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Perceptions of somatic and affective symptoms and psychosocial care utilization in younger and older survivors of lung cancer

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Abstract

Objective

Rates of depression identification in oncology settings and referral to psychosocial services remain low. Patients with lung cancer face an elevated risk of depression relative to patients with other cancers. This study explored perceptions of somatic and affective symptoms and psychosocial care utilization among younger and older lung cancer survivors.

Methods

We conducted in-depth interviews with 20 adults at two academic medical centers in Boston, MA, who had received a lung cancer diagnosis in the past 24 months. A semi-structured interview guide was used to assess experiences with, and perceptions of, depression symptoms and psychosocial services. Interviews were audio-recorded, transcribed, and coded to identify themes. We also explored differences between younger (<65years; N=9) and older (>65years; N=11) patients.

Results

Participants commonly described somatic symptoms (i.e., changes in appetite, sleep, or energy levels) and affective symptoms (i.e., worry, fear, sadness) as side effects of cancer treatment. Older participants more commonly contextualized these symptoms with information about how they impacted daily life. Both younger and older participants faced barriers to accessing psychosocial services, with older adults more commonly referencing stigma of service referral and utilization.

Discussion

Patients with lung cancer associated both somatic and affective symptoms with their cancer and its treatment, with age differences in how symptoms were described and how psychosocial referrals may be perceived. More systematic integration of psychosocial care into cancer care may help to increase the identification of depression in lung cancer and reduce barriers to psychosocial service utilization.

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Data Availability

De-identified data is available upon request.

Code availability

Not applicable.

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Acknowledgements

We are grateful for research support from Dr. Laura Hayman, PhD, RN, FAAN, FAHA, University of Massachusetts Boston, and the Patient Perceptions Project research participants.

Funding

This study was funded by grant U54-CA156732 to Drs. Park, Cannon, and Traeger from the National Institutes of Health/National Cancer Institute (NIH/NCI).

Author information

Authors and Affiliations

  1. Center for Clinical Management Research, Department of Veterans Affair, Ann Arbor, MI, USA

    Sarah E. Skurla

  2. Cancer Outcomes Research and Education Program, Massachusetts General Hospital, Boston, MA, USA

    Emily R. Friedman, Elyse R. Park & Lara Traeger

  3. Mongan Institute Health Policy Center, Massachusetts General Hospital, Boston, MA, USA

    Emily R. Friedman & Elyse R. Park

  4. Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA

    Elyse R. Park & Lara Traeger

  5. School of Nursing, Fayetteville State University, Fayetteville, NC, USA

    Sheila Cannon

  6. Beth Israel Deaconess Plymouth, Plymouth, MA, USA

    Gretchen A. Kilbourne

  7. Division of Adult Psychosocial Oncology and Palliative Care, Harvard Medical School, Boston, MA, USA

    William F. Pirl

  8. Harvard Medical School, Boston, MA, USA

    Lara Traeger

Authors
  1. Sarah E. Skurla
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  2. Emily R. Friedman
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  3. Elyse R. Park
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  4. Sheila Cannon
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  5. Gretchen A. Kilbourne
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  6. William F. Pirl
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  7. Lara Traeger
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Emily Friedman, Elyse Park, Shelia Cannon, and Lara Traeger. The first draft of the manuscript was written by Sarah Skurla, Emily Friedman, and Lara Traeger and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Elyse R. Park.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Partners Human Research Committee, protocol # 2011-P-000815.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Skurla, S.E., Friedman, E.R., Park, E.R. et al. Perceptions of somatic and affective symptoms and psychosocial care utilization in younger and older survivors of lung cancer. Support Care Cancer 30, 5311–5318 (2022). https://doi.org/10.1007/s00520-022-06926-6

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  • DOI: https://doi.org/10.1007/s00520-022-06926-6

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