
Additionally, researchers discovered that greater emotional coping with prognosis was correlated with improved QoL and less psychological distress at diagnosis, including fewer anxiety, depression, and PTSD symptoms.
Of the study population, 64.6% believed the disease was curable, and 66.7% reported that the oncologist informed them it was incurable.
Based on their findings, the authors wrote, “Patients newly diagnosed with indolent lymphoma frequently experience psychological distress, threatening perceptions of illness, and prognosis-related concerns, even in the absence of physical symptoms.”
The authors also indicated that awareness among oncologists about prognosis-related concerns at diagnosis of indolent lymphoma is critical to patient care, and that implementation of supportive care interventions to encourage higher emotional coping with prognosis can be instrumental in diminishing psychological distress in patients diagnosed with iNHL.
The authors concluded, “Interventions to address prognostic uncertainty and to promote positive emotional coping with prognosis in patients with iNHL are an unmet need and have the potential to ameliorate psychological distress and improve QoL in this patient population.”
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