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Effect of sex on psychological distress and fatigue over time in a prospective cohort of cancer survivors

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Abstract

Background

Studies indicate a higher level of distress in women than men with cancer, but whether this difference is retained over time is unknown. We studied the frequency and level of distress and fatigue during time according to gender in a cohort of cancer survivors.

Patients and methods

In this prospective study, cancer survivors were invited to undergo a psychological session immediately before the medical visit. Distress was assessed by the distress thermometer, and fatigue was assessed by the ESAS-r scale. Patients underwent follow-up visits to assess changes over time.

Results

A total of 305 patients and 568 visits were performed with a median follow-up of 15.8 months. At baseline, females, young age, and breast cancer patients had significantly higher distress. However, there was an increase in distress of 0.29 points every 6 months in males (95% CI, 0.09–0.50) versus no change in females (0.03 points, 95% CI, − 0.09–0.15; p-interaction = 0.01). The different behavior of cancer distress during time according to gender was more evident in subjects aged 68 or older due to increasing physical problems in men (p-interaction = 0.005). There was no change in fatigue with time according to sex.

Conclusions

Women, younger age, and breast cancer patients had increased cancer distress at the initial visit. However, women tend to stabilize during follow-up, whereas men tend to worsen their distress, especially because of physical and emotional problems, suggesting different coping capabilities.

Trial registration

The study is registered at ClinicalTrials.gov NCT05122052.

Implications for Cancer Survivors

Interventions aimed at improving recognition of emotions related to disease experience in male cancer survivors appear necessary.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The study was funded by Ospedali Galliera and Villa Serena Hospital Genoa, Italy.

Author information

Authors and Affiliations

  1. E.O. Ospedali Galliera, 16128, Genoa, Italy

    Gabriella Rondanina, Giacomo Siri, Domenico Marra & Andrea DeCensi

  2. Villa Serena Hospital, GVM, 16145, Genoa, Italy

    Gabriella Rondanina & Andrea DeCensi

  3. Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK

    Andrea DeCensi

  4. European Institute of Oncology, IRCCS, 20141, Milan, Italy

    Andrea DeCensi

Authors
  1. Gabriella Rondanina
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by all authors. The first draft of the manuscript was written by Gabriella Rondanina and Andrea De Censi, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Gabriella Rondanina.

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Competing interests

The authors declare no competing interests.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Regione Liguria (028/2019).

Informed consent

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

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The authors declare no competing interests.

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Rondanina, G., Siri, G., Marra, D. et al. Effect of sex on psychological distress and fatigue over time in a prospective cohort of cancer survivors. J Cancer Surviv 18, 586–595 (2024). https://doi.org/10.1007/s11764-022-01291-z

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