T he surge in cutaneous melanoma incidence largely has involved localized disease, treated surgically with high survival rates. Despite the increase in cases, the psychological well-being of survivors in the US remains poorly understood.
“Many studies have documented the psychological and physical repercussions of a melanoma diagnosis,” wrote Ayisha N. Mahama, MD, MPH, and colleagues in JAMA Dermatology. “However, despite the increasing incidence and prevalence of lower-stage melanomas, particularly melanoma in situ, fewer studies have used qualitative methods to understand how a melanoma diagnosis affects the lived experiences of this patient population.
” Dr. Mahama and coinvestigators conducted a qualitative, survey-based study to better understand lived experiences and fear of cancer recurrence among survivors of localized cutaneous melanoma.
The researchers recruited patients from an academic dermatology practice affiliated with the University of Texas from August 2021 to September 2022. They conducted semi structured interviews and administered the Fear of Cancer Recurrence Inventory short form (FCRI-SF) survey. The investigators analyzed themes and subthemes related to patients’ experiences and tabulated FCRI-SF scores, with scores of 13 or greater indicating potential cases of clinically significant fear of cancer recurrence. Fifty-one patients completed the interview and survey. They were an average age of 49 years (SD 11.7), mostly female (67%) and had a history of localized melanoma. Among the respondents, 17 (33%) had survived a diagnosis of stage 0 melanoma, while the remainder had at least 1 invasive melanoma diagnosis (stage 1-2A).
Themes from the interviews included emotions surrounding follow-up appointments, intensity of melanoma surveillance, lifestyle changes regarding sun exposure, and thoughts about life and death. Findings showed that 38 of 51 participants had an FCRI-SF score above the threshold for clinical fear of cancer recurrence.
The study revealed that despite an excellent prognosis, some survivors of localized melanoma, including those with stage 0, had significant fear of cancer recurrence and intense survivorship experiences that impacted their psychological well-being. “These findings underscore the importance of addressing the psychological well-being of patients with early melanoma and potentially implementing supportive interventions,” Dr. Mahama and colleagues concluded.