Health-related quality of life, emotional burden, and neurocognitive function in the first generation of metastatic melanoma survivors treated with pembrolizumab: a longitudinal pilot study.

PURPOSE: The aim of this study was to assess the evolution of health-related quality of Life (HRQoL), emotional burden, and neurocognitive function in the first-generation metastatic melanoma survivors treated with pembrolizumab. METHODS: Survivors were defined as patients who achieved a durable remission for at least 6 months after initiating pembrolizumab in a single-center observational study (N = 141). A semi-structured interview was performed at baseline. Neurocognitive computerized testing and patient-reported outcomes were collected at 4 time points to assess HRQoL using the EORTC QLQ-C30 and the HADS to assess anxiety and depression. RESULTS: Out of 35 eligible patients, 25 were recruited and completed baseline assessment (18 female; median age 58 years [range 28-86]; 24 completed the 1-year follow-up phase. Median time since diagnosis was 30 months (range 12-84); median time since initiation of pembrolizumab was 19 months (range 6-42). At all visits, survivors reported a significantly lower global HRQoL, lower physical, emotional, cognitive, role, and social functioning compared with the European Mean of the healthy population. Fifteen patients (64%) had clinical levels of anxiety/depression at one time point during follow-up. The clinical interview revealed that 12 patients (48%) suffered from Cancer-Related-Post-Traumatic-Stress disorder, of whom 7 (28%) developed transient suicidal ideation, 1 patient made a suicide attempt. Neurocognitive testing revealed cognitive impairment in 8 patients (32%). CONCLUSIONS: Metastatic melanoma survivors, treated successfully with pembrolizumab, are at risk for suffering from emotional distress and neurocognitive impairment with a persistent impact on their HRQOL. Timely detection in order to offer tailored care is indicated.

An experimental approach to the joint effects of relations with partner, friends and parents on happiness

Personal relations constitute an important life domain and satisfaction therein affects happiness in people. In an experimental approach with a 3×3×3 vignettes study in which 103 first year psychology students participated, the contribution of the quality of relationships with parents, friends, and a partner are studied. It is found that the studied relationships contribute to imagined happiness according to an averaging model with equal weights, whereby relationship with a partner is weighted the most important, followed by the relationship, with friends and parents respectively. The averaging model implies that the impact of the quality of the one kind of relationship can be compensated for by the effect from another kind of relationship. The equal weighting implies that the impact of each kind of relationships (parents, friends, and a partner), within the relationships domain, is constant and so does not depend on its quality. Moreover, it seems that at some high level of satisfaction the positive effect of a very good relationship with a partner cannot further be increased by better relationship with friends. Further research with participants from different age groups is needed to further understand the impact of relations with parents, friends, and a partner on happiness(AU)

The 'Distress Barometer': validation of method of combining the Distress Thermometer with a rated complaint scale.

OBJECTIVE: Screening instruments may enhance the clinician's ability to detect elevated levels of distress in cancer patients, but these are often neither suitable nor effective for the routine of daily care for cancer patients. The newly developed Distress Barometer (DB) was intended to provide medical doctors with a convenient tool to interpret 'at single glance' the nature and the intensity of distress in ambulatory cancer patients. The DB, i.e. a combination of the Distress Thermometer (DT) and a new tool, the Colored Complaint Scale was developed to improve the specificity of distress screening without decreasing the sensitivity of the Distress Thermometer. METHODS: Distress was screened in a sample of 538 out-patients, using the Hospital Anxiety and Depression Scale (HADS) and the new Distress Barometer (DB). RESULTS: The results confirm the validity of the Dutch version of the DT against the HADS as standard measure. In addition, it was found that the overall accuracy of the new DB was higher, with a sensitivity of 0.79 and a specificity of 0.81. CONCLUSION: These results indicate that the Distress Barometer, which is convenient for both patients and doctors, can be used as an acceptable, brief and sufficiently accurate method for detecting distress in cancer patients.