ADJUVANT CHEMOTHERAPY IN DUKES-B AND DUKES-C COLORECTAL-CANCER HAS ONLY A MINOR INFLUENCE ON PSYCHOLOGICAL DISTRESS

The object of this cross-sectional study on psychological distress was to reveal such distress among patients treated for colorectal cancer (CRC). Between 1993 and 1996, 95 patients in northern Norway were incl uded in the national study randomising Dukes' B and C CRC patients bet ween adjuvant chemotherapy (ACT:5-fluorouracil and levamisole) or foll ow up following radical surgery, In April 1996, all 82 survivors were mailed the Impact-of-Event Scale (IES), to which 64 patients responded (78%). Less than one-third of the patients reported a moderate to hig h level of psychological distress. Scores predicting significant stres s response syndrome were revealed in 14% of the patients. The mean sco re on the intrusion and avoidance scales were 6.1 and 7.7, respectivel y, Such variables as age, sex, tumour location (rectum/colon), Dukes' stage B/C and time of follow up did not significantly influence the sc ores. Patients receiving ACT reported only a slightly raised level on the intrusion (6.97 vs 5.17) and avoidance (8.48 vs 6.80) scales. This study indicates that ACT in CRC Dukes' B and C is not a stressful hap pening, All advantages in survival achieved by ACT have to be weighed against the ''cost'' in terms of physical and psychological side effec ts. This study indicates the weighting in terms of psychological distr ess may be minimal.