Fear of progression in patients with gastrointestinal stromal tumors (GIST): Is extended lifetime related to the Sword of Damocles?
BACKGROUND
Gastrointestinal stromal tumors (GIST) are rare and before 2000, patients had a dismal prognosis with a median survival of less than a year after tumor metastasis. However, the median overall survival has increased to more than five years following the introduction of imatinib and other tyrosine kinase inhibitors (TKI). Little is known about the psychosocial consequences of treatment of GIST, but this is important because patients now are treated and live for longer. This cross-sectional study assessed quality of life, distress, and fear of cancer recurrence or progression in patients with GIST.


METHODS
Eighty-six patients with localized or metastatic GIST were asked to participate. Patients completed self-report questionnaires including the EORTC-Quality of Life Questionnaire, Hospital Anxiety and Depression Scale, Impact of Event Scale, Cancer Worry Scale, and Fear of Cancer Recurrence Inventory.


RESULTS
Fifty-four patients (median age 63.3 years) completed the questionnaires, 33 (61%) of whom were receiving TKI treatment at the time of the study. Overall, the GIST patients had a good global quality of life, but 28 patients had high levels of fear of cancer recurrence/progression. This high level of fear was not related to patient- or treatment-related variables. These patients experienced significantly higher levels of psychological distress, functional impairments, and difficulty making plans for the future than did patients with lower levels of fear.


CONCLUSIONS
More attention should be paid to specific cancer-related problems, such as fear of cancer recurrence/progression, in addition to general quality of life issues in patients with GIST.
a Department of Medical Psychology , Radboud University Medical Center , Nijmegen , The Netherlands.
José A E
JA
Custers
Ronald
R
Tielen
Judith B
JB
Prins
Johannes H W
JH
de Wilt
Marieke F M
MF
Gielissen
Winette T A
WT
van der Graaf
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005239:Fear / Q000523:psychology*; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011788:Quality of Life; D017741:Survivors / Q000523:psychology*; D055815:Young Adult
D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors