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Annals of Oncology
model. Specifically, external variables have an impact on adherence behaviour.
However, this relationship is moderated by cognitive variables. Central to the
theoretical model is the dynamic influence of AEs. AEs are proposed as having an
impact on clinical outcomes and HRQoL, directly and indirectly through adherence
behaviour, as well as impacting on external factors and may influence cognitive
variables. Improving patient preference may improve clinical outcomes/HRQoL in
oncology patients. The proposed theoretical model provides the opportunity to
identify such hypotheses for further research with a view to improving adherence
and clinical outcomes in oncology.
Disclosure: S.L. Shingler: Oxford Outcomes were paid a fixed fee for conducting this
research project. B. Bennett: Oxford Outcomes were paid a fixed fee to conduct this
research project. J. Cramer: Prof Cramer was paid a fixed honorary payment for her
expert input on this study. C. Twelves: Prof Twelves was paid a fixed honorary fee
for his expert input into this study. A. Towse: Prof towse was paid a fixed honorary
fee forhis expert input into the study. A.J. Lloyd: Oxford Outcomes were paid a fixed
fee for conducting this research project.
1474 MORBIDITY IN ADVANCED BASAL CELL CARCINOMA (BCC)
AND BCC NEVUS SYNDROME (BCCNS) FROM THE PATIENT
(PT) AND PHYSICIAN PERSPECTIVE: DEVELOPMENT OF A
PATIENT-REPORTED OUTCOME (PRO) QUESTIONNAIRE
S.D. Mathias 1 , M. Chren 2 , Y.M. Yim 3 , H. Colwell 1 ,C.Reyes 3 , D.M. Chen 4 and S.
W. Fosko 5
1 Health Outcomes, Health Outcomes Solutions, Winter Park, FL, UNITED
STATES OF AMERICA, 2 Dermatology, University of California, San Francisco,
San Francisco, CA, UNITED STATES OF AMERICA, 3 Biometrics, Health
Outcomes and Payer Support, Genentech/Roche, South San Francisco, CA,
UNITED STATES OF AMERICA, 4 U.S. Medical Affairs, Genentech, South
San Francisco, CA, UNITED STATES OF AMERICA, 5 Dermatology, St. Louis
University, School of Medicine, St. Louis, MO, UNITED STATES OF AMERICA
Purpose: Although BCC is the most common skin cancer, the pt experience is not
well understood. In a small subset of BCC pts, extensive invasion to subcutaneous
structures can lead to locally advanced disease or metastases (advanced BCC
(aBCC)). BCCNS is a rare genetic condition associated with life long, multiple BCCs.
BCCNS pts may also develop aBCC. Lesions are common in sun-exposed areas such
as the face and upper trunk and may result in disfiguring scars. To inform the
development of a PRO questionnaire, qualitative concept elicitation interviews were
conducted with aBCC and BCCNS pts and physicians.
Methods: In an IRB approved study, interviews were conducted in pts > 18 yr
diagnosed with aBCC or BCCNS and physicians using an interview guide containing
open-ended questions about impact of symptoms on functioning and well-being.
Transcripts from each 1 hr interview were analyzed.
Results: A total of 30 pts were interviewed, comprised of 14 aBCC (locally advanced,
n = 8 and metastatic, n = 6; 73% male) and 16 BCCNS (50% male) pts. Mean (SD)
age for aBCC pts was 64 (11) and 51 (10) for BCCNS pts. A variety of patient
experiences were reported (eg, bleeding, oozing wounds, vision problems). Physical
appearance, including scarring and disfigurement affected 73% of pts. 80% of pts
made lifestyle changes such as avoidance of outdoor activities, meeting new people,
and intimate relationships. Assistance in tasks was often needed. Emotional effects,
including worry about when and where the next lesion would appear, were evident
in BCCNS pts (81%). Physicians (n = 4) noted that aBCC pts worry about cancer in
general and the possibility of more tumors, while BCCNS pts face tumor recurrence,
multiple surgeries and disfigurement. Based on the interview results and lack of
existing PRO questionnaires capturing these concepts, 2 questionnaires were
developed for aBCC and BCCNS.
Conclusion: aBCC and BCCNS can have significant and unique impacts on
well-being, appearance, daily and emotional functioning, and overall quality of life.
Results from an ongoing validation study will be used to finalize these PRO
questionnaires.
