{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T18:11:40Z","timestamp":1774548700871,"version":"3.50.1"},"reference-count":48,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T00:00:00Z","timestamp":1674432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Almost one-third of all malignant melanoma patients exhibit emotional stress indicating the need for professional care. Considering this, patients\u2019 psychological needs are routinely overlooked and unfulfilled, even though there is substantial evidence that psychological therapies may enhance psychosocial outcomes for melanoma patients, such as low mood, sadness, and anxiety. Among developing countries and some health systems in developed regions, the lack of awareness and screening methods for skin cancer creates a high risk of psychological issues associated with more advanced diseases. Therefore, the current study aimed to investigate and compare the impact of malignant melanoma awareness for screening, prevention, and treatment on the patient\u2019s quality of life and coping with stress and depression, based on patients\u2019 age. This cross-sectional study recruited 238 patients with malignant melanoma distributed into two groups, Group A patients between 18 and 65 years and Group B patients older than 65. There were no significant gender differences and cancer staging differences between groups, although self-reported depressed mood and anhedonia were significantly more frequent in younger adults with malignant melanoma (43.8% vs. 28.9%). From the unstandardized surveys, it was observed that significantly fewer patients from Group B knew that melanoma could be caused by sun exposure (34.2% vs. 52.2%), and they were less likely to use sunscreen or visit a doctor to evaluate their skin moles (25.9% vs. 14.5%). Elderly patients preferred television as the main source of information, and only 68.4% of patients from Group B were using smart devices. There was a significantly higher physical score on the SF-12 scale among Group A patients, although patients from Group B scored higher in the mental health assessment, and the perceived helplessness on the PSS-10 scale was significantly higher compared to younger adults with melanoma (2.97 vs. 2.71, p-value = 0.036). Lower scores on the physical and mental SF-12 questionnaire determined a higher presence of depressive symptoms (rho = \u22120.352, respectively rho = \u22120.273). Higher scores on the DLQI sexual difficulties and treatment difficulties also correlated significantly with the presence of depressive symptoms and anhedonia (rho = 0.341, respectively rho = 0.264). Awareness campaigns for malignant melanoma should focus on the elderly population, too, using the television as the main communication channel. On the other hand, the more informed and knowledgeable group of adults younger than 65 are more likely to experience psychological problems and should be targeted for psycho-oncological aid.<\/jats:p>","DOI":"10.3390\/curroncol30020116","type":"journal-article","created":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T01:59:03Z","timestamp":1674525543000},"page":"1516-1528","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Effects of Lack of Awareness in Age-Related Quality of Life, Coping with Stress, and Depression among Patients with Malignant Melanoma"],"prefix":"10.3390","volume":"30","author":[{"given":"Ana-Olivia","family":"Toma","sequence":"first","affiliation":[{"name":"Department of Microbiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estera","family":"Boeriu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Discipline of Pediatric Oncology and Hematology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luminita","family":"Decean","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Strada Gheorghe Marinescu 38, 540139 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vlad","family":"Bloanca","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Bratosin","sequence":"additional","affiliation":[{"name":"Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihaela Codrina","family":"Levai","sequence":"additional","affiliation":[{"name":"Research Center for Medical Communication, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neeharika Gayatri","family":"Vasamsetti","sequence":"additional","affiliation":[{"name":"Faculty of General Medicine Nizampura, Kaloji Narayana Rao University of Health Sciences, Warangal 506007, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satish","family":"Alambaram","sequence":"additional","affiliation":[{"name":"Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrada Licinia","family":"Oprisoni","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Discipline of Pediatric Oncology and