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Chen YP, Zhang Y, Chen X, Luo J, Chen Z, Zhao L, Xia G, Sui X, Li Y. The effects of different surgical approaches on the psychological status, medical coping mode and quality of life of patients with lung cancer. Front Psychol 2023; 14:1039501. [PMID: 37063587 PMCID: PMC10101174 DOI: 10.3389/fpsyg.2023.1039501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 03/07/2023] [Indexed: 03/28/2023] Open
Abstract
ObjectiveThis study aimed to compare the effects of robot-assisted thoracic surgery (RATS), video-assisted thoracic surgery (VATS), and thoracotomy on the psychological status, medical coping mode, and quality of life of patients with lung cancer.MethodsA total of 158 patients with lung cancer were selected from the thoracic surgery center of a third-grade hospital in Hunan Province, China, from September to November 2020. The Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Medical Coping Modes Questionnaire (MCMQ), and Medical Outcomes Study (MOS) 36-item Short Form Health Survey (SF-36) were used to assess the effects of the surgical approaches on the study parameters before and 48–96 h after surgery. The t-test and analysis of variance were used to analyze the data.ResultsThe results revealed that the patients’ depression increased, their short-term quality of life decreased, and they tended to adopt a positive coping mode after surgery (p < 0.05). The RATS and VATS groups differed in avoidance dimension of medical coping modes (p < 0.05). The VATS and thoracotomy groups differed in the body pain dimension of quality of life (p < 0.05). Different surgical approaches had no effect on the psychological status, medical coping modes except the avoidance dimension, and quality of life except the body pain dimension.ConclusionSurgical approaches have little effect on the psychological status, medical coping modes, and quality of life of patients with lung cancer; however, their depression increased and quality of life decreased after the surgery.
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Affiliation(s)
- Yi-ping Chen
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China
| | - Yi Zhang
- Hunan Key Laboratory of Oral Health Research & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Xing Chen
- Department of Nursing Research, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China
| | - Jiang Luo
- Hunan Key Laboratory of Oral Health Research & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Zhangqun Chen
- Hunan Key Laboratory of Oral Health Research & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Liping Zhao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Guili Xia
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China
- Guili Xia,
| | - Xueqi Sui
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yunchen Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- *Correspondence: Yunchen Li,
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Abu-Odah H, Molassiotis A, Liu JYW. A distress thermometer with a cutoff score of ≥ 6 is the optimal point to identify highly distressed patients with advanced cancer stages in resource-limited countries without palliative care services. Front Oncol 2023; 13:970164. [PMID: 37007106 PMCID: PMC10050695 DOI: 10.3389/fonc.2023.970164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
PurposeAlthough the distress thermometer (DT) scale has been widely validated and used in different cancer types and settings, an optimal cutoff score of DT is not defined to screen advanced cancer patients. The study aimed to define the optimal DT’s cutoff score among advanced cancer patients in resource-limited countries without palliative care services and to assess the prevalence and factors associated with psychological distress among this population.MethodsA secondary analysis was performed. Three hundred seventy-nine patients were recruited from Palestine. Participants completed the DT and the Hospital Anxiety and Depression Scale (HADS). Receiver operating characteristic analysis (ROC) was used to define the optimal cutoff score for the DT against HADS-Total ≥15. Multiple logistic regression was utilized for identifying the factors associated with psychological distress of the DT.ResultsA DT cutoff score ≥ 6 correctly identified 74% of HADS distress cases and 77% of HADS non-distress cases, with a positive predictive value (PPV) and negative predictive value (NPV) of 97% and 18%, respectively. The prevalence of distress was found to be 70.7%, and the major sources of distress were related to physical (n = 373; 98.4%) and emotional problems (n = 359; 94.7%). Patients with colon (OR = 0.44, 95% CI: 0.31 – 0.62) and lymphoid cancers (OR = 0.41, 95% CI: 0.26 – 0.64) were less likely to have psychological distress than patients with other types of cancer, whereas patients with lung (OR = 1.80, 95% CI: 1.20 – 2.70) and bone cancers (OR = 1.75, 95% CI: 1.14 – 2.68) were more likely to experience it.ConclusionA cutoff DT score of 6 appeared acceptable and effective for screening distress in patients with advanced cancer stages. Palestinian patients exhibited a high level of distress, and the high prevalence supports the argument of using a DT within the standard delivery of cancer care to identify highly distressed patients. These highly distressed patients should then be involved in a psychological intervention programme.
