title: Supportive care needs, anxiety, depression and quality of life amongst newly diagnosed patients with localised invasive cutaneous melanoma in Queensland, Australia.
abstract: OBJECTIVE
  The aim of this paper is to determine levels of supportive care needs, anxiety, depression and symptoms amongst patients newly diagnosed with localised invasive primary melanoma and if these varied amongst patients who had a sentinel lymph node biopsy (SLNB). We also considered quality of life compared with general population norms.
  
  
  METHODS
  Patients newly diagnosed with clinical stage IB-II invasive melanoma were ascertained through Queensland hospitals, specialist clinics and pathology laboratories. Validated surveys measured 46 need items (Supportive Care Needs Survey-Short Form + melanoma subscale), anxiety and depression (Hospital Anxiety and Depression Scale) and quality of life and symptoms (Functional Assessment of Cancer Therapy-Melanoma). Regression models compared outcomes according to whether or not participants had a SLNB.
  
  
  RESULTS
  We surveyed 386 patients, 155 before and 231 after wide local excision, of whom 46% reported ≥1 moderate-level or high-level unmet need. The three highest needs were for help with fears about cancer spreading (17%), information about risk of recurrence (17%) and outcomes when spread occurred (16%). Those who had a SLNB were more likely to report a moderate or high unmet need for help with uncertainty about the future or with lymphoedema (p < 0.05). Overall, 32% of participants had anxiety and 15% had depression regardless of performance of SLNB. Melanoma-specific symptoms were worse in SLNB patients (p = 0.03). Compared with the general population, emotional well-being was lower amongst melanoma patients.
  
  
  CONCLUSIONS
  A substantial proportion of newly diagnosed patients with localised invasive melanoma need further melanoma-specific information and support with psychological concerns. Patients who have a SLNB clear of disease may need help with symptoms after surgery.
authors.affiliation: Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Beesley
authors.affiliation: Queensland Melanoma Project, Discipline of Surgery, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: B Mark
authors.initials: BM
authors.lastname: Smithers
authors.affiliation: Experimental Dermatology Group, Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia.|Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Kiarash
authors.initials: K
authors.lastname: Khosrotehrani
authors.affiliation: Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
authors.forename: Mohsina
authors.initials: M
authors.lastname: Khatun
authors.affiliation: Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: O'Rourke
authors.affiliation: Cancer and Population Studies group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
authors.forename: Maria Celia B
authors.initials: MC
authors.lastname: Hughes
authors.affiliation: Cancer and Population Studies group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
authors.forename: Maryrose K
authors.initials: MK
authors.lastname: Malt
authors.affiliation: The Townsville Hospital, Townsville, QLD, Australia.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Zonta
authors.affiliation: Queensland Melanoma Project, Discipline of Surgery, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia.|Phoenix Plastic Surgery Institute, Brisbane, QLD, Australia.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Bayley
authors.affiliation: Queensland Melanoma Project, Discipline of Surgery, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Barbour
authors.affiliation: Kawana Private Hospital, Sunshine Coast, QLD, Australia.
authors.forename: Lee J
authors.initials: LJ
authors.lastname: Brown
authors.affiliation: Nambour General Hospital, Nambour, QLD, Australia.
authors.forename: Justin
authors.initials: J
authors.lastname: D'Arcy
authors.affiliation: Queensland Melanoma Project, Discipline of Surgery, Princess Alexandra Hospital, The University of Queensland, Brisbane, QLD, Australia.|Mater Health Services, Brisbane, QLD, Australia.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Allan
authors.affiliation: Cancer and Population Studies group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.|Institute of Inflammation and Repair, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
authors.forename: Adèle C
authors.initials: AC
authors.lastname: Green
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000523:psychology*; D008875:Middle Aged; D020380:Needs Assessment; D009367:Neoplasm Staging; D011788:Quality of Life / Q000523:psychology*; D021701:Sentinel Lymph Node Biopsy / Q000523:psychology; D012878:Skin Neoplasms / Q000473:pathology / Q000523:psychology*; D012944:Social Support
keywords: cancer; distress; melanoma; oncology; quality of life; sentinel lymph node biopsy; supportive care needs