Palesh Oxana, Aldridge-Gerry Arianna, Bugos Kelly, Pickham David, Chen Jie Jane, Greco Ralph, Swetter Susan M
Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Office 2318, Stanford, CA, 94305, USA,
Support Care Cancer. 2014 Nov;22(11):2973-80. doi: 10.1007/s00520-014-2286-0. Epub 2014 May 31.
Little is known about melanoma survivors' long-term symptoms, sun protection practices, and support needs from health providers.
Melanoma survivors treated at Stanford Cancer Center from 1995 through 2011 were invited to complete a heath needs survey. We compared responses of survivors by sex, education, time since diagnosis (long-term vs. short-term survivors), and extent of treatment received (wide local excision (WLE) alone versus WLE plus additional surgical or medical treatment (WLE+)).
One hundred sixty melanoma survivors (51 % male; 61 % long-term; 73 % WLE+) provided evaluable data. On average, patients were 62 years of age (SD = 14), highly educated (75 % college degree), and Caucasian (94 %). Overall, participants rated anxiety as the most prevalent symptom (34 %). Seventy percent reported that their health provider did not address their symptoms, and 53 % requested education about melanoma-specific issues. Following treatment, women spent significantly less time seeking a tan compared with men (p = 0.01), had more extremity swelling (p = 0.014), and expressed higher need for additional services (p = 0.03). Long-term survivors decreased their use of tanning beds (p = 0.03) and time spent seeking a tan (p = 0.002) and were less likely to receive skin screening every 3-6 months (p < 0.001) compared with short-term survivors. WLE+ survivors reported greater physical long-term effects than WLE survivors (p ≤ 0.001) following treatment.
Melanoma survivors experience continuing symptoms long after treatment, namely anxiety, and they express a need for information about long-term melanoma effects, psychosocial support, and prevention of further skin cancer.
对于黑色素瘤幸存者的长期症状、防晒措施以及对医疗服务提供者的支持需求,我们知之甚少。
邀请1995年至2011年在斯坦福癌症中心接受治疗的黑色素瘤幸存者完成一项健康需求调查。我们根据性别、教育程度、确诊后的时间(长期幸存者与短期幸存者)以及接受的治疗程度(单纯广泛局部切除(WLE)与WLE加额外手术或药物治疗(WLE+))对幸存者的回答进行了比较。
160名黑色素瘤幸存者(51%为男性;61%为长期幸存者;73%为WLE+)提供了可评估的数据。患者平均年龄为62岁(标准差=14),受教育程度高(75%拥有大学学位),且为白种人(94%)。总体而言,参与者将焦虑评为最普遍的症状(34%)。70%的人报告称他们的医疗服务提供者未处理他们的症状,53%的人要求获得有关黑色素瘤特定问题的教育。治疗后,与男性相比,女性花在晒黑上的时间显著减少(p=0.01),肢体肿胀更多(p=0.014),并且表示对额外服务的需求更高(p=0.03)。与短期幸存者相比,长期幸存者减少了对晒黑床的使用(p=0.03)和花在晒黑上的时间(p=0.002),并且每3至6个月接受皮肤筛查的可能性更小(p<0.001)。治疗后,WLE+幸存者报告的长期身体影响比WLE幸存者更大(p≤0.001)。
黑色素瘤幸存者在治疗后很长时间仍会经历持续的症状,即焦虑,并且他们表示需要有关黑色素瘤长期影响、心理社会支持以及预防进一步皮肤癌的信息。