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Affiliation(s)
- Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong SAR, China
- Nursing and Health Sciences Department, University College of Applied Sciences (UCAS), Gaza, Palestine
- *Correspondence: Hammoda Abu-Odah, ;
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong SAR, China
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - Justina Yat Wa Liu
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Hong Kong SAR, China
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103
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The Impact of Depression and Anxiety on Adult Cancer Patients’ Health-Related Quality of Life. J Clin Med 2023; 12:jcm12062196. [PMID: 36983197 PMCID: PMC10059703 DOI: 10.3390/jcm12062196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
Background: Cancer patients are at high risk for mental illness and, in turn, poorer health-related quality of life. This study used nationally representative United States (US) data to examine nuances of the impact of depression and/or anxiety on HRQoL in different cancer groups (e.g., cancer only, cancer and depression, cancer and anxiety, cancer and both conditions). Methods: Adult patients aged 18 years and older with a cancer diagnosis were identified from the Medical Expenditure Panel Survey data for 2012–2016. HRQoL was measured using the SF-12 Physical and Mental Component Summary (PCS & MCS) scores. Multivariate linear regressions were used, controlling for a multitude of factors. Results: Around 12% of the 1712 identified patients with cancer had depression, 13% had anxiety, and 8.4% had both depression and anxiety. Patients with comorbid depression and anxiety had the lowest mean scores of both PCS and MCS compared to patients in other groups. In addition, cancer patients with either depression and/or anxiety were more likely to have lower MCS scores compared to those with cancer only (depression: β = −6.554; anxiety: β = −3.916; both conditions: β = −11.759, p < 0.001). Interestingly, patients with comorbid depression and anxiety were more likely to have higher PCS scores compared to those with cancer only. Conclusions: The psychological burden of cancer is immense, with a substantial impact on patients’ HRQoL. Routine screening for depression and anxiety, especially for women and those with low poverty status and comorbidities, should be conducted by healthcare providers to identify those with high odds of having a lower HRQoL. Additionally, early psychiatric interventions, such as psychotherapy and prescription drugs, may positively impact patients’ mental well-being and HRQoL.
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104
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Giallauria F, Testa C, Cuomo G, Di Lorenzo A, Venturini E, Lauretani F, Maggio MG, Iannuzzo G, Vigorito C. Exercise Training in Elderly Cancer Patients: A Systematic Review. Cancers (Basel) 2023; 15:cancers15061671. [PMID: 36980559 PMCID: PMC10046194 DOI: 10.3390/cancers15061671] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
Due to the aging of the population, in 70% of cases, a new cancer diagnosis equals a cancer diagnosis in a geriatric patient. In this population, beyond the concept of mortality and morbidity, functional capacity, disability, and quality of life remain crucial. In fact, when the functional status is preserved, the pathogenetic curve towards disability will stop or even regress. The present systematic review investigated the effectiveness of physical exercise, as part of a holistic assessment of the patient, for preventing disability and improving the patient’s quality of life, and partially reducing all-cause mortality. This evidence must point towards decentralization of care by implementing the development of rehabilitation programs for elderly cancer patients either before or after anti-cancer therapy.
