An Exploration of the Relative Influence of Patient's Age and Cancer Recurrence Status on Symptom Distress, Anxiety, and Depression Over Time

Abstract

Past research suggests that psychosocial responses to advanced or recurrent cancer vary by age. This study compares the relative influences of patients’ age and recurrence status on indicators of symptom distress, anxiety, and depression following a diagnosis of advanced cancer. A prospective study of advanced cancer support provided patient outcome data reported at baseline, 3-, and 6-month intervals. Cohorts were defined by age group and recurrence status and latent growth curves fit to anxiety, depression, and symptom distress outcomes. Middle-age recurrent patients reported the highest symptom distress, depression, and anxiety across time points. Older recurrent patients fared worse at baseline than older nonrecurrent patients, but outcome scores converged across time points. Recurrent cancer presents a distinct challenge that, for middle-age patients, persists across time. It may be beneficial to develop targeted educational and support resources for middle-age patients with recurrent disease.

KEYWORDS:

• age differences
• distress
• anxiety
• depression
• cancer recurrence

Acknowledgments

This study was supported by funds granted to Dr. Step through a Case Comprehensive Cancer Center support grant from the National Cancer Institute CA043703. Dr. Rose and Dr. Kypriotakis were further supported by National Cancer Institute and National Institute of Aging funds (Rose: R01CA10282).