101
|
Kano M, Chen L, Boyce T, Gomez R, Gundelach AC, Jaffe SA, Sussman AL, Dayao ZR, Lobo J, Pestak CR, Rutledge TL. Characterizing Low-Risk Breast and Gynecological Cancer Patients for Transition into an Oncology/Primary Care Coordinated Care Model: Findings from a Survey of Diverse Survivors in a Rural U.S. State. Cancers (Basel) 2021; 13:cancers13174428. [PMID: 34503237 PMCID: PMC8431122 DOI: 10.3390/cancers13174428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 02/01/2023] Open
Abstract
We conducted a survey to characterize the key attributes of racial/ethnic and geographically diverse low-risk breast and gynecologic cancer patients. We collected data regarding patients' access to primary care (PC); compliance with screening recommendations; treatment for comorbidities; logistical barriers to clinic visits; and receipt of survivorship care documentation (SCD). Survey findings informed the development of an oncology/Primary Care Provider (PCP) care coordination intervention to improve care. We distributed a cross-sectional survey among a convenience sample of 150 cancer survivors. Responses were calculated using descriptive statistics and compared based on the distance participants traveled to their appointments at the cancer center (≤30 vs. >30 miles). Of the 150 respondents, 35% traveled >30 miles for follow-up care and 78% reported having one or more comorbid condition(s). PC utilization was high: 88% reported having a PCP, and 91% indicated ≤1 yearly follow-up visit. Participants traveling >30 miles reported higher rates of logistical challenges associated with cancer center visits compared to those traveling ≤30 miles. Nearly half of respondents (46%) had not received SCD. In conclusion, survey studies such as these allow for the systematic assessment of survivor behaviors and care utilization patterns to inform the development of care coordination interventions for diverse, low-risk cancer patients.
Collapse
Affiliation(s)
- Miria Kano
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (Z.R.D.); (C.R.P.)
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
- Correspondence: ; Tel.: +1-(505)-925-1115
| | - Lu Chen
- Department of Preventive Medicine and Population Health, The University of Texas Medical Branch; Albuquerque, NM 77555, USA;
| | - Tawny Boyce
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
| | - Ricardo Gomez
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
| | - Amy C. Gundelach
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
| | - Shoshana Adler Jaffe
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
| | - Andrew L. Sussman
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Zoneddy R. Dayao
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (Z.R.D.); (C.R.P.)
- Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Jolene Lobo
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Claire R. Pestak
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA; (Z.R.D.); (C.R.P.)
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Teresa L. Rutledge
- The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87131, USA; (T.B.); (R.G.); (A.C.G.); (S.A.J.); (A.L.S.); (T.L.R.)
- Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM 87131, USA
| |
Collapse
|
102
|
Cancer et sexualité : que doit savoir le professionnel de santé non spécialisé ? SEXOLOGIES 2021. [DOI: 10.1016/j.sexol.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
103
|
Nutrition Status and Renal Function as Predictors in Acute Myocardial Infarction with and without Cancer: A Single Center Retrospective Study. Nutrients 2021; 13:nu13082663. [PMID: 34444823 PMCID: PMC8399317 DOI: 10.3390/nu13082663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/19/2021] [Accepted: 07/28/2021] [Indexed: 11/22/2022] Open
Abstract
Background: Clinical characteristics of nutrition status in acute myocardial infarction (AMI) patients with cancer remains unknown. Therefore, this study aimed to clarify the differences of clinical parameters, including nutrition status, between AMI patients with and without history of cancer. Methods and Results: This retrospective cohort study, using the database of AMI between 2014 and 2019 in Kurume University Hospital, enrolled 411 patients; AMI patients without cancer (n = 358, 87.1%) and with cancer (n = 53, 12.9%). AMI patients with cancer were significantly older with lower body weight, worse renal function, and worse nutrition status. Next, we divided the patients into 4 groups by cancer, age, and plaque area, detected by coronary image devices. The prediction model indicated that nutrition, lipid, and renal functions were significant predictors of AMI with cancer. The ordinal logistic regression model revealed that worse nutrition status, renal dysfunction, lower uric acid, and elevated blood pressure were significant predictors. Finally, we were able to calculate the probability of the presence of cancer, by combining each factor and scoring. Conclusions: Worse nutrition status and renal dysfunction were associated with AMI with cancer, in which nutrition status was a major different characteristic from those without cancer.
Collapse
|
104
|
Neris RR, Nascimento LC. Childhood cancer survival: Emerging reflections on pediatric oncology nursing. Rev Esc Enferm USP 2021; 55:e03761. [PMID: 34346967 DOI: 10.1590/s1980-220x2020041803761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/20/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this study is to analyze and critically reflect on childhood cancer survival, including conceptual aspects, repercussions, survival care, and challenges. This is a theoretical and reflective study, based on the scientific literature on the subject and on the researchers' experience. Childhood cancer survival is conceptualized as the process of living beyond the oncological diagnosis. A person is considered a cancer survivor from the diagnosis until the end of life and is at high risk of experiencing physical, psychosocial, and economic effects. Therefore, survival care shall minimize, as far as possible, these impacts throughout life. Such care includes an action plan to track and treat the persistent effects of therapy, preventing diseases and promoting healthy behaviors, not being restricted to monitoring oncological recurrence. In the national setting, challenges persist, such as the scarcity of policies to guide comprehensive, good quality, and coordinated survival care. Despite these challenges, the nurse occupies a privileged position and is competent to implement survival care and manage the effects related to cancer treatment.
Collapse
Affiliation(s)
- Rhyquelle Rhibna Neris
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-graduação Enfermagem em Saúde Pública, Ribeirão Preto, São Paulo, Brasil
| | - Lucila Castanheira Nascimento
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-graduação Enfermagem em Saúde Pública, Ribeirão Preto, São Paulo, Brasil
| |
Collapse
|
105
|
Cuvelier S, Blaise D, Boher JM, Villaron-Goetgheluck C, Justafré S, Pakradouni J, Granata A, Furst S, Dantin P, Viens P, Calvin S. A study of elite sport-inspired coaching for patients after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2021; 56:2755-2762. [PMID: 34262141 PMCID: PMC8277989 DOI: 10.1038/s41409-021-01401-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/16/2021] [Accepted: 06/25/2021] [Indexed: 11/20/2022]
Abstract
A need for social support is often expressed after hospitalization post HSCT. Emotional support and positive psychological constructs play an important role in post-HSCT recovery. Interventions generating positive affect can influence the health and well-being of transplant patients. It has been established that coaching in elite sport area leads to performance by playing a decisive role in maintaining the athlete’s feelings of hope and autonomy in order to enable him or her to achieve their goals. In this single-center, prospective, one-arm study, we evaluated, in 32 post-HSCT patients, the acceptability of a coaching program inspired by elite sport coaching. Benefits were evaluated by questionnaires and semi-structured interviews. The coaching program was accepted by 97% of the patients. Analysis of the scores on the “Means” sub-dimension of Hope showed a significant increase over time (p = 0.0249 < 0.05) for every patient. Qualitative analysis of patient’s satisfaction pointed out that this support facilitated the transition to a life without illness in particular in the non-hospital context of coaching sessions. Our results show that a “sport-inspired coaching“ may offer an innovative approach supporting psychological and social recovery after HSCT and helping to start and/or maintain the processes leading to psychological well-being.
Collapse
Affiliation(s)
- Sarah Cuvelier
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France
| | - Didier Blaise
- Department of Onco-Hematology, Transplant and Cellular Therapy Program, Institut Paoli Calmettes, Marseille, France.,Cancer Research Center of Marseille, INSERM (UMR 1068), CNRS (UMR 7258), Marseille, France
| | - Jean-Marie Boher
- Department of Clinical Research and Innovation. Institut Paoli Calmettes, Marseille, France
| | - Charlène Villaron-Goetgheluck
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France
| | - Sebastien Justafré
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France
| | - Jihane Pakradouni
- Department of Clinical Research and Innovation. Institut Paoli Calmettes, Marseille, France
| | - Angela Granata
- Department of Onco-Hematology, Transplant and Cellular Therapy Program, Institut Paoli Calmettes, Marseille, France
| | - Sabine Furst
- Department of Onco-Hematology, Transplant and Cellular Therapy Program, Institut Paoli Calmettes, Marseille, France
| | - Pierre Dantin
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France
| | - Patrice Viens
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France.,Departement of Medical Oncology, Institut Paoli Calmettes, Marseille, France
| | - Sarah Calvin
- Management Sport Cancer Laboratory (UR 20122035V), Faculty of Sport Sciences, Aix-Marseille University, Marseille, France.
| |
Collapse
|
106
|
Namin S, Zhou Y, Neuner J, Beyer K. Neighborhood Characteristics and Cancer Survivorship: An Overview of the Current Literature on Neighborhood Landscapes and Cancer Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7192. [PMID: 34281129 PMCID: PMC8297243 DOI: 10.3390/ijerph18137192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/21/2021] [Accepted: 07/02/2021] [Indexed: 12/18/2022]
Abstract
There is a growing literature on the association between neighborhood contexts and cancer survivorship. To understand the current trends and the gaps in the literature, we aimed to answer the following questions: To what degree, and how, has cancer survivorship research accounted for neighborhood-level effects? What neighborhood metrics have been used to operationalize neighborhood factors? To what degree do the neighborhood level metrics considered in cancer research reflect neighborhood development as identified in the Leadership for Energy and Environmental Design for Neighborhood Development (LEED-ND) guidelines? We first conducted a review guided by PRISMA extension for scoping review of the extant literature on neighborhood effects and cancer survivorship outcomes from January 2000 to January 2021. Second, we categorized the studied neighborhood metrics under six main themes. Third, we assessed the findings based on the LEED-ND guidelines to identify the most relevant neighborhood metrics in association with areas of focus in cancer survivorship care and research. The search results were scoped to 291 relevant peer-reviewed journal articles. Results show that survivorship disparities, primary care, and weight management are the main themes in the literature. Additionally, most articles rely on neighborhood SES as the primary (or only) examined neighborhood level metric. We argue that the expansion of interdisciplinary research to include neighborhood metrics endorsed by current paradigms in salutogenic urban design can enhance the understanding of the role of socioecological context in survivorship care and outcomes.
Collapse
Affiliation(s)
- Sima Namin
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (Y.Z.); (K.B.)
| | - Yuhong Zhou
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (Y.Z.); (K.B.)
| | - Joan Neuner
- General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Kirsten Beyer
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (Y.Z.); (K.B.)
| |
Collapse
|
107
|
Horicks F, Coppieters Y. [Current challenges in cancer care in Brussels-capital region: A qualitative study]. Bull Cancer 2021; 108:705-717. [PMID: 34127254 DOI: 10.1016/j.bulcan.2021.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 11/29/2022]
Abstract
Cancer is a disease with multidimensional consequences accompanied by new challenges in order to guarantee optimal care involving physical, psychological and social consequences of the disease and his treatments. The objective of this study is to identify the main challenges encountered by different stakeholders around cancer, including patients, in Brussels. This qualitative study was carried out with various stakeholders in the field of oncology. The semi-structured interviews and focus groups were transcribed directly and the data collected was analysed manually. Healthcare professionals and patients face many challenges in the current context of oncology care. Communication difficulties can affect the therapeutic relationship and the sharing of complex information. The increasing complexity of therapeutic strategies complicates interprofessional collaborations and care coordination. In a context of early return home and home hospitalization in particular, continuity in care and collaboration between the different lines of care are crucial. Patients face a variety of challenges, such as managing long-term side effects and post-cancer difficulties, including redefining their social and professional identities. Finally, cancer involves financial toxicity and social inequalities in health are particularly marked. Cancer is a complex disease which management involves a growing number of caretakers. It is also frequently synonymous with disruption in the personal, social and professional life of patients. The emerging themes of this study are closely interconnected and communication seems to occupy a central place. A holistic approach to the individual and inter-professional interactions could guide future prospects for the overall management of this constantly changing field.
