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Setting This study was conducted at 3 separate locations. Location A is a 6-bay infusion center within a medium-size midwest acute care hospital accredited by the American College of Surgeons Commission on Cancer for 30 consecutive years. The other 2 facilities are located in the same medical complex. Facility B is a medical oncology office with a 12-bay treatment area, and facility C is a radiation oncology office with 2 linear accelerators.
Instruments NCCN developed distress guidelines to help the treatment team best treat distress in the cancer patient.10 Within the distress guidelines is a distress thermometer. The thermometer measures patient distress on a scale of 0 (no distress) to 10 (the highest level of distress experienced in the previous week). Patients who reported their distress as a 4 or lower is managed within the clinical setting. Patients who reported their distress as a 5 or higher met directly with the researcher to ensure that a plan was in place to meet their needs.
In addition to overall distress, the tool lists problems in 5 topic areas (practical, family, emotional, spiritual/religious, and physical) that may be contributing to the patient’s distress over the previous week, with space to list other problems. The patient checks yes or no to each potential problem.
The researchers added questions to collect data on gender and age, and cancer characteristics (eg, cancer type, year of diagnosis, prior and/or concurrent treatment, and current point in treatment cycle). The 2 treatment-related questions were included to determine if the patient’s distress was associated with the previous treatment and/or the current point in treatment.
Study population A total of 55 people participated in this research study (Table 1). Most respondents were female (69%; N = 38), and age 66 to 75 years (36%; N = 20). The most common cancer types were breast (26%; N = 14), lung (18%; N = 10), and colorectal (16%; N = 9). In addition, 11 other cancer types were represented in this study (Table 2).
TABLE 1. Study Participant Demographics
| Characteristic | Percent (N) |
| Gender | |
| Female | 69 (38) |
| Male | 31 (17) |
| Age | |
| 26-35 years | 2 (1) |
| 36-45 years | 6 (3) |
| 46-55 years | 16 (9) |
| 56-65 years | 29 (16) |
| 66-75 years | 36 (20) |
| >75 years | 11 (6) |
TABLE 2. Participants’ Disease and Treatment Demographics
| Cancer Type | Percent (N) |
| Breast | 26 (14) |
| Lung | 18 (10) |
| Colorectal | 16 (9) |
| Prostate | 4 (2) |
| Lymphoma | 7 (3) |
| Renal Cell | 2 (1) |
| Bone | 2 (1) |
| Head and neck | 7 (4) |
| Gynecologic | 5 (3) |
| Multiple myeloma | 4 (2) |
| Leukemia | 2 (1) |
| MDS | 2 (1) |
| Brain | 2 (1) |
| Melanoma skin | 4 (2) |
| Treatment Type | |
| Radiation | 38 (21) |
| Chemotherapy | 62 (34) |
| Year of Diagnosis | |
| 2015 | 13 (7) |
| 2014 | 46 (25) |
| 2013 | 6 (3) |
| 2012 | 4 (2) |
| 2011 | 2 (1) |
| 2010-2007 | 9 (5) |
| 2000 or earlier | 6 (3) |
| Unknown | 16 (9) |
| Prior Treatment | |
| Yes | 35 (19) |
| No | 46 (25) |
| Concurrent | 2 (1) |
| Cannot remember | 18 (10) |
| Number of Treatments | |
| First cycle/week | 7 (4) |
| Second cycle/week | 11 (6) |
| Third cycle/week to half-way point | 20 (11) |
| Half-way point to second to last cycle/week | 7 (4) |
| Last cycle/week | 18 (10) |
| Palliative till End of Life | 5 (9) |
| Cannot remember | 27 (15) |
Sixty-two percent (N = 34) of participants were receiving chemotherapy, and the remaining patients (38%; N = 21), were undergoing radiation treatment. One patient was receiving concurrent chemotherapy and radiation; this patient’s results were included once under radiation as the survey was completed on the day of a radiation treatment.
