title: Women with self-reported lower-limb lymphedema after treatment for gynecological cancers: are they more likely to self-report psychosocial symptoms and less likely to use services?
abstract: BACKGROUND
  Survivorship for gynecological cancers has increased because of improved screening and treatment. Use of supportive care services after treatment is important to improve patient quality of life.
  
  
  OBJECTIVE
  To assess self-reported lower-limb lymphedema (LLL), depression, anxiety, quality of life, unmet supportive care needs, and service use among gynecological cancer survivors.
  
  
  METHODS
  In 2010, a population-based, cross-sectional mail survey was conducted among 160 gynecological cancer survivors 5-30 months after their diagnoses (response rate, 53%).
  
  
  RESULTS
  Overall, 30% of women self-reported symptoms of LLL, 21% and 24% self-reported symptoms of depression or anxiety, respectively. Women with LLL were more likely to also report symptoms of depression or anxiety, and had higher unmet supportive care needs. Services needed but not used by 10%-15% of women with LLL, anxiety, or depression were those of a lymphedema specialist, pain specialist, and physiotherapist for LLL, and a psychiatrist, psychologist, and pain specialist for anxiety and depression.
  
  
  CONCLUSIONS
  Small sample size, self-reported data, limited generalization to other countries, underrepresentation of older women (age >70 years) and women from non-Caucasian backgrounds.
  
  
  CONCLUSIONS
  Women with LLL or high distress were less likely to use services they needed.
authors: Queensland Centre for Gynaecological Cancer, University of Queensland, Brisbane, Australia; and Department of Medical Sciences, Radboud University Nijmegen, The Netherlands.
authors: Iris
authors: I
authors: Kusters
authors: Queensland Centre for Gynaecological Cancer, University of Queensland, Brisbane, Australia.
authors: Merran
authors: M
authors: Williams
authors: Queensland Centre for Gynaecological Cancer, University of Queensland, Brisbane, Australia.
authors: Andreas
authors: A
authors: Obermair
authors: School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
authors: Monika
authors: M
authors: Janda
keywords: anxiety; depression; gynaecological cancer; lymphoedema; service use; supportive care