Collapse
Affiliation(s)
- Florence Horicks
- Centre de recherche Politiques et systèmes de santé, École de Santé Publique, Université libre de Bruxelles (ULB), route de Lennik 808, 1070 Bruxelles, Belgique.
| | - Yves Coppieters
- Centre de recherche Politiques et systèmes de santé, École de Santé Publique, Université libre de Bruxelles (ULB), route de Lennik 808, 1070 Bruxelles, Belgique
| |
Collapse
|
108
|
Canadian Resources, Programs, and Models of Care to Support Cancer Survivors' Transition beyond Treatment: A Scoping Review. ACTA ACUST UNITED AC 2021; 28:2134-2145. [PMID: 34207635 PMCID: PMC8293069 DOI: 10.3390/curroncol28030198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 12/01/2022]
Abstract
(1) Background: One in two Canadians will be diagnosed with cancer in their lifetime, but as a result of the progress in diagnosis and treatment, more individuals are surviving cancer than ever before. However, the impact of cancer does not end with treatment. The objectives of this review are to (1) provide a broad overview of the supportive care interventions and models of care that have been researched to support Canadian post-treatment cancer survivors; and (2) analyze how these supportive care interventions and/or care models align with the practice recommendations put forth by Cancer Care Ontario (CCO) and the Canadian Association of Psychosocial Oncology/Canadian Partnership Against Cancer (CAPO/CPAC). (2) Methods: An electronic search was completed in MEDLINE, Embase, PsycINFO, and CINAHL in January 2021. Included studies described supportive care interventions or models of care utilized by adult Canadian cancer survivors. (3) Results: Forty-two articles were included. Survivors utilized a multitude of supportive care interventions, with peer support and physical activity programs being most frequently cited. Four models of follow-up care were identified: primary care, oncology care, shared-care, and transition clinics. The supportive care interventions and models of care variably aligned with the recommendations set by CCO and CAPO/CPAC. The most commonly followed recommendation was the promotion of self-management and quality resources for patients. (4) Conclusions: Results indicate an inconsistency in access to supportive care interventions and the delivery of survivorship care for cancer survivors across Canada. Current efforts are being made to implement the recommendations by CCO and CAPO/CPAC; however, provision of these guidelines remains varied.
Collapse
|
109
|
Somayaji D, Melendez M, Kwon M, Lathan C. Access to Cancer Care Resources in a Federally Qualified Health Center: a Mixed Methods Study to Increase the Understanding of Met and Unmet Needs of Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:591-602. [PMID: 31828550 DOI: 10.1007/s13187-019-01669-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Assessing the met and unmet needs of cancer survivors is critical in optimizing access to cancer services especially in underserved populations. The purpose of this study is to expand our understanding of the priority needs for cancer survivorship within racial/ethnic and underserved populations that speak either English or Spanish and seek health care in a federally qualified health center (FQHC). A convergent mixed methods design integrating survey and focus group data was utilized for this study. A total of 17 participants were enrolled in the study. The meta-inferences were drawn by looking across the top ten matched survey and focus group met and unmet needs including psychological, informational, and health system as well as patient care and support. The preferred languages of participants were Spanish 53% (n = 9) and English 47% (n = 8), and the survival breakdown was 65% (n = 11) within 0-5 years with 17.5% (n = 3), 6-10 years and 17.5% (n = 3), and 17.5% (n = 3) > 11 years. The most frequently met needs included health care providers and hospital staff being attentive to their physical and emotional needs and feeling they were treated with respect. Unmet needs were often related to physical and daily living needs such as pain, fatigue, sadness, depression, and not being able to work. Providing a needs-based approach of cancer health services in a FQHC or similar community-based health center is critical to meet the needs of cancer survivors to improve health outcomes and quality of life.
Collapse
Affiliation(s)
- Darryl Somayaji
- School of Nursing, University at Buffalo, 3435 Main St, Wende Hall 201C, Buffalo, NY, 14214, USA.
| | | | - Misol Kwon
- School of Nursing, University at Buffalo, 3435 Main St, Wende Hall 201C, Buffalo, NY, 14214, USA
| | - Christopher Lathan
- Dana Farber/Harvard Cancer Center Medicine Department, Harvard Medical School, 450 Brookline Ave, Boston, MA, 02215, USA
| |
Collapse
|
110
|
Stegmann ME, Geerse OP, van Zuylen L, Nekhlyudov L, Brandenbarg D. Improving Care for Patients Living with Prolonged Incurable Cancer. Cancers (Basel) 2021; 13:2555. [PMID: 34070954 PMCID: PMC8196984 DOI: 10.3390/cancers13112555] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/17/2022] Open
Abstract
The number of patients that can no longer be cured but may expect to live with their cancer diagnosis for a substantial period is increasing. These patients with 'prolonged incurable cancer' are often overlooked in research and clinical practice. Patients encounter problems that are traditionally seen from a palliative or survivorship perspective but this may be insufficient to cover the wide range of physical and psychosocial problems that patients with prolonged incurable cancer may encounter. Elements from both fields should, therefore, be delivered concordantly to further optimize care pathways for these patients. Furthermore, to ensure future high-quality care for this important patient population, enhanced clinical awareness, as well as further research, are urgently needed.
Collapse
Affiliation(s)
- Mariken E. Stegmann
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, 9700 CC Groningen, The Netherlands; (M.E.S.); (D.B.)
| | - Olaf P. Geerse
- Academic Medical Center, Department of Pulmonary Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Lia van Zuylen
- Amsterdam University Medical Center, Department of Medical Oncology, 1105 AZ Amsterdam, The Netherlands;
| | - Larissa Nekhlyudov
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Daan Brandenbarg
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, 9700 CC Groningen, The Netherlands; (M.E.S.); (D.B.)
| |
Collapse
|
111
|
Nonaka M, Hosoda H, Uezono Y. Cancer treatment-related cardiovascular disease: Current status and future research priorities. Biochem Pharmacol 2021; 190:114599. [PMID: 33989656 DOI: 10.1016/j.bcp.2021.114599] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 10/21/2022]
Abstract
With the development of new drugs, such as molecular-targeted drugs, and multidisciplinary therapies, cancer treatment outcomes have improved, and the number of cancer survivors is increasing every year. However, some chemotherapeutic agents cause cardiovascular complications (cancer treatment-related cardiovascular disease, CTRCVD), which affect the life prognosis and quality of life (QOL) of cancer patients. Therefore, it is necessary to select treatment methods that take into account the prognosis and QOL of cancer patients, and to take measures against CTRCVD. The mechanism of cardiotoxicity of high-risk drugs, such as doxorubicin and HER2 inhibitors, are still unclear; genetic factors, and cardiovascular disease risk factors (e.g., hypertension, dyslipidemia, and diabetes) are associated with CTRCVD progression. The establishment of methods for prevention, early diagnosis, and treatment of CTRCVD and the generation of evidence for these methods are needed. It is also necessary to develop screening methods for chemotherapy cardiotoxicity. In this review, we discuss the current status of CTRCVD, its complications, and expected countermeasures.
Collapse
Affiliation(s)
- Miki Nonaka
- Department of Pain Control Research, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan(1)
| | - Hiroshi Hosoda
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center Research Institute, 6-1, Kishibe-Shimmachi, Suita-City, Osaka 564-8565, Japan(1)
| | - Yasuhito Uezono
- Department of Pain Control Research, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan(1); Department of Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; Supportive and Palliative Care Research Support Office, National Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa-City, Chiba 277-8577, Japan; Project for Supportive Care Research, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
| |
Collapse
|
112
|
Saltaouras G, Lightowler H, Coe S, Horne A, Matthews S, Caulfield L, Watson EK. Diet and nutrition in patients who have received pelvic radiotherapy: A mixed-methods study to explore dietary habits, nutritional awareness, and experiences of nutritional care. Nutrition 2021; 89:111309. [PMID: 34166893 DOI: 10.1016/j.nut.2021.111309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Individuals who have survived cancer may benefit from dietary modifications to improve quality of life and future health outcomes. The aim of this study was to explore dietary habits and experiences of nutritional support in patients with a cancer diagnosis who have received radiotherapy to the pelvic area. METHODS A mixed-methods approach was used. Individuals diagnosed with a pelvic cancer (anal, bladder, rectal, and cancers of the reproductive organs), either undergoing or having completed pelvic radiotherapy 6 to 24 mo previously, were invited to participate in a postal survey. A purposive subsample was also invited to take part in telephone interviews. Thematic analysis of interview data was undertaken and integrated with data from quantitative analysis. RESULTS The survey was completed by 254 (38%) respondents. Two-thirds of respondents (170) reported dietary changes since diagnosis; most notable changes were reduction of sugary foods (48%) and alcohol (41%). Receipt of support from the health care team was significantly associated with dietary change (odds ratio, 3.26; 95% confidence interval, 1.58-6.75); however, only 43% (108) had received dietary support from the health care team. Of the respondents, 68% (171) said they would like to receive additional dietary support. The effect of the condition on diet was highlighted in the theme "Impact of diagnosis and treatments on dietary choices." Self-management of disease was influenced by personal resources, social resources, comorbidities and disabilities, influence of work, regaining normality, and barriers to dietary changes. CONCLUSION Lack of routine provision of nutritional care to patients after a cancer diagnosis and patient interest in this area highlighted unmet needs in managing diet-related problems and leading a healthy future lifestyle.
Collapse
Affiliation(s)
- Georgios Saltaouras
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford, UK; Oxford School of Nursing and Midwifery, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford, UK.
| | - Helen Lightowler
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford, UK
| | - Shelly Coe
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford, UK
| | - Amanda Horne
- Department of Radiotherapy, Oxford Cancer Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sara Matthews
- Oxford School of Nursing and Midwifery, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford, UK; Department of Radiotherapy, Oxford Cancer Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Loryn Caulfield
- Department of Radiotherapy, Oxford Cancer Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Eila K Watson
- Oxford School of Nursing and Midwifery, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford, UK
| |
Collapse
|
113
|
Wollersheim BM, Helweg E, Tillier CN, van Muilekom HAM, de Blok W, van der Poel HG, van Asselt KM, Boekhout AH. The role of routine follow-up visits of prostate cancer survivors in addressing supportive care and information needs: a qualitative observational study. Support Care Cancer 2021; 29:6449-6457. [PMID: 33900459 DOI: 10.1007/s00520-021-06222-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/11/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To understand the role of routine follow-up visits in addressing prostate cancer survivors' supportive care and information needs. METHODS We audio-recorded follow-up visits of 32 prostate cancer survivors. Follow-up visits were analyzed according to the Verona Network of Sequence Analysis. We categorized survivors' cues, concerns, and questions into five supportive care domains and divided the responses by the healthcare professionals into providing versus reducing space that is to determine whether or not the response invites the patient to talk more about the expressed cue or concern. RESULTS Prostate cancer survivors mostly expressed cues, concerns, and questions (in the health system and information domain) about test results, potential impotence treatment, follow-up appointments, and (their) cancer treatment during follow-up visits. Survivors also expressed urinary complaints (physical and daily living domain) and worry about the recurrence of prostate cancer (psychological domain). Healthcare professionals were two times more likely to provide space on cues and concerns related to the physical and daily living domain than to psychological related issues. CONCLUSION Follow-up visits can serve to address prostate cancer survivors' supportive care and information needs, especially on the health system, information, and physical and daily living domain. Survivors also expressed problems in the psychological domain, although healthcare professionals scarcely provided space to these issues. We would like to encourage clinicians to use these results to personalize follow-up care. Also, these data can be used to develop tailored (eHealth) interventions to address supportive care and information needs and to develop new models of survivorship care delivery.
