Younger Female Patients With Cancer Report Less Emotional Function

Among patients with solid tumors, analysis of patient-reported outcomes for emotional functioning (EF) showed that at baseline EF was moderate, and it identified groups with lower EF such as female and younger patients.

Study results were presented at the European Society for Medical Oncology 2025 Congress in Berlin, Germany.

“We found general low EF scores in our large cohort at baseline, which stresses the need to assess for depressive symptoms, to follow up, and to offer early psychiatric, psychotherapeutic treatment in patients with cancer undergoing systemic therapy,” said lead author Angelika Starzer, a fellow in medical oncology Medical University of Vienna in Vienna, Austria. “We found an especially vulnerable cohort, which was younger female patients.”

EF scores varied significantly by sex and age; at baseline, female patients had a mean EF of 61.1 versus 66.7 for male patients, and patients younger than the median age of 62.5 years had a mean EF of 66.7 versus 75 for patients at least 62.5 years old.

Young female patients had a mean baseline EF of 58.3 compared with 75 for older male patients. Additionally, emotional function scores varied by disease type. When divided by cancer type and sex, the highest median EF score was in older male patients with colorectal cancer (75), and the lowest median EF was in patients with rarer cancers (41.7).

Of note, patients treated in the palliative setting had a significantly lower baseline EF score (66.7) than patients treated in the curative setting (75).

The results shared at the meeting divided patients by tumor type into lung, head and neck, breast, colorectal, pancreatic, cholangiocellular, sarcoma and other cancers. “Other” cancers were considered those with fewer than 50 occurrences in the cohort.

The range for each of these groups included patients with EFs of 100, and all groups except for breast, cholangiocellular and sarcoma included patients with EFs of 0.

Median EF score at baseline was 66.7 and patients were largely being treated in the palliative setting (70.8%) rather than curative (29.2%), and 55.1% of patients were treatment naive. Median EF did not significantly vary in patients with and without prior treatment.

What is the clinical significance of this study?

For patients with cancer, depression is a considerable comorbidity which can impact quality of life and is associated with mortality, explained Starzer in her presentation.

“We can conclude that patient-reported outcome tools such as questionnaires are an easy tool to assess for depressive symptoms and to follow up on them and to identify the patients who are most in need of psychiatric counseling,” said Starzer.

She also added that further analysis of this patient population is in process.

“At the moment in this cohort we are performing longitudinal EF assessment and blood biomarker analysis for the development of depression,” said Starzer.

Of note, invited discussant Dr. Nathan Cherny provided context that per EORTC reference data, scores from 60 to 80 are considered moderate on the EF scale. This qualifies the overall median EF and the median EF for each cancer type as moderate.

Cherney, of the departments of medical oncology and palliative care at Helmsley Cancer Center, Shaare Zedek Medical Center, Jerusalem, Israel also noted that observed differences in sex and age are consistent with normative scores.

What patients were screened, and how?

A prospective cohort study of patients (1,450 patients) with solid tumors undergoing systemic therapy at the Medical University of Vienna from April 2019 to April 2025 observed EORTC QLQ-C30 questionnaires ascertaining patients’ quality of life at baseline and each restaging using an EF subscore.

The most common cancer types among patients observed were lung (20.1%), breast (13%), pancreatic (12.6%) and colorectal (10.4%). Median age at inclusion was 62.5.

This subscore measured EF on a scale from 0 to 100, with lower scores indicating higher symptom burden and higher scores indicating greater function. The preliminary analysis presented at the meeting evaluated baseline EF.

Patients across solid tumor types were enrolled after granting informed consent. Prior to receiving systemic therapy, patients’ baseline symptoms were assessed via questionnaire and blood draw. The questionnaires and blood draws were repeated at each restaging of the patient’s disease.

Reference

“Monitoring the development of depressive symptoms in real-world patients with solid cancer under systemic therapy,” by Angelika Starzer, et al, presented at ESMO 2025 Congress; October 17-21, 2025; Berlin, Germany. Abstract 2544MO.

For more news on cancer updates, research and education, don’t forget to subscribe to CURE®’s newsletters here.