title: Recurrent brain tumour: the impact of illness on patient's life.
abstract: OBJECTIVE
  Despite advances in therapies that offer improved survival rates, clinical course of brain tumours leads to a progressive functional deterioration in patients with modifications in their psychological reaction to the disease. Patients with brain tumours are rarely assessed for quality of life and psychological variables, and even fewer studies have assessed patients who have experienced a recurrence of brain tumours. Therefore, the aim of the present study is to investigate the patients with recurrent brain tumours and their reaction to the illness.
  
  
  METHODS
  We enrolled 81 patients with recurrent CNS tumours. Karnofsky Performance Status scale (KPS) was used to evaluate functional status of patients; the multidimensional aspect of quality of life was assessed through "Functional Assessment of Cancer Therapy-Brain" (FACT-Br), "Hospital Anxiety and Depression Scale" and "Psychological Distress Inventory". These were all used as tests of psychological well-being.
  
  
  RESULTS
  Distress and almost all mean FACT-Br subscale scores seemed to be significantly lower in patients, in comparison with normative data. Surprisingly, the emotional well-being mean score was significantly higher in our recurrence sample than in patients with brain tumours at first diagnosis. Anxiety seemed not to be influenced by a relapse diagnosis; instead, depression was higher and differed significantly from normative data. Low correlation between KPS and FACT-Br total and some sub-scores was found.
  
  
  CONCLUSIONS
  Apparent dissociation between patients' judgment on their quality of life (bad except for emotional) and their reported distress (low) is the most intriguing finding, suggesting highly preserved coping strategies in the emotional sphere, despite intact judgment and disease awareness.
authors: Department of Neurooncology, Fondazione IRCCS Istituto Neurologico C. Besta, Via Celoria, 11, 20133, Milan, Italy. lamperti@istituto-besta.it
authors: Elena
authors: E
authors: Lamperti
authors: Giuseppe
authors: G
authors: Pantaleo
authors: Claudia Yvonne
authors: CY
authors: Finocchiaro
authors: Antonio
authors: A
authors: Silvani
authors: Andrea
authors: A
authors: Botturi
authors: Paola
authors: P
authors: Gaviani
authors: Lucio
authors: L
authors: Sarno
authors: Andrea
authors: A
authors: Salmaggi
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D001294:Attitude to Health; D001932:Brain Neoplasms / Q000473:pathology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*