Psychological distress, understanding of cancer and illness uncertainty in patients with Cancer of Unknown Primary.

Content Provider	Europe PMC
Author	Wolyniec, Kamil Sharp, Jessica Fisher, Krista Tothill, Richard W. Bowtell, David Mileshkin, Linda Schofield, Penelope
Abstract	AbstractObjectivePatients diagnosed with Cancer of Unknown Primary (CUP) experience high levels of psychological distress and report poor understanding of their cancer. We aimed to investigate: (1) if CUP patients with poorer understanding of their cancer diagnosis and testing experience more symptoms of psychological distress than those with better understanding; (2) if the relationship between patients' understanding of their cancer and psychological distress is mediated by illness uncertainty; and (3) explore whether patients' degree of understanding of their cancer can be predicted by clinical and socio‐demographic factors.Methods209 CUP patients completed a questionnaire measuring anxiety, depression, illness uncertainty, fatigue, pain, sleep and understanding of their cancer. Using an apriori theoretical framework, we employed structural equation modelling to investigate predictors of patient's understanding of their cancer and psychological distress and the relationships between understanding, illness uncertainty and distress.ResultsThe structural equation model displayed good fit indices and supported the hypothesised relationship of patient's understanding of their cancer and the extent of psychological distress, which was mediated via illness uncertainty. Physical symptoms were positively associated with psychological distress and illness uncertainty. Younger age was predictive of lower patient's understanding of their cancer and higher levels of psychological distress.ConclusionsPatients with CUP, particularly those who are younger and experiencing more physical symptoms, report higher levels of psychological distress and may require additional mental health support. Our findings highlight a need to improve CUP patient's understanding about their illness, which could help reduce their illness uncertainty and alleviate psychological distress.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9796856&blobtype=pdf
Page Count	8
ISSN	10579249
Journal	Psycho-Oncology
Volume Number	31
DOI	10.1002/pon.5990
PubMed Central reference number	PMC9796856
Issue Number	11
PubMed reference number	35765251
e-ISSN	10991611
Language	English
Publisher	John Wiley and Sons Inc.
Publisher Date	2022-07-03
Publisher Place	Hoboken
Access Restriction	Open
Rights License	This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. © 2022 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.
Subject Keyword	cancer illness uncertainty oncology psycho‐oncology psychological distress understanding of cancer unknown primary tumour site
Content Type	Text
Resource Type	Article
Subject	Experimental and Cognitive Psychology Psychiatry and Mental Health Oncology