Emotional distress and needs for psychosocial support among breast cancer patients at start of radiotherapy

Radiotherapy is considered to be associated with psychological distress in cancer patients. The present pilot study was aimed at exploring both emotional distress and support needs among patients with primary breast cancer. 77 women were evaluated at the start of radiotherapy after completion of their breast-conserving surgical treatment. Emotional distress was measured with the Hospital Anxiety and Depression Scale and the Hornheider Questionnaire. Needs for additional psychosocial support as well as acceptance of support were assessed by single items. In addition to the patients' views, ratings from physicians, nurses and technical assistants were obtained. Although according to their self-reports only one third of the patients wished to talk about their disease and almost all of them had sufficient opportunities for discussions with their family members, 36% reported needs for additional support and 75% said that they would be willing to accept support in the case that it would be offered to them. Emotional distress and support needs were rated even higher by the members of the medical team. 20% of the patients had high values (> 10) on the anxiety subscale and 5 % had high values (> 10) on the depression subscale of the HADS. 37% were distressed according to the Hornheider Questionnaire. However, neither the HADS nor the Hornheider Questionnaire were sufficiently sensitive and specific to detect those patients reporting support needs. It was concluded that better screening tools have to be developed for identifying breast cancer patients in need of psychosocial support during radiotherapy.