Psychological reactions and quality of life in patients with posterior uveal melanoma treated with ruthenium plaque therapy or enucleation: a one year follow-up study

Purpose To investigate psychological reactions and quality of life among pa tients with posterior uveal melanoma. Methods Consecutive patients with uveal malignant melanoma (99/106), referr ed to St Erik's Eye Hospital 1995-1996, treated with rutheniuim plaque radi otherapy (n = 50) or enucleation (n = 49), were included in this non-random ised prospective comparative study. Questionnaires were completed before tr eatment (Hospital Anxiety and Depression Scale, HAD scale) and 2 and 12 mon ths after diagnosis including the HAD scale, the Impact of Event Scale and the EORTC QLQ-C30. A disease-specific questionnaire was included 12 months after diagnosis. Between-group differences were analysed by chi-square, Stu dent's t-test and ANOVA. Results A majority of the patients reported reduced 'Quality of Life' (72-8 5%), 'Emotional functioning' (60-74%) and 'Cognitive functioning' (51-61%). 'Fatigue' was the most frequently reported symptom (61-72%) followed by 'I nsomnia' (43-58%). Anxiety and depressive symptoms were relatively frequent up to 1 year after treatment, but the levels of anxiety decreased during t he first year after treatment. Disease and treatment-related problems were reported in both treatment groups 1 year after diagnosis. Enucleated patien ts had more problems with appearance and judging distances, whereas those t reated with radiotherapy reported vision impairment to a higher extent. Conclusions Enucleated patients reported high levels of emotional distress, problems with appearance and judging distances during the first year after treatment. Patients treated with radiotherapy reported similar levels of q uality of life and emotional problems, but more problems with visual impair ment. These differences in impact on disease-related functioning should be taken into account when treatment options are discussed.