title: Psychosocial stress in cancer patients during and after radiotherapy.
abstract: OBJECTIVE
  The aim of this study was to investigate stress in tumor patients by means of a cancer-specific questionnaire in the course of radiotherapy.
  
  
  METHODS
  Disease-specific aspects of psychosocial stress (Herschbach's Questionnaire on Stress in Cancer Patients, QSC) were self-assessed by patients with different tumor types before radiotherapy (ti1), after radiotherapy (ti2), and 6 weeks after the end of radiotherapy (ti3). We investigated 265 of 446 patients (157 male, 108 female; median age 58.6 years) with complete data of ti1-ti3.
  
  
  RESULTS
  In the course of investigation, the most prominent stress scale of the patients proved to be physical efficiency, without significant changes during treatment and after therapy. Significant increases in stress were observed for anxiety, pain, and information at ti3 (p < 0.001, p = 0.001, p = 0.035). Women showed significantly higher stress from ti1 to ti3, younger patients displayed a decrease in anxiety, whereas elderly patients demonstrated an increase (p = 0.016). Breast cancer patients had the highest stress levels. The probability of correctly predicting increase in stress (sensitivity) was 78% and the specificity 67%. The relevant predictor variables were tumor stage, addiction to alcohol or nicotine, metabolic disorder, marital status, and age.
  
  
  CONCLUSIONS
  Patients who experienced stress at the beginning of radiotherapy also had the same or increased levels of stress during and shortly after treatment and needed permanent psychosocial support to improve quality of life. The identification of patients with high stress levels at the beginning of therapy could be helpful.
authors.affiliation: Department and Polyclinic of Radiotherapy, Klinikum Grosshadern, Ludwig Maximilians University, Munich, Germany. susanne.sehlen@helios.med.uni-muenchen.de
authors.forename: Susanne
authors.initials: S
authors.lastname: Sehlen
authors.forename: Helmuth
authors.initials: H
authors.lastname: Hollenhorst
authors.forename: Beatrice
authors.initials: B
authors.lastname: Schymura
authors.forename: Peter
authors.initials: P
authors.lastname: Herschbach
authors.forename: Uelker
authors.initials: U
authors.lastname: Aydemir
authors.forename: Martina
authors.initials: M
authors.lastname: Firsching
authors.forename: Eckhart
authors.initials: E
authors.lastname: Dühmke
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D011788:Quality of Life; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012737:Sex Factors; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D013997:Time Factors