Hematology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5336-5789","authenticated-orcid":false,"given":"Bogdan","family":"Miutescu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kakarla","family":"Hemaswini","sequence":"additional","affiliation":[{"name":"Malla Reddy Institute of Medical Sciences, Suraram Main Road 138, Hyderabad 500055, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iulius","family":"Juganaru","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrei-Cristian","family":"Bondar","sequence":"additional","affiliation":[{"name":"Psychiatry Hospital \u201cProf. Dr. Alexandru Obregia\u201d, Soseaua Berceni 10, 041914 Bucuresti, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marius Liviu","family":"Moise","sequence":"additional","affiliation":[{"name":"Department of Radiology, \u201cPremiere\u201d Hospital\u2014\u201cRegina Maria\u201d, Calea Aradului 113, 300643 Timisoara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2678","DOI":"10.1158\/1078-0432.CCR-20-4092","article-title":"Melanoma research foundation. the state of melanoma: Emergent challenges and opportunities","volume":"27","author":"Atkins","year":"2021","journal-title":"Clin. Cancer Res."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Aabed, H., Bloanca, V., Crainiceanu, Z., Bratosin, F., Citu, C., Diaconu, M.M., Ciorica, O., and Bratu, T. (2022). The impact of SARS-CoV-2 pandemic on patients with malignant melanoma at a Romanian academic center: A four-year retrospective analysis. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19148499"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"725523","DOI":"10.3389\/fonc.2021.725523","article-title":"Melanoma in adolescents and young adults: Evaluation of the characteristics, treatment strategies, and prognostic factors in a monocentric retrospective study","volume":"11","author":"Russo","year":"2021","journal-title":"Front. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"443","DOI":"10.3322\/caac.21637","article-title":"Cancer statistics for adolescents and young adults, 2020","volume":"70","author":"Miller","year":"2020","journal-title":"CA Cancer J. Clin."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1080\/15384047.2019.1640032","article-title":"Current state of melanoma diagnosis and treatment","volume":"20","author":"Davis","year":"2019","journal-title":"Cancer Biol. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1615\/CritRevEukaryotGeneExpr.2020028454","article-title":"Malignant melanoma: Skin cancer-diagnosis, prevention, and treatment","volume":"30","author":"Ahmed","year":"2020","journal-title":"Crit. Rev. Eukaryot. Gene Expr."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Moreira, A., Heinzerling, L., Bhardwaj, N., and Friedlander, P. (2021). Current melanoma treatments: Where do we stand?. Cancers, 13.","DOI":"10.3390\/cancers13020221"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1534735421990078","DOI":"10.1177\/1534735421990078","article-title":"Current advancements and novel strategies in the treatment of metastatic melanoma","volume":"20","author":"Sood","year":"2021","journal-title":"Integr. Cancer Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2898","DOI":"10.1002\/ijc.33479","article-title":"Skin melanoma deaths within 1 or 3\u2009years from diagnosis in Europe","volume":"148","author":"Sacchetto","year":"2021","journal-title":"Int. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1111\/ced.14323","article-title":"Increasing melanoma awareness among health and social care professionals in secondary care in an era of reduced skin cancer referrals due to COVID-19","volume":"45","author":"Quinlan","year":"2020","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.ijwd.2020.01.003","article-title":"Art of prevention: The importance of melanoma surveillance","volume":"6","author":"Goddard","year":"2020","journal-title":"Int. J. Womens Dermatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e13844","DOI":"10.2196\/13844","article-title":"Patient attitudes and their awareness towards skin cancer-related apps: Cross-sectional survey","volume":"7","author":"Steeb","year":"2019","journal-title":"JMIR mHealth uHealth"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1016\/j.ejso.2017.06.008","article-title":"Melanoma patients\u2019 disease-specific knowledge, information preference, and appreciation of educational YouTube videos for self-inspection","volume":"43","author":"Damude","year":"2017","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3043","DOI":"10.3889\/oamjms.2019.770","article-title":"Psychological impact of melanoma, how to detect, support and help","volume":"7","author":"Vojvodic","year":"2019","journal-title":"Open Access. Maced. J. Med. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Wiens, L., Sch\u00e4ffeler, N., Eigentler, T., Garbe, C., and Forschner, A. (2021). Psychological distress of metastatic melanoma patients during treatment with immune checkpoint inhibitors: Results of a prospective study. Cancers, 3.","DOI":"10.3390\/cancers13112642"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1080\/14780887.2016.1145774","article-title":"Breast cancer representations in Canadian news media: A critical discourse analysis of meanings and the implications for identity","volume":"13","author":"McGannon","year":"2016","journal-title":"Qual. Res. Psychol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.socscimed.2016.01.011","article-title":"A new normal?: Women\u2019s experiences of biographical disruption and liminality following treatment for early stage breast cancer","volume":"151","author":"Trusson","year":"2016","journal-title":"Soc. Sci. Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Sebri, V., Durosini, I., Mazzoni, D., and Pravettoni, G. (2022). The body after cancer: A qualitative study on breast cancer survivors\u2019 body representation. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191912515"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/SPC.0000000000000184","article-title":"Sexual identity after breast cancer: Sexuality, body image, and relationship repercussions","volume":"10","author":"Male","year":"2016","journal-title":"Curr. Opin. Support Palliat. Care"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1002\/pon.4909","article-title":"Exploring the relationship between the body self and the sense of coherence in women after surgical treatment for breast cancer","volume":"28","author":"Mirucka","year":"2019","journal-title":"Psychooncology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"722211","DOI":"10.3389\/fpsyg.2021.722211","article-title":"The impact of unsupportive social support on the injured self in breast cancer patients","volume":"12","author":"Sebri","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1136\/jamia.2009.001230","article-title":"International classification of diseases, 10th edition, clinical modification and procedure coding system: Descriptive overview of the next generation HIPAA code sets","volume":"17","author":"Steindel","year":"2010","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_23","first-page":"5091","article-title":"Spindle cell melanoma: Incidence and survival, 1973\u20132017","volume":"16","author":"Xu","year":"2018","journal-title":"Oncol. Lett."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"100024","DOI":"10.1016\/j.lanepe.2021.100024","article-title":"Changing epidemiology and age-specific incidence of cutaneous malignant melanoma in England: An analysis of the national cancer registration data by age, gender and anatomical site, 1981\u20132018","volume":"2","author":"Memon","year":"2021","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_25","unstructured":"Ontario Ministry of Health and Long-Term Care (2019). Population Estimates, IntelliHealth."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1080\/13607863.2019.1693972","article-title":"Age differences in cancer-related stress, spontaneous emotion regulation, and emotional distress","volume":"25","author":"Bamonti","year":"2021","journal-title":"Aging Ment. Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5826\/dpc.0702a01","article-title":"Epidemiological trends in skin cancer","volume":"7","author":"Apalla","year":"2017","journal-title":"Dermatol. Pract. Concept."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1037\/0022-3514.56.2.267","article-title":"Assessing coping strategies: A theoretically based approach","volume":"56","author":"Carver","year":"1989","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Timircan, M., Bratosin, F., Vidican, I., Suciu, O., Turaiche, M., Bota, A.V., Mitrescu, S., and Marincu, I. (2021). Coping strategies and health-related quality of life in pregnant women with SARS-CoV-2 infection. Medicina, 57.","DOI":"10.3390\/medicina57101113"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","article-title":"A 12-item short-form health survey","volume":"34","author":"Ware","year":"1996","journal-title":"Med. Care"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Dehelean, L., Papava, I., Musat, M.I., Bondrescu, M., Bratosin, F., Bucatos, B.O., Bortun, A.-M.C., Mager, D.V., Romosan, R.S., and Romosan, A.