Collapse
Affiliation(s)
- Barbara M Wollersheim
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Ellis Helweg
- Department of General Practice, Utrecht University, Utrecht, The Netherlands
| | - Corinne N Tillier
- Department of Urology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - H A M van Muilekom
- Department of Urology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Willem de Blok
- Department of Urology, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Henk G van der Poel
- Department of Urology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Kristel M van Asselt
- Department of General Practice, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Annelies H Boekhout
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| |
Collapse
|
114
|
Esser P, Mehnert-Theuerkauf A. [Cancer survivorship care programs and self-management]. DER ONKOLOGE : ORGAN DER DEUTSCHEN KREBSGESELLSCHAFT E.V 2021; 27:766-770. [PMID: 33935378 PMCID: PMC8063579 DOI: 10.1007/s00761-021-00945-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 03/25/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Survivorship care programs (SCP) are increasingly being implemented in order to ensure long-term and comprehensive care of physical and psychosocial cancer-related sequelae among survivors. In this article, we provide a short overview of SCP and the importance of health-related self-management. RESULTS The broad definition of "survivorship" and the high diversity of impairments among cancer survivors warrants a personalized and multidimensional approach. This in turn requires both interdisciplinary and integrated care. To date, the state of knowledge on the efficacy of SCP is limited. A central aim of SCP is to increase health-related self-management, which in turn requires the ability to correctly evaluate and apply health-related information in order to resolve health-related problems (health literacy). Due to the technological developments, additional skills are needed to stay health literate (digital health literacy). CONCLUSION Further research on the efficacy of SCP is warranted. Both advantages and risks of digital health programs need to be carefully weighed to avoid inequalities in health care ("digital divide"). Specific education programs to improve digital health literacy may help to minimize such risks.
Collapse
Affiliation(s)
- Peter Esser
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Deutschland
| | - Anja Mehnert-Theuerkauf
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universität Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Deutschland
| |
Collapse
|
115
|
Peixoto NMDSM, Peixoto TADSM, Pinto CAS, Santos CSVDB. Nursing intervention focusing on health promotion behaviors in adult cancer patients: a scoping review. Rev Esc Enferm USP 2021; 55:e03673. [PMID: 33886904 DOI: 10.1590/s1980-220x2019039403673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 05/29/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE This review aims to map and provide an overview of literature concerning nursing strategies and intervention programs that promote healthy behaviors in cancer patients. METHOD A scoping review was conducted using the methodological framework developed by Joanna Briggs Institute and preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews. Twelve databases were searched (2012-2019). Retrieved data included descriptive analyses exploring studies' methodological characteristics and results. RESULTS From 1589 studies, 12 were included. Most studies included patients on survivorship period (n=10) and selected intervention strategies focusing patient's knowledge and awareness (n=8). Educational sessions were supported by behavioral change reinforcements and motivational incentives. Only two of the considered studies analysed intervention cost effectiveness, but none disclosed intervention-related costs. CONCLUSION Nursing interventions are effective in promoting health behaviors when include health education and encouragement towards change. Survivorship is the perfect time for health promotion. Nurses can be considered health promoters, by encouraging health education and enhance survivor's motivation.
Collapse
|
116
|
Truant TLO, Lambert LK, Thorne S. Barriers to Equity in Cancer Survivorship Care: Perspectives of Cancer Survivors and System Stakeholders. Glob Qual Nurs Res 2021; 8:23333936211006703. [PMID: 33912623 PMCID: PMC8050754 DOI: 10.1177/23333936211006703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/09/2021] [Accepted: 03/12/2021] [Indexed: 11/16/2022] Open
Abstract
As more cancer patients survive into post-treatment, the challenge of managing their survivorship care is confronting health care systems globally. In striving to deliver high quality survivorship care, equity constitutes a particularly troublesome challenge. We analyzed accounts from both cancer survivors and stakeholders within care system management to uncover insights with respect to barriers to equitable cancer survivorship services. Beyond the social determinants of health that shape inequities across all of our systems, the cancer care system involves a pattern of prioritizing biomedicine, evidence-based options, and care standardization. We learned that these lead to system rigidities that not only compromise the individualization essential to person-centered care but also obscure the attention to group differences that becomes indispensable to responsiveness to inequities. On the basis of these insights, we reflect on what may be required to begin to redress the current and projected inequities with respect to access to appropriate cancer survivorship supports and services.
Collapse
Affiliation(s)
| | - Leah K Lambert
- BC Cancer, Vancouver, Canada.,University of British Columbia, Vancouver, Canada
| | - Sally Thorne
- University of British Columbia, Vancouver, Canada
| |
Collapse
|
117
|
Psychosocial, behavioral, and supportive interventions for pediatric, adolescent, and young adult cancer survivors: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2021; 160:103291. [DOI: 10.1016/j.critrevonc.2021.103291] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/28/2020] [Accepted: 02/27/2021] [Indexed: 11/24/2022] Open
|
118
|
Taruya A, Nakajima Y, Tanaka A, Kashiwagi M, Tanimoto T, Kuroi A, Shiono Y, Shimamura K, Kubo T, Sougawa H, Masuno T, Ozaki Y, Satogami K, Ota S, Katayama Y, Ino Y, Hoshiya H, Akasaka T. Cancer-related vulnerable lesions in patients with stable coronary artery disease. Int J Cardiol 2021; 335:1-6. [PMID: 33781853 DOI: 10.1016/j.ijcard.2021.03.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Coronary artery disease (CAD) has become a major cause of morbidity and mortality in cancer survivors. It is still unclear whether cancer history influences lesion characteristics. The purpose of this study was to investigate cancer-related lesion morphology in patients with CAD. METHODS This study enrolled 400 patients with stable CAD. The patients were classified into a cancer survivor group (n = 69) and a noncancer group (n = 331). We investigated coronary lesion morphology by optical coherence tomography, and we assessed the prognosis in terms of both all-cause mortality and major adverse cardiovascular events (MACE). RESULTS Adenocarcinoma was the most common histopathological diagnosis. Serum C-reactive protein levels were significantly higher in the cancer survivor group than in the noncancer group (cancer survivors 0.12 [0.05-0.42] mg/dL vs. noncancer 0.08 [0.04-0.17] mg/dL, p = 0.019). The cancer survivor group was more likely than the noncancer group to have thrombi (cancer survivors 30.4% vs. noncancer 15.4%, p = 0.004), and layered fibrotic plaques (LFPs; cancer survivors 18.8% vs. noncancer 3.6%, p < 0.0001). Cancer survivors had poorer outcomes than noncancer controls in terms of both all-cause mortality (p = 0.020) and MACE (p = 0.036). CONCLUSIONS Because of underlying inflammation, CAD patients with cancer had more high-risk lesions than those without cancer, which could result in poorer prognosis for the former. This result might inform the management of CAD in cancer patients in terms of secondary prevention.
Collapse
Affiliation(s)
- Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yuki Nakajima
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
| | - Manabu Kashiwagi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akio Kuroi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kunihiro Shimamura
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Kubo
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiromichi Sougawa
- Department of Cardiovascular Medicine, Hashimoto Municipal Hospital, Hashimoto, Japan
| | - Tomizo Masuno
- Department of Cardiovascular Medicine, Hashimoto Municipal Hospital, Hashimoto, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Keisuke Satogami
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Shingo Ota
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Yosuke Katayama
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Yasushi Ino
- Department of Cardiovascular Medicine, Shingu Municipal Medical Center, Shingu, Japan
| | - Hironobu Hoshiya
- Department of Cardiovascular Medicine, Hashimoto Municipal Hospital, Hashimoto, Japan
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| |
Collapse
|
119
|
Coping Strategies and Their Impact on Emotional Distress and Fatigue Among Breast Cancer Survivors: A Cross-sectional Survey. Cancer J 2021; 27:83-89. [PMID: 33750065 DOI: 10.1097/ppo.0000000000000505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study examined the relations between subjective stress and strategies for coping with stress (emotion control strategies and self-compassion), as well as the relations between emotional distress and fatigue. METHODS The study used a cross-sectional survey design. Participants were 170 women aged 24 to 82 years with diagnoses of breast cancer stages I to III who were 1 to 12 months postchemotherapy, with no current evidence of disease and no previous cancer diagnosis. Participants were recruited by consecutive sampling, and the overall response rate was 85%. RESULTS Higher subjective stress was associated with higher emotional control (r = 0.23, P < 0.01), and both were associated with higher emotional distress (r = 0.63, P < 0.001; r = 0.20, P < 0.05). Lower self-compassion was associated with higher emotional distress (r = -0.20, P < 0.05). Fatigue exhibited a high association with emotional distress (r = 0.67, P < 0.001), which increased as subjective stress increased. Older age was associated with emotional control (r = 0.16, P < 0.05), whereas younger age was associated with emotional distress. Time elapsed since chemotherapy was negatively associated with both emotional distress (r = -0.19, P < 0.05) and fatigue (r = -0.18, P < 0.05). A strong positive association emerged between fatigue and emotional distress (r = 0.67, P < 0.001). CONCLUSIONS The results of this study underline the importance of self-compassion as a coping strategy to decrease emotional distress among breast cancer survivors.
Collapse
|
120
|
Vena JA, Copel LC. Cancer survivorship and quality of life outcomes of adolescents and young adults with lymphoma: An integrative review. Eur J Oncol Nurs 2021; 52:101948. [PMID: 33799021 DOI: 10.1016/j.ejon.2021.101948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/21/2021] [Accepted: 03/14/2021] [Indexed: 01/26/2023]
Abstract
PURPOSE Lymphoma is a common hematologic malignancy of adolescents and young adults. Cancer survivorship and quality of life are two outcomes studied to measure the types and scope of problems cancer patients experience leading to diagnosis, treatment, and long-term survivorship. This integrative literature review aims to review published literature in the adolescent and young adult lymphoma population, emphasizing cancer survivorship and quality of life outcomes. METHODS The integrative review framework by Whittemore and Knafl was used as the guideline for this study. A literature search of three relevant health science databases, including PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Ovid Emcare, was completed. RESULTS Twelve publications were included in the review, including ten quantitative and two qualitative studies. The studies consisted of sample populations from the United States, England, Germany, and the Netherlands; one study was an international, Children's Oncology Group study. The included studies detailed the cancer survivorship and quality of life outcomes of young adults with lymphoma by quantitative retrospective and longitudinal analysis; two studies used descriptive qualitative and grounded theory methods. The limited qualitative and longitudinal research in adolescents and young adults with lymphoma demonstrates a gap in the lived experience of this cancer population and the adherence to long-term survivorship recommendations. CONCLUSION Future research in adolescents and young adults with lymphoma should employ longitudinal and qualitative designs to examine the quality of life from diagnosis through extended survivorship, and the experiences at diagnosis, treatment, post-treatment, and long-term follow up.
Collapse
Affiliation(s)
- Joseph A Vena
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, 19085, USA.
| | - Linda C Copel
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, 19085, USA
| |
Collapse
|
121
|
Delrieu L, Bouaoun L, Fatouhi DE, Dumas E, Bouhnik AD, Noelle H, Jacquet E, Hamy AS, Coussy F, Reyal F, Heudel PE, Bendiane MK, Fournier B, Michallet M, Fervers B, Fagherazzi G, Pérol O. Patterns of Sequelae in Women with a History of Localized Breast Cancer: Results from the French VICAN Survey. Cancers (Basel) 2021; 13:1161. [PMID: 33800346 PMCID: PMC7962808 DOI: 10.3390/cancers13051161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022] Open
Abstract
Breast cancer (BC) remains complex for women both physically and psychologically. The objectives of this study were to (1) assess the evolution of the main sequelae and treatment two and five years after diagnosis in women with early-stage breast cancer, (2) explore patterns of sequelae associated with given sociodemographic, clinical, and lifestyle factors. The current analysis was based on 654 localized BC patients enrolled in the French nationwide longitudinal survey "vie après cancer" VICAN (January-June 2010). Information about study participants was collected at enrollment, two and five years after diagnosis. Changes over time of the main sequelae were analyzed and latent class analysis was performed to identify patterns of sequelae related to BC five years after diagnosis. The mean age (±SD) of study participants at inclusion was 49.7 (±10.5) years old. Six main classes of sequelae were identified two years and five years post-diagnosis (functional, pain, esthetic, fatigue, psychological, and gynecological). A significant decrease was observed for fatigue (p = 0.03) and an increase in cognitive sequelae was reported (p = 0.03). Two latent classes were identified-functional and esthetic patterns. Substantial sequelae remain up to five years after BC diagnosis. Changes in patient care pathways are needed to identify BC patients at a high risk.
Collapse
Affiliation(s)
- Lidia Delrieu
- Department Prevention, Cancer, Environment, Léon Bérard Cancer Center, 69008 Lyon, France; (L.D.); (H.N.); (B.F); (B.F.)
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France; (E.D.); (A.-S.H.); (F.C.); (F.R.)
| | - Liacine Bouaoun
- International Agency for Research on Cancer, 69372 Lyon, France;
| | - Douae El Fatouhi
- Center of Research in Epidemiology and Population Health, UMR 1018 Inserm, Institut Gustave Roussy, Paris-Sud Paris-Saclay University, 94807 Villejuif, France; (D.E.F.); (G.F.)
| | - Elise Dumas
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France; (E.D.); (A.-S.H.); (F.C.); (F.R.)
- MINES ParisTech, PSL Research University, CBIO-Centre for Computational Biology, 75006 Paris, France
| | - Anne-Deborah Bouhnik
- INSERM, IRD, SESSTIM, Economics & Social Sciences Applied to Health & Analysis of Medical Information, Aix Marseille University, 13007 Marseille, France; (A.-D.B.); (M.-K.B.)
| | - Hugo Noelle
- Department Prevention, Cancer, Environment, Léon Bérard Cancer Center, 69008 Lyon, France; (L.D.); (H.N.); (B.F); (B.F.)
| | - Emmanuelle Jacquet
- Oncology and Blood Diseases Department, University Hospital Center, Joseph Fourier University, CEDEX 9, 38043 Grenoble, France;
| | - Anne-Sophie Hamy
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France; (E.D.); (A.-S.H.); (F.C.); (F.R.)
- Department of Medical Oncology, Institut Curie, 75005 Paris, France
| | - Florence Coussy
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France; (E.D.); (A.-S.H.); (F.C.); (F.R.)
- Department of Medical Oncology, Institut Curie, 75005 Paris, France
| | - Fabien Reyal
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris University, 75005 Paris, France; (E.D.); (A.-S.H.); (F.C.); (F.R.)
- Department of Surgical Oncology, Institut Curie, University Paris, 75005 Paris, France
| | - Pierre-Etienne Heudel
- Department of Medical Oncology, Léon Bérard Cancer Center, 69008 Lyon, France; (P.-E.H.); (M.M.)
| | - Marc-Karim Bendiane
- INSERM, IRD, SESSTIM, Economics & Social Sciences Applied to Health & Analysis of Medical Information, Aix Marseille University, 13007 Marseille, France; (A.-D.B.); (M.-K.B.)
| | - Baptiste Fournier
- Department Prevention, Cancer, Environment, Léon Bérard Cancer Center, 69008 Lyon, France; (L.D.); (H.N.); (B.F); (B.F.)
| | - Mauricette Michallet
- Department of Medical Oncology, Léon Bérard Cancer Center, 69008 Lyon, France; (P.-E.H.); (M.M.)
| | - Béatrice Fervers
- Department Prevention, Cancer, Environment, Léon Bérard Cancer Center, 69008 Lyon, France; (L.D.); (H.N.); (B.F); (B.F.)
- Cancer Research Center of Lyon, INSERM UA8, Léon Bérard Cancer Center, 69008 Lyon, France
| | - Guy Fagherazzi
- Center of Research in Epidemiology and Population Health, UMR 1018 Inserm, Institut Gustave Roussy, Paris-Sud Paris-Saclay University, 94807 Villejuif, France; (D.E.F.); (G.F.)
- Department of Population Health, Luxembourg Institute of Health (LIH), 1445 Strassen, Luxembourg
| | - Olivia Pérol
- Department Prevention, Cancer, Environment, Léon Bérard Cancer Center, 69008 Lyon, France; (L.D.); (H.N.); (B.F); (B.F.)
- Cancer Research Center of Lyon, INSERM UA8, Léon Bérard Cancer Center, 69008 Lyon, France
| |
Collapse
|
122
|
Halpin SN, Konomos M, Jowers I. Interrupted Identities: Autologous Stem Cell Transplant in Patients With Multiple Myeloma. J Patient Exp 2021; 8:2374373521998864. [PMID: 34179409 PMCID: PMC8205410 DOI: 10.1177/2374373521998864] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In the current study, we sought to examine whether patients incorporate the identity of a patient receiving autologous stem cell transplant (ASCT) for multiple myeloma (MM) into their daily lives. Multiple myeloma patients receive education before initiating the ASCT treatment process. In this ethnographic study using interpretative phenomenological analysis, we observed pretransplant education visits with 30 MM patients, followed by semistructured interviews in their hospital rooms during transplant. The experience of receiving ASCT for MM required effort by patients to not only maintain their past identity but also establish a new patient identity. Reconciling these 2 identities required deliberate and emotionally draining effort from the patient. Results were organized into 2 overarching themes of social relationships and aesthetics with subthemes for each. Understanding methods MM patients who are receiving ASCT use to negotiate normalcy during treatment may be helpful for developing interventions for alleviating distress during this difficult time.
Collapse
Affiliation(s)
- Sean N Halpin
- Department of Education, University of Georgia, Atlanta, GA, the United States
| | - Michael Konomos
- Emory University, School of Medicine, Atlanta, GA, the United States
| | - Ivey Jowers
- Emory University, Winship Cancer Institute, Atlanta, GA, the United States
| |
Collapse
|
123
|
Park JH, Lee JS, Ko YH, Kim YH. Physical activity of Korean cancer survivors is associated with age and sex. Korean J Intern Med 2021; 36:S225-S234. [PMID: 32375206 PMCID: PMC8009165 DOI: 10.3904/kjim.2019.240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 11/04/2019] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND/AIMS This study aimed to assess adherence to physical activity guidelines in cancer survivors and to investigate related factors. METHODS The cross-sectional data of 39,845 community-dwelling participants aged ≥ 20 years (1,254 cancer survivors) in the Korea National Health and Nutrition Examination Survey were analyzed. The age- and sex-stratified prevalence for meeting exercise guidelines was obtained. The correlates of meeting exercise recommendations were evaluated by using complex-sample logistic regression models. RESULTS Overall, 36.2% and 20.5% of cancer survivors met the recommendations for aerobic and resistance exercises, respectively. Cancer survivors and noncancer controls had similar low adherence to exercise recommendations in most age and sex groups, except young female cancer survivors (20 to 49 years old) who showed higher engagement in aerobic exercise than female noncancer controls in the same age group. Old cancer survivors (≥ 65 years) were less likely to engage in recommended levels of aerobic exercise than young cancer survivors (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.24 to 0.79). Female cancer survivors were less likely to meet resistance exercise guidelines than male cancer survivors (OR, 0.32; 95% CI, 0.21 to 0.50). In addition, cancer survivors with current smoking status and cardiovascular disease were less likely to meet aerobic exercise recommendations. CONCLUSION The prevalence of meeting exercise guidelines are low in Korean cancer survivors and varied by age and sex. Old age is associated with an insufficient level of aerobic exercise, and female sex is associated with low participation in resistance exercise.
Collapse
Affiliation(s)
- Jae Hyeon Park
- Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Jung Soo Lee
- Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon Ho Ko
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeo Hyung Kim
- Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Correspondence to Yeo Hyung Kim, M.D. Department of Rehabilitation Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 271 Cheonbo-ro, Uijeongbu 11765, Korea Tel: +82-31-820-3172 Fax: +82-31-847-8077 E-mail:
| |
Collapse
|
124
|
Vena JA, Copel LC. A concept analysis of remission within the domain of cancer survivorship. Nurs Forum 2021; 56:421-428. [PMID: 33634534 DOI: 10.1111/nuf.12558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 01/09/2021] [Accepted: 01/25/2021] [Indexed: 11/30/2022]
Abstract
AIM This concept analysis aims to formulate a unique theoretical definition of the term remission as used in cancer survivorship. BACKGROUND Inadequate communication between healthcare providers and cancer survivors is a shared burden affecting survivor well-being. Healthcare providers regularly use the term remission in cancer prognosis, treatment, and long-term cancer management; yet, how healthcare providers and cancer survivors define and interpret the concept of remission is less understood. DESIGN The Walker and Avant method of concept analysis was applied to define the term remission within the domain of cancer survivorship. DATA SOURCE: Three health sciences databases were chosen for the literature search, including PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Ovid Medline. REVIEW METHODS: Included research articles were evaluated to define the antecedents, attributes, consequences, and empirical referents of the term remission. RESULTS A cancer diagnosis is the most commonly cited antecedent to cancer remission. During remission, most cancer patients are free of measurable or symptomatic disease; however, the remission milestone is complemented by multiple physical and psychological symptoms. More specific cancer remission attributes include anxiety, recurrence fears, self-perseverance, and loss of social support. Both positive and negative outcomes accompany cancer remission, including acceptance of the treatment journey, appreciation for life, hope, persistent anxiety, personal relief, and triggered memories. CONCLUSIONS This concept analysis reviewed numerous publications to understand remission in the context of cancer survivorship. Advanced practice and registered nurses have a continued opportunity to improve the communication methods of patient-centered teaching and care planning for cancer patients in remission.
Collapse
Affiliation(s)
- Joseph A Vena
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
| | - Linda C Copel
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
| |
Collapse
|
125
|
Bilodeau K, Lee V, Pepin J, Pomey MP, Sultan S, Folch N, Charpentier D, Vachon MF, Dumont-Lagacé É, Piché L. Learning through the experience of cancer survivorship: differences across age groups. J Psychosoc Oncol 2021; 39:553-570. [PMID: 33527878 DOI: 10.1080/07347332.2021.1878316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify and describe challenges that contribute to experiential learning among cancer survivors across different age groups. RESEARCH APPROACH Qualitative collaborative study. PARTICIPANTS 27 cancer survivors. METHODOLOGICAL APPROACH Participants were invited to explain the after-cancer challenges they learned from during six focus groups. Five were organized by age-group (15-18, 19-34, 35-44, 45-59, ≥ 60) and a mixed group was held to ensure the co-construction of findings with participants. Inductive content analysis was performed. FINDINGS While learning to live with a chronic disease, participant's experiential learning appeared through four challenges: Searching for one's identity, Autonomy, Disruption of social roles and responsibilities, Reclaiming one's life. Particular aspects of challenges were identified across ages-groups and life courses. INTERPRETATION Results indicate that psychosocial and health professionals should be sensitive to the fact that life courses are now diverse and not always associated with biological age. This has the potential to improve care by informing how these challenges affect the experience of cancer survivorship over time.
Collapse
Affiliation(s)
- Karine Bilodeau
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada.,Research Centre of the Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada
| | - Virginia Lee
- McGill University Health Centre, Montreal, Quebec, Canada
| | - Jacinthe Pepin
- Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada
| | - Marie-Pascale Pomey
- School of Public Health, University of Montreal, Montreal, Quebec, Canada.,Research Center of Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Serge Sultan
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada.,Research Centre of the Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Nathalie Folch
- Centre hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | | | | | - Élise Dumont-Lagacé
- Research Center of Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Lynda Piché
- Centre hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| |
Collapse
|
126
|
Vandendorpe B, Drouet Y, Ramiandrisoa F, Guilbert P, Costa B, Servagi-Vernat S. Psychological and physical impact in women treated for breast cancer: Need for multidisciplinary surveillance and care provision. Cancer Radiother 2021; 25:330-339. [PMID: 33446421 DOI: 10.1016/j.canrad.2020.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 12/02/2020] [Accepted: 12/12/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Cancer survivors often experience adverse physical and psychosocial effects. Fear of recurrence is a difficulty very commonly reported in post-cancer life. The primary objective of this study was to describe post-cancer supportive care needs in patients treated for breast cancer. PATIENTS AND METHODS In this monocentric observational study, cancer survivors aged≥18years, diagnosed with breast cancer and treated in 2017 (cohort A) and in 2015 (cohort B) were administered a post-cancer needs questionnaire, and the Fear of Cancer Recurrence Inventory (severity subscale). RESULTS The study included 139 patients. Pain (51.9%), fatigue (51.9%), weight gain during treatment (35.1%), psychological difficulties (20.5%), and difficulties in marriage and sexual life (13.1%) were the complaints in the post-cancer period. There were no differences between the two cohorts. The severity subscale of the Fear of Cancer Recurrence Inventory showed 35.8% patients with a score>13. The fear of recurrence was a source of social difficulties, psychological disorders, and difficulties in marriage and sexual life. CONCLUSIONS Not only FCR, but also issues such as fatigue, pain, psychological difficulties, and difficulties in marriage and sexual life all call for a psycho-oncological follow-up. Clinical and radio-senological surveillance is essential, but it absolutely must be accompanied by a multidisciplinary follow-up, with central importance to psychological care.