Disclosure: S.D. Mathias: Susan D Mathias is an employee of Health Outcomes
Solutions, which was paid by Genentech Inc to undertake this study. M. Chren:
Consultant for Genentech Y.M. Yim: Roche employment and stock ownership
H. Colwell: Consultant for Genentech and Health Outcomes Solutions C. Reyes:
Roche employment and stock ownership D.M. Chen: Roche employment and stock
ownership S.W. Fosko: Consultant for Genentech
1475 SOMATIC VULNERABILITY IN ONCOLOGICAL PATIENTS
L. Onganía 1 , P. Climentzos 2 , M.P. Bramajo 2 , O. Osores 1 and M. Blanco Villalba 3
1 Psychooncology, Lucha Contra el Cáncer Ushuaia, Ushuaia, ARGENTINA,
2 Psychooncology, Centro Médico Austral Omi, Buenos Aires, ARGENTINA,
3 Oncology, Centro Médico Austral Omi, Buenos Aires, ARGENTINA
Introduction: Making a complete psychosocial diagnosis in oncological patients, at
the beginning of medical treatment enriches the approach of interdisciplinary teams.
It gives important information that may be used to decide future interventions.
Somatic vulnerability is a psychoanalytic concept that shows some dimensions of the
personality and environment that may put the patient in risk. Some of them are
alexitimia (difficulty to express emotions), operatory thinking, over-adaptation,
depression, anxiety, stress and supportive environment. Doctors are fairly used to
detect some depressive symptoms, but no so familiarized with the detection of the
other kind of dimensions that are also risky for the patient evolution or quality of
life.
Objectives: Observe the presence of somatic vulnerability in cancer patients.
Material and methods: Descriptive, transversal and randomized study. Sample: 103
cancer patients that attend to a private cancer center between April and June of
2011. Instruments: Somatic Vulnerability Scale (EVS-25) and specifically designed
questionnaire.
Results: 50 of 103 patients show somatic vulnerability. The 54% of the vulnerable
ones, doesn’t evidence any depressive disorder. Only 15% of the vulnerable patients
are in psychological treatment. Most of them give high results for the other
dimensions that involve somatic vulnerability (alexitimia, operatory thinking,
over-adaptation, anxiety, stress or unsupportive environment in different
percentages).
Conclusion: This study shows that a high percentage of the patients have somatic
vulnerability. The somatic vulnerability seems to be hard to be detected by doctors
because it involves many specific mental dimensions. In fact, only 15% of the
patients in risk are in psychological treatment. The intervention of a trained
professional seems to be relevant to make an earlier diagnosis of the patients in risk,
affecting directly in the evolution and quality of life of them and their families.
Disclosure: All authors have declared no conflicts of interest.
1476 SEXUALITY OF BREAST CANCER PATIENTS TREATED WITH
MASTECTOMY
M. Yassine 1 , L. Védrine 2 , C. Chargari 2 , B. Ceccaldi 2 , S. Le Moulec 3 , M. Ichou 4
and H. Errihani 1
1 Department of Oncology, National Institute of Oncology, Rabat, MOROCCO,
2 Oncology and Radiation Oncology, Hôpital d’instruction des armées du
Val-de-Grâce, Paris, FRANCE, 3 Department of Oncology, Val de Grace Hospital,
Paris, FRANCE, 4 Department of Oncology, Hôpital d’instruction des armées
Mohamed V, Rabat, MOROCCO
Background: Approximately 20% of breast cancer diagnoses are made in women
younger than 45 years of age. Anticancer treatments are associated with serious
problems in the sexual functioning of breast cancer patients. We assessed the sexual
functioning of breast cancer patients treated with mastectomy.
Patients and methods: We performed a prospective study in 110 women who had
been treated with mastectomy for a breast cancer using a self-administered
questionnaire on how the mastectomy had changed their sexual life since the
primary diagnosis of breast cancer.
Results: All patients expressed not having received sufficient information about how
the disease and treatment including surgery might affect their sexual life. Sixty eight
percent reported being still sexually active, but 62% revealed that the cancer
treatment had affected their sexual desire or possibility to reach orgasm; 25%
observed that their partner was afraid of sexual intercourse and 18% felt an
emotional separation in the couple during the course of the disease.
Conclusion: Problems related to body image and sexuality were identified in all
women post mastectomy. It is time to better take into account quality of life, and
more particularly the sexual function in breast cancer survivors.
Disclosure: All authors have declared no conflicts of interest.
Volume 23 | Supplement 9 | September 2012 doi:10.1093/annonc/mds413 | ix477