Effect of the rehabilitation on distress levels among patients undergoing surgical treatment for cervical cancer: a comparative randomized trial

INTRODUCTION. Diagnosis and management of cervical cancer (СС) can be distressing for patients. They may also face complications from surgical treatment that compromise their quality of life and require rehabilitation. AIM. To investigate the effect of rehabilitation programs on the level of distress in surgically treated cervical cancer (CC). MATERIALS AND METHODS. The randomized trial included adult patients with СС stage 1A–1B undergoing surgical treatment. The group receiving comprehensive “active” rehabilitation (СС-1) received psychotherapeutic support, lifestyle changes and other rehabilitation measures for 1 year. The “passive” rehabilitation group (СС-2) received interventions according to current local clinical guidelines. Distress was assessed using the modified International Psycho-Oncology Society Distress Self-Assessment Scale (IPOS score) for 3 years after surgery. RESULTS AND DISCUSSION. Before surgery, all patients with СС had IPOS scores in the range of 6 points or higher (6.9 ± 0.9 for the СС-1 group and 6.9 ± 0.8 for the СС-2 group), indicating a significant level of distress before surgery. At all follow-up time points, the scores in the СС-1 and СС-2 groups were statistically significantly lower than at baseline (p 0.05). From month 1, the IPOS score was significantly lower in the СС-1 group than in the СС-2 group: 4.8 ± 1.5 points in the СС-1 group мы 5.8 ± 1.1 points in the СС-2 group (p 0.05). The differences between СС-1 and СС-2 remained statistically significant up to 24 months after surgery. At year 3 the IPOS score was 2.8 ± 2.0 in the СС-1 group and 3.8 ± 1.7 in the СС-2 group. CONCLUSION. The faster and more pronounced reduction of the IPOS score in the СС-1 group demonstrates the effectiveness of a comprehensive «active» rehabilitation program. The highest level of distress at baseline emphasizes the need to initiate psychotherapeutic support in the post-diagnosis phase before surgical intervention.