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Fujiyoshi K, Sudo T, Fujita F, Tanihara S, Ishida H, Shichijo S, Chino A, Nagasaski T, Takao A, Sasaki K, Akagi K, Matsubara T, Ueno H, Hirata K, Miyakura Y, Ishikawa T, Sunami E, Takahashi Y, Yamaguchi T, Tanakaya K, Tomita N, Ajioka Y. Marital status after colorectal surgery in familial adenomatous polyposis: a nationwide multicenter study in Japan. Int J Clin Oncol 2024; 29:1274-1283. [PMID: 38819608 DOI: 10.1007/s10147-024-02558-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 05/17/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Patients with familial adenomatous polyposis (FAP) experience psychological and social challenges concerning future events such as marriage and childbirth alongside the medical risks of colorectal cancer (CRC) and FAP-related disease. We retrospectively investigated the rate of marriage and childbirth postoperatively in Japanese patients with FAP. METHODS We included 161 patients who had colorectal surgery and reported marital status from a national survey of 35 Japanese institutions. Participants were classified according to marital status: married before colectomy (80 patients), married after colectomy (13 patients), and unmarried (68 patients). RESULTS The marriage rate for all 161 patients (57.8%, standardized ratio 0.95, 95% confidence interval [CI] 0.76-1.14) was comparable to that in the general Japanese population (57.1%). The marriage rate among the 81 patients who were unmarried before colectomy was low (16.0%); however, the standardized marital ratio (0.75, 95% CI 0.34-1.15) was not significantly lower than that of the general population. In multivariable logistic regression, younger age (born after 1980, odds ratio [OR] 0.12, p < 0.001) and genetic testing (OR 4.06, p = 0.001) were associated with postoperative marriage. Seventy-one percent of patients with FAP who married after colectomy became pregnant and achieved delivery. CONCLUSIONS The marriage rate of patients with FAP was comparable to that of the general population whereas the rate after colectomy was low among patients with FAP. However, in patients with FAP, colorectal surgery itself may not lead to negative consequences in terms of fecundity.
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Affiliation(s)
- Kenji Fujiyoshi
- Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan.
| | - Tomoya Sudo
- Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Shinichi Tanihara
- Department of Public Health, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Hideyuki Ishida
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, 350-8550, Japan
| | - Satoki Shichijo
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan
| | - Akiko Chino
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Toshiya Nagasaski
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan
| | - Akinari Takao
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Kazuhito Sasaki
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kiwamu Akagi
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Division of Molecular Diagnosis and Cancer Prevention, Saitama Cancer Center, 818 Komuro, Ina-machi, Kitaadachi-gun, Saitama, 362-0806, Japan
| | - Takaaki Matsubara
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Surgery, Division of Lower Gastrointestinal Surgery, Hyogo College of Medicine, Nishinomiya, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Hideki Ueno
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Keiji Hirata
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Surgery I, School of Medicine, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu-shi, Fukuoka, 807-8555, Japan
| | - Yasuyuki Miyakura
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Surgery, Saitama Medical Center Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama-shi, Saitama, 330-0834, Japan
| | - Toshiaki Ishikawa
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Clinical Oncology, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Eiji Sunami
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-0004, Japan
| | - Yusuke Takahashi
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Surgery, National Hospital Organization Osaka National Hospital, 2-1-1 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan
| | - Tatsuro Yamaguchi
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Clinical Genetics, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan
| | - Kohji Tanakaya
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Department of Surgery, Iwakuni Clinical Center, 1-1-1 Atago-cho, Iwakuni-shi, Yamaguchi, 740-8510, Japan
| | - Naohiro Tomita
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Cancer Treatment Center, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka-shi, Osaka, 560-8565, Japan
| | - Yoichi Ajioka
- Study Group for Familial Adenomatous Polyposis in the Japanese Society for Cancer of the Colon and Rectum, Sanbancho KS Building, 2 Sanbancho, Chiyoda-ku, Tokyo, 102-0075, Japan
- Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachi-dori, Chuo Ward, Niigata, 951-8510, Japan
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Ren Y, Maselko J, Tan X, Olshan AF, Stover AM, Bennett AV, Reeder-Hayes KE, Edwards JK, Reeve BB, Troester MA, Emerson MA. Emotional and functional well-being in long-term breast cancer survivorship. Cancer Causes Control 2024; 35:1191-1200. [PMID: 38642278 DOI: 10.1007/s10552-024-01877-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/26/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE Emotional and functional well-being (EWB and FWB) are important components of mental health and quality of life. This study aims to evaluate long-term EWB and FWB in breast cancer (BC) survivors. METHODS The Carolina Breast Cancer Study Phase 3 oversampled Black and younger (< 50 years in age) women so that they each represent approximately 50% of the study population and assessed participants' EWB and FWB with the Functional Assessment of Cancer Therapy-Breast (FACT-B) at 5- (baseline), 25-, and 84-months post diagnosis. Multinomial logit models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for associations between demographic and clinical characteristics and well-being change relative to baseline. RESULTS Among 2,781 participants with BC, average EWB and FWB improved with time since diagnosis. Persistent FWB decrements were associated with Black race [OR 1.4 (95% CI 1.2-1.7) and 1.3 (95% CI 1.1-1.6), at 25-months and 84-months respectively], older age [OR 1.4 (95% CI 1.1-1.7) and 1.5 (95% CI 1.2-1.8), respectively], no chemotherapy, and recurrence [OR 2.9 (95% CI 1.8-4.8) and 3.1 (95% CI 2.1-4.6), respectively]. EWB decrements were associated with advanced stage and recurrence. Decrements in combined (FWB+EWB) well-being were associated with recurrence at both follow-up survey timepoints [ORs 4.7 (95% CI 2.7-8.0) and 4.3 (95% CI 2.8-6.6), respectively]. CONCLUSIONS Long-term well-being varies by demographics and clinical features, with Black women and women with aggressive disease at greatest risk of long-term decrements.
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Affiliation(s)
- Yumeng Ren
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Joanna Maselko
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Xianming Tan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Angela M Stover
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Antonia V Bennett
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine E Reeder-Hayes
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Division of Oncology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Jessie K Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Melissa A Troester
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Marc A Emerson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Yang C, Li P, Chen Y, Zheng J, Zhang X, Gao HF, Zhang L, Wang K. Pooled analysis of NeoCARH and NeoCART trials: patient-reported outcomes in patients with early-stage breast cancer receiving platinum-based or anthracycline-based neoadjuvant chemotherapy. Support Care Cancer 2024; 32:401. [PMID: 38829506 DOI: 10.1007/s00520-024-08610-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 05/27/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE Anthracycline-based or platinum-based neoadjuvant chemotherapy belongs to the standard treatment for early-stage breast cancer (EBC) that is either triple-negative or human epidermal growth factor receptor 2 positive (HER2 +). Currently, there is a paucity of data comparing their impact on health-related quality of life (HRQoL). METHODS Triple-negative or HER2 + EBC from our two prospective randomized controlled trials, neoCARH and neoCART, were divided into two groups based on the neoadjuvant chemotherapy regimens they received: anthracycline-based or platinum-based group. HRQoL was the exploratory endpoint in these two trials, which was assessed using the European Organization for Research and Treatment of Cancer Quality of Life-Core30 and Breast23 questionnaires. The primary variable of interest was the C30 summary score (C30-SumSc). Assessments were carried out at baseline, after neoadjuvant chemotherapy, and 1 year and 2 years after diagnosis. RESULTS The mean questionnaires' compliance rate was 95.0%. After neoadjuvant chemotherapy, 210 patients had evaluable HRQoL data, the mean least square change from baseline for the platinum-based group was - 15.997 (95% confidence interval (CI): - 17.877 to - 14.117), and it was - 20.156 (95% CI: - 22.053 to - 18.258) for the anthracycline-based group (difference: 4.159, 95% CI: 1.462 to 6.855, P = 0.003, minimal important difference = 3). For the majority of the domains of interest assessed by the C30 and BR23 questionnaires, the platinum-based group demonstrated superior outcomes in comparison to the anthracycline-based group. CONCLUSION Patients receiving platinum-based or anthracycline-based regimens both experienced worsened HRQoL after neoadjuvant chemotherapy; however, the former provided relatively better HRQoL compared with the latter. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov: NCT03140553. Registered 4 May 2017 (neoCARH). NCT03154749. Registered 16 May 2017 (neoCART).
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Affiliation(s)
- Ciqiu Yang
- Department of Breast Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 123 Huifu West Road, Guangta Street, Yuexiu District, Guangzhou, 510080, China
| | - Peiyong Li
- Department of Breast Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 123 Huifu West Road, Guangta Street, Yuexiu District, Guangzhou, 510080, China
- Guangdong Medical University, Zhanjiang, 524000, China
| | - Yitian Chen
- Department of Breast Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 123 Huifu West Road, Guangta Street, Yuexiu District, Guangzhou, 510080, China
| | - Junqiu Zheng
- Department of Breast Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 123 Huifu West Road, Guangta Street, Yuexiu District, Guangzhou, 510080, China
| | - Xiaoqi Zhang
- Department of Breast Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 123 Huifu West Road, Guangta Street, Yuexiu District, Guangzhou, 510080, China
| | - Hong-Fei Gao
- Department of Breast Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 123 Huifu West Road, Guangta Street, Yuexiu District, Guangzhou, 510080, China
| | - Liulu Zhang
- Department of Breast Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 123 Huifu West Road, Guangta Street, Yuexiu District, Guangzhou, 510080, China
| | - Kun Wang
- Department of Breast Cancer, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, No. 123 Huifu West Road, Guangta Street, Yuexiu District, Guangzhou, 510080, China.
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Ghowinam MA, Albokhari AA, Badheeb AM, Lamlom M, Alwadai M, Hamza A, Aladalah A. Prevalence of Depression and Anxiety Symptoms Among Patients With Cancer in Najran, Saudi Arabia. Cureus 2024; 16:e54349. [PMID: 38500908 PMCID: PMC10945987 DOI: 10.7759/cureus.54349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Depression and anxiety are associated with poor health consequences in patients with cancer, and these mental health issues may affect cancer treatment. They are frequently triggered by stress, and cancer is among the most stressful conditions experienced by a person. Depression and anxiety are related to several sociodemographic variables in patients with cancer. However, only a few studies have examined the prevalence of depression and anxiety symptoms in patients with cancer in Saudi Arabia. OBJECTIVES To detect the prevalence of depression and anxiety symptoms among patients with cancer at the Najran Oncology Center in Najran, Saudi Arabia, and determine the risk factors associated with these symptoms. METHODS A cross-sectional study was conducted from April 1, 2023, to September 30, 2023, on a convenience sample of patients diagnosed with cancer who were receiving chemotherapy at Najran Oncology Center, King Khalid Hospital, Najran, Saudi Arabia, and who agreed to participate in the study. The Hospital Anxiety and Depression Scale was used. Data on the demographic characteristics of the patients were collected using a self-administered questionnaire. Moreover, medical data were collected from the medical records of the patients. RESULTS In total, 92 patients with various cancer diagnoses were recruited in this study. Among them, 51 and 41 were women and men, respectively. Moreover, 81 were married and 11 were either single, widow, or divorced. The mean age of the participants was 51.24 ± 15.15 years. The prevalence rates of depression and anxiety were 42.4% and 23.9%, respectively. There were significant associations between depression and marital status in patients with cancer-associated pain and those with a current history of chemotherapy. Furthermore, the association between anxiety and cancer-associated pain was significant. However, marital status was not associated with anxiety. Age, sex, family history of mental disorders, cancer duration, current cancer stage, and surgical interventions were not associated with the prevalence of depression and anxiety. CONCLUSIONS Our findings underline the importance of identifying depression and anxiety in patients with cancer. Marital status, presence of pain, and current chemotherapy history were significantly associated with depression and pain with anxiety. RECOMMENDATIONS Further studies with a higher number of patients with cancer should be conducted in Saudi Arabia and other Arab countries. Screening for depression and anxiety symptoms should be a part of the comprehensive evaluation of patients with cancer. Appropriate treatment interventions must be provided to patients with cancer who present with mental disorders.
