Issue 24-1, 2025

Original article

https://doi.org/10.38025/2078-1962-2025-24-1-120-127

Effect of the Rehabilitation on Distress Levels Among Patients Undergoing Surgical Treatment for Cervical Cancer: a Comparative Randomized Trial

View article (Download PDF file)



Download XML file

1,2,3 ORCIDDmitry V. Blinov, 1,2,* ORCIDAntonina G. Solopova, 1,2 ORCIDElena V. Gameeva, 2 ORCIDVsevolod N. Galkin, 2 ORCIDAlexander E. Ivanov, 2 ORCIDSaida A. Akavova, 2 ORCIDOlga S. Gridasova

1 Institute for Social and Preventive Medicine, Moscow, Russia
2 Federal Scientific and Clinical Center of Medical Rehabilitation and Balneology, Moscow, Russia
3 Moscow Haass Medical-Social Institute, Moscow, Russia
4 Sechenov First Moscow State Medical University, Moscow, Russia
5 S.S. Yudin City Clinical Hospital, Moscow, Russia
6 R.T.H. Clinic, Moscow, Russia


ABSTRACT

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.


KEYWORDS: cervical cancer, rehabilitation, distress, psychoemotional disorders

FOR CITATION:

Blinov D.V., Solopova A.G., Gameeva E.V., Galkin V.N., Ivanov A.E., Akavova S.A., Gridasova O.S. Effect of the Rehabilitation on Distress Levels Among Patients Undergoing Surgical Treatment for Cervical Cancer: a Comparative Randomized Trial. Bulletin of Rehabilitation Medicine. 2025; 24(1):120–127. https://doi.org/10.38025/2078-1962-2025-24-1-120-127 (In Russ.).

FOR CORRESPONDENCE: Dmitry V. Blinov, Е-mail: blinov2010@googlemail.com


References:

