Body image distress in women and men with advanced pancreatic cancer approaching death – post-hoc analyses from the MISTRAL-trial

Background Weight loss is common in individuals with pancreatic cancer. The aim of the present study was to address how body image distress and weight worries change over time as death approaches in patients with pancreatic cancer, and whether there are gender differences. Methods Post-hoc analyses were performed using data from the MISTRAL-trial. Body image distress and weight worries were assessed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-PAN-26-questionnaire as part of the original trial. Data were used to assess body image distress and weight worries at time points corresponding to 1, 2, 3, 4, 5, and 6 months prior to death. Mixed-effects linear models with random intercepts were used to examine trajectories of body image distress and weight worries in women and men. Results We analysed data from 125 participants, of whom 64 (51.2%) were women. Both body image distress and weight worries increased over time during the 6 months preceding death, β = 3.54, 95%CI: 1.67- 5.41; and β = 2.98, 95%CI: 0.53- 5.44, respectively. There were no statistically significant sex differences in the rate of change although women tended to report higher body image distress closer to death and men higher weight worries across all time points. Conclusion Increased body image distress and weight loss concerns observed in both women and men with pancreatic cancer at the end of life highlight the importance of addressing these issues in palliative care.