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Affiliation(s)
| | | | | | | | - Mari Alwadai
- Psychiatry, Eradah Complex and Mental Health Services, Najran, SAU
| | - Aseel Hamza
- Psychiatry, Eradah Complex and Mental Health Services, Jeddah, SAU
| | - Ali Aladalah
- Psychiatry, Eradah Complex and Mental Health Services, Najran, SAU
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Bower JE, Partridge AH, Wolff AC, Cole SW, Irwin MR, Thorner ED, Joffe H, Petersen L, Crespi CM, Ganz PA. Improving biobehavioral health in younger breast cancer survivors: Pathways to Wellness trial secondary outcomes. J Natl Cancer Inst 2023; 115:83-92. [PMID: 36130057 PMCID: PMC9830488 DOI: 10.1093/jnci/djac180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/27/2022] [Accepted: 09/12/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The Pathways to Wellness trial tested the efficacy of 2 interventions for younger breast cancer survivors: mindful awareness practices (MAPs) and survivorship education (SE). This planned secondary analysis examines intervention effects on stress, positive psychological outcomes, and inflammation (Clincaltrials.gov NCT03025139). METHODS Women diagnosed with breast cancer at or before age 50 years who had completed treatment and had elevated depressive symptoms were randomly assigned to 6 weeks of MAPs, SE, or wait-list control (WLC). Assessments conducted at pre- and postintervention and at 3- and 6-month follow-up measured general stress perceptions, cancer-related intrusive thoughts and worry, positive affect, meaning and peace in life, altruism and empathy, and markers of inflammation. Analyses compared change in outcomes over time in each intervention group relative to WLC using linear mixed models. RESULTS A total 247 women were randomly assigned to MAPs (n = 85), SE (n = 81), or WLC (n = 81). MAPs statistically significantly decreased intrusive thoughts and worry at postintervention and 3-month follow-up relative to WLC (P < .027) and statistically significantly increased positive affect and meaning and peace at postintervention, with positive affect persisting at 3-month follow-up (P < .027). SE statistically significantly decreased intrusive thoughts at 3-month follow-up and statistically significantly increased positive affect at 6-month follow-up relative to WLC (P < .01). Proinflammatory gene expression increased in WLC relative to MAPs (P = .016) but did not differ from SE. There were no intervention effects on other outcomes. CONCLUSION MAPs had beneficial effects on psychological and immune outcomes in younger breast cancer survivors and is a promising approach for enhancing biobehavioral health.
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Affiliation(s)
- Julienne E Bower
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ann H Partridge
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Antonio C Wolff
- The Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Steve W Cole
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine (Hematology-Oncology), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Michael R Irwin
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Elissa D Thorner
- The Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Hadine Joffe
- Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Laura Petersen
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Patricia A Ganz
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine (Hematology-Oncology), David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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Psychosocial Aspects of Breast Cancer. Breast Cancer 2022. [DOI: 10.1007/978-981-16-4546-4_27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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7
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Efficacy of physical therapy interventions on quality of life and upper quadrant pain severity in women with post-mastectomy pain syndrome: a systematic review and meta-analysis. Qual Life Res 2021; 31:951-973. [PMID: 34185226 PMCID: PMC8960660 DOI: 10.1007/s11136-021-02926-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2021] [Indexed: 11/20/2022]
Abstract
Purpose To determine the efficacy of physical therapy interventions on quality of life (QoL) and pain severity in post-mastectomy pain syndrome (PMPS). Methods Multiple databases were searched from database inception to October 2020. Searches were limited to human studies published in either English or Chinese in peer-reviewed journals with full text available for randomized controlled trials conducted on females. Trials comparing the effectiveness of physical therapy interventions against control conditions on QoL and pain were included. Results Eighteen trials were included in the review. The pooled analysis of the four exercise trials revealed a significant effect of the intervention on general [standardized mean difference [SMD]: 0.87 (95%CI: 0.36, 1.37); p = 0.001], physical [SMD: 0.34 (95%CI: 0.01, 0.66); p = 0.044], and mental health components [SMD: 0.27 (95%CI: 0.03, 0.51); p = 0.027] of QoL compared with the control condition. Meta-analyses of six exercise trials, two myofascial release trials, and two acupuncture trials revealed a significant improvement in pain severity in the treatment group than in the control group. However, meta-analyses of two studies revealed a non-significant effect of compression therapy compared to control on pain severity. Conclusion Our meta-analyses found that exercise is beneficial for improving the QoL and pain severity of women with PMPS. Future studies are needed to determine the optimal parameters for exercise interventions designed to improve QoL and pain severity in women with PMPS. The effect of acupuncture, myofascial release, and compression therapy remains inconclusive, and future research is required to validate the effect of these interventions on PMPS. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02926-x.
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8
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He C, Zhu WX, Tang Y, Bai Y, Luo Z, Xu J, Wang H, Xu S, Xu J, Xiao L, Zhang R, Wang Y, Du J, Huang Y, Li X, Su T. Knowledge of a cancer diagnosis is a protective factor for the survival of patients with breast cancer: a retrospective cohort study. BMC Cancer 2021; 21:739. [PMID: 34176477 PMCID: PMC8237449 DOI: 10.1186/s12885-021-08512-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 06/15/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The health burden of breast cancer is rising in China. The effect of informed diagnosis on long-term survival is not fully understood. This retrospective cohort study aims to explore the association between early informed diagnosis and survival time in breast cancer patients. METHODS A total of 12,327 breast cancer patients were enrolled between October 2002 and December 2016. Potential factors, including knowing the cancer diagnosis status, sex, age, clinical stage, surgery history, grade of reporting hospital and diagnostic year were, analyzed. We followed up all participants every 6 months until June 2017. Propensity score matching (PSM) was used to balance the clinicopathologic characteristics between patients who knew their diagnosis and those who did not. RESULTS By June 2017, 18.04% of the participants died of breast cancer. Before PSM, both the 3-year and 5-year survival rates of patients who knew their cancer diagnosis were longer (P < 0.001). After PSM, the above conclusion was still established. By stratified analysis, except for the subgroups of male patients and stage III patients, patients who knew their diagnosis showed a better prognosis in all the other subgroups (P < 0.05). Cox regression analysis showed that knowing a cancer diagnosis was an independent risk factor for survival in breast cancer patients (P < 0.001). CONCLUSIONS Being aware of their cancer diagnosis plays a protective role in extending the survival time of breast cancer patients, which suggests that medical staff and patients' families should disclose the cancer diagnosis to patients in a timely manner. Further prospective studies need to be made to validate our findings.
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Affiliation(s)
- Chen He
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Wen Xi Zhu
- School of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Yunxiang Tang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Yonghai Bai
- Department of Medical Psychology, Changzheng Hospital Affiliated to Naval Medical University, Shanghai, China
| | - Zheng Luo
- Zhoupu Hospital affiliated to Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Jinfang Xu
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Hao Wang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Shuyu Xu
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Jingzhou Xu
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Lei Xiao
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Ruike Zhang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Yajing Wang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Jing Du
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Yujia Huang
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China
| | - Xiaopan Li
- Department of Cancer Prevention and Vital Statistics, Center for Disease Control and Prevention, Pudong New Area, Shanghai, China.
- Pudong Institute of Preventive Medicine, Fudan University, Shanghai, China.
| | - Tong Su
- Department of Medical Psychology, College of Psychology, Naval Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
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9
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Ganz PA, Bower JE, Partridge AH, Wolff AC, Thorner ED, Joffe H, Irwin MR, Petersen L, Crespi CM. Screening for Depression in Younger Breast Cancer Survivors: Outcomes From Use of the 9-item Patient Health Questionnaire. JNCI Cancer Spectr 2021; 5:pkab017. [PMID: 34164605 PMCID: PMC8216636 DOI: 10.1093/jncics/pkab017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 12/12/2022] Open
Abstract
Background Major cancer organizations recommend depression screening in patients and survivors. The 9-item Patient Health Questionnaire (PHQ-9) is often suggested, with limited information about its use. Methods Enrollment data collected from younger breast cancer survivors participating in a behavioral intervention trial were used to examine the relationship between PHQ-9 scores (range = 0-27), patient characteristics, and responses to standardized psychosocial assessment tools. Major depressive disorder criterion was met if responses to the first 2 PHQ-9 items (range = 0-6) were 3 or greater. The sample was categorized by total PHQ-9 scores: less than 5 (minimal depressive symptoms), 5-9 (mild to moderate depressive symptoms), and 10 or greater (moderate to severe depression). PHQ-9 category associations with medical, demographic, psychosocial, and behavioral characteristics were examined using analysis of variance for continuous variables and χ2 tests for categorical variables. Results A total of 231 women met the study prescreening eligibility criterion of mild depressive symptoms and enrolled in the study. On average, they were 45.2 years old and 2.6 years since diagnosis. At enrollment, 22.1% met the screening criterion for possible major depressive disorder; among those with PHQ-9 scores of 10 or greater, 58.3% met this criterion. Anxiety, fatigue, insomnia, and intrusive thoughts about cancer were frequent and were associated with depressive symptom severity (all P < .001). In contrast, neither demographic nor cancer treatment characteristics were associated with depressive symptoms. Conclusions Depressive symptoms in this selected sample of younger breast cancer survivors were independent of demographic characteristics or cancer treatment history, suggesting that depression screening is necessary to detect uncontrolled depressive symptoms.
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Affiliation(s)
- Patricia A Ganz
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.,Department of Medicine (Hematology-Oncology), David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Julienne E Bower
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine and Semel Institute, Los Angeles, CA, USA.,Department of Psychology, UCLA, Los Angeles, CA, USA.,Cousins Center for Psychoneuroimmunology, UCLA, Los Angeles, CA, USA
| | - Ann H Partridge
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Antonio C Wolff
- The Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Elissa D Thorner
- The Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Hadine Joffe
- Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Michael R Irwin
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine and Semel Institute, Los Angeles, CA, USA.,Cousins Center for Psychoneuroimmunology, UCLA, Los Angeles, CA, USA
| | - Laura Petersen
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Catherine M Crespi
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.,Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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10
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Kim JHJ, Drake BL, Accortt EE, Pollin IS, Bairey Merz CN, Stanton AL. Younger Women Living with Chronic Disease: Comparative Challenges, Resiliencies, and Needs in Heart Disease and Breast Cancer. J Womens Health (Larchmt) 2021; 30:1288-1302. [PMID: 33428530 DOI: 10.1089/jwh.2020.8506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Younger women with chronic disease (<60 years of age), especially women with stereotypically "men's" heart disease (HD), are understudied. Unique difficulties may occur with HD, which is less commonly associated with women, compared with breast cancer (BC). Similarities may also exist across younger women, as chronic disease is less normative in younger people. Intersections of gender, age, and the specific disease experience require greater attention for improving women's health. This exploratory qualitative study compared younger women's experiences of HD or BC. Methods: Semistructured interviews with 20 women (n = 10 per disease) were analyzed using applied thematic analysis. Results: Amidst building careers, intimate relationships, and families, women felt thwarted by disease-related functional problems. Cognitive-behavioral coping strategies spurred resilience, including integrating the illness experience with self-identity. Barriers arose when medical professionals used representativeness heuristics (e.g., chronic disease occurs in older age). Important experiences in HD included worsened self-image from disability, negative impact of illness invisibility, and persisting isolation from lacking peer availability. Initial medical care reported by women with HD may reflect gender biases (e.g., HD missed in emergency settings and initial diagnostics). New information provided by the younger women includes limited illness-related optimism in women with HD facing age and gender stereotypes, as well as the advantages and disadvantages of peer availability in BC. Conclusions: Greater public awareness of younger women with chronic disease, alongside structural support and connection with similarly challenged peers, is suggested. As advocacy for BC awareness and action has strengthened over past decades, similar efforts are needed for younger women with HD.
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Affiliation(s)
- Jacqueline H J Kim
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Brittany L Drake
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA
| | - Eynav E Accortt
- Department of Obstetrics and Gynecology and Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Irene S Pollin
- Cedars-Sinai Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences and University of California, Los Angeles, Los Angeles, California, USA.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, California, USA
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11
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Ferreira AR, Di Meglio A, Pistilli B, Gbenou AS, El-Mouhebb M, Dauchy S, Charles C, Joly F, Everhard S, Lambertini M, Coutant C, Cottu P, Lerebours F, Petit T, Dalenc F, Rouanet P, Arnaud A, Martin A, Berille J, Ganz PA, Partridge AH, Delaloge S, Michiels S, Andre F, Vaz-Luis I. Differential impact of endocrine therapy and chemotherapy on quality of life of breast cancer survivors: a prospective patient-reported outcomes analysis. Ann Oncol 2020; 30:1784-1795. [PMID: 31591636 DOI: 10.1093/annonc/mdz298] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In early breast cancer (BC), there has been a trend to escalate endocrine therapy (ET) and to de-escalate chemotherapy (CT). However, the impact of ET versus CT on the quality of life (QoL) of early BC patients is unknown. Here, we characterize the independent contribution of ET and CT on patient-reported outcomes (PROs) at 2 years after diagnosis. PATIENTS AND METHODS We prospectively collected PROs in 4262 eligible patients using the European Organization for Research and Treatment of Cancer QLQ-C30/BR23 questionnaires inside CANTO trial (NCT01993498). The primary outcome was the C30 summary score (C30-SumSc) at 2 years after diagnosis. RESULTS From eligible patients, 37.2% were premenopausal and 62.8% postmenopausal; 81.9% received ET and 52.8% CT. In the overall cohort, QoL worsened by 2 years after diagnosis in multiple functions and symptoms; exceptions included emotional function and future perspective, which improved over time. ET (Pint = 0.004), but not CT (Pint = 0.924), had a persistent negative impact on the C30-SumSc. In addition, ET negatively impacted role and social function, pain, insomnia, systemic therapy side-effects, breast symptoms and further limited emotional function and future perspective recovery. Although CT had no impact on the C30-SumSc at 2-years it was associated with deteriorated physical and cognitive function, dyspnea, financial difficulties, body image and breast symptoms. We found a differential effect of treatment by menopausal status; in premenopausal patients, CT, despite only a non-significant trend for deteriorated C30-SumSc (Pint = 0.100), was more frequently associated with QoL domains deterioration than ET, whereas in postmenopausal patients, ET was more frequently associated with QoL deterioration, namely using the C30-SumSc (Pint = 0.004). CONCLUSION(S) QoL deterioration persisted at 2 years after diagnosis with different trajectories by treatment received. ET, but not CT, had a major detrimental impact on C30-SumSc, especially in postmenopausal women. These findings highlight the need to properly select patients for adjuvant ET escalation.
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Affiliation(s)
- A R Ferreira
- INSERM Unit 981, Gustave Roussy, Cancer Campus, Villejuif, France; Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal
| | - A Di Meglio
- INSERM Unit 981, Gustave Roussy, Cancer Campus, Villejuif, France
| | - B Pistilli
- Medical Oncology, Gustave Roussy, Cancer Campus, Villejuif
| | - A S Gbenou
- INSERM Unit 981, Gustave Roussy, Cancer Campus, Villejuif, France
| | - M El-Mouhebb
- INSERM Unit 981, Gustave Roussy, Cancer Campus, Villejuif, France
| | - S Dauchy
- Department of Supportive Care, Gustave Roussy, Cancer Campus, Villejuif
| | - C Charles
- Department of Supportive Care, Gustave Roussy, Cancer Campus, Villejuif
| | - F Joly
- Medical Oncology, Centre François Baclesse Caen, Caen
| | | | - M Lambertini
- Department of Medical Oncology, U.O.C. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - C Coutant
- Surgical Oncology, Centre Georges-François Leclerc, Dijon
| | - P Cottu
- Medical Oncology, Institut Curie, Paris
| | - F Lerebours
- Medical Oncology, Institut Curie, Hôpital René Huguenin, Saint-Cloud
| | - T Petit
- Department of Medicine, Paul Strauss Cancer Center and University of Strasbourg, Strasbourg
| | - F Dalenc
- Department of Medical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer - Oncopole, Toulouse
| | - P Rouanet
- Surgical Oncology, C.R.L.C Val d'Aurelle, Montpellier
| | - A Arnaud
- Radiotherapy Department, Clinique Sainte Catherine Avignon, Avignon
| | | | - J Berille
- Ministry of Higher Education and Research, Ministere de l'Enseignement Superieur et de la Recherche, Paris, France
| | - P A Ganz
- Medical Oncology, Ronald Reagan UCLA Medical Center, Los Angeles
| | - A H Partridge
- Women's Cancers, Dana-Farber Cancer Institute, Boston, USA
| | - S Delaloge
- Medical Oncology, Gustave Roussy, Cancer Campus, Villejuif
| | - S Michiels
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, University Paris-Sud, University Paris-Saclay, Villejuif; CESP, INSERM, U1018 ONCOSTAT, Université Paris-Saclay, Univ. Paris-Sud, Villejuif, France
| | - F Andre
- INSERM Unit 981, Gustave Roussy, Cancer Campus, Villejuif, France; Medical Oncology, Gustave Roussy, Cancer Campus, Villejuif
| | - I Vaz-Luis
- INSERM Unit 981, Gustave Roussy, Cancer Campus, Villejuif, France; Medical Oncology, Gustave Roussy, Cancer Campus, Villejuif.
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12
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Dewi EU, Nursalam N, Mahmudah M, Halawa A, Ayu A. Factors affecting hardiness in cancer patients: A case study of the Indonesian Cancer Foundation. J Public Health Res 2020; 9:1807. [PMID: 32775311 PMCID: PMC7376452 DOI: 10.4081/jphr.2020.1819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/13/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Cancer patients are usually filled with fear and anxiety but hardiness is a personal characteristic that makes them stronger, resistant, and optimistic in dealing with the pressures related to the disease. There are, however, several factors influencing hardiness and those include social support, parenting, and selfconfidence. Therefore, the objective of this study was to identify these factors in cancer patients at the Indonesian Cancer Foundation in Surabaya. Design and Methods: The study made use of observational design with a population of 70 and a total sample of 64 cancer patients were selected as respondents using simple random sampling. The research instrument used for data collection was a questionnaire and results were analyzed using Spearman statistical test. Results: The results showed social support was 0.009, parenting patterns was 0.035, and confidence was 0.647. Therefore, H1 was accepted and this means there was a relationship between support and hardiness, as well as parenting patterns and hardiness. Moreover, H0 was also accepted and this indicates self-confidence did not have any influence on hardiness. Conclusions: In conclusion, providing adequate support and good parenting have the ability to increase hardiness.
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Affiliation(s)
- Erika Untari Dewi
- Doctoral Program of Public Health, Faculty of Public Health, Universitas Airlangga, Mulyorejo
- William Booth Health Science College, Surabaya, East Java, Indonesia
| | | | | | - Aristina Halawa
- William Booth Health Science College, Surabaya, East Java, Indonesia
| | - Azhari Ayu
- William Booth Health Science College, Surabaya, East Java, Indonesia
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13
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Fekih-Romdhane F, Bouali S, Balti M, Labbane R, Cheour M. Évaluation des symptômes de stress post-traumatique chez les femmes atteintes d’un cancer du sein nouvellement diagnostiqué. PSYCHO-ONCOLOGIE 2020. [DOI: 10.3166/pson-2019-0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction : Le diagnostic du cancer du sein est un événement potentiellement mortel associé à une détresse importante. La présente étude visait à évaluer la prévalence et la sévérité des symptômes de stress post-traumatique ; et à analyser l’association entre les symptômes de stress posttraumatique et la dépression, les données relatives à la maladie cancéreuse et les données sociodémographiques chez ces femmes.
Méthodes : Soixante et une femmes atteintes d’un cancer du sein nouvellement diagnostiqué ont rempli deux questionnaires : l’Impact of Event Scale révisé (IES-R) et la souséchelle DASS–Dépression des échelles de dépression, de stress et d’anxiété (DASS-21). Les femmes ont été interrogées quatre semaines après l’annonce du diagnostic. Les patientes étaient âgées de 18 à 65 ans et avaient un cancer du sein histologiquement confirmé et sans antécédents d’autres cancers.
Résultats : L’âge moyen des patientes incluses dans cette étude était de 46,5 ans. La majorité d’entre elles vivaient en milieux urbains (82 %) et avaient un niveau socioéconomique moyen (83,6 %). Trente-six pour cent des patientes atteintes d’un cancer du sein ont été diagnostiquées à un stade avancé (III et IV) et ont reçu un traitement chirurgical dans 73,8 % des cas. 57,4 % des patientes atteintes d’un cancer du sein nouvellement diagnostiqué présentaient des symptômes de stress post-traumatique supérieurs au seuil (score IER-S > 33) et 18,0 %des symptômes dépressifs (score DASS-dépression > 9). L’absence de revenu (notamment être sans profession ou étudiante) et la dépression étaient les meilleurs prédicteurs des symptômes du trouble de stress post-traumatique dans notre population.
Conclusion : L’observation de la complexité du vécu des patientes atteintes de cancer du sein renforce l’idée de la nécessité d’un accompagnement spécifique. Une évaluation précoce des besoins psychoémotionnels des patientes atteintes de cancer du sein et une intervention précoce pourraient être particulièrement utiles.
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14
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Edward KL, Chipman M, Giandinoto JA, Robinson K. Quality of life and personal resilience in the first two years after breast cancer diagnosis: systematic integrative review. ACTA ACUST UNITED AC 2019; 28:S4-S14. [PMID: 31116589 DOI: 10.12968/bjon.2019.28.10.s4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The aim of this systematic integrative review was to examine the early impacts of a breast cancer diagnosis (up to 2 years after diagnosis) in relation to quality of life and personal resilience. The bibliographic databases of Medline, CINAHL, Cochrane, and Psychology and Behavioral Science Collection were searched using predetermined search criteria. Research studies published up to February 2019 were considered and following appraisal 36 articles were included in the review. Younger age, disease progression at first presentation, personality factors such as optimism, and moderators such as social support, clinical interventions and development of self-management abilities predicted better quality of life and personal resilience. Not recovering from the physical and psychological impacts of a new diagnosis has implications for future mental and physical health. This systematic, integrative review highlighted that building resilience and working with women's strengths should be the focus for contemporary clinical interventions for women in the early period after diagnosis of breast cancer.
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Affiliation(s)
- Karen-Leigh Edward
- Professor of Nursing and Practice Based Research, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Mitchell Chipman
- Oncologist, Victorian Breast and Oncology Care, East Melbourne, Australia
| | - Jo-Ann Giandinoto
- PhD Student, Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | - Kayte Robinson
- Research Assistant, Victorian Breast and Oncology Care, East Melbourne, Australia
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15
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de Kruif JTCM, Visser M, van den Berg MMGA, Derks MJM, de Boer MR, van Laarhoven HWM, de Vries JHM, de Vries YC, Kampman E, Winkels RW, Westerman MJ. A longitudinal mixed methods study on changes in body weight, body composition, and lifestyle in breast cancer patients during chemotherapy and in a comparison group of women without cancer: study protocol. BMC Cancer 2019; 19:7. [PMID: 30611243 PMCID: PMC6321717 DOI: 10.1186/s12885-018-5207-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 12/11/2018] [Indexed: 02/08/2023] Open
Abstract
Background More than 60% of women diagnosed with early stage breast cancer receive (neo)adjuvant chemotherapy. Breast cancer patients receiving chemotherapy often experience symptoms such as nausea, vomiting and loss of appetite that potentially affect body weight and body composition. Changes in body weight and body composition may detrimentally affect their quality of life, and could potentially increase the risk of disease recurrence, cardiovascular disease and diabetes. To date, from existing single method (quantitative or qualitative) studies is not clear whether changes in body weight and body composition in breast cancer patients are treatment related because previous studies have not included a control group of women without breast cancer. Methods We therefore developed the COBRA-study (Change Of Body composition in BReast cancer: All-in Assessment-study) to assess changes in body weight, body composition and related lifestyle factors such as changes in physical activity, dietary intake and other behaviours. Important and unique features of the COBRA-study is that it used I) a “Mixed Methods Design”, in order to quantitatively assess changes in body weight, body composition and lifestyle factors and, to qualitatively assess how perceptions of women may have influenced these measured changes pre-, during and post-chemotherapy, and II) a control group of non-cancer women for comparison. Descriptive statistics on individual quantitative data were combined with results from a thematic analysis on the interviews- and focus group data to understand patients’ experiences before, during and after chemotherapy. Discussion The findings of our mixed methods study, on chemotherapy treated cancer patients and a comparison group, can enable healthcare researchers and professionals to develop tailored intervention schemes to help breast cancer patients prevent or handle the physical and mental changes they experience as a result of their chemotherapy. This will ultimately improve their quality of life and could potentially reduce their risk for other co-morbidity health issues such as cardiovascular disease and diabetes.
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Affiliation(s)
- J Th C M de Kruif
- Department of Health Sciences, Faculty of Science, the Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - M Visser
- Department of Health Sciences, Faculty of Science, the Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M M G A van den Berg
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - M J M Derks
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - M R de Boer
- Department of Health Sciences, Faculty of Science, the Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - H W M van Laarhoven
- Department of Medical Oncology, Academic Medical Center, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - J H M de Vries
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Y C de Vries
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - E Kampman
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - R W Winkels
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands.,Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - M J Westerman
- Department of Health Sciences, Faculty of Science, the Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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16
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Mhaidat NM, Al-Wedyan TJ, Alzoubi KH, Al-Efan QM, Al-Azzam SI, Balas QA, Bataineh ZA. Measuring quality of Life among Colorectal Cancer Patients in Jordan. J Palliat Care 2018. [DOI: 10.1177/082585971403000302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Quality of life among colorectal cancer (CRC) patients was evaluated using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C30 and EORTC QLQ-CR29. We interviewed 74 CRC patients, and our results indicated lower anxiety functional scores and higher abdominal pain and embarrassment symptom scores among patients aged 55 and under. Patients with disease metastasis showed significantly lower global health scores and higher fatigue, loss of appetite, hair loss, and change in taste symptom scores. Scores for emotional functioning were significantly lower among patients with stage IV disease. Fatigue, nausea and vomiting, loss of appetite, abdominal pain, and change in taste symptom scores were significantly higher in patients treated with a combination of surgery and chemotherapy compared to surgery alone. Age, disease metastasis, late disease stage, and combined treatment modalities were associated with lower scores on health-related quality-of-life scales; patients likely to have low scores on these measures should receive special attention from healthcare providers and be targeted by supportive care strategies. Nous avons évalué la qualité de vie de patients atteints du cancer colorectal à l'aide du Questionnaire C30 et EORTC QLQ-CR29 de l'Organisation européenne pour la recherche et le traitement du cancer. Nous avons interviewé 74 patients et nos résultats indiquent que les patients agés de 55 ans et moins éprouvent un moindre niveau d'anxiété alors que le niveau de douleurs abdominales et du sentiment de gêne est élevé. Les patients atteints de métastases ont démontré lors des tests que leur état général de santé était plutôt mauvais et qu'ils souffraient de fatigue accrue, de perte de cheveux et de la perte du goût L'état émotionel était à son plus bas chez les patients au stade IV de la maladie. La fatigue, la nausée, le vomissement, la perte d'appétit, les douleurs abdominales, et la perte de goût étaient significativement plus élevés chez les patients ayant été traités par chirurgie et chimiothérapie comparativement à ceux qui n'avaient subi que la chirurgie. L'âge, les métastases et le stade avancé de la maladie combinés à divers traitements médicaux sont les facteurs ayant contribué aux scores plus bas observés sur l'échelle de qualité de vie. Les patients susceptibles de démontrer de faibles résultats devraient recevoir une attention spéciale de la part des soignants et être la cible de soins de soutien appropriés à leur état.
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Affiliation(s)
- Nizar M. Mhaidat
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, PO Box 3030, Jordan
| | - Tahani J. Al-Wedyan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Qais M. Al-Efan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Sayer I. Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Qosay A. Balas
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Ziad A. Bataineh
- Department of Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Skelton WP, Parekh H, Starr JS, Trevino J, Cioffi J, Hughes S, George TJ. Clinical Factors as a Component of the Personalized Treatment Approach to Advanced Pancreatic Cancer: a Systematic Literature Review. J Gastrointest Cancer 2018; 49:1-8. [PMID: 29110227 DOI: 10.1007/s12029-017-0021-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Pancreatic cancer is often diagnosed at late stages, where disease is either locally advanced unresectable or metastatic. Despite advances, long-term survival is relatively non-existent. DISCUSSION This review article discusses clinical factors commonly encountered in practice that should be incorporated into the decision-making process to optimize patient outcomes, including performance status, nutrition and cachexia, pain, psychological distress, medical comorbidities, advanced age, and treatment selection. CONCLUSION Identification and optimization of these clinical factors could make a meaningful impact on the patient's quality of life.
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Affiliation(s)
- William Paul Skelton
- Division of Hematology and Oncology, Department of Medicine, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL, 32610, USA.
| | - Hiral Parekh
- Division of Hematology and Oncology, Department of Medicine, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL, 32610, USA
| | - Jason S Starr
- Division of Hematology and Oncology, Department of Medicine, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL, 32610, USA
| | - Jose Trevino
- Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Jessica Cioffi
- Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Steven Hughes
- Department of Surgery, University of Florida College of Medicine, Gainesville, FL, USA
| | - Thomas J George
- Division of Hematology and Oncology, Department of Medicine, University of Florida College of Medicine, 1600 SW Archer Road, Gainesville, FL, 32610, USA.
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Amichetti M, Caffo O. Quality of Life in Patients with Early Stage Breast Carcinoma Treated with Conservation Surgery and Radiotherapy. An Italian Monoinstitutional Study. TUMORI JOURNAL 2018; 87:78-84. [PMID: 11401211 DOI: 10.1177/030089160108700203] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims To evaluate the quality of life (QOL) in patients with early stage invasive carcinoma of the breast treated with conservative surgery and postoperative irradiation. Methods A mailed survey to examine QOL was conducted in 227 subjects with breast cancer treated in 1990 and 1994 with conservation surgery plus definitive irradiation. The self-compiled questionnaire was developed based on a series of 38 items assessing six core areas of QOL. Furthermore, the patients were requested to evaluate the degree of information provided by the medical staff concerning the disease, the treatment and related side effects and to evaluate the effects of the treatment on their social, overall QOL, and health status. Results The questionnaire was completed by 156 patients (68.7%) who had a median age of 56 years (range, 28–75 years) at the time of treatment and 59 years (range, 31–82 years) at the time of the study. The physical condition was reported to be good. Data relating to sexual life were provided by more than 90% of the patients. Some limitations in sexuality, some interference with sexual desire, and some modifications during intercourse were reported by 11, 11, and 10 patients, respectively. The subjective evaluations of the cosmetic results of the therapies were judged good-excellent by 56% of the patients, 12 (8%) only had a negative perception of their body image. Twenty-five percent of the sample declared that they felt tense, 19% nervous, 18% lonely, 27% anxious and 16% depressed. Only six patients (4%) declared that the treatment had had a bad on their social life, and 18 (11%) thought that their health status has been affected by the treatment. A worsening of QOL due to the disease or the treatment was reported by 8% of the responders. The amount of information received concerning the treatment and its side effects was considered sufficient by most of the patients. Conclusions The results of the study revealed a satisfactory health-related QOL in patients treated with breast conservation and postoperative irradiation. A preserved favorable body image and lack of a negative impact on sexuality was observed, even though about half of the patients reported a negative judgement on esthetic outcome. Some patients had persistent psychosocial concerns. No significant additional problems attributable to radiation therapy capable of affecting QOL outcomes were reported.
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Affiliation(s)
- M Amichetti
- Department of Radiation Oncology, Santa Chiara Hospital, Trento, Italy.
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Patient-clinician communication among patients with stage I lung cancer. Support Care Cancer 2017; 26:1625-1633. [PMID: 29209835 DOI: 10.1007/s00520-017-3992-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/20/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE Limited data exist about patient-centered communication (PCC) and patient-centered outcomes among patients who undergo surgery or stereotactic body radiation therapy (SBRT) for stage I non-small cell lung cancer (NSCLC). We aimed to examine the relationship between PCC and decision-making processes among NSCLC patients, using baseline data from a prospective, multicenter study. METHODS Patients with stage 1 NSCLC completed a survey prior to treatment initiation. The survey assessed sociodemographic characteristics, treatment decision variables, and patient psychosocial outcomes: health-related quality of life (HRQOL), treatment self-efficacy, decisional conflict, and PCC. RESULTS Fifty-two percent (n = 85) of 165 individuals planned to receive SBRT. There were no baseline differences detected on patient psychosocial outcomes between those who planned to receive SBRT or surgery. All participants reported high HRQOL (M = 72.5, SD = 21.3) out of 100, where higher scores indicate better functioning; high self-efficacy (M = 1.5, SD = 0.5) out of 6, where lower numbers indicate higher self-efficacy; minimal decisional conflict (M = 15.2, SD = 12.7) out of 100, where higher scores indicate higher decisional conflict; and high levels of patient-centered communication (M = 2.4, SD = 0.8) out of 7 where higher scores indicate worse communication. Linear regression analyses adjusting for sociodemographic and clinical variables showed that higher quality PCC was associated with higher self-efficacy (β = 0.17, p = 0.03) and lower decisional conflict (β = 0.42, p < 0.001). CONCLUSIONS Higher quality PCC was associated with higher self-efficacy and lower decisional conflict. Self-efficacy and decisional conflict may influence subsequent health outcomes. Therefore, our findings may inform future research and clinical programs that focus on communication strategies to improve these outcomes.
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Online support groups for young women with breast cancer: a proof-of-concept study. Support Care Cancer 2017; 25:2285-2296. [DOI: 10.1007/s00520-017-3639-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 02/10/2017] [Indexed: 11/25/2022]
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Efficace F, Breccia M, Cottone F, Okumura I, Doro M, Riccardi F, Rosti G, Baccarani M. Psychological well-being and social support in chronic myeloid leukemia patients receiving lifelong targeted therapies. Support Care Cancer 2016; 24:4887-4894. [PMID: 27448405 DOI: 10.1007/s00520-016-3344-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 07/10/2016] [Indexed: 01/09/2023]
Abstract
PURPOSE The main objective of this study was to investigate whether social support is independently associated with psychological well-being in chronic myeloid leukemia (CML) patients. Secondary objectives were to compare the psychological well-being profile of CML patients with that of their peers in general population and to examine possible age- and sex-related differences. PATIENTS AND METHODS Analysis was performed on 417 patients in treatment with lifelong molecularly targeted therapies. Mean age of patients analyzed was 56 years (range 19-87 years) and 247 (59 %) were male and 170 (41 %) were female. Social support was assessed with the Multidimensional Scale of Perceived Social Support and psychological well-being was evaluated with the short version of the Psychological General Well-Being Index. Descriptive statistics and multivariate logistic regression analyses were used. RESULTS Multivariate logistic regression analysis revealed that a greater social support was independently associated with lower anxiety and depression, as well as with higher positive well-being, self-control, and vitality (p < 0.001). Female patients reported statistically significant worse outcomes in all dimensions of psychological well-being. Age- and sex-adjusted comparisons with population norms revealed that depression (ES = -0.42, p < 0.001) and self-control (ES = -0.48, p < 0.001) were the two main impaired psychological dimensions. CONCLUSION This study indicates that social support is a critical factor associated with psychological well-being of CML patients treated with modern lifelong targeted therapies.
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Affiliation(s)
- Fabio Efficace
- GIMEMA Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Via Benevento, 6, 00161, Rome, Italy.
| | - Massimo Breccia
- Department of Biotechnologies and Hematology, University of Rome Sapienza, Rome, Italy
| | - Francesco Cottone
- GIMEMA Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Via Benevento, 6, 00161, Rome, Italy
| | - Iris Okumura
- Unidade de Hematologia, Hemoterapia e Oncologia (UHHO), Serviço de Transplante de Medula Óssea (STMO), Complexo Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil
| | - Maribel Doro
- Unidade de Hematologia, Hemoterapia e Oncologia (UHHO), Serviço de Transplante de Medula Óssea (STMO), Complexo Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Gianantonio Rosti
- Department of Hematology-Oncology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Michele Baccarani
- Department of Hematology-Oncology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
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Silay K, Akinci S, Silay YS, Guney T, Ulas A, Akinci MB, Ozturk E, Canbaz M, Yalcin B, Dilek I. Hospitalization risk according to geriatric assessment and laboratory parameters in elderly hematologic cancer patients. Asian Pac J Cancer Prev 2015; 16:783-6. [PMID: 25684525 DOI: 10.7314/apjcp.2015.16.2.783] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Utilizing geriatric screening tools for the identification of vulnerable older patients with cancer is important. The aim of this study is to evaluate the hospitalization risk of elderly hematologic cancer patients based on geriatric assessment and laboratory parameters. MATERIALS AND METHODS In this cross sectional study 61 patients with hematologic malignancies, age 65 years and older, were assessed at a hematology outpatient clinic. Standard geriatric screening tests; activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), timed up and go test (TUG), geriatrics depression scale (GDS) were administered. Demographic and medical data were obtained from patient medical records. The number of hospitalizations in the following six months was then recorded to allow analysis of associations with geriatric assessment tools and laboratory parameters. RESULTS The median age of the patients, 37 being males, was 66 years. Positive TUG test and declined ADL was found as significant risk factors for hospitalization (p=0.028 and p=0.015 respectively). Correlations of hospitalization with thrombocytopenia, vitamin B12 and folic acid deficiency were statistically significant (p=0.004, p=0.011 and p=0.05 respectively). CONCLUSIONS In this study, geriatric conditions which are usually unrecognized in a regular oncology office visit were identified. Our study indicates TUG and ADL might be use as predictive tests for hospitalization in elderly oncology populations. Also thrombocytopenia, and vitamin B12 and folic acid deficiencies are among the risk factors for hospitalization. The importance of vitamin B12 and folic acid vitamin replacement should not be underestimated in this population.
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Affiliation(s)
- Kamile Silay
- Department of Geriatrics, Ataturk Research and Training Hospital, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey E-mail :
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Silay K, Akinci S, Ulas A, Silay YS, Akinci MB, Ozturk E, Canbaz M, Dilek I, Yalcin B. The myth of not disclosing the diagnosis of cancer: does it really protect elderly patients from depression? Asian Pac J Cancer Prev 2015; 16:837-40. [PMID: 25684534 DOI: 10.7314/apjcp.2015.16.2.837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The disclosure of a diagnosis of cancer is complex, particularly in older patients. The aim of this study was to investigate the association between age and not knowing the diagnosis, and its impact on mood. MATERIALS AND METHODS The study included 70 patients with various types of solid and hematologic cancer in early stages, which were followed up in an outpatient oncology/hematology clinic in Turkey between January, 2014 and June, 2014. Initially the caregivers of patients were asked whether the patients knew their diagnosis or not. A questionnaire for the Geriatric Depression Scale was then administered to the patients. Patient age, gender, marital status and education level were noted and analyzed with respect to knowing the diagnosis and depression. RESULTS Of the 70 patients, 40% of them were female. The mean age was 68.2±8.9. The rate of the patients who does not know their diagnosis was 37.1% (n=26). The overall depression rate with GDS was found 37.1% (n=26) among the participants. There was no association with knowing the diagnosis (p=0.208) although the association between not knowing the diagnosis and age was significant (p=0.01). CONCLUSIONS In this study we revealed no association between not knowing the diagnosis and depression in elderly patients. Contrary to what some has thought, the patient is not protected from psychological distress by not being informed about the diagnosis. We believe this study and similar ones will help to discuss and further explore patient autonomy, the principle of respect to self-determination and end of life issues in different cultures.
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Affiliation(s)
- Kamile Silay
- Department of Geriatrics, Ataturk Research and Training Hospital, Yildirim Beyazit University, Ankara, Turkey E-mail :
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Fergus K, Ahmad S, McLeod DL, Stephen J, Gardner S, Pereira A, Warner E, Carter W. Couplelinks - an online intervention for young women with breast cancer and their male partners: study protocol for a randomized controlled trial. Trials 2015; 16:33. [PMID: 25630357 PMCID: PMC4336511 DOI: 10.1186/s13063-014-0534-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 12/19/2014] [Indexed: 11/24/2022] Open
Abstract
Background Young breast cancer survivors (aged 50 years and under) and their partners are at an elevated risk for relationship distress and poor psychological adjustment relative to older age couples. Limited availability of time and resources and the distance to travel are major barriers to engaging in evidence-based psychosocial support programs. This paper describes the study protocol of a novel, manualized online intervention called Couplelinks that was developed to improve relationship adjustment and psychological wellbeing of young couples affected by breast cancer. Couplelinks is a custom-designed website offering a professionally facilitated, couple-centered intervention that entails informational, experiential, and interactive components. Methods/Design A total of 80 heterosexual couples from across Canada in which the female partner has been diagnosed with a primary breast cancer will be recruited and randomized to a treatment or waitlist control group. Six dyadic learning modules form the core of the program and will be undertaken on a weekly basis. The manualized online intervention involves psycho-education and experiential exercises to enhance communication, coping ability, mutual empathy, and perspective-taking in relation to cancer. An online facilitator who is a trained mental health professional will guide and support couples throughout the process. Data collection will occur at baseline, at post-treatment or eight weeks into the waiting period, and at the three-month follow-up assessment. Primary outcome measures include the Revised Dyadic Adjustment Survey (RDAS) and Dyadic Coping Inventory (DCI) scores, and secondary outcome measures include the Hospital Anxiety and Depression Survey (HADS) score. Discussion Couplelinks is one of the first internet-based psychological interventions to improve the psychosocial adjustment of couples coping with a life-threatening illness such as cancer. If successful, the design of this program as described in this paper makes a valuable contribution to the literature on the delivery of couple-focused psychosocial interventions, both within and outside of oncology. Trial registration This trial was registered with ClinicalTrials.gov (identifier: NCT01089764) on 17 March 2010.
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Affiliation(s)
- Karen Fergus
- Department of Psychology, Faculty of Health, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada. .,Patient and Family Support Program, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada.
| | - Saunia Ahmad
- Department of Psychology, Faculty of Health, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada. .,Patient and Family Support Program, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada.
| | - Deborah L McLeod
- Cancer Program, Queen Elizabeth II Health Sciences Centre, Victoria 11-006, 1276 South Park Street, Halifax, Nova Scotia, B3H 2Y9, Canada.
| | - Joanne Stephen
- Department of Oncology, Faculty of Medicine, Cumming School of Medicine, Health Sciences Centre, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
| | - Sandra Gardner
- Ontario HIV Treatment Network, 1300 Yonge Street, Toronto, Ontario, M4T 1X3, Canada. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
| | - Amanda Pereira
- Department of Psychology, Faculty of Health, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
| | - Ellen Warner
- Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada.
| | - Wendy Carter
- Dr. Wendy Carter, 7 Admiral Road, Coach House, Toronto, Ontario, M5R 2L4, Canada.
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Ganz PA, Bower JE, Stanton AL. Special Issues in Younger Women with Breast Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 862:9-21. [PMID: 26059926 DOI: 10.1007/978-3-319-16366-6_2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although women less than 50 years old make up less than 25% of the patient population with breast cancer in industrialized countries, they have unique clinical and psychosocial issues that must be addressed as part of their oncology care to ensure the best health and psychosocial outcomes after treatment. Preserving fertility is a major issue for many younger women who have either not had children or would like to have additional children after treatment. Dealing with the disruption of a cancer diagnosis at a young age is challenging physically, socially and emotionally, and the health care system does not always address these patients' concerns. Because younger women have the potential for a long life expectancy after cancer treatment, preventing and reducing the risk for late effects of cancer treatment is very important. We discuss these and a range of other issues throughout this chapter.