  1. Memon A., Bannister P. Epidemiology of Cervical Cancer. In: Farghaly, S. (Eds) Uterine Cervical Cancer. Springer. Cham. 2019; pp. 1–16. https://doi.org/10.1007/978-3-030-02701-8_1
  2. Ghosh I., Mandal R., Kundu P., Biswas J. Association of Genital Infections Other Than Human Papillomavirus with Pre-Invasive and Invasive Cervical Neoplasia. J Clin Diagn Res. 2016; 10(2):XE01–XE06. https://doi.org/10.7860/JCDR/2016/15305.7173
  3. Ленкова К.В., Хусаинова Р.И., Минниахметов И.Р. Молекулярно-генетические основы рака шейки матки. Молекулярная медицина. 2023; 21(4):25–33. https://doi.org/10.29296/24999490-2023-04-04 [Lenkova K.V., Khusainova R.I., Minniakhmetov I.R. Molecular genetic basis of cervical cancer. Molecular medicine. 2023; 21(4):25–33. https://doi.org/10.29296/24999490-2023-04-04 (In Russ.).]
  4. Pimple S., Mishra G. Cancer cervix: Epidemiology and disease burden. CytoJournal Monograph Related Review Series. 2022; 19:21. https://doi.org/10.25259/CMAS_03_02_2021
  5. Mardhia M., Effiana E., Irsan A., et al. Infections of Chlamydia trachomatis and Mycoplasma hominis as Risk Factors for Abnormal Cervical Cells. Makara J Health Res. 2018; 22(1). https://doi.org/10.7454/msk.v22i1.7965
  6. Ramachandran D., Dörk T. Genomic Risk Factors for Cervical Cancer. Cancers. 2021; 13(20):5137. https://doi.org/10.3390/cancers13205137
  7. Devouassoux-Shisheboran M. Glandular lesions of the uterine cervix: Introduction/ Annales de Pathologie. 2016; 36(3):174–175. https://doi.org/10.1016/j.annpat.2016.03.007 [Devouassoux-Shisheboran M. Les lésions glandulaires du col utérin: introduction. Annales de Pathologie. 2016; 36(3):174–175. https://doi.org/10.1016/j.annpat.2016.03.007 (In French).]
  8. Di Bonito L. Sémiologie des anomalies des cellules glandulaires cervicales Semiology of cervical glandular cell abnormalities Ann Pathol. 2011; 31(5 Suppl):S105–106. https://doi.org/10.1016/j.annpat.2011.08.008 [Di Bonito L. Semiology of cervical glandular cell abnormalities nn Pathol. 2011; 31(5 Suppl):S105–106. https://doi.org/10.1016/j.annpat.2011.08.008 (In French).]
  9. Босш X.Ф. Релевантность распространенности типов ВПЧ при раке шейки матки. Проблемы здоровья и экологии. 2010; (1S):54–55. https://doi.org/10.51523/2708-6011.2010-7-1s-19 [Bosch X.F. The relevance of the HPV type distribution in cervical cancer. Health and Ecology Issues. 2010; (1S):54–55. https://doi.org/10.51523/2708-6011.2010-7-1s-19 (In Russ.).]
  10. Pan X., Yang W., Wen Z., Li F., Tong L., Tang W. Does adenocarcinoma have a worse prognosis than squamous cell carcinoma in patients with cervical cancer? A real-world study with a propensity score matching analysis. J Gynecol Oncol. 2020; 31(6):e80. https://doi.org/10.3802/jgo.2020.31.e80
  11. Babakanrad E., Mohammadian T., Esmaeili D., Behzadi P. Cervical Cancer: A Review of Epidemiology, Treatments and Anticancer Drugs. Current Cancer Therapy Reviews. 2023; 19(3):e070223213485. https://doi.org/10.2174/1573394719666230207101655
  12. Yee G.P., de Souza P., Khachigian L.M. Current and potential treatments for cervical cancer. Curr Cancer Drug Targets. 2013; 13(2):205–220. https://doi.org/10.2174/1568009611313020009
  13. Акавова С.А., Солопова А.Г., Блинов Д.В., Ачкасов Е.Е., Галкин В.Н., Корабельников Д.И., Мнацаканьян А.Н., Петренко Д.А., Быковщенко Г.К., Хазан П.Л. Лечение и реабилитация при раке шейки матки: опыт организации маршрутизации пациентов. Акушерство, Гинекология и Репродукция. 2023;17(5):625–637. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.461 [Akavova A.A., Solopova A.G., Blinov D.V., Achkasov E.E., Galkin V.N., Korabelnikov D.I., Mnatsakanyan A.N., Petrenko D.A., Bykovshchenko G.K., Khazan P.L. Treatment and rehabilitation for cervical cancer: the experience of patient journey management. Obstetrics, Gynecology and Reproduction. 2023; 17(5):625–637. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.461 (In Russ.).]