Collapse
Affiliation(s)
- B Vandendorpe
- Department of Radiation Oncology, Oscar-Lambret Centre, 3, rue Frédéric-Combemale, 59000 Lille, France; Department of Radiation Oncology, Jean-Godinot Institute, 1, rue du Général-Koenig, 51100 Reims, France.
| | - Y Drouet
- Public Health Department, Léon-Bérard Centre, Lyon, France; CNRS UMR 5558 LBBE, Lyon university, Villeurbanne, France
| | - F Ramiandrisoa
- Department of Radiation Oncology, Jean-Godinot Institute, 1, rue du Général-Koenig, 51100 Reims, France
| | - P Guilbert
- Department of Radiation Oncology, Jean-Godinot Institute, 1, rue du Général-Koenig, 51100 Reims, France
| | - B Costa
- Support Care Department, Godinot Institute, 1, rue du Général-Koenig, 51100 Reims, France
| | - S Servagi-Vernat
- Department of Radiation Oncology, Jean-Godinot Institute, 1, rue du Général-Koenig, 51100 Reims, France
| |
Collapse
|
127
|
Hutchcraft ML, Teferra AA, Montemorano L, Patterson JG. Differences in Health-Related Quality of Life and Health Behaviors Among Lesbian, Bisexual, and Heterosexual Women Surviving Cancer from the 2013 to 2018 National Health Interview Survey. LGBT Health 2021; 8:68-78. [PMID: 33325783 PMCID: PMC7826421 DOI: 10.1089/lgbt.2020.0185] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose: Health-related quality of life (HRQoL) and health behaviors contribute to cancer morbidity and mortality, which are elevated in lesbian and bisexual women (LBW). The purpose of this study was to assess differences in HRQoL and health behaviors between heterosexual and lesbian women and heterosexual and bisexual women cancer survivors. Methods: We pooled 2013-2018 National Health Interview Survey data. HRQoL comprised physical, mental, financial, and social health domains. Health behaviors included tobacco and alcohol use, physical activity, and preventive health care. Weighted, multivariable logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (CIs). Results: The sample included 10,830 heterosexual, 141 lesbian, and 95 bisexual cancer survivors. Lesbian women reported higher odds of fair/poor self-rated health (OR: 1.68, 95% CI 1.02-2.78), chronic obstructive pulmonary disease (OR: 1.98, 95% CI 1.09-3.56), and heart conditions (OR: 1.90, 95% CI 1.16-3.12) than heterosexual women. Bisexual women reported higher odds of severe psychological distress (OR: 3.03, 95% CI 1.36-6.76), heart conditions (OR: 1.98, 95% CI 1.12-3.53), and food insecurity (OR: 2.89, 95% CI 1.29-6.50) than heterosexual women. For health behaviors, lesbian women reported greater odds of current (OR: 2.34, 95% CI 1.26-4.34) and former tobacco use (OR: 1.89, 95% CI 1.21-2.96), and bisexual women had lower odds of a recent mammogram (OR: 0.42, 95% CI 0.23-0.78) than heterosexual women. Conclusions: LBW cancer survivors reported disparities in HRQoL and health behaviors. In cancer care settings, identification of LBW patients requiring physical and mental health promotion, financial services, and supported tobacco cessation may improve health and survival.
Collapse
Affiliation(s)
- Megan L. Hutchcraft
- Department of Obstetrics and Gynecology, Carle Illinois College of Medicine, Champaign, Illinois, USA
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Markey Cancer Center, Lexington, Kentucky, USA
| | - Andreas A. Teferra
- Department of Public Health, Division of Epidemiology, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Lauren Montemorano
- Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | | |
Collapse
|
128
|
Zhu Z, Zhang D, Wang JHY, Qiao Y, Liu Y, Braithwaite D. Is education or income associated with insufficient fruit and vegetable intake among cancer survivors? A cross-sectional analysis of 2017 BRFSS data. BMJ Open 2020; 10:e041285. [PMID: 33262193 PMCID: PMC7709504 DOI: 10.1136/bmjopen-2020-041285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Previous studies found that low education or income level was associated with insufficient fruit and vegetable consumption (IFVC) among the general population. However, cancer survivors can be heterogeneous from the general population in many aspects. Our objective was to disentangle their association among cancer survivors. DESIGN Nationwide cross-sectional survey in the USA. SETTING 2017 Behaviour Risk Factor Surveillance System. PARTICIPANTS 5409 cancer survivors. EXPOSURE AND OUTCOME Educational level (graduated from college/technical school, attended college/technical school and high school or less) and annual household income (≥US$75 000, US$35 000 to <US$75 000 and <US$35 000) were exposures of interest. IFVC, which was defined as <5 servings/day according to the American Cancer Society recommendation, was treated as the outcome. DATA ANALYSIS Multivariable logistic regression corrected for sampling weight was performed to estimate the association. Subgroup analyses and interaction tests were performed by age, gender, obesity and physical activity. RESULTS Overall, 4750 survivors (weighted percentage: 88.5%) had IFVC. Participants with lower education had a significantly higher rate of IFVC (high school or less vs college graduates: adjusted OR=2.17, 95% CI 1.45 to 3.25, p trend <0.01). The association between income and IFVC was almost null. Associations did not differ in most subgroups; however, the association of lower education appeared to be more substantial among physically inactive survivors (p interaction <0.01). CONCLUSION Low educational background, not low income, was associated with IFVC among cancer survivors. Prospective cohort studies are needed to verify the conclusion.
Collapse
Affiliation(s)
- Zhikai Zhu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Oncology, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Dongyu Zhang
- Department of Oncology, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Judy Huei-Yu Wang
- Department of Oncology, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Youlin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dejana Braithwaite
- University of Florida Health Cancer Center, Gainesville, Florida, USA
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
129
|
Factors Influencing Supportive Care Needs of Colorectal Cancer Survivors. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 15:60-66. [PMID: 33249141 DOI: 10.1016/j.anr.2020.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 01/04/2023] Open
Abstract
PURPOSE There is an increasing number of colorectal cancer survivors in South Korea. However, no research has identified supportive care needs of survivors of colorectal cancer in South Korea. Thus, the purpose of this study was to determine the level of supportive care needs and effects of emotional state and quality of life (QoL) on supportive care needs of colorectal cancer survivors. METHODS This cross-sectional study was conducted among 115 survivors of colorectal cancer in South Korean who had primary treatment of surgery for colorectal cancer. Data were collected from April to September 2016. Participants responded to self-reported questionnaires assessing supportive care needs, emotional state (Hospital Anxiety and Depression Scale), and QoL (Functional Assessment of Cancer Therapy-Colorectal scale). RESULTS The overall score of supportive care needs for colorectal cancer survivors was 1.22 ± 0.61 (full score: 3 points), with health care staff and social support needs garnering highest scores. Approximately, 20.0% and 21.7% of patients had anxiety and depression, respectively. The mean QoL score was 2.90 ± 0.53, with social and family status having the lowest QoL score. Multiple regression analysis showed that both the period after treatment and anxiety significantly influenced supportive care needs. CONCLUSION Appropriate interventions should be used immediately after completion of treatment to help reduce anxiety and meet supportive care needs of colorectal cancer survivors.
Collapse
|
130
|
Herrmann A, Mansfield E, Tzelepis F, Lynagh M, Hall A. Use of the supportive care framework to explore haematological cancer survivors' unmet needs: a qualitative study. BMC Health Serv Res 2020; 20:1062. [PMID: 33228652 PMCID: PMC7686725 DOI: 10.1186/s12913-020-05927-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/15/2020] [Indexed: 12/30/2022] Open
Abstract
Background Some sub-types of haematological cancers are acute and require intensive treatment soon after diagnosis. Other sub-types are chronic, relapse over many years and require life-long cycles of monitoring interspersed with bouts of treatment. This often results in significant uncertainty about the future, high levels of depression and anxiety, and reduced quality of life. Little is known about how to improve care for haematological cancer survivors. This study explored qualitatively, in a sample of haematological cancer survivors, (i) their unmet needs experienced as a result of their disease and treatment; and (ii) strategies that may help address these needs. Methods Semi-structured interviews were conducted with 17 adult haematological cancer survivors. Data was analysed using qualitative content analysis. The Supportive Care Framework guided data collection and analysis. Results Participants had a mean age of 57 years (SD 13). Most were male (n = 10, 59%). Five themes emerged from the data: (i) changes in unmet needs across the care trajectory (with greatest unmet needs experienced soon after diagnosis, at discharge from hospital and with cancer recurrence); (ii) informational unmet needs requiring improved patient-centred communication; (iii) uncertainty about treatment and the future; (iv) coordinated, tailored and documented post-treatment care planning as a strategy for optimal care delivery; and (v) ongoing support services to meet psychosocial and practical unmet needs by involving peer support, less bureaucratic transport services and flexible work arrangements. Conclusions To our knowledge, this is the first qualitative investigation using the Supportive Care Framework to explore unmet needs of haematological cancer survivors. Our findings offer fresh insights into this important area of study. Written, take-home care plans which provide simple but tailored guidance on where to seek additional support may help decrease uncertainty and feelings of vulnerability post-treatment for adult haematological cancer survivors. Future research should further develop and test strategies aimed at addressing unmet needs of haematological cancer survivors identified in this study. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-020-05927-7.
Collapse
Affiliation(s)
- Anne Herrmann
- Department for Epidemiology and Preventive Medicine, Professorship for Medical Sociology, University of Regensburg, Regensburg, Germany. .,Department of Haematology and Internal Oncology, University Hospital Regensburg, Regensburg, Germany. .,School of Medicine and Public Health, University of Newcastle, Newcastle, Australia. .,Hunter Medical Research Institute, Newcastle, Australia.
| | - Elise Mansfield
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Flora Tzelepis
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Marita Lynagh
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Alix Hall
- Hunter Medical Research Institute, Newcastle, Australia.,Clinical Research, Design and Statistics, Hunter Medical Research Institute, Newcastle, Australia
| |
Collapse
|
131
|
Cancer survivorship training in family medicine residency programs. J Cancer Surviv 2020; 15:748-754. [PMID: 33175993 DOI: 10.1007/s11764-020-00966-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 11/01/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE The objective of the study was to examine current family medicine residency education in cancer survivorship and barriers to cancer survivorship education in the residency curriculum. METHODS Family medicine residency program directors (n = 628) were surveyed electronically between September 2019 and November 2019 through the Council of Academic Family Medicine Educational Research Alliance (CERA) annual program directory survey. Respondents (n = 250) answered questions regarding eventual cancer survivorship curriculum in their residency program, including interest and barriers to implementation. Program characteristics were assessed using univariate and multivariate analyses. RESULTS Only 9.2% of family medicine residency program directors reported having a cancer survivorship curriculum. Sixty-nine percent of program directors reported they would implement a cancer survivorship curriculum if one was available. The most significant barrier to implementation of a cancer survivorship curriculum was insufficient time (39.6%) followed by lack of faculty expertise (26.9%). Respondents that reported lack of faculty expertise as a barrier to implementation of cancer survivorship training were more likely be report that they would be willing to implement a cancer survivorship curriculum (p < 0.01). CONCLUSIONS Despite the majority of primary care physicians providing care to cancer survivors, few family medicine residency programs have formal training in cancer survivorship care. There is interest in expanding family medicine residency training in cancer survivorship care among program directors. IMPLICATIONS FOR CANCER SURVIVORS Gaining insight into the current educational curriculum and barriers to cancer survivorship training will lead to opportunities to improve residency training, and ultimately provide better care to cancer survivors in primary care settings.