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Affiliation(s)
- Patricia A Ganz
- UCLA Schools of Medicine and Public Health, Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA,
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Bower JE, Crosswell AD, Stanton AL, Crespi CM, Winston D, Arevalo J, Ma J, Cole SW, Ganz PA. Mindfulness meditation for younger breast cancer survivors: a randomized controlled trial. Cancer 2014; 121:1231-40. [PMID: 25537522 DOI: 10.1002/cncr.29194] [Citation(s) in RCA: 230] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 11/11/2014] [Accepted: 11/12/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Premenopausal women diagnosed with breast cancer are at risk for psychological and behavioral disturbances after cancer treatment. Targeted interventions are needed to address the needs of this vulnerable group. METHODS This randomized trial provided the first evaluation of a brief, mindfulness-based intervention for younger breast cancer survivors designed to reduce stress, depression, and inflammatory activity. Women diagnosed with early stage breast cancer at or before age 50 who had completed cancer treatment were randomly assigned to a 6-week Mindful Awareness Practices (MAPS) intervention group (n = 39) or to a wait-list control group (n = 32). Participants completed questionnaires before and after the intervention to assess stress and depressive symptoms (primary outcomes) as well as physical symptoms, cancer-related distress, and positive outcomes. Blood samples were collected to examine genomic and circulating markers of inflammation. Participants also completed questionnaires at a 3-month follow-up assessment. RESULTS In linear mixed models, the MAPS intervention led to significant reductions in perceived stress (P = .004) and marginal reductions in depressive symptoms (P = .094), as well as significant reductions in proinflammatory gene expression (P = .009) and inflammatory signaling (P = .001) at postintervention. Improvements in secondary outcomes included reduced fatigue, sleep disturbance, and vasomotor symptoms and increased peace and meaning and positive affect (P < .05 for all). Intervention effects on psychological and behavioral measures were not maintained at the 3-month follow-up assessment, although reductions in cancer-related distress were observed at that assessment. CONCLUSIONS A brief, mindfulness-based intervention demonstrated preliminary short-term efficacy in reducing stress, behavioral symptoms, and proinflammatory signaling in younger breast cancer survivors.
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Affiliation(s)
- Julienne E Bower
- Department of Psychology, University of California-Los Angeles, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, Los Angeles, California; Cousins Center for Psychoneuroimmunology, University of California-Los Angeles, Los Angeles, California; Jonsson Comprehensive Cancer Center, University of California-Los Angeles, Los Angeles, California
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Gómez-Campelo P, Bragado-Álvarez C, Hernández-Lloreda MJ. Psychological distress in women with breast and gynecological cancer treated with radical surgery. Psychooncology 2014; 23:459-66. [PMID: 25485338 DOI: 10.1002/pon.3439] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The objective of this study is to compare psychological distress (body image disturbance,self-esteem, depression, and anxiety) in women with breast or gynecological cancer treated by radical surgery. Additionally, another objective is to analyze the association between psychological distress and sociodemographic characteristics, medical history, and social support to produce a prediction model for the outcome measures. METHODS A cross-sectional study was carried out with 100 women who had undergone radical surgery for breast or gynecological cancer. Both groups were divided into the following: younger than 50 years old and 50 years old or older. Body Image Scale, Rosenberg's Self-Esteem Scale, Beck Depression Inventory, and Beck Anxiety Inventory were used. RESULTS Age had a significant main effect on psychological distress but the type of cancer did not.Younger women showed significantly greater distress than older women (p-values<0.001). A significant interaction between age and type of cancer was found, indicating that older women with breast cancer had worse body image and more depression than those with gynecological cancer (p-values 0.001); no significant differences were found between younger groups.The prediction model for increased body image disturbance and depression included the joint effect of the following variables: being younger, inactive occupational status, and post-adjuvant therapy side effects. For lower self-esteem, the variables were: being younger, post-adjuvant therapy side effects,and dissatisfaction with social support. And for higher anxiety, the sole variable included was post-adjuvant therapy side effects. CONCLUSIONS Both mastectomy and hysterectomy/oophorectomy cause similar psychological distress in younger women, but mastectomy causes greater distress in older women than hysterectomy/oophorectomy.
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Cohen M. Depression, anxiety, and somatic symptoms in older cancer patients: a comparison across age groups. Psychooncology 2013; 23:151-7. [DOI: 10.1002/pon.3383] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 07/24/2013] [Accepted: 07/28/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Miri Cohen
- Department of Gerontology, Faculty of Social Welfare and Health Sciences; University of Haifa; Haifa Israel
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Harrington S, Michener LA, Kendig T, Miale S, George SZ. Patient-reported upper extremity outcome measures used in breast cancer survivors: a systematic review. Arch Phys Med Rehabil 2013; 95:153-62. [PMID: 23932969 DOI: 10.1016/j.apmr.2013.07.022] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 07/23/2013] [Accepted: 07/24/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES (1) To identify English-language published patient-reported upper extremity outcome measures used in breast cancer research and (2) to examine construct validity and responsiveness in patient-reported upper extremity outcome measures used in breast cancer research. DATA SOURCES PubMed, Cumulative Index to Nursing and Allied Health Literature, and ProQuest MEDLINE databases were searched up to February 5, 2013. STUDY SELECTION Studies were included if a patient-reported upper extremity outcome measure was administered, the participants were diagnosed with breast cancer, and the study was published in English. DATA EXTRACTION A total of 865 articles were screened. Fifty-nine full text articles were assessed for eligibility. A total of 46 articles met the initial eligibility criteria for aim 1. Eleven of these articles reported means and SDs for the outcome scores and included a comparison group analysis for aim 2. DATA SYNTHESIS Construct validity was evaluated by calculating effect sizes for known-group differences in 6 studies using the Disabilities of Arm, Shoulder and Hand (DASH), University of Pennsylvania Shoulder Score, Shoulder Disability Questionnaire-Dutch, and 10 Questions by Wingate. Responsiveness was analyzed comparing a treatment and control group by calculating the coefficient of responsiveness in 5 studies for the DASH and 10 Questions by Wingate. CONCLUSIONS Eight different patient-reported upper extremity outcome measures have been reported in the peer-review literature for women with breast cancer; some that were specifically developed for breast cancer survivors (n=3) and others that were not (n=5). Based on the current evidence, we recommend administering the DASH to assess patient-reported upper extremity function in breast cancer survivors because the DASH has the most consistently large effects sizes for construct validity and responsiveness. Future large studies are needed for more definitive recommendations.
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Affiliation(s)
- Shana Harrington
- Department of Clinical and Applied Movement Sciences, University of North Florida, Jacksonville, FL; K12 Scholar, Department of Physical Therapy, University of Florida, Gainesville, FL.
| | - Lori A Michener
- Department of Physical Therapy, Virginia Commonwealth University - Medical College of Virginia Campus, Richmond, VA
| | - Tiffany Kendig
- Rehabilitation Medicine Service, Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Susan Miale
- Department of Physical Therapy, School of Health Technology and Management, Stony Brook University, Stony Brook, NY
| | - Steven Z George
- Department of Physical Therapy, University of Florida, Gainesville, FL
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Resilience in the year after cancer diagnosis: a cross-lagged panel analysis of the reciprocity between psychological distress and well-being. J Behav Med 2013; 37:391-401. [DOI: 10.1007/s10865-013-9497-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 02/11/2013] [Indexed: 10/27/2022]
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Yoo W, Chih MY, Kwon MW, Yang J, Cho E, McLaughlin B, Namkoong K, Shah DV, Gustafson DH. Predictors of the change in the expression of emotional support within an online breast cancer support group: a longitudinal study. PATIENT EDUCATION AND COUNSELING 2013; 90:88-95. [PMID: 23122429 PMCID: PMC3653575 DOI: 10.1016/j.pec.2012.10.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 09/25/2012] [Accepted: 10/05/2012] [Indexed: 05/26/2023]
Abstract
OBJECTIVES To explore how the expression of emotional support in an online breast cancer support group changes over time, and what factors predict this pattern of change. METHODS We conducted growth curve modeling with data collected from 192 participants in an online breast cancer support group within the Comprehensive Health Enhancement Support System (CHESS) during a 24-week intervention period. RESULTS Individual expression of emotional support tends to increase over time for the first 12 weeks of the intervention, but then decrease slightly with time after that. In addition, we found that age, living situation, comfort level with computer and the Internet, coping strategies were important factors in predicting the changing pattern of expressing emotional support. CONCLUSIONS Expressing emotional support changed in a quadratic trajectory, with a range of factors predicting the changing pattern of expression. PRACTICAL IMPLICATIONS These results can provide important information for e-health researchers and physicians in determining the benefits individuals can gain from participation in should CMSS groups as the purpose of cancer treatment.
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Affiliation(s)
- Woohyun Yoo
- School of Journalism and Mass Communication, University of Wisconsin, Madison, USA.
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Mahjoubi B, Mirzaei R, Azizi R, Jafarinia M, Zahedi-Shoolami L. A cross-sectional survey of quality of life in colostomates: a report from Iran. Health Qual Life Outcomes 2012; 10:136. [PMID: 23170951 PMCID: PMC3511248 DOI: 10.1186/1477-7525-10-136] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 10/11/2012] [Indexed: 12/17/2022] Open
Abstract
Background Considering the complications that colostomies may cause, patient self-assessments of their social, emotional, physical, sexual and functional conditions may help their surgeons to evaluate the impact of their interventions or use supplementary methods to maintain patient functional status or decrease its loss to the minimum level. The aim of this study was to evaluate the Quality of Life in Iranian patients with colostomies and to compare the age and gender differences among them. Method This cross-sectional study was conducted from 2009 to 2010 to evaluate the quality of life of 96 patients who had undergone surgery for rectal cancer and had permanent colostomies. The European Organization for Research and Treatment of Cancers Quality of Life Questionnaire (EORTC QLQ)-C30 and the EORTC QLQ-CR38 were used to assess patient Quality of Life. Results The mean scores for the functional subscales were as follows: Physical Function, 70.9 (±2.2); Role Function, 68.4 (±2.6); Emotional Function, 56.9 (±2.7); Cognitive Function, 68.7 (± 2.6); and Social Function, 64.2 (±3.3). The EORTC questionnaires showed significant differences between males and females. Males had better body image scores. Sexual Function and Sexual Enjoyment were impaired in both males and females, but males had significantly higher scores and better roles in Physical and Sexual Functions. More sexual enjoyment problems in older ages were observed in both males and females. Conclusion Having a colostomy was associated with a high level of emotional and sexual function impairment. The differing challenges between males and females should encourage us to design sex-specific interventions that improve the quality of life in this group of patients.