-M. (2021). Coping strategies and stress related disorders in patients with COVID-19. Brain Sci., 11.","DOI":"10.3390\/brainsci11101287"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/j.1365-2230.1994.tb01167.x","article-title":"Dermatology life quality index (DLQI)\u2014A simple practical measure for routine clinical use","volume":"19","author":"Finlay","year":"1994","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1177\/1359105316684938","article-title":"Reliability and validity of the perceived stress scale-10 in Hispanic Americans with English or Spanish language preference","volume":"24","author":"Baik","year":"2019","journal-title":"J Health Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"93","DOI":"10.3322\/caac.21388","article-title":"The eighth edition AJCC cancer staging manual: Continuing to build a bridge from a population-based to a more \"personalized\" approach to cancer staging","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J. Clin."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1080\/17538157.2017.1399131","article-title":"Digital age and the public eHealth perspective: Prevailing health app use among Austrian internet users","volume":"43","author":"Naszay","year":"2018","journal-title":"Inform. Health Soc. Care"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.2196\/mhealth.7689","article-title":"Mobile health in oncology: A patient survey about app-assisted cancer care","volume":"5","author":"Kessel","year":"2017","journal-title":"JMIR mHealth uHealth"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1111\/ddg.13630","article-title":"Information-seeking and use of information resources among melanoma patients of German skin cancer centers","volume":"16","author":"Bergmann","year":"2018","journal-title":"J. Dtsch. Dermatol. Ges."},{"key":"ref_38","first-page":"116","article-title":"Malignant melanoma S3-guideline \u201cdiagnosis, therapy and follow-up of melanoma\u201d","volume":"11","author":"Pflugfelder","year":"2013","journal-title":"J. Ger. Soc. Dermatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3540","DOI":"10.1200\/JCO.2014.56.0086","article-title":"Four-week prevalence of mental disorders in patients with cancer across major tumor entities","volume":"32","author":"Mehnert","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"19","DOI":"10.5460\/jbhsi.v7.2.52889","article-title":"Self-efficacy and adherence to treatment: The mediating effects of social support","volume":"7","year":"2015","journal-title":"J. Behav. Health Soc. Issues"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0022-4804(03)00167-7","article-title":"Evaluating health utility in patients with melanoma, breast cancer, colon cancer, and lung cancer: A nationwide, population-based assessment","volume":"114","author":"Ko","year":"2003","journal-title":"J. Surg. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1053\/sonu.2003.50006","article-title":"Psychological adjustment to the melanoma experience","volume":"19","author":"Boyle","year":"2003","journal-title":"Semin. Oncol. Nurs."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"VI51","DOI":"10.1093\/annonc\/mdp255","article-title":"A systematic review of health-related quality of life in cutaneous melanoma","volume":"20","author":"Cornish","year":"2009","journal-title":"Ann. Oncol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Toma, A.-O., Prodan, M., Reddyreddy, A.R., Seclaman, E., Crainiceanu, Z., Bloanca, V., Bratosin, F., Dumitru, C., Pilut, C.N., and Alambaram, S. (2023). The epidemiology of malignant melanoma during the first two years of the COVID-19 pandemic: A systematic review. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20010305"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2726","DOI":"10.1038\/sj.jid.5701142","article-title":"Critical review of generic and dermatology-specific health-related quality of life instruments","volume":"127","author":"Both","year":"2007","journal-title":"J. Investig. Dermatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.suronc.2004.10.003","article-title":"Choices in the management of asymptomatic lung nodules in the elderly","volume":"13","author":"Wiener","year":"2004","journal-title":"Surg. Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"538","DOI":"10.7150\/jca.2.538","article-title":"Malignant melanoma in the elderly: Different regional disease and poorer prognosis","volume":"2","author":"Macdonald","year":"2011","journal-title":"J. Cancer"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1080\/08870449808407422","article-title":"Health promotion from the perspective of social cognitive theory","volume":"13","author":"Bandura","year":"1998","journal-title":"Psychol. Health"}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/2\/116\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:14:09Z","timestamp":1760120049000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/30\/2\/116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,23]]},"references-count":48,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["curroncol30020116"],"URL":"https:\/\/doi.org\/10.3390\/curroncol30020116","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,23]]}}}