title: Illness-related distress in women with clinically localized cutaneous melanoma.
abstract: BACKGROUND
  Women may experience distress or changes in their quality of life following treatment for early-stage melanoma. In order to plan future interventions and identify areas of primary concern, we conducted a cross-sectional survey to describe the experiences of women treated for clinically localized melanoma.
  
  
  METHODS
  We examined quality of life, levels of distress, appearance perceptions, body image, fear of recurrence, and reproductive concerns in 100 patients (age 21-90 years, M = 54.34 years). Most (61 %) had melanoma of the extremity, with a median depth of 1.1 mm (range, 0-10.5 mm).
  
  
  RESULTS
  Significant depressive symptomatology occurred in 10 % of patients, and 12 % reported a clinically established high level of intrusive thoughts related to melanoma. Quality-of-life scores indicated more disruption on psychological, compared with social and physical functioning. Also, 64 % of women rated their appearance as worse post-treatment; 23 % were unsatisfied with the appearance of the surgical site. Recurrence concerns indicated significant worry about health and death. Most patients (>85 %) were not concerned about fertility, but 52 % worried that future children would have an increased risk of cancer.
  
  
  CONCLUSIONS
  Some women treated for clinically localized melanoma reported high levels of distress associated with their altered body image and fear of recurrence. Improvements in patient education prior to surgical intervention may reduce the distress associated with the diagnosis and treatment of melanoma.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. atkinsot@mskcc.org
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Atkinson
authors.forename: Nikki S
authors.initials: NS
authors.lastname: Noce
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hay
authors.forename: Brian T
authors.initials: BT
authors.lastname: Rafferty
authors.forename: Mary S
authors.initials: MS
authors.lastname: Brady
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008545:Melanoma / Q000150:complications / Q000473:pathology / Q000523:psychology*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011788:Quality of Life; D012878:Skin Neoplasms / Q000150:complications / Q000473:pathology / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology / Q000473:pathology / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D055815:Young Adult