Distress Levels High Among Patients With Common Form of Kidney Cancer

Many patients with renal cell carcinoma, the most common type of kidney cancer, experience high levels of distress, according to study findings published in BJU International.

Researchers from City of Hope in Duarte, California, surveyed 450 people online about age, gender, histologic subtype and disease recurrence. Most patients where white (93 percent) and more than half were women (56 percent), at a mean age of 56 years. Seventy-four percent of patients had non-metastatic disease and 61 percent had disease recurrence.

“We observed that more than 70 percent of patients report moderate to severe distress, even if these patients have completed treatment and are in the survivorship period of their lives,” Cristiane Decat Bergerot, Ph.D., a postdoctoral fellow, said in an interview with CURE.

Distress was measured by using the National Comprehensive Cancer Network (NCCN) Distress Thermometer, which ranks the feeling from zero (no distress) to 10 (extreme distress). Patients with renal cell carcinoma had the chance to complete the survey from April 1, 2017 to June 15, 2017.

Moderate to severe distress was reported by 77 percent of patients, and it was more common in younger women who had non-clear cell histology — which accounts for about 20 to 25 percent of all renal cell carcinoma cases —and disease recurrence. However, race, metastatic disease and removal of one or both kidneys had no association with greater distress.

“Non-clear cell histology is not a common type of renal cell carcinoma, so (these patients) have less information to access online about their treatment,” Decat Bergerot said. “Usually, when our patients finish their treatment, they have more fear of cancer progression and fear of recurrence. It is something that we can work with them to mitigate these kinds of symptoms and go back to enjoying their lives.”

In addition, researchers noted that distress is more prevalent in patients with renal cell carcinoma than in other cancer types, which they attributed to specific subsets of patients. “For instance, patients with recurrence demonstrated high levels of distress, and understandably so, as these populations face a poorer prognosis,” researchers wrote.

Decat Bergerot explained that interventions are needed to target this population of patients to help lower levels of distress and anxiety. “We can keep screening these patients for emotional problems and try to refer them for early interventions with psychologists or social workers, or we can even make more affordable programs,” she said. “As soon as they feel like this is disrupting activities, their social life and behaviors, they should report this to their nurse or social worker.”

Caregivers also play an important role in treatment. “They already know the patient before everything starts to come up in their lives, so they have a way to compare if a patient is more isolated or depressed,” Decat Bergerot said. “This can be one call of action for them to ask for support from their cancer center.”

This year in the United States, more than 63,000 new cases of kidney cancer — mainly in men — will be diagnosed. Kidney cancer is among the 10 most common cancers in both men and women. “It is normal for someone to be sad with this kind of diagnosis, but we don’t have to live with these feelings for a long period of time,” Decat Bergerot said.