  14. Александров А.Г. Организация реабилитации при злокачественных новообразованиях репродуктивной системы. Реабилитология. 2024; 2(2):247–263. https://doi.org/10.17749/2949-5873/rehabil.2024.22 [Aleksandrov A.G. Organization of rehabilitation for reproductive system malignant neoplasms. Rehabilitology. 2024; 2(2):247–263. https://doi.org/10.17749/2949-5873/rehabil.2024.22 (In Russ.).]
  15. Акавова С.А. Маршрутизация пациенток при реабилитации после лечения онкогинекологических патологий. Реабилитология. 2024; 2(1):158–172. https://doi.org/10.17749/2949-5873/rehabil.2024.21 [Akavova S.A. Patient routing system in rehabilitation after treatment for oncogynecological pathologies. Rehabilitology. 2024; 2(1):158–172. https://doi.org/10.17749/2949-5873/rehabil.2024.21 (In Russ.).]
  16. Рубрикатор клинических рекомендаций Минздрава России. Рак шейки матки. Клинические рекомендации. 2020. Доступно на: https://cr.minzdrav.gov.ru/preview-cr/537_1 (Дата обращения: 08.08.2024). [Clinical guidelines of the Ministry of Health of the Russian Federation. Cervical cancer. Clinical guidelines. Available at: https://cr.minzdrav.gov.ru/preview-cr/537_1. (Accessed: 08.08.2024) (In Russ.).]
  17. Петренко Д.А., Корабельников Д.И. Методы оценки качества жизни при раке. Реабилитология. 2023; 1(1):33–48. https://doi.org/10.17749/2949-5873/rehabil.2023.7 [Petrenko D.A., Korabelnikov D.I. Methods for assessing quality of life in cancer. Rehabilitology. 2023; 1(1):33–48. https://doi.org/10.17749/2949-5873/rehabil.2023.7 (In Russ.).]
  18. Беляев А.М. и др. Онкопсихология для врачей-онкологов и медицинских психологов. Руководство. Ред. Беляев А.М., Чулкова В.А., Семиглазова Т.Ю., Рогачев М.В. СПб.: Издательство АНО «Вопросы онкологии». 2017; 350 с. [Belyayev A.M.et al. Oncopsychology for oncologists and medical psychologists. Guide. Ed. Belyaev A.M., Chulkova V.A., Semiglazova T.Yu., Rogachev M.V. SPb.: Publishing house ANO “Questions of Oncology”. 2017; 350 p. (In Russ.).]
  19. Акарачкова Е.С., Байдаулетова А.И., Беляев А.А., Блинов Д.В. Громова О.А., Дулаева М.С., Замерград М.В., Исайкин А.И., Кадырова Л.Р., Клименко А.А., Кондрашов А.А., Косивцова О.В., Котова О.В., Лебедева Д.И., Медведев В.Э., Орлова А.С., Травникова Е.В., Яковлев О.Н. Стресс: причины и последствия, лечение и профилактика. Клинические рекомендации. СПб.: Скифия-принт. М.: Профмедпресс. 2020; 138 с. [Akarachkova E.S., Baiduletova A.I., Belyaev A.A., Blinov D.V., Gromova O.A., Dulaeva M.S., Zamergrad M.V., Isaikin A.I., Kadyrova L.R., Klimenko A.A., Kondrashov A.A., Kosivtsova O.V., Kotova O.V., Lebedeva D.I., Medvedev V.E., Orlova A.S., Travnikova E.V., Yakovlev O.N. Stress; causes and effects, management, and prevention. Clinical guidelines. St. Petersburg: Skifia-print; Moscow: Profmedpress. 2020; 138 p. (In Russ.).]
  20. Акарачкова Е.С., Байдаулетова А.И., Блинов Д.В., Бугорский Е.В., Кадырова Л.Р., Климов Л.В., Котова О.В., Лебедева Д.И., Орлова А.С., Травникова Е.В., Царева Е.В., Яковлев О.Н. Cтресс у детей и подростков: причины и последствия, лечение и профилактика. Клиническое руководство. СПб.: Скифия-принт; М.: Профмедпресс. 2022. 90 с. [Akarachkova E.S., Baidauletova A.I., Blinov D.V., Bugorsky E.V., Kadyrova L.R., Klimov L.V., Kotova O.V., Lebedeva D.I., Orlova A.S., Travnikova E.V., Tsareva E.V., Yakovlev O.N. Stress in children and adolescents: causes and consequences, treatment and prevention. Clinical Guide. SPb.: Skifia-print; M.: Profmedpress. 2022. 90 p. (In Russ.).]
  21. Schmitt F., Najjari L., Kupec T., Stickeler E., Meinhold-Heerlein I., Wittenborn J. Predictors of significant distress in cervical cancer patients: a cross sectional study. Arch Gynecol Obstet. 2024; 310(1):551–560. https://doi.org/10.1007/s00404-024-07505-2
  22. Mantegna G., Petrillo M., Fuoco G., Venditti L., Terzano S., Anchora L.P., Scambia G., Ferrandina G. Long-term prospective longitudinal evaluation of emotional distress and quality of life in cervical cancer patients who remained disease-free 2-years from diagnosis. BMC Cancer. 2013; 13:127. https://doi.org/10.1186/1471-2407-13-127