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Affiliation(s)
- Bahar Mahjoubi
- Colorectal Unit, Surgery Department, Hazrat e Rasoul Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Kwak M, Zebrack BJ, Meeske KA, Embry L, Aguilar C, Block R, Hayes-Lattin B, Li Y, Butler M, Cole S. Prevalence and predictors of post-traumatic stress symptoms in adolescent and young adult cancer survivors: a 1-year follow-up study. Psychooncology 2012; 22:1798-806. [PMID: 23135830 DOI: 10.1002/pon.3217] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 09/24/2012] [Accepted: 10/10/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Post-traumatic stress symptoms (PTSS) have been identified as a meaningful indicator of distress in cancer survivors. Distinct from young adult survivors of childhood cancer, young people diagnosed with cancer as adolescents and young adults (AYAs) face unique psychosocial issues; however, there is little published research of PTSS in the AYA population. This study examines prevalence and predictors of PTSS among AYAs with cancer. METHODS As part of a longitudinal study of AYAs with cancer, 151 patients aged 15-39 years completed mailed surveys at 6 and 12 months post-diagnosis. Severity of PTSS was estimated at 6 and 12 months post-diagnosis. Multiple regression analyses were conducted to investigate the predictive effects of socio-demographic and clinical characteristics on changes in PTSS over time. RESULTS At 6 and 12 months, respectively, 39% and 44% of participants reported moderate to severe levels of PTSS; 29% had PTSS levels suggestive of post-traumatic stress disorder. No significant differences in severity of PTSS between 6 and 12 months were observed. Regression analyses suggested that a greater number of side effects were associated with higher levels of PTSS at 6 months. Currently receiving treatment, having surgical treatment, diagnosis of a cancer type with a 90-100% survival rate, remaining unemployed/not in school, and greater PTSS at 6 months were associated with higher levels of PTSS at 12 months. CONCLUSIONS Post-traumatic stress symptoms were observed as early as 6 months following diagnosis and remained stable at 12-month follow-up. The development of early interventions for reducing distress among AYA patients in treatment is recommended.
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Affiliation(s)
- Minyoung Kwak
- School of Social Work, University of Michigan, Ann Arbor, MI 48109-1106, USA.
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Avis NE, Levine B, Naughton MJ, Case DL, Naftalis E, Van Zee KJ. Explaining age-related differences in depression following breast cancer diagnosis and treatment. Breast Cancer Res Treat 2012; 136:581-91. [PMID: 23053661 DOI: 10.1007/s10549-012-2277-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 09/24/2012] [Indexed: 11/25/2022]
Abstract
Younger women with breast cancer consistently show greater psychological distress than older women. This study examined a range of factors that might explain these age differences. A total of 653 women within 8 months of a first-time breast cancer diagnosis provided data on patient characteristics, symptoms, and psychosocial variables. Chart reviews provided cancer and treatment-related data. The primary outcome was depressive symptomatology assessed by the Beck Depression Inventory. A succession of models that built hierarchically upon each other was used to determine which variables could account for age group differences in depression. Model 1 contained age group only. Models 2-5 successively added patient characteristics, cancer-related variables, symptoms, and psychosocial variables. As expected, in the unadjusted analysis (Model 1) younger women were significantly more likely to report depressive symptomatology than older women (p < 0.0001). Age remained significantly related to depression until Model 4 which added bodily pain and vasomotor symptoms (p = 0.24; R (2) = 0.27). The addition of psychosocial variables in Model 5 also resulted in a model in which age was nonsignificant (p = 0.49; R (2) = 0.49). Secondary analyses showed that illness intrusiveness (the degree that illness intrudes on specific areas of life such as work, sex life, recreation, etc.) was the only variable which, considered individually with age, made the age group-depression association nonsignificant. Age differences in risk of depression following a breast cancer diagnosis can be explained by the impact of cancer and its treatment on specific areas of a woman's life.
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Affiliation(s)
- Nancy E Avis
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.
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Vadaparampil ST, Christie J, Quinn GP, Fleming P, Stowe C, Bower B, Pal T. A pilot study to examine patient awareness and provider discussion of the impact of cancer treatment on fertility in a registry-based sample of African American women with breast cancer. Support Care Cancer 2012; 20:2559-64. [PMID: 22270090 PMCID: PMC3826952 DOI: 10.1007/s00520-012-1380-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 01/02/2012] [Indexed: 10/14/2022]
Abstract
PURPOSE Fertility is a concern for many cancer patients diagnosed during their reproductive years. Although African American women are more likely to be diagnosed with early breast cancer (i.e., ≤age 40), little is known about patient awareness of or provider discussion related to fertility in this group. We examined African American women's awareness of the possible impact of cancer treatment on fertility. METHODS In a cross-sectional survey of African American women with early-onset breast cancer, demographic and clinical variables were compared with patient awareness and physician discussion of potential fertility loss. RESULTS For women in our sample (N = 48), 45.8% reported being aware of the potential impact of cancer treatment on fertility, and 56.3% reported that their providers discussed fertility with them. Bivariate analyses demonstrated that awareness was significantly higher in women diagnosed at age ≤45 (p < 0.05), who were nulliparous (p < 0.01), or who did not have tubal ligation (p < 0.001). Provider discussion was more often reported by patients who were diagnosed in stages 2/3 (p < 0.05) and had no children (p < 0.01). CONCLUSION Study results suggest potential health disparities in reproductive health among early-onset breast cancer patients and demonstrate missed clinical opportunities to provide information about fertility that may impact long-term quality of life in early-onset African American breast cancer patients.
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Affiliation(s)
- Susan T Vadaparampil
- Department of Oncologic Science, College of Medicine, University of South Florida, Tampa, FL, USA.
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Sjolander C, Rolander B, Järhult J, Mårtensson J, Ahlstrom G. Health-related quality of life in family members of patients with an advanced cancer diagnosis: a one-year prospective study. Health Qual Life Outcomes 2012; 10:89. [PMID: 22846452 PMCID: PMC3489687 DOI: 10.1186/1477-7525-10-89] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Accepted: 07/16/2012] [Indexed: 01/24/2023] Open
Abstract
Background Receiving a cancer diagnosis affects family members as well as the person diagnosed. Family members often provide support for the sick person in daily life out of duty and love, and may not always think of their own vulnerability to illness. To individualise support for them, family members who are most at risk for becoming ill must be identified. The aim of this study was to investigate health-related quality of life (HRQOL) in family members of patients with advanced lung or gastrointestinal cancer 3 to 15 months after diagnosis. Methods Data on mental and physical dimensions of HRQOL were collected from family members of these patients in this prospective quantitative study. Five assessments using the Short Form 36 Health Survey (SF-36) and EuroQol (EQ-5D) were conducted during a 1-year period starting 3 months after diagnosis. Thirty-six family members completed the study, i.e. participated in all five data collections. Results No statistically significant changes in physical or mental HRQOL within the study group appeared over the 1-year follow-up. Compared with norm-based scores, family members had significantly poorer mental HRQOL scores throughout the year as measured by the SF-36. Family members also scored statistically significantly worse on the EQ-5D VAS in all five assessments compared to the norm-based score. Findings showed that older family members and partners were at higher risk for decreased physical HRQOL throughout the 1-year period, and younger family members were at higher risk for poorer mental HRQOL. Conclusions It is well known that ill health is associated with poor HRQOL. By identifying family members with poor HRQOL, those at risk of ill health can be identified and supported. Future large-scale research that verifies our findings is needed before making recommendations for individualised support and creating interventions best tailored to family members at risk for illness.
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Bergouignan L, Lefranc JP, Chupin M, Morel N, Spano JP, Fossati P. Breast cancer affects both the hippocampus volume and the episodic autobiographical memory retrieval. PLoS One 2011; 6:e25349. [PMID: 22016764 PMCID: PMC3189914 DOI: 10.1371/journal.pone.0025349] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 09/01/2011] [Indexed: 11/18/2022] Open
Abstract
Background Neuroimaging studies show the hippocampus is a crucial node in the neural network supporting episodic autobiographical memory retrieval. Stress-related psychiatric disorders, namely Major Depression and Post Traumatic Stress Disorder (PTSD), are related to reduced hippocampus volume. However, this is not the case for remitted breast cancer patients with co-morbid stress-related psychiatric disorders. This exception may be due to the fact that, consequently to the cancer experience as such, this population might already be characterized by a reduced hippocampus with an episodic autobiographical memory deficit. Methodology We scanned, with a 3T Siemens TRIO, 16 patients who had lived through a “standard experience of breast cancer” (breast cancer and a standard treatment in remission since 18 month) in the absence of any associated stress-related psychiatric or neurological disorder and 21 matched controls. We then assessed their episodic autobiographical memory retrieval ability. Principal Findings Remitted breast cancer patients had both a significantly smaller hippocampus and a significant deficit in episodic autobiographical memory retrieval. The hippocampus atrophy was characterized by a smaller posterior hippocampus. The posterior hippocampus volume was intimately related to the ability to retrieve negative memories and to the past experience of breast cancer or not. Conclusions/Significance These results provide two main findings: (1) we identify a new population with a specific reduction in posterior hippocampus volume that is independent of any psychiatric or neurological pathology; (2) we show the intimate relation of the posterior hippocampus to the ability to retrieve episodic autobiographical memories. These are significant findings as it is the first demonstration that indicates considerable long-term effects of living through the experience of breast cancer and shows very specific hippocampal atrophy with a functional deficit without any presence of psychiatric pathology.
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Park BW, Lee S, Lee AR, Lee KH, Hwang SY. Quality of Life Differences between Younger and Older Breast Cancer Patients. J Breast Cancer 2011; 14:112-8. [PMID: 21847405 PMCID: PMC3148538 DOI: 10.4048/jbc.2011.14.2.112] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2010] [Accepted: 03/10/2011] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study was designed to investigate quality of life (QOL) differences between younger (<50 years) and older (≥50 years) breast cancer survivors and to determine the unique effect of age on QOL after adjusting age-correlated variables. METHODS One thousand two hundred fifty patients were enrolled. Clinicopatholgical and social parameters were reviewed and Functional Assessment of Cancer Therapy-Breast cancer instrument (FACT-B) and the Ladder of Life scale were used to measure the QOL. Among 1,250 eligible patients, 1,094 patients completed the questionnaire and were used for analysis. Chi-square test, t-test and a series of multiple regression analyses were conducted to verify age-related differences in QOL between two groups and to evaluate the unique contribution of age variable on QOL of breast cancer patients. RESULTS Significant socio-demographic and clinical differences existed based on age categories, including education, job, time since surgery, chemotherapy and daily activity. Also, there were significant age-related differences in FACT-B total, physical well-being, social/family well-being, functional well-being and breast cancer subscale and in subjective QOL. Older patients ≥50 years showed significantly lower QOL than younger patients <50 years. However, after controlling for age-correlated variables including job, education, time since surgery, chemotherapy, and daily activity, there was no unique age difference in QOL among breast cancer survivors. CONCLUSION Our study results suggest that older women with breast carcinoma suffered significantly lower QOL, even though the unique age effect was not found. Therefore, various interventions for enhancing QOL for women with breast carcinoma should be provided to older age group.
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Affiliation(s)
- Byeong-Woo Park
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
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Welzel G, Hägele V, Wenz F, Mai SK. Quality of life outcomes in patients with anal cancer after combined radiochemotherapy. Strahlenther Onkol 2011; 187:175-82. [PMID: 21347639 DOI: 10.1007/s00066-010-2175-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 12/01/2010] [Indexed: 01/04/2023]
Abstract
PURPOSE To assess self-reported quality of life (QoL) experienced by anal cancer patients after radiochemotherapy, and to identify patient- and disease-related factors associated with QoL. PATIENTS AND METHODS A total of 88 patients treated for anal cancer at our institution between 1990 and 2006 were identified from our database. Of these, 15 patients had died, and 4 were lost to follow-up. QoL was assessed using the EORTC QLQ-C30 questionnaire (cancer-specific QoL) and the colorectal cancer module QLQ-CR38 (site-specific QoL); 52 responses were received. The median follow-up was 36 months (range, 5-137 months). RESULTS As for cancer-specific QoL, global health QoL score (mean 60.4) was similar to the general German population, whereas most of the function and symptom scale scores were considerably lower/higher in anal cancer patients. The most prominent mean score differences were observed in role functioning (-21.8 points), emotional functioning (-20.7 points), social functioning (-28.9 points), diarrhea (+34.6 points), and financial difficulties (+26.9 points; p < 0.001). As for site-specific QoL, the mean function scale scores ranged from 22.1 (sexual function) to 63.2 (body image), and the mean symptom scale scores from 14.7 (weight loss) to 69.0 (stoma-related problems, 4 patients) and 67.9 (male sexual dysfunction), respectively. Most of the QoL scores were not affected by late toxicity, patient- or disease-related factors. Fatigue (+18.2 points) emerged as the strongest predictor of impaired QoL. CONCLUSION The global health QoL of anal cancer patients is comparable with that of the general German population, but there are specific limitations, e.g., sexual dysfunction, urological/gastrointestinal complaints, financial difficulties, fatigue, and a reduction in emotional and social well-being.
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Affiliation(s)
- Grit Welzel
- Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Germany.
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Follow-up care after breast cancer treatment: experiences and perceptions of service provision and provider interactions in rural Australian women. Support Care Cancer 2010; 19:1975-82. [DOI: 10.1007/s00520-010-1041-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 11/01/2010] [Indexed: 10/18/2022]
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Henselmans I, Fleer J, de Vries J, Baas PC, Sanderman R, Ranchor AV. The adaptive effect of personal control when facing breast cancer: Cognitive and behavioural mediators. Psychol Health 2010; 25:1023-40. [DOI: 10.1080/08870440902935921] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Henselmans I, Sanderman R, Helgeson VS, de Vries J, Smink A, Ranchor AV. Personal control over the cure of breast cancer: adaptiveness, underlying beliefs and correlates. Psychooncology 2010; 19:525-34. [PMID: 19557825 DOI: 10.1002/pon.1599] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Although cognitive adaptation theory suggests that personal control acts as a stress buffer when facing adversity, maladaptive outcomes might occur when control is disconfirmed. The moderating effect of disappointing news on the adaptiveness of personal control over cure in women with breast cancer was examined and contrasted with the effect on the adaptiveness of general control over life. Additionally, the underlying beliefs and correlates of control over cure were explored. METHODS Women with newly diagnosed breast cancer were assessed after surgery (n=228). For a sub-sample (n=133) data before surgery and after the end of treatment were available as well. Data were collected through questionnaires and face-to-face interviews. The prescription of chemotherapy after surgery was used as an indicator of disappointing news. RESULTS A chemotherapy prescription neither enhances nor limits the adaptiveness of disease-specific or general control perceptions. Women reported that maintaining a positive attitude, accepting treatment and adopting a healthy life style gave them a sense of control over cure. Women with a strong sense of control over cure more often had invasive cancer, were younger and were best characterized by high optimism and strong sense of control over life. CONCLUSIONS The findings add to our understanding of exaggerated control perceptions in cancer patients treated with curative intent and do not give reason to assume that such perceptions should be altered because of potentially maladaptive effects. On the contrary, a strong sense of control over the cure of breast cancer seems to reflect the capacity to adapt.
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Affiliation(s)
- Inge Henselmans
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Hou WK, Law CC, Fu YT. Does change in positive affect mediate and/or moderate the impact of symptom distress on psychological adjustment after cancer diagnosis? A prospective analysis. Psychol Health 2010; 25:417-31. [PMID: 20397294 DOI: 10.1080/08870440802559375] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Physical symptom distress is one of the commonest correlates of psychological adjustment in cancer patients. Positive affect (PA) can be a dynamic resource for patients to cope with the cancer-related physical demands. The present study examined whether differential patterns of change in PA were associated with anxiety and depressed mood, and whether PA modified the association between change in symptom distress and psychological distress in 215 Chinese people newly diagnosed with colorectal cancer (CRC). Participants completed measures of physical symptoms, PA, and anxiety and depression at diagnosis and again at 3-month follow-up. Multivariate analyses of covariance revealed that at follow-up, people reporting higher anxiety and depressed mood demonstrated loss in PA, whereas those reporting lower depressed mood demonstrated a gain in PA. Structural equation modelling revealed that change in PA significantly mediated and moderated the associations between increased symptom distress and anxiety and depressed mood. We conclude that in line with Hobfoll's conservation of resources theory, continuous physical symptom distress depletes PA of newly diagnosed cancer patients, resulting in higher levels of anxiety and depressed mood. Effectiveness of symptom management intervention could be enhanced by preserving or enhancing PA in patients.
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Affiliation(s)
- Wai Kai Hou
- Department of Psychology, University of Hong Kong, Hong Kong SAR, China.
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Wittenberg L, Yutsis M, Taylor S, Giese-Davis J, Bliss-Isberg C, Star P, Spiegel D. Marital Status Predicts Change in Distress and Well-being in Women Newly Diagnosed With Breast Cancer and Their Peer Counselors. Breast J 2010; 16:481-9. [DOI: 10.1111/j.1524-4741.2010.00964.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vivar CG, Whyte DA, Mcqueen A. ‘Again’: the impact of recurrence on survivors of cancer and family members. J Clin Nurs 2010; 19:2048-56. [DOI: 10.1111/j.1365-2702.2009.03145.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Evaluation of quality of life after breast reconstruction using an autologous latissimus dorsi myocutaneous flap. Eur J Surg Oncol 2010; 36:520-7. [PMID: 20452169 DOI: 10.1016/j.ejso.2010.04.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Revised: 02/03/2010] [Accepted: 04/12/2010] [Indexed: 11/23/2022] Open
Abstract
AIMS To evaluate the patients' satisfaction with breast reconstruction using the autologous latissimus dorsi technique and the impact of the procedure on the quality of life and body image of women who had mastectomy for breast cancer. METHODS A retrospective transversal study was conducted at the Georges François Leclerc Cancer Care Center in Dijon, France. From 1990 to 2008, 193 women underwent reconstruction (RW), among these, 141 were matched for age at diagnosis and the date of the mastectomy with women who did not undergo reconstruction (NRW) identified using data from the Côte d'Or breast cancer registry. Questionnaires concerning quality of life, body image and satisfaction (MBROS-S, MBROS-BI, EORTC QLQ-C30, EORTC QLQ-BR23) were sent through the post following surgery. RESULTS The overall response rate was 77% and the mean (MBROS-S) satisfaction score was 3.36. The quality of life (EORTC QLQ-C30, EORTC QLQ-BR23) in RW was no better than that in NRW, but body image was better (p = 0.0247) especially before 60 years (p = 0.0192), in obese patients (p = 0.03) and when the breasts of RW were heavy (p = 0.0197). Moreover, when the time from the mastectomy was less than 4 years, body image (p = 0.0008) and the sexual activity score (p = 0.0078) were higher in RW. CONCLUSIONS The level of satisfaction was higher in RW, and breast reconstruction made a strong contribution in terms of improvement in body image. A prospective study to evaluate quality of life in the long term is now necessary.
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Springer BA, Levy E, McGarvey C, Pfalzer LA, Stout NL, Gerber LH, Soballe PW, Danoff J. Pre-operative assessment enables early diagnosis and recovery of shoulder function in patients with breast cancer. Breast Cancer Res Treat 2010; 120:135-47. [PMID: 20054643 DOI: 10.1007/s10549-009-0710-9] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Accepted: 12/22/2009] [Indexed: 10/20/2022]
Abstract
In order to determine the extent and time course of upper limb impairment and dysfunction in women being treated for breast cancer (BC), and followed prospectively, a novel physical therapy surveillance model post-treatment was used. Subjects included adult women with newly diagnosed, untreated, unilateral, Stage I to III BC, and normal physiological and biomechanical shoulder function. Subjects were excluded if they had a previous history of BC, or prior injury or surgery of the affected upper limb. Measurements included body weight, shoulder ranges of motion (ROM), manual muscle tests, pain levels, upper limb volume, and an upper limb disability questionnaire (ULDQ). Measurements were taken at baseline (pre-surgery), and 1, 3-6, and 12 months post-surgery. All subjects received pre-operative education and exercise instruction and specific physical therapy (PT) protocol after surgery including ROM and strengthening exercises. All measures of function were significantly reduced 1 month post-surgery, but most recovered to baseline levels by 1-year post-surgery. Some subjects developed signs of lymphedema 3-12 months post-surgery, but this did not compromise function. Shoulder abduction, flexion, and external rotation, but not internal rotation ROM, were associated with the ULDQ. Most women in this cohort undergoing surgery for BC who receive PT intervention may expect a return to baseline ROM and strength by 3 months. Those who do not reach baseline, often continue to improve and reach their pre-operative levels by 1-year post-surgery. Lymphedema develops independently of shoulder function 3-12 months post-surgery, necessitating continued monitoring. A prospective physical therapy model of surveillance allows for detection of early and later onset of impairment following surgery for BC in this specific cohort of patients.
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Affiliation(s)
- Barbara A Springer
- Proponency Office for Rehabilitation and Reintegration, Office of the Surgeon General, 5109 Leesburg Pike, Suite 684, Falls Church, VA 22041-3258, USA.
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Kwan ML, Ergas IJ, Somkin CP, Quesenberry CP, Neugut AI, Hershman DL, Mandelblatt J, Pelayo MP, Timperi AW, Miles SQ, Kushi LH. Quality of life among women recently diagnosed with invasive breast cancer: the Pathways Study. Breast Cancer Res Treat 2010; 123:507-24. [PMID: 20140494 DOI: 10.1007/s10549-010-0764-8] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 01/20/2010] [Indexed: 01/05/2023]
Abstract
Few studies have assessed quality of life (QOL) of women diagnosed with breast cancer within the first few weeks of their initial diagnosis. We describe QOL among 950 women recently diagnosed with invasive breast cancer. Starting in January 2006, we invited women aged > or =21 years who were diagnosed with first primary invasive breast cancer within Kaiser Permanente Northern California (KPNC) to enroll in the Pathways Study, a prospective study of breast cancer survivorship. QOL was measured using the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B), along with sociodemographic and social support information. Clinical characteristics were obtained from the KPNC cancer registry and electronic medical record. We used multivariable linear regression models to identify factors associated with QOL scores calculated from the FACT-B. The mean age +/- SD of the sample was 59.6 years (+/-11.9 years), and the mean time +/-SD from diagnosis until interview was 8.0 weeks (+/-3.2 weeks). Younger age at diagnosis was associated with lower scores in all QOL domains (P < 0.01), and later stage at diagnosis was associated with lower scores in all domains (P < 0.05) except for social well-being. Higher levels of social support were associated with higher QOL except for physical well-being (P < 0.05). These associations were stronger within 2 months of breast cancer diagnosis. Quality of life as influenced by a diagnosis of breast cancer is an important factor in cancer survivorship. Age, stage at diagnosis, and social support are key factors in this important variable.
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Affiliation(s)
- Marilyn L Kwan
- Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA.
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