Collapse
|
132
|
Cardiovascular Screening and Lipid Management in Breast Cancer Survivors. J Am Board Fam Med 2020; 33:894-902. [PMID: 33219068 PMCID: PMC8637931 DOI: 10.3122/jabfm.2020.06.190459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death among breast cancer (BC) survivors. BC survivors are at increased risk of CVD due to a higher prevalence of risk factors. Current data are limited on the cardiovascular screening practices and lipid management in this population in primary care settings. METHODS A retrospective case control study was performed with 105 BC survivors and 210 matched controls (based on age and medical comorbidities of diabetes, hypertension, and hyperlipidemia). BC survivors were established with primary care practices within a large academic institution and had completed primary cancer treatment. Data on screening for CVD and lipid management were collected via a retrospective chart review. RESULTS The average BC survivor was 63 years old, with 9 years since diagnosis. Compared with matched controls, BC survivors had more cholesterol screening (88% vs 70%, P < .001) and active statin prescriptions (63% vs 40%, P < .05) if indicated by the Atherosclerotic Cardiovascular Disease Calculator. There were no differences in CVD screening in White and African American BC survivors. However, African American BC survivors were more likely to have hypertension (P < .01) and have a body mass index in the overweight and obese category (P < .001) than White BC survivors. Older BC survivors were more likely to receive cholesterol screening. DISCUSSION This study demonstrates that BC survivors who have an established primary care provider have improved cholesterol screening and statin therapy based on their risk of developing chronic diseases.
Collapse
|
133
|
Muhsen IN, Bar M, Savani BN, Estey EH, Hashmi SK. Follow-up issues in survivors of hematologic malignancies – Current stance and future perspectives. Blood Rev 2020; 44:100674. [DOI: 10.1016/j.blre.2020.100674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 01/12/2020] [Accepted: 02/24/2020] [Indexed: 12/28/2022]
|
134
|
dos Santos ATC, da Silva RP, de Almeida LM, Bosi MLM, de Menezes MDFB, Skaba MMVF, Nigenda G, Arruda CAM, Pinheiro CPO, González-Robledo MC, Knaul FM. Cancer survivorship needs in Brazil: Patient and family perspective. PLoS One 2020; 15:e0239811. [PMID: 33031426 PMCID: PMC7544129 DOI: 10.1371/journal.pone.0239811] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/14/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction Cancer Survivorship is a growing public health challenge. Effective responses from health care and social services depend on appropriate identification of survivors and their families´ specific needs. There are few studies on survivorship in low and middle-income countries, therefore, more evidence-based studies are necessary to develop a comprehensive approach to cancer survivorship. Objectives Identify the needs of cancer survivors and their relatives, specifically those of individuals with breast, cervical or prostate cancer, and with acute lymphocytic leukemia (ALL). Methods A qualitative, exploratory study conducted in two referral institutions in Brazil, located in Rio de Janeiro (Southeast region) and Fortaleza (Northeast region). The study included 47 patients of public and private health services and 12 family members. We used script-based semi-structured interviews. The discursive material obtained was categorized and analyzed using the Thematic Analysis approach. Results The analysis identified three central themes: 1) consequences of cancer treatment; 2) Changes in daily life associated with cancer survivorship; and 3) Unmet structural needs in cancer survivorship. Conclusion Social and cancer control policies in Brazil should provide resources, specific care standards and clinical, psychological and social support. Cancer survivors should also receive rehabilitation and work reintegration guidelines. This matter requires broader access to qualified cancer information, development of an integrated patient-centered care and care model, and more research resources for the country's post-treatment cancer period.
Collapse
Affiliation(s)
- Antonio Tadeu Cheriff dos Santos
- Population Research Division, Nucleus of Research and Qualitative Studies, National Cancer Institute, Rio de Janeiro, Brazil
- * E-mail:
| | - Rildo Pereira da Silva
- Population Research Division, Nucleus of Research and Qualitative Studies, National Cancer Institute, Rio de Janeiro, Brazil
| | - Liz Maria de Almeida
- Division of Population Research, National Cancer Institute, Rio de Janeiro, Brazil
| | - Maria Lúcia Magalhães Bosi
- Laboratory of Qualitative Research and Evaluation in Health, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | | | | | - Gustavo Nigenda
- National School of Nursing and Obstetrics, National Autonomous University of México, México City, México
| | - Carlos André Moura Arruda
- Laboratory of Qualitative Research and Evaluation in Health, Federal University of Ceara, Fortaleza, Ceará, Brazil
| | | | | | - Felícia Marie Knaul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Coral Gables, Florida, United States of America
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, United States of America
- Programa Universalidad y Competitividad en Salud, Fundación Mexicana para la Salud, Mexico City, Mexico
- Tómatelo a Pecho, Mexico City, Mexico
| |
Collapse
|
135
|
Yoon J, Park B. Factors Associated with Health Behaviors in Thyroid Cancer Survivors. J Cancer Prev 2020; 25:173-180. [PMID: 33033711 PMCID: PMC7523035 DOI: 10.15430/jcp.2020.25.3.173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 12/24/2022] Open
Abstract
In this study, we compared health behaviors, including current smoking, drinking, and physical inactivity, in thyroid cancer survivors and non-cancer controls and investigated the factors associated with unhealthy behaviors among survivors. Baseline data from the Health Examinees study, collected from 2004 to 2013, were used. Thyroid cancer survivors (n = 942), defined as those who had received a clinical diagnosis of thyroid cancer, and 9,420 matched non-cancer controls without past history of any cancer were included in the analysis. The prevalence of smoking, alcohol consumption, and physical inactivity in thyroid cancer survivors were 2.3%, 26.6%, and 52.0%, respectively, with adjusted OR (aOR) and 95% CI between survivors and non-cancer controls of 0.35 (95% CI = 0.08-1.56), 0.46 (95% CI = 0.29-0.74), and 0.65 (95% CI = 0.44-0.96). The prevalence of unhealthy behaviors was higher among male thyroid cancer survivors than female thyroid cancer survivors. In thyroid cancer survivors, those who smoked were more likely to drink (aOR = 4.55 [95% CI = 1.61-12.85]) and those who were physically inactive were less likely to drink (aOR = 0.58 [95% CI = 0.42-0.82]). Current drinking and physical inactivity contributed to a higher likelihood of smoking (aOR = 4.31 [95% CI = 1.35-13.73] and 6.34 [95% CI = 1.65-24.34]). Thyroid cancer survivors had better health behaviors than the non-cancer controls. However, some survivors still had unhealthy lifestyles, especially displaying a clustering of unhealthy behaviors. Thus, health behavior promotion through medical intervention is important for thyroid cancer survivors.
Collapse
Affiliation(s)
- Junghyun Yoon
- Departments of Health Sciences, Hanyang University, Seoul, Korea
| | - Boyoung Park
- Departments of Medicine, College of Medicine, Hanyang University, Seoul, Korea
| |
Collapse
|
136
|
Neris RR, Nascimento LC, Leite ACAB, de Andrade Alvarenga W, Polita NB, Zago MMF. The experience of health-related quality of life in extended and permanent cancer survivors: A qualitative systematic review. Psychooncology 2020; 29:1474-1485. [PMID: 32658362 DOI: 10.1002/pon.5472] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/31/2020] [Accepted: 06/30/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE This qualitative systematic review aims to synthesize qualitative evidence from primary studies on experiencing health-related quality of life (HRQoL) in extended and permanent cancer survivors. METHODS A systematic literature search was performed in PubMed, CINAHL, LILACS, PsycINFO, Scopus, and Web of Science. It followed guidelines from the statement in the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). A quality appraisal of each study was undertaken using the Critical Appraisal Skills Programme. Data synthesis was conducted according to the thematic synthesis approach. Confidence in each review finding was assessed using the Confidence in the Evidence from Reviews of Qualitative research (Grade-CERQual). RESULTS Twenty-four studies from nine countries were selected for the final sample. Analysis of the studies' results allowed for the construction of nine descriptive themes that were interpreted into three analytical themes: "The body as a representation of HRQoL," "Living through and beyond cancer: the re-signification of HRQoL," and "Employing resources to improve HRQoL." According to the CERQual approach, moderate confidence estimations were achieved for the results. CONCLUSIONS The themes reflect that the HRQoL experience is re-signified by survivors from the privilege of being alive. This process happens with the support of social resources, family, hope, and spirituality. Based on the findings, it is suggested that health staff should be able to recognize the impact that cancer survival has on HRQoL and develop a care plan that addresses needs to sustain health in these survivors.
Collapse
Affiliation(s)
- Rhyquelle Rhibna Neris
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | | | - Willyane de Andrade Alvarenga
- Centro Universitário Santo Agostinho, Teresina, Piauí, Brazil.,Faculdade de Educação São Francisco, Pedreiras, Maranhã, Brazil
| | - Naiara Barros Polita
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.,Universidade Estadual do Norte do Paraná, Bandeirantes, Paraná, Brazil
| | - Márcia Maria Fontão Zago
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
137
|
Li J, Xu Q, Wu M, Huang T, Wang Y. Pan-Cancer Classification Based on Self-Normalizing Neural Networks and Feature Selection. Front Bioeng Biotechnol 2020; 8:766. [PMID: 32850695 PMCID: PMC7417299 DOI: 10.3389/fbioe.2020.00766] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/17/2020] [Indexed: 11/13/2022] Open
Abstract
Cancer is a one of the severest diseases and cancer classification plays an important role in cancer diagnosis and treatment. Some different cancers even have similar molecular features such as DNA copy number variant. Pan-cancer classification is still non-trivial at molecular level. Herein, we propose a computational method to classify cancer types by using the self-normalizing neural network (SNN) for analyzing pan-cancer copy number variation data. Since the dimension of the copy number variation features is high, the Monte Carlo feature selection method was used to rank these features. Then a classifier was built by SNN and feature selection method to select features. Three thousand six hundred ninety-four features were chosen for the prediction model, which yields the accuracy value is 0.798 and macro F1 is 0.789. We compared our model to random forest method. Results show the accuracy and macro F1 obtained by our classifier are higher than those obtained by random forest classifier, indicating the good predictive power of our method in distinguishing four different cancer types. This method is also extendable to pan-cancer classification for other molecular features.
Collapse
Affiliation(s)
- Junyi Li
- Department of Computer Science and Technology, Harbin Institute of Technology, Shenzhen, China
| | - Qingzhe Xu
- Department of Computer Science and Technology, Harbin Institute of Technology, Shenzhen, China
| | - Mingxiao Wu
- Department of Computer Science and Technology, Harbin Institute of Technology, Shenzhen, China
| | - Tao Huang
- Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Yadong Wang
- Department of Computer Science and Technology, Harbin Institute of Technology, Shenzhen, China
| |
Collapse
|
138
|
Ang WHD, Lau Y, Ngo LPE, Siew AL, Ang NKE, Lopez V. Path analysis of survivorship care needs, symptom experience, and quality of life among multiethnic cancer survivors. Support Care Cancer 2020; 29:1433-1441. [PMID: 32676855 DOI: 10.1007/s00520-020-05631-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 07/13/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE Cancer survivors continue to experience issues that persist across the survivorship trajectory. This study aims to explore the relationship among survivorship care need, symptom experience, and quality of life (QoL) of multiethnic cancer survivors by using path analytic methods. METHODS Participants were recruited from an academic medical center in Singapore that provides inpatient and outpatient oncology and hematology service. The Cancer Survivor Unmet Needs measure, physical effects subscale of the Cancer Survivors' Survey of Needs tool, and a Global QoL 10-point Likert scale were used to identify survivorship care needs, symptom experience, and QoL. Descriptive statistics were used to compute sociodemographic information, total survivorship needs, symptom experienced, and quality of life scores. The symptom experience model was used as the hypothetical model. The Analysis of Moment Structure was used to conduct the path analysis to evaluate the relationship between survivorship care needs, symptom experience, and quality of life. RESULTS Older cancer survivors were more likely to have spent a longer duration having cancer. Males were unlikely to suffer from solid tumor malignancies. Survivors with solid tumor malignancies were less likely to require supportive care. Survivors who require more supportive care were more likely to have a greater symptom burden. Cancer survivors with more symptoms have poorer QoL. The findings from this study partially supported the symptom experience model. CONCLUSIONS Our findings reveal that cancer survivors continue to experience symptoms across the survivorship trajectory. The results provide information for nurses during the planning and execution of survivorship care.
