Abstract
Purpose: :
Following treatment of the primary uveal melanoma, up to 50% of patients will develop metastatic disease, for which effective therapy does not currently exist. Current standard of care following surgical excision or radiation therapy of the primary tumor is periodic patients monitoring for metastatic disease. Tumor biopsy based methods to identify molecular prognostic markers (at the time of ophthalmic diagnosis) of metastatic disease have become available. One study evaluating mood and anxiety in patients with uveal melanoma, found rates consistent with those found in other cancer populations. However, there are no studies evaluating mood and anxiety in patients undergoing molecular prognostication for uveal melanoma. Further, regret about having this type of testing has not been studied in this population.
Methods: :
Hospital Anxiety and Depression Scale (HADS) was administered to patients consenting to tumor biopsy for molecular prognostication pre-operatively, and at follow up times of 3 and 12 months, to assess for depression and anxiety. A brief decision making regret scale was given at the same time as the HADS.
Results: :
Pre-operative data on 28 patients, showed that 36% (N=10) had scores on the HADS consistent with either "suggestive or probable" depression or anxiety. The mean age of patients in this group was 54 and 60% of the group are men. In the non-anxious/depressed group, the average age was 59 and 76% of the group are men. With regard to decision regret, the majority of patients, 82% (N=23), did not regret this decision. Only 5 (18%) patients either had some or complete regret in making the decision to undergo prognostic testing.
Conclusions: :
The preliminary data suggests that there are high rates of depression and/or anxiety pre-operatively in the uveal melanoma population. The majority of patients do not regret the decision to undergo prognostic testing.
Keywords: melanoma • genetics • mutations