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Body Image Dissatisfaction in Patients With Primary Brain Tumors

A new study reports that nearly a third of patients with primary brain tumors experience clinically significant body image dissatisfaction, which can negatively impact their quality of life and psychosocial well-being.

Body image—a concept consisting of cognitive, emotional, and relational elements derived from one's physical appearance—plays an important role in an individual's self-esteem, relationships, and outlook on life. Due to the physical impacts of treatment, patients with cancer face an increased likelihood of experiencing a negative body image, which is associated with a higher risk of depression, anxiety, and psychological distress. While body image dissatisfaction has been studied in a number of malignancies, its impact on patients with primary brain tumors had not been investigated until now.

In a study now published in the Journal of Neuro-Oncology, a team of researchers led by Lindsay Rowe, MD, an assistant research physician in the Radiation Oncology Branch of the National Cancer Institute in Bethesda, Maryland, evaluated the prevalence of altered body image among patients with primary brain tumors. The study enrolled 100 patients who had been diagnosed with a histologically confirmed primary brain tumor, with a median time from diagnosis of five years. The most common tumor type was glioblastoma, seen in 32% of patients, and all of the patients had undergone brain tumor surgery. The participants completed several questionnaires, including the Body Image Scale (BIS), the Appearance Schemas Inventory–Revised (ASI–R), the MD Anderson Symptom Inventory–Brain Tumor Module (MDASI–BT), and the Patient Reported Outcomes Measurement Information System (PROMIS).

The assessments revealed that 28% of patients experienced clinically significant body image dissatisfaction, defined as a BIS score of 10 or higher in a range of 0 to 30. Disease- and treatment-related symptoms, including pain, fatigue, weight gain, hair loss, vision problems, head indentations, scars, and dry skin significantly contributed to negative body image. Dissatisfaction was more prevalent in younger patients and in those with a higher body mass index (BMI). Only 14% of participants reported experiencing a healthy body image.

"These findings underscore the potential contribution of disease- and treatment-related body image concerns to psychosocial wellbeing in patients with primary brain tumors," conclude Dr. Rowe and colleagues. "Establishing a model of body dissatisfaction among primary brain tumor patients is of clinical importance and may allow for intervention in this population, as has been done in other tumor types. With increasing longevity and survival in a variety of brain tumors, the potential impact of body image will become a more significant patient survivorship concern." The researchers add that patients may benefit from the development of recommendations for interventions regarding education, cosmetic rehabilitation, strength training, and cognitive behavioral therapy to improve their body image satisfaction and quality of life.

For More Information

Rowe L, Vera E, Acquaye A, et al (2020). The prevalence of altered body image in patients with primary brain tumors: an understudied population. J Neurooncol. [Epub ahead of print] DOI:10.1007/S11060-020-03433-8

Image credit: Ebrahim. Licensed under Apache 2.0

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