Collapse
Affiliation(s)
- Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | - Lay Poh Ednajoy Ngo
- Division of Oncology Nursing, National University Cancer Institute, Singapore, Singapore
| | - An Ling Siew
- Department of Nursing, Tan Tock Seng Hospital, Singapore, Singapore
| | - Neo Kim Emily Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Nursing, National University Health System, Singapore, Singapore
| | - Violeta Lopez
- School of Nursing, Hubei University of Medicine, Shiyan, Hubei Province, People's Republic of China
| |
Collapse
|
139
|
Mead KH, Raskin S, Willis A, Arem H, Murtaza S, Charney L, Pratt-Chapman M. Identifying patients' priorities for quality survivorship: conceptualizing a patient-centered approach to survivorship care. J Cancer Surviv 2020; 14:939-958. [PMID: 32607715 DOI: 10.1007/s11764-020-00905-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 06/14/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE This study explored cancer survivors' experiences with and priorities for cancer survivorship care to describe a patient-centered approach to quality survivorship care. METHODS We conducted 22 focus groups with 170 adult survivors of breast, prostate, and colorectal cancer from six cities across the country and online. We used thematic analysis to identify participants' principles and priorities for quality survivorship care. RESULTS Based on our analysis of a limited group of cancer survivors, we identified two core principles that underlie participants' expectations for survivorship care and 11 practice priorities that reflect opportunities to improve patient-centeredness at the individual, interpersonal, and organizational levels. The principles reflect participants' desire to be better prepared for and equipped to accept and manage their chronic care needs post-cancer treatment. The priorities reflect practices that patients, providers, and cancer centers can engage in to ensure survivors' goals for post-treatment care are met. CONCLUSIONS Results from the study suggest the need to expand conceptualization of high-quality survivorship care. The survivor principles and practice priorities identified in this study challenge the field to organize a more patient-centered survivorship care system that empowers and respects patients and provides a holistic approach to survivors' chronic and long-term needs. IMPLICATIONS FOR CANCER SURVIVORS Quality cancer survivorship care must reflect patients' priorities. The findings from this study can be used to develop a patient-centered framework for survivorship care that can be used in conjunction with quality guidelines to ensure survivorship care is organized to achieve both clinical and patient-centered outcomes.
Collapse
Affiliation(s)
- K Holly Mead
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave., Washington, DC, 20052, USA.
| | - Sarah Raskin
- L. Douglas Wilder School of Government and Public Affairs, Virginia Commonwealth University, 1001 W. Franklin St., Richmond, VA, 23284, USA
| | - Anne Willis
- Cystic Fibrosis Foundation, 4550 Montgomery Ave., Bethesda, MD, 20814, USA
| | - Hannah Arem
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave., Washington, DC, 20052, USA
| | - Sarah Murtaza
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave., Washington, DC, 20052, USA
| | - Laura Charney
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave., Washington, DC, 20052, USA
| | - Mandi Pratt-Chapman
- George Washington University Cancer Center, George Washington University, 2600 Virginia Ave., NW, #300, Washington, DC, 20037, USA
| |
Collapse
|
140
|
Liska TM, Kolen AM. The role of physical activity in cancer survivors' quality of life. Health Qual Life Outcomes 2020; 18:197. [PMID: 32571351 PMCID: PMC7310034 DOI: 10.1186/s12955-020-01448-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 06/11/2020] [Indexed: 12/15/2022] Open
Abstract
PURPOSE As a result of a cancer diagnosis and treatment, many cancer survivors experience persistent physical, mental, and emotional symptoms that affect their quality of life. Physical activity has been identified as an intervention that may help to manage the side effects of a cancer diagnosis and its treatment. The purpose of this study was to investigate the role of physical activity on overall quality of life in adult cancer survivors. METHODS One-on-one semi-structured interviews were conducted in person or via telephone with 13 adult (≥18 yrs) cancer survivors who had completed cancer treatment. RESULTS These cancer survivors described their physical activity as improving their physical functioning and mental health, as a means of positive social engagement, and adding positivity to their daily life. CONCLUSION Even though the cancer survivors in this study experienced diverse types of cancer and for different lengths of time as well as varying methods of treatment(s), these results support the role of physical activity in enhancing cancer survivors' quality of life. Further research is warranted to (a) expand this research with a larger sample and quantitative methods, (b) examine healthcare providers' knowledge and application of exercise guidelines to cancer survivors in cancer care, and (c) explore implementation strategies for greater advocacy for healthcare providers to share the exercise recommendations with cancer survivors.
Collapse
Affiliation(s)
- Tayah M Liska
- Department of Human Kinetics, St. Francis Xavier University, 1140 Convocation Blvd, Antigonish, NS B2G 2W5, Canada
- Present Address: Department of Kinesiology and Physical Education, McGill University, Montreal, Québec, Canada
| | - Angela M Kolen
- Department of Human Kinetics, St. Francis Xavier University, 1140 Convocation Blvd, Antigonish, NS B2G 2W5, Canada.
| |
Collapse
|
141
|
Cortés-Ibáñez FO, Jaramillo-Calle DA, Vinke PC, Byambasukh O, Corpeleijn E, Sijtsma A, Eulenburg C, Vonk JM, de Bock GH. Comparison of health behaviours between cancer survivors and the general population: a cross-sectional analysis of the Lifelines cohort. J Cancer Surviv 2020; 14:377-385. [PMID: 31933151 PMCID: PMC7256022 DOI: 10.1007/s11764-020-00854-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 01/03/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE To compare the differences in lifestyle behaviours between cancer survivors (CSs) and cancer-free participants in a large and representative population-based cohort. METHODS We included 115,257 adults from the Lifelines cohort. Cancer status was self-reported, and health behaviours were measured (e.g. body mass index [BMI]) or assessed by questionnaire (e.g. physical activity, smoking, alcohol consumption, sedentary behaviour and diet). The data were then categorised for logistic regression analysis, stratified and adjusted by sex and age (< 55 vs ≥ 55 years). RESULTS CSs (5473; 4.7%) were diagnosed 9 ± 8.5 years before data collection, were older (mean age 55.4 vs 44.4 years) and more often female (66.6% vs 33.4%) than the cancer-free participants. They were also more likely to be physically active and to have a better diet, and also less likely to be alcohol drinkers; but, were more likely to have a higher BMI, be former smokers and to be sedentary. After adjustment for sex and age, however, BMI was more likely to be normal, physical activity was more likely to be higher and smoking to be prevalent in CSs. Current smoking was also significantly higher among females and those aged < 55 years who were CSs than for those with no history of cancer. CONCLUSIONS In this population-based cohort, CSs have health behaviour comparable to those without a cancer diagnosis. IMPLICATIONS FOR CANCER SURVIVORS Smoking cessation strategies should target all CSs, but efforts could yield greatest benefit if they target females and those younger than 55 years.
Collapse
Affiliation(s)
- Francisco O Cortés-Ibáñez
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands.
- National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
| | - Daniel A Jaramillo-Calle
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
- IPS Universitaria, University of Antioquia, Medellin, Colombia
| | - Petra C Vinke
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
| | - Oyuntugs Byambasukh
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
| | - Anna Sijtsma
- The Lifelines Cohort, University Medical Center in Groningen, Groningen, The Netherlands
| | - Christine Eulenburg
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
| | - Judith M Vonk
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1 (9713 GZ), Groningen, The Netherlands
| |
Collapse
|
142
|
|
143
|
Sase K. [Clinical pharmacology of cardio-oncology: a novel interdisciplinary platform for basic and translational research]. Nihon Yakurigaku Zasshi 2020; 155:179-184. [PMID: 32378640 DOI: 10.1254/fpj.19137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Advances in cancer treatment have led to dramatic increase in cancer survivors. In addition to cardiotoxicity resulting from anthracyclines and radiation therapy, the emergence of novel cancer treatment-related cardiovascular disease (CTRCD) with molecularly targeted therapies and immune checkpoint inhibitors has been recognized as an unmet medical need. Cardio-oncology is a new interdisciplinary research opportunity at the intersection of cardiovascular disease and cancer. Research priorities need to be identified for diagnosis, treatment, and prevention of previously unknown CTRCD(s), including (a) cardiac dysfunction and heart failure, (b) coronary artery disease, (c) valvular disease, (d) arrhythmias and QT-prolongation, (e) arterial hypertension, (f) thromboembolic disease, and (g) other cardiovascular disorders. In particular, understanding the fundamental mechanisms underlying CTRCD is essential for developing new methods. Applying more appropriate disease models and more effective methods for toxicity screening will help to better understand CTRCD. Although animal models have been used to predict potential problems, more advanced predictive models are also needed. Biobanks and other specimens with patient registries are expected to facilitate the validation of new biomarkers, genomic analysis, and imaging methods.
Collapse
Affiliation(s)
- Kazuhiro Sase
- Clinical Pharmacology and Regulatory Science, Graduate School of Medicine, Juntendo University
| |
Collapse
|
144
|
Venous Thromboembolism in Cancer Patients on Simultaneous and Palliative Care. Cancers (Basel) 2020; 12:cancers12051167. [PMID: 32384641 PMCID: PMC7281278 DOI: 10.3390/cancers12051167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/29/2020] [Accepted: 05/02/2020] [Indexed: 12/25/2022] Open
Abstract
Simultaneous care represents the ideal integration between early supportive and palliative care in cancer patients under active antineoplastic treatment. Cancer patients require a composite clinical, social and psychological management that can be effective only if care continuity from hospital to home is guaranteed and if such a care takes place early in the course of the disease, combining standard oncology care and palliative care. In these settings, venous thromboembolism (VTE) represents a difficult medical challenge, for the requirement of acute treatments and for the strong impact on anticancer therapies that might be delayed or, even, totally discontinued. Moreover, cancer patients not only display high rates of VTE occurrence/recurrence but are also more prone to bleeding and this forces clinicians to optimize treatment strategies, balancing between hemorrhages and thrombus formation. VTE prevention is, therefore, regarded as a double-edged sword. Indeed, while on one hand the appropriate use of antithrombotic agents can reduce VTE occurrence, on the other it significantly increases the bleeding risk, especially in the frail patients who present with multiple co-morbidities and poly-therapy that can interact with anticoagulant drugs. For these reasons, thromboprophylaxis should start while active cancer treatment is ongoing, according to a simultaneous care model in a patient-centered perspective.
Collapse
|
145
|
Crabtree BF, Miller WL, Howard J, Rubinstein EB, Tsui J, Hudson SV, O'Malley D, Ferrante JM, Stange KC. Cancer Survivorship Care Roles for Primary Care Physicians. Ann Fam Med 2020; 18:202-209. [PMID: 32393555 PMCID: PMC7213992 DOI: 10.1370/afm.2498] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/27/2019] [Accepted: 08/13/2019] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Despite a burgeoning population of cancer survivors and pending shortages of oncology services, clear definitions and systematic approaches for engaging primary care in cancer survivorship are lacking. We sought to understand how primary care clinicians perceive their role in delivering care to cancer survivors. METHODS We conducted digitally recorded interviews with 38 clinicians in 14 primary care practices that had national reputations as workforce innovators. Interviews took place during intense case study data collection and explored clinicians' perspectives regarding their role in cancer survivorship care. We analyzed verbatim transcripts using an inductive and iterative immersion-crystallization process. RESULTS Divergent views exist regarding primary care's role in cancer survivor care with a lack of coherence about the concept of survivorship. A few clinicians believed any follow-up care after acute cancer treatment was oncology's responsibility; however, most felt cancer survivor care was within their purview. Some primary care clinicians considered cancer survivors as a distinct population; others felt cancer survivors were like any other patient with a chronic disease. In further interpretative analysis, we discovered a deeply ingrained philosophy of whole-person care that creates a professional identity dilemma for primary care clinicians when faced with rapidly changing specialized knowledge. CONCLUSIONS This study exposes an emerging identity crisis for primary care that goes beyond cancer survivorship care. Facilitated national conversations might help specialists and primary care develop knowledge translation platforms to support the prioritizing, integrating, and personalizing functions of primary care for patients with highly complicated issues requiring specialized knowledge.
Collapse
Affiliation(s)
- Benjamin F Crabtree
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey .,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | | | - Jenna Howard
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | | | - Jennifer Tsui
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Shawna V Hudson
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Denalee O'Malley
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Jeanne M Ferrante
- Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | | |
Collapse
|
146
|
Haase KR, Puts M, Sattar S, Gray M, Kenis C, Donison V, Hall S, McLean B, Wills A, Howell D. Protocol for a systematic review of self-management interventions for older adults living with cancer. Syst Rev 2020; 9:80. [PMID: 32303263 PMCID: PMC7164137 DOI: 10.1186/s13643-020-01346-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 04/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer predominates in adults over age 65. Cancer treatments are known to create physical and psychosocial challenges, which may be amplified for older adults with cancer. Learning and applying self-management behaviours and skills during treatment with cancer can help to manage/recover health and improve quality of life. In many other chronic illnesses, self-management interventions are known to improve health outcomes and lower healthcare costs. The purpose of this systematic review is to determine the effectiveness of self-management interventions for older adults with cancer on physical, psychosocial, and health system-related outcomes. METHODS We are conducting a systematic review of self-management interventions for older adults (65+) diagnosed with cancer (solid tumour or haematological) in the active treatment phase of cancer. This systematic review is guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Studies are limited to experimental or quasi-experimental methods published in English, French, German, or Dutch. A search strategy was designed with a Health Sciences librarian and performed using the following electronic databases: Ageline, AMED, ASSIA, Cinahl, Cochrane, Embase, Medline, PsychINFO, and Sociological Abstracts. Approximately 14,000 titles and abstracts are being electronically screened by a minimum of 2 reviewers, with relevant studies to be screened for full text. The final sample of included studies will be assessed for quality using the Cochrane Risk of Bias tool and Down and Black for quasi-experimental studies, with data synthesized in a narrative and tabular format. DISCUSSION This systematic review will expand the knowledge base of interventions supporting self-management for older adults with cancer. This study will inform future intervention development by identifying gaps and strengths in effective self-management interventions targeting the needs of older adults receiving active treatment for cancer. SYSTEMATIC REVIEW REGISTRATION PROPERO registry ID# CRD42019134113.
Collapse
Affiliation(s)
- Kristen R. Haase
- College of Nursing, University of Saskatchewan, 4th Floor, Health Sciences E-Wing, 104 Clinic Place, Saskatoon, Saskatchewan S7N 2Z4 Canada
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON Canada
| | - Schroder Sattar
- College of Nursing, University of Saskatchewan, Regina, Canada
| | - Mikaela Gray
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
| | - Cindy Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Valentina Donison
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON Canada
| | - Steven Hall
- College of Nursing, University of Saskatchewan, 4th Floor, Health Sciences E-Wing, 104 Clinic Place, Saskatoon, Saskatchewan S7N 2Z4 Canada
| | - Bianca McLean
- De Groote School of Medicine, McMaster University, Hamilton, ON Canada
| | - Aria Wills
- De Groote School of Medicine, McMaster University, Hamilton, ON Canada
| | - Doris Howell
- Princess Margaret Hospital, University of Toronto, Toronto, ON Canada
| |
Collapse
|
147
|
Shakeel S, Tung J, Rahal R, Finley C. Evaluation of Factors Associated With Unmet Needs in Adult Cancer Survivors in Canada. JAMA Netw Open 2020; 3:e200506. [PMID: 32142127 PMCID: PMC7060489 DOI: 10.1001/jamanetworkopen.2020.0506] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
IMPORTANCE Understanding the challenges faced by an increasing number of cancer survivors can guide the development and implementation of effective survivorship care models. OBJECTIVE To identify the physical, emotional, and practical concerns and associated unmet needs reported by cancer survivors. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional survey study obtained data from the Experiences of Cancer Patients in Transitions Study of the Canadian Partnership Against Cancer, in collaboration with cancer agencies in the 10 Canadian provinces, that was disseminated in 2016. This analysis included only adult survivors aged 30 years or older who underwent chemotherapy, radiation therapy, surgical treatment, or a combination of these therapies for breast, prostate, colorectal, melanoma, or hematological cancer within the past 1 to 3 years. Data synthesis and quality assessment were conducted in 2017. Data analysis was completed in July 2019. MAIN OUTCOMES AND MEASURES The outcomes were the (1) quantification of the magnitude and multiplicity of the physical, emotional, and practical concerns of adult survivors of breast, colorectal, prostate, melanoma, or hematological cancer; (2) exploration of the magnitude of associated unmet needs; and (3) identification of patient-, treatment-, and cancer-specific factors associated with the reporting of unmet needs. RESULTS Overall, 10 717 adult respondents were included (5660 [53%] female and 6367 [60%] aged ≥65 years). The median number of concerns per respondent was 6 (interquartile range [IQR], 3-10). Among respondents with concerns, help was sought for a median of 2 (IQR, 0-4) concerns. Unmet needs were reported for a median of 4 (IQR, 2-7) concerns. Emotional concerns were reported by 8330 respondents (78%), physical concerns by 9236 respondents (86%), and practical concerns by 4668 respondents (44%). At least 1 unmet need was reported by 7033 survivors (84%) with emotional concerns, 7475 (81%) with physical concerns, and 3459 (74%) with practical concerns. Age, sex, annual income, marital status, geographic location, language, and treatment type were significant factors associated with unmet needs. Survivors of melanoma cancer had a significantly higher likelihood of reporting unmet emotional needs (odds ratio [OR], 1.75; 95% CI, 1.17-2.61; P = .01), whereas survivors of prostate (OR, 0.60; 95% CI, 0.43-0.84; P < .001) and hematological (OR, 0.70; 95% CI, 0.50-0.99; P = .04) cancers were significantly less likely to report unmet needs for physical concerns when compared with breast cancer survivors. Involvement of the general practitioner combined with the oncologist in providing care was associated with a significantly lower likelihood of reporting unmet emotional (OR, 0.78; 95% CI, 0.62-1.00; P = .05) and practical (OR, 0.72; 95% CI, 0.55-0.94; P = .01) needs. CONCLUSIONS AND RELEVANCE The extent of unmet needs among cancer survivors found in this study suggests the need for enhancements in survivorship care, including better awareness of the realities of survivorship, earlier interventions for emerging concerns among survivors, and greater integration of cancer programs and primary care for more seamless transitions.
Collapse
Affiliation(s)
- Saad Shakeel
- School of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jasmine Tung
- Canadian Partnership Against Cancer, Toronto, Ontario, Canada
| | - Rami Rahal
- Canadian Partnership Against Cancer, Toronto, Ontario, Canada
| | - Christian Finley
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Oncology, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
148
|
REBOUND "Trained to live again": The practice of great Olympic coaches improves and enhances the quality of life of cancer patients in remission after hematopoietic stem cell allogeneic transplantation. Bone Marrow Transplant 2020; 55:997-999. [PMID: 32123291 DOI: 10.1038/s41409-020-0845-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 11/09/2022]
|
149
|
Li J, Pang H, Sun Z, Zhao L, Bai C. Health status of middle-aged and older cancer survivors: a nationwide cross-sectional study from the China Health and Retirement Longitudinal Study (CHARLS). ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:183. [PMID: 32309330 PMCID: PMC7154473 DOI: 10.21037/atm.2020.01.105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background The number of Chinese cancer survivors has increased bolstered by the combined trends of an aging population and improved cancer survival; however, related research on cancer survivorship remains limited. Therefore, this study aimed to provide an overview of the health status of middle-aged and older cancer survivors in China. Methods We used the cross-sectional self-reported survey data from wave 4 in the China Health and Retirement Longitudinal Study (CHARLS). A total of 354 cancer survivors and 16,664 participants without cancer were identified from CHARLS. Physical and mental health, health behavior, and health care information collected by questionnaire were compared between these two groups. Results Compared with the general middle-aged and older population, cancer survivors had more concomitant chronic diseases (2.75 vs. 2.00, P<0.001). In addition, cancer survivors were found to be more statistically likely to have difficulties with activity (3.53 vs. 2.39, P<0.001) and have depressive symptoms (10.07 vs. 8.01, P<0.001) compared with participants without cancer. Also, cancer survivors were less likely to drink compared to those without a cancer diagnosis (OR 0.49; 95% CI, 0.36–0.66, P<0.001), but smoking behavior and physical activity did not show a significant difference. Coexisting chronic diseases and smoking harmed the physical and mental health of middle-aged and older people. We also found that cancer survivors had higher medical care expenses when compared with participants without cancer. Conclusions Cancer survivors older than 45 years in China have poorer outcomes in comorbidities and physical and mental health than their age-matched individual counterparts without cancer. Therefore, a higher quality and more cost-effective supportive care for these individuals is needed.
Collapse
Affiliation(s)
- Jiarui Li
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100032, China
| | - Haiyu Pang
- Central Research Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Zhao Sun
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100032, China
| | - Lin Zhao
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100032, China
| | - Chunmei Bai
- Department of Medical Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100032, China
| |
Collapse
|
150
|
Harvey A, Zhang Y, Phillips S, Suarez R, Dekle L, Villalobos A, Pratt-Chapman ML. Initial Outcomes of an Online Continuing Education Series Focused on Post-treatment Cancer Survivorship Care. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:144-150. [PMID: 30488369 PMCID: PMC6774892 DOI: 10.1007/s13187-018-1453-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
There is a growing number of post-treatment cancer survivors in the USA. Cancer survivors can have a variety of care needs and health care professionals must be prepared to meet these needs. The American Cancer Society (ACS) and the George Washington University (GW) Cancer Center developed The Cancer Survivorship E-Learning Series for Primary Care Providers (E-Learning Series) to address the need for cancer survivorship training and education among health care professionals with a focus on primary care. The GW Cancer Center analyzed evaluation data from 1341 learners who voluntarily completed a module pre- and post-assessment between April 15, 2013, and December 31, 2017, to assess differences in self-rated confidence, on a five-point Likert scale, to meet learning objectives. Descriptive statistics characterize the sample and paired samples t tests were used to assess any statistically significant differences from pre to post (p < 0.05). Most learners were nurses (75.19%) and a majority of learners worked in oncology (74.68%) followed by primary care (11.60%). At pre-assessment, the module with the lowest mean self-confidence rating was 3.16 (SD = 0.81) and the highest was 3.60 (SD = 0.73). At post-assessment, module means in self-confidence rating ranged from 4.08 (SD = 0.46) to 4.26 (SD = 0.56). All differences were statistically significant (p < 0.0001). Results highlight gaps in confidence among health care professionals regarding cancer survivorship care and the need for continuing education. There is also a need for additional uptake of the E-Learning Series among primary care providers. Results suggest that the E-Learning Series is an effective educational tool that increases learners' confidence in providing cancer survivorship care.
Collapse
Affiliation(s)
- Allison Harvey
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington, DC 20037 USA
| | - Yuqing Zhang
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington, DC 20037 USA
| | - Serena Phillips
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington, DC 20037 USA
| | - Rhea Suarez
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington, DC 20037 USA
| | - Laura Dekle
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington, DC 20037 USA
| | - Aubrey Villalobos
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington, DC 20037 USA
| | - Mandi L. Pratt-Chapman
- Institute for Patient-Centered Initiatives and Health Equity, The George Washington University Cancer Center, 2600 Virginia Avenue NW, Suite 300, Washington, DC 20037 USA
| |
Collapse
|