Screening for Brain Metastases in Patients With NSCLC: A Qualitative Study on the Psychologic Impact of Being Diagnosed With Asymptomatic Brain Metastases

Janna J.A.O. Schoenmaekers, Jeroen Bruinsma, Claire Wolfs, Lidia Barberio, Anita Brouns, Anne Marie C. Dingemans, Lizza E.L. Hendriks*

*Corresponding author for this work

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Abstract

Introduction: The brain is a frequent site of metastases in NSCLC, and screening for asymptomatic brain metastases (BM) is increasingly advised in NSCLC guidelines. An asymptomatic BM diagnosis may trigger anxiety for future neurologic problems and can negatively affect quality of life of patients and their relatives. Therefore, we performed this qualitative study. Methods: Three focus group discussions were organized with patients with NSCLC and asymptomatic BM (N = 3–4 per group) and separately with their relatives, to explore this psychosocial impact. Two researchers independently performed an inductive content analysis. Results: A total of 10 patients and 10 relatives participated in six focus groups. A diagnosis of BM caused feelings of distress and anxiety in both patients and relatives. These feelings diminished over time in case of a tumor responding to systemic therapy. The diagnosis of BM was not perceived as more distressful than other metastases, and scan-related anxiety was not experienced. Although magnetic resonance imaging screening and follow-up were thought of as burdensome, follow-up was valued. The coping strategies of both groups seemed related to personality and to the efficacy of the given systemic therapy. Relatives appreciated peer support of other relatives during the focus groups, and they seemed open for future psychological support. Conclusions: Asymptomatic BM diagnosis can cause anxiety and distress, but this diminishes over time with effective systemic treatment. Although patients perceive magnetic resonance imaging as burdensome, they value follow-up screening and imaging. Relatives highly appreciated peer support, and psychological distress of relatives should not be overlooked.

Original languageEnglish
Article number100401
JournalJTO Clinical and Research Reports
Volume3
Issue number10
DOIs
Publication statusPublished - Oct 2022

Bibliographical note

Funding Information:
This work was supported by the Longfonds (grant number 11.1.18.250) and an unrestricted grant from Roche Genentech. The authors want to thank the patients and their family and friends for participating in the focus groups.

Funding Information:
Disclosure: Ms. Schoenmaekers reports receiving unrestricted grant from Roche Genentech, United States; travel grants from Roche Genentech and GlaxoSmithKline, outside of the current manuscript; and grants from Takeda and Boehringer Ingelheim serving as a subinvestigator. Mrs. Barberio reports having no conflicts of interest related to the current manuscript; however, outside of the current manuscript, reports receiving project reimbursements from AbbVie, Amgen, United States, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Janssen-Cilag, Lilly, Merck Sharp & Dohme, United Kingdom, Novartis, Switzerland, Nutricia Danone, Pfizer, Roche, Sanofi, and Takeda; and grants from the Dutch Cancer Foundation and the Ministry of Health. Ms. Brouns reports having no conflicts of interest related to the current manuscript; however, outside of the current manuscript, reports serving on the advisory board of Janssen. Prof. Dingemans reports having no conflicts of interest related to the current manuscript; however, outside of the current manuscript, reports receiving personal fees from Roche, Switzerland, Boehringer Ingelheim, Eli Lilly, Takeda, Pfizer, United States, Bristol-Myers Squibb, Novartis, Amgen, Chiesi, PharmaMar, Bayer, and Sanofi; grants from Bristol-Myers Squibb and Amgen; and nonfinancial support from AbbVie. Dr. Hendriks reports receiving grants from Longfonds Nederland and Roche Genentech; outside of the current manuscript, receiving research funding from Roche Genentech, Boehringer Ingelheim, AstraZeneca, and Takeda (all institution); serving on the advisory board of Bristol-Myers Squibb, Eli Lilly, Roche Genentech, Pfizer, Takeda, Merck Sharp & Dohme, Boehringer Ingelheim, Amgen, Janssen, Novartis, and Merck (all institution); serving as a speaker of Merck Sharp & Dohme and Lilly (institution); receiving travel/conference reimbursement from Roche Genentech (self); having mentorship program with key opinion leaders funded by AstraZeneca, United Kingdom; receiving fees for educational webinars from Benecke, Medtalks, and VJOncology (self); having interview sessions funded by Roche Genentech, Lilly, and Bayer (institution); and serving as a local principal investigator of clinical trials of AstraZeneca, Novartis, Bristol-Myers Squibb, Merck Sharp & Dohme, Merck, United States, GlaxoSmithKline, Takeda, Blueprint Medicines, Roche Genentech, Janssen Pharmaceuticals, Mirati, AbbVie, and Gilead. The remaining authors declare no conflicts of interest.

Publisher Copyright:
© 2022 The Authors

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