  23. Bakker R.M., Kenter G.G., Creutzberg C.L., Stiggelbout A.M., Derks M., Mingelen W., Kroon C.D., Vermeer W.M., Ter Kuile M.M. Sexual distress and associated factors among cervical cancer survivors: A cross-sectional multicenter observational study. Psychooncology. 2017; 26(10):1470–1477. https://doi.org/10.1002/pon.4317
  24. Бегович Ё., Байгалмаа Б., Солопова А.Г., Бицадзе В.О., Хизроева Д.Х., Сон Е.А., Зобаид Ш.Х., Быковщенко Г.К. Качество жизни как критерий оценки эффективности реабилитационных программ у пациенток с болевой формой наружного генитального эндометриоза. Акушерство, Гинекология и Репродукция. 2023;17(1):92–103. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.391 [Begovich E., Baigalmaa B., Solopova A.G., Bitsadze V.O., Khizroeva J.Kh., Son E.A., Zobaid Sh.Kh., Bykovshchenko G.K. Quality of life as a criterion for assessing the effectiveness of rehabilitation programs in patients with painful external genital endometriosis. Obstetrics, Gynecology and Reproduction. 2023;17(1):92–103. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.391 (In Russ.).]
  25. Бегович Ё., Солопова А.Г., Хлопкова С.В., Сон Е.А., Идрисова Л.Э. Качество жизни и особенности психоэмоционального статуса больных наружным генитальным эндометриозом. Акушерство, Гинекология и Репродукция. 2022; 16(2):122–133. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2022.283 [Begovich E., Solopova A.G., Khlopkova S.V., Son E.A., Idrisova L.E. Quality of life and psychoemotional status in patients with external genital endometriosis. Obstetrics, Gynecology and Reproduction. 2022; 16(2):122–133. https://doi.org/10.17749/2313-7347/ob.gyn.rep.2022.283 (In Russ.).]
  26. Блинов Д.В., Солопова А.Г., Гамеева Е.В., Бадалов Н.Г., Галкин В.Н., Ерёмушкин М.А., Степанова А.М., Иванов А.Е., Гридасова О.С. Влияние реабилитации на психоэмоциональное состояние женщин с хирургическим лечением рака вульвы: рандомизированное контролируемое исследование. Вестник восстановительной медицины. 2024; 23(5):52–60. https://doi.org/10.38025/2078-1962-2024-23-5-52-60 [Blinov D.V., Solopova A.G., Gameeva E.V., Badalov N.G., Galkin V.N., Eremushkin M.A., Stepanova A.M., Ivanov A.E., Gridasova O.S. Rehabilitation Effects on Psycho-Emotional Well-Being in Women with Surgically Treated Vulvar Cancer: a Randomised Controlled Trial. Bulletin of Rehabilitation Medicine. 2024; 23(5):52–60. https://doi.org/10.38025/2078-1962-2024-23-5-52-60 (In Russ.).]
  27. Блинов Д.В., Солопова А.Г., Ачкасов Е.Е., Акарачкова Е.С., Котова О.В., Акавова С.А., Галкин В.Н., Быковщенко Г.К., Санджиева Л.Н., Корабельников Д.И., Блбулян Т.А., Петренко Д.А., Власина А.Ю. Алгоритм комплексной психотерапевтической поддержки для женщин с психоневрологическими симптомами в период реабилитации после лечения злокачественных новообразований репродуктивной системы. Эпилепсия и пароксизмальные состояния. 2023; 15(3):232–245. https://doi.org/10.17749/2077-8333/epi.par.con.2023.168 [Blinov D.V., Solopova A.G., Achkasov E.E., Akarachkova E.S., Kotova O.V., Akavova S.A., Galkin V.N., Bykovshchenko G.K., Sandzhieva L.N., Korabelnikov D.I., Blbulyan T.A., Petrenko D.A., Vlasina A.Yu. Algorithm for the provision of comprehensive psychotherapeutic support to women experiencing neuropsychiatric symptoms during rehabilitation following the treatment of malignant neoplasms of the reproductive system. Epilepsy and paroxysmal conditions. 2023; 15(3):232–245. https://doi.org/10.17749/2077-8333/epi.par.con.2023.168 (In Russ.).]
  28. Rutherford C., Mercieca-Bebber R., Tait M., Mileshkin L., King M.T. Quality of Life in Women with Cervical Cancer. In: Farghaly. S. (eds) Uterine Cervical Cancer. Springer. Cham. 2019; pp. 267–289. https://doi.org/10.1007/978-3-030-02701-8_15



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©


This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.