Patients with high-grade glioma are under high levels of distress

Distress levels are high among patients with high-grade gliomas (HGG) and demonstrate high unmet need for distress screening and referral services, a new study has found.

Researchers conducted a prospective cohort analysis of 116 patients (mean age 55.7 years, 71 percent men) who were surveyed at three time points: before chemoradiotherapy, and at 3 and 6 months after treatment. Assessments were conducted using the Distress Thermometer, Functional Assessment of Cancer/Brain Cancer Treatment-general (Fact-G/FACT-BR), and Supportive Care Needs Scale (SF-34).

Distress levels varied over time. Some patients had high distress scores at baseline, which dropped by the 3- and 6-month follow-up, while others showed increasing distress. For example, 45 percent of participants who had no distress at baseline reported moderate or severe levels at later time points, while distress eased in around a third of patients who reported high baseline levels.

Four distress trajectory groups were identified: consistently low distress (18 percent), low to high distress (38 percent), high to low distress (24 percent), and consistently high distress (19 percent).

Unmet needs were common among those with high distress levels. These included changes in mental ability, physical side effects, changes in appearance, being treated differently by other people, and feeling like a different person.

“Our data demonstrate the urgent need for policy changes to implement regular screening for distress and unmet needs in HGG populations,” the researchers said. “To enable needs of patients and carers to be effectively addressed, clinical pathways to guide referrals, increased workforce particularly neuropsychology, and targeted interventions are critical.”