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Affiliation(s)
- Francesco Giallauria
- Department of Translational Medical Sciences, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
- Faculty of Sciences and Technology, University of New England, Armidale, NSW 2351, Australia
- Correspondence:
| | - Crescenzo Testa
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy
| | - Gianluigi Cuomo
- Department of Translational Medical Sciences, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Anna Di Lorenzo
- Department of Translational Medical Sciences, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Elio Venturini
- Cardiac Rehabilitation Unit and Department of Cardiology, Azienda USL Toscana Nord-Ovest, “Cecina Civil Hospital”, 57023 Cecina, Italy
| | - Fulvio Lauretani
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University Hospital of Parma, 43126 Parma, Italy
| | - Marcello Giuseppe Maggio
- Geriatric Clinic Unit, Geriatric-Rehabilitation Department, University Hospital, 43126 Parma, Italy
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University Hospital of Parma, 43126 Parma, Italy
| | - Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | - Carlo Vigorito
- Department of Translational Medical Sciences, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
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105
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Depression and anxiety in older adults with cancer: Systematic review and meta-summary of risk, protective and exacerbating factors. Gen Hosp Psychiatry 2023; 81:32-42. [PMID: 36724695 DOI: 10.1016/j.genhosppsych.2023.01.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To systematically evaluate the risk factors of depression and anxiety in older adults with cancer. METHOD This PRISMA-adherent systematic review (PROSPERO CRD42022372747) involved a systematic database search for prospective and retrospective cohort studies. RESULTS We included 33 cohort studies with 31 evaluating depression and seven evaluating anxiety. Systematic synthesis yielded various protective and exacerbating factors for depression and anxiety amongst older adults with cancer. These factors span a range of domains: (1) Cancer and associated treatment-related factors; (2) Medical, physical and functional factors; (3) Demographic factors and; (4) Social and lifestyle factors. At the individual-level, the most significant factors were the presence of chronic medical comorbidities, having pre-existing psychological symptoms, and poor baseline physical and functional status. Within the social unit, the degree of social support and presence of a partner were most significant. CONCLUSION The deleterious impact comorbid psychological symptoms can have on older adults with cancer can be profound. In this review, we highlight a range of protective and exacerbating factors identified from cohort studies that may enable policymakers to tailor and individualise interventions to manage depression, anxiety and associated burden in this vulnerable population. The relative paucity of studies evaluating anxiety highlights an important research gap.
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106
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Zhu J, Ma S, Chen R, Xie S, Liu Z, Liu Z, Wei W. Long-term anxiety and depression signatures of participants that received esophageal cancer screening: A multicenter population-based cohort study. Cancer Med 2023; 12:6294-6306. [PMID: 36420699 PMCID: PMC10028031 DOI: 10.1002/cam4.5404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/16/2022] [Accepted: 10/24/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Current evidence on the psychological impact of screening and diagnosis of esophageal cancer (EC) is limited and unclear. METHODS This multicenter, population-based, prospective study was conducted in five high-incidence regions in China from 2017 to 2020. The screened participants were diagnosed as healthy, esophagitis, low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia (HGIN), or EC based on pathological biopsy. The psychological impact of the screening was assessed by comparing anxiety and depression symptoms at baseline and follow-up. RESULTS A total of 1973 individuals were ultimately included, with an average follow-up of 22.2 months. The prevalence of anxiety and depression symptoms in screened population at baseline was 14.3% and 18.4%. The prevalence of anxiety and depression symptoms of screeners at follow-up declined (all p < 0.001). The anxiety (RR [95% CI]: 0.37 [0.30-0.46]) and depression (0.29 [0.24-0.36]) of screeners weakened over time, but the anxiety and depression symptoms was continuous for patients with HGIN and patients with EC. Compared with the participants classified as normal, the RRs(95% CI) of anxiety and depression symptoms were 2.20 (1.10-4.30) and 2.03 (1.07-3.86) for the patients with HGIN and 2.30 (0.82-6.20) and 3.79 (01.71-8.43) for the patients with EC. CONCLUSION The anxiety and depression symptoms of screeners weakened over time, except in patients with HGIN and EC, for whom it remained lasting and high. Psychological assistance and interventions are urgently needed for individuals who are ready for screening and for those diagnosed as having HGIN or EC.
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Affiliation(s)
- Juan Zhu
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Cancer Prevention, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Shanrui Ma
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ru Chen
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuanghua Xie
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhaorui Liu
- Key Laboratory of Mental Health, Ministry of Health (Peking University), Institute of Mental Health, Peking University, Beijing, China
| | - Zhengkui Liu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Wenqiang Wei
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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107
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Bochicchio I, La Rosa VL, Marino G, Craparo G, Commodari E, Deiana G, Sanseverino F, Tartarone A, Conca R, Lettini AR. Psychological Well-Being of Cancer Patients before and during the Pandemic: The Impact of COVID-19 Peritraumatic Distress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4106. [PMID: 36901117 PMCID: PMC10002171 DOI: 10.3390/ijerph20054106] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This study aimed to evaluate the psychological impact of the COVID-19 pandemic on cancer patients. METHODS Ninety cancer patients undergoing chemotherapy with antiblastics were recruited from a tertiary medical center and completed a battery of standardized questionnaires to assess anxiety, depression, peritraumatic stress, and quality of life before and during the pandemic. RESULTS Quality of life worsened significantly during the pandemic compared with the pre-pandemic period. Anxiety and depression levels also increased significantly during the pandemic. COVID-19 peritraumatic distress significantly predicted lower quality-of-life scores during the pandemic. CONCLUSIONS COVID-19 distress affected the overall quality of life of patients who already had lower levels of quality of life before the pandemic and who had advanced cancers. Cancer patients must receive adequate support from psychiatrists and psychologists to mitigate the psychological distress related to the pandemic.
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Affiliation(s)
- Ilaria Bochicchio
- Unit of Clinical Psychology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | | | - Graziella Marino
- Unit of Breast Surgery, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy
| | - Elena Commodari
- Department of Educational Sciences, University of Catania, 95124 Catania, Italy
| | - Giovanni Deiana
- Unit of Clinical Psychology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | - Francesca Sanseverino
- Unit of Oncological Gynecology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | - Alfredo Tartarone
- Unit of Oncological Gynecology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | - Raffaele Conca
- Unit of Oncological Gynecology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
| | - Alessandro Rocco Lettini
- Unit of Clinical Psychology, Centro di Riferimento Oncologico della Basilicata (IRCCS-CROB), 85028 Rionero in Vulture, Italy
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108
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Gulliver A, Morse AR, Banfield M. Cancer Survivors' Experiences of Navigating the Australian Health Care System for Physical and Mental Health Care Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3988. [PMID: 36900994 PMCID: PMC10002190 DOI: 10.3390/ijerph20053988] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
People living with cancer experience many impacts on their health and mental health, and are thus likely to require ongoing health care. The aim of the current study was to investigate the health and mental health care experiences and needs of Australian cancer survivors. A total of 131 people (119 female, 12 male) with lived experience of a cancer diagnosis (at least 12 months ago) participated in an online survey collecting qualitative and quantitative data, advertised via social media groups and paid advertising. Analysis of the written responses was conducted using inductive qualitative content analysis. The findings showed that a major issue facing cancer survivors was difficulties around access to and management of services for both their mental and physical health. There was also a strong preference for increasing access to allied health care, such as physiotherapy, psychology, and remedial massage. There appear to be some inequities in the experiences of cancer survivors, particularly in accessing care. Improving the experiences of health care for physical and mental health cancer survivors should focus on increasing access to and improving the management of services, specifically allied health, through a variety of avenues, including reducing costs, increasing transport, and providing closer and more co-located services.
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109
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Kohli K, Jain B, Dee EC. Crossing Borders: Improving Mental Health Outcomes in Asian American Immigrants With Cancer. JCO Oncol Pract 2023; 19:234-237. [PMID: 36821806 DOI: 10.1200/op.22.00740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Affiliation(s)
| | - Bhav Jain
- Massachusetts Institute of Technology, Cambridge, MA
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110
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Rodriguez-Gonzalez A, Hernández R, Cruz-Castellanos P, Fernández-Montes A, Castillo-Trujillo O, Muñoz MM, Cano-Cano JM, Corral MJ, Esteban E, Jiménez-Fonseca P, Calderon C. Using the emotional functioning in clinical practice to detect psychological distress in patients with advanced thoracic and colorectal cancer. Health Qual Life Outcomes 2023; 21:15. [PMID: 36800957 PMCID: PMC9936733 DOI: 10.1186/s12955-023-02099-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
PURPOSE Patients with advanced cancer suffer significant decline of their psychological state. A rapid and reliable evaluation of this state is essential to detect and treat it and improve quality of life. The aim was to probe the usefulness of the emotional function (EF) subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EF-EORTC-QLQ-C30) to assess psychological distress in cancer patients. METHODS This is a multicenter, prospective, observational study involving 15 Spanish hospitals. Patients diagnosed with unresectable advanced thoracic or colorectal cancer were included. Participants completed the Brief Symptom Inventory 18 (BSI-18), the current the gold standard, and the EF-EORTC-QLQ-C30 to assess their psychological distress prior to initiating systemic antineoplastic treatment. Accuracy, sensitivity, positive predictive value (PPV), specificity, and negative predictive value (NPV) were calculated. RESULTS The sample comprised 639 patients: 283 with advanced thoracic cancer and 356 with advanced colorectal cancer. According to the BSI scale, 74% and 66% displayed psychological distress with an EF-EORTC-QLQ-C30 accuracy of 79% and 76% in detecting psychological distress in individuals with advanced thoracic and colorectal cancer, respectively. Sensitivity was 79 and 75% and specificity was 79 and 77% with a PPV of 92 and 86% and a NPV of 56 and 61% (scale cut-off point, 75) for patients with advanced thoracic and colorectal cancer, respectively. The mean AUC for thoracic cancer was 0.84 and, for colorectal cancer, it was 0.85. CONCLUSION This study reveals that the EF-EORTC-QLQ-C30 subscale is a simple and effective tool for detecting psychological distress in people with advanced cancer.
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Affiliation(s)
- Adán Rodriguez-Gonzalez
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Raquel Hernández
- grid.411220.40000 0000 9826 9219Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Patricia Cruz-Castellanos
- grid.81821.320000 0000 8970 9163Department of Oncology Medical. Hospital, Universitario La Paz, Madrid, Spain
| | - Ana Fernández-Montes
- grid.418883.e0000 0000 9242 242XDepartment of Medical Oncology, Complejo Hospitalario Universitario de Ourense – CHUO, Orense, Spain
| | - Oscar Castillo-Trujillo
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - María M. Muñoz
- Department of Medical Oncology, Hospital General Virgen de La Luz, Cuenca, Spain
| | - Juana M. Cano-Cano
- grid.411096.bDepartment of Medical Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - María J. Corral
- grid.5841.80000 0004 1937 0247Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Emilio Esteban
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Paula Jiménez-Fonseca
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.
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Ding X, Wu M, Zhang Y, Liu Y, Han Y, Wang G, Xiao G, Teng F, Wang J, Chen J, Zhang W, Cai M, Zhang Y, Zhou S, Hu D. The prevalence of depression and suicidal ideation among cancer patients in mainland China and its provinces, 1994-2021: A systematic review and meta-analysis of 201 cross-sectional studies. J Affect Disord 2023; 323:482-489. [PMID: 36496103 DOI: 10.1016/j.jad.2022.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 12/01/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
To evaluate the national prevalence depression of Chinese cancer patients and clarify its potential associated factors. Twelve databases were searched from database inception through October 31, 2022 for relevant studies published in English (PubMed MEDLINE, Ovid MEDLINE, Embase, Scopus, PsycINFO, and Cochrane and Web of Science) and Chinese (China National Knowledge Infrastructure, Wanfang, Weipu, Chinese Biomedical Literature Service System, Duxiu) that estimated point or period prevalence of depression, depressive disorder, or suicidal ideation as assessed by self-report scale or structured interview. 201 studies were eligible for inclusion in our meta-analyses. We found the national pooled prevalence rates of depression and suicidal ideation were 44.63 % (95 % CI 42.24 %-47.01 %) and 24.95 % (95 % CI 10.96 %-38.95 %), respectively. The pooled prevalence of depression was associated with study location, cancer type, comorbid chronic disease, and female sex (all P < 0.05). The distribution of the depression prevalence among cancer patients in mainland China was characterized by significant geographical variation and clustering. The highest pooled prevalence of depression was among gynecologic oncology patients. We recommend that more attention and resources be given to mental health problems such as depression and suicidal ideation among Chinese cancer patients, and that prevention programs be developed, especially in areas with a high prevalence of depression.
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Affiliation(s)
- Xiaoping Ding
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Minge Wu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yingying Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yanhong Han
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Gang Wang
- Wuhan Mental Health Center, Wuhan 430010, China
| | - Guangqin Xiao
- Department of Oncology Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Fen Teng
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jiaqing Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jie Chen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wei Zhang
- Department of Nursing, School of Medicine, Yangtze University, Jingzhou 434022, China
| | - Meijie Cai
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yan Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Su Zhou
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Deying Hu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Gilham K, Gadermann A, Dummer T, Murphy RA. Mental health, cancer risk, and the mediating role of lifestyle factors in the CARTaGENE cohort study. PLoS One 2023; 18:e0281588. [PMID: 36787319 PMCID: PMC9928103 DOI: 10.1371/journal.pone.0281588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 01/26/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Evidence on the association between mental health disorders and cancer risk is inconclusive, despite well-established associations between mental health disorders and lifestyle factors such as smoking. This study examines the relationships between depression, anxiety and cancer risk, and the potential mediating effects of lifestyle factors. METHODS A study of 34,571 participants aged 40-69 years in the CARTaGENE cohort was conducted. Depression was defined by questionnaire (PHQ-9), antidepressant use, and a composite of questionnaire, antidepressant use, or lifetime self-reported physician diagnosis. Anxiety was defined by questionnaire (GAD-7). Co-morbid depression and anxiety was also assessed. Cox regression models were used to investigate associations between mental health and risk of prostate, lung, and all cancers combined. Mediating effects of lifestyle factors were assessed using Baron and Kenny mediation criteria. RESULTS There were positive associations between mental health disorders, all cancers and lung cancer risk, however with the exception of anxiety and lung cancer in women (Hazard Ratio [HR] = 1.67, 95% CI: 1.01-2.76), associations were attenuated with adjustment for sociodemographics, health status and lifestyle factors. In the mediation analysis, smoking accounted for 27%, 18%, and 26%, of the total effect between depression (PHQ-9), anxiety, and co-morbidity and lung cancer, respectively in women. In men, smoking accounted for 17% of the total effect between depression (PHQ-9, antidepressant, or lifetime self-report of physician diagnosis) and all cancers. CONCLUSIONS Positive associations were observed between mental health disorders, all cancer and lung cancer risk, however most relationships were attenuated with adjustment for lifestyle factors. Smoking status mediated a significant proportion of the relationships between mental health disorders and cancer risk.
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Affiliation(s)
- Kaitlyn Gilham
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Anne Gadermann
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Human Early Learning Partnership, School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
| | - Trevor Dummer
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Rachel A. Murphy
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Cancer Control Research, BC Cancer, Vancouver, British Columbia, Canada
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Depression Is Associated with an Increased Risk of Subsequent Cancer Diagnosis: A Retrospective Cohort Study with 235,404 Patients. Brain Sci 2023; 13:brainsci13020302. [PMID: 36831845 PMCID: PMC9954234 DOI: 10.3390/brainsci13020302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/31/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Background: Depression and cancer share common risk factors and mechanisms of disease. The current literature has not explored the effect of depression on cancer risk. We assessed the difference in cancer risk in patients with and without depression in a large cohort in Germany. Methods: We compared cancer risk and incidence in patients with and without depression aged 18 or above diagnosed between 2015 and 2018 documented in the Disease Analyzer Database. Patients from a comparator group were matched 1:1 to patients with depression based on propensity scores. Patients with previous bipolar disorder (F31), mania (F30) or schizophrenia (F20-29) and cancer diagnosis 3 years prior to index date were excluded. Analyses were stratified by cancer type, age group, and gender. Results: A total of 117,702 patients with depression were included and matched 1:1, resulting in a cohort overall of 235,404. 4.9% of patients with depression compared to 4.1% without depression received at least one cancer diagnosis over 3.9 years median follow-up. The depression group showed an 18% increase in risk for a cancer diagnosis overall, with largest increased risk in lung cancer (HR: 1.39 [1.21-1.60], p < 0.0001), cancers of the gastro-intestinal-tract (HR: 1.30 [1.15-1.46], p < 0.0001), breast (HR: 1.23 [1.12-1.35], p < 0.0001) and urinary (HR: 1.23 [1.06-1.43], p < 0.01). Similarly, the incidence of cancer diagnosis overall increased by 22% for depressed patients. IRs showed no difference across cancer types. Conclusions: Depression increased the risk for cancer diagnosis consistently independent of the comparison method used. The potential mediating factors or shared mechanisms of the disease require further investigation.
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Hughes D, Yardley S, Greenfield P, Rolph M. Delivering mental healthcare to patients with a depressive disorder alongside a life-limiting illness. BJPsych Bull 2023; 47:43-48. [PMID: 34994340 PMCID: PMC10028549 DOI: 10.1192/bjb.2021.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The concurrent assessment and treatment of mental health disorders and palliative illnesses is complex. Affective disorders are more prevalent in people who need palliative care. Identifying the most suitable place of care and multi-professional multidisciplinary teams to provide support can be challenging and bewildering for professionals and patients. Mental health clinicians may be left with a sense of therapeutic nihilism, while palliative care teams can feel limited by the mental health resources available for treating those living with significant physical and mental health needs. We discuss the fictional case of a gentleman with metastatic bowel cancer who has developed symptoms of depressive disorder and identify how taking a pragmatic patient-centred approach can offer a route through potential dilemmas when seeking to provide individualised care based on needs. We used lay person experience alongside our own experiences of novel mechanisms for cross-specialty working in order to direct psychiatric trainees' approaches to such cases.
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115
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Yeo TP, Cannaday S, Thompson RE, Fogg R, Nevler A, Lavu H, Yeo CJ. Distress, Depression, and the Effect of ZIP Code in Pancreaticobiliary Cancer Patients and Their Significant Others. J Am Coll Surg 2023; 236:339-349. [PMID: 36648262 DOI: 10.1097/xcs.0000000000000469] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Distress screening of cancer patients is mandated by the American College of Surgeons Commission on Cancer. Clinical implementation remains limited, particularly in surgical oncology settings in individuals with pancreaticobiliary cancers. STUDY DESIGN This study evaluated differences in mean distress scores based on the National Comprehensive Cancer Network Distress Thermometer & Problem List for patients with pancreaticobiliary cancers, benign pancreatic conditions, and for their significant others (SOs). The distress screening was conducted at the first office visit and postoperatively in a subset of those who had surgery. Distress Thermometer (DT) scores were dichotomized at ≤5 vs >5 and at ≥7 and correlated with Problem List items. The US ZIP Code database was used to correlate income range, percent poverty, and unemployment in the patient's self-identified ZIP code. Regression models were fitted to identify independent predictors of distress. RESULTS A total of 547 patients and 184 SOs were evaluated. Thirty percent of patients had DT scores >5, with pancreatic adenocarcinoma patients reporting the highest levels of distress. SOs of pancreatic adenocarcinoma patients reported even greater distress than the patients themselves. As the number of pre-existing medical problems increased; so did DT scores. Distress correlated with physical and emotional problems and worry about insurance coverage and transportation. Higher income level predicted higher DT scores, although poverty predicted lower DT scores. Depression was present in 12% of the patients. Distress improved in those undergoing surgery. CONCLUSIONS Distress and depression in pancreaticobiliary cancer patients and SOs are prevalent. The findings of this study have multiple actionable implications and require diagnosis, treatment, and referral to supportive care resources.
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Affiliation(s)
- Theresa P Yeo
- From the Jefferson College of Nursing (TP Yeo), Thomas Jefferson University, Philadelphia, PA
- The Jefferson Pancreas, Biliary and Related Cancer Center, Sidney Kimmel Cancer Center (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo), Thomas Jefferson University, Philadelphia, PA
- Thomas Jefferson University, Sidney Kimmel Cancer Center, Philadelphia, PA (TP Yeo, Nevler, Lavu, CJ Yeo)
- Thomas Jefferson University Hospital, Philadelphia, PA (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo)
| | - Shawnna Cannaday
- The Jefferson Pancreas, Biliary and Related Cancer Center, Sidney Kimmel Cancer Center (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo), Thomas Jefferson University, Philadelphia, PA
- Thomas Jefferson University Hospital, Philadelphia, PA (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo)
| | | | - Ryan Fogg
- Sidney Kimmel Medical College, Philadelphia, PA, (Fogg)
| | - Avinoam Nevler
- The Jefferson Pancreas, Biliary and Related Cancer Center, Sidney Kimmel Cancer Center (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo), Thomas Jefferson University, Philadelphia, PA
- Thomas Jefferson University, Sidney Kimmel Cancer Center, Philadelphia, PA (TP Yeo, Nevler, Lavu, CJ Yeo)
- Thomas Jefferson University Hospital, Philadelphia, PA (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo)
| | - Harish Lavu
- The Jefferson Pancreas, Biliary and Related Cancer Center, Sidney Kimmel Cancer Center (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo), Thomas Jefferson University, Philadelphia, PA
- Thomas Jefferson University, Sidney Kimmel Cancer Center, Philadelphia, PA (TP Yeo, Nevler, Lavu, CJ Yeo)
- Thomas Jefferson University Hospital, Philadelphia, PA (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo)
| | - Charles J Yeo
- The Jefferson Pancreas, Biliary and Related Cancer Center, Sidney Kimmel Cancer Center (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo), Thomas Jefferson University, Philadelphia, PA
- Thomas Jefferson University, Sidney Kimmel Cancer Center, Philadelphia, PA (TP Yeo, Nevler, Lavu, CJ Yeo)
- Thomas Jefferson University Hospital, Philadