Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.
Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Psychooncology. 2021 Jul;30(7):1077-1085. doi: 10.1002/pon.5647. Epub 2021 Feb 25.
Somatic symptoms (e.g., pain, fatigue) are common after childhood cancer and are associated with greater fear of cancer recurrence and poorer health-related quality of life (HRQoL). Qualitative studies indicate that survivors of childhood cancer (SCCs) worry about somatic symptoms as indicating cancer recurrence, which could in part explain associations between symptoms and poorer psychosocial outcomes. However, the prevalence, characteristics, and impact of symptom worry has not been quantitatively studied.
SCCs (N = 111; 52% female; Mage at study = 17.67 years, range = 8-25 years; Mage at diagnosis = 6.70 years) across a variety of diagnoses were recruited from a pediatric cancer center in Canada and completed self-report measures of symptom worry, symptom frequency, general anxiety, fear of cancer recurrence, and HRQoL.
A majority (62%) of SCCs worried about at least one symptom as a sign of recurrence. Pain was the most worrisome symptom, but SCCs also reported worrying about symptoms that are rarely associated with cancer recurrence such as hunger, dizziness, and feeling cold. Symptom worry was more strongly associated with fear of cancer recurrence than the mere frequency of those symptoms, and this relationship held while controlling for treatment factors and general anxiety. Symptom worry and frequency each explained unique variance in HRQoL.
Worry about somatic symptoms as a sign of cancer recurrence is common and may be impactful after childhood cancer. Excessive worry about somatic symptoms could be an important target to reduce fear of recurrence and increase HRQoL in SCCs.
儿童癌症治疗后常出现躯体症状（如疼痛、疲劳），且与更高的癌症复发恐惧和更差的健康相关生活质量（HRQoL）有关。定性研究表明，儿童癌症幸存者（SCCs）担心躯体症状是癌症复发的迹象，这部分可以解释症状与较差的心理社会结局之间的关联。然而，症状担忧的普遍性、特征和影响尚未进行定量研究。
本研究从加拿大一家儿科癌症中心招募了各种诊断的 SCCs（N=111；女性占 52%；研究时年龄均数为 17.67 岁，范围为 8-25 岁；诊断时年龄均数为 6.70 岁），并完成了症状担忧、症状频率、一般焦虑、癌症复发恐惧和 HRQoL 的自我报告测量。
大多数（62%）SCCs对至少一种症状作为复发的迹象表示担忧。疼痛是最令人担忧的症状，但 SCCs 也报告了对一些很少与癌症复发相关的症状感到担忧，如饥饿、头晕和发冷。与这些症状的单纯频率相比，症状担忧与癌症复发恐惧的关系更为密切，而在控制治疗因素和一般焦虑的情况下，这种关系仍然存在。症状担忧和频率均各自解释了 HRQoL 的独特差异。
对躯体症状作为癌症复发迹象的担忧很常见，且在儿童癌症后可能具有影响。过度担心躯体症状可能是减少 SCCs 对癌症复发恐惧和提高 HRQoL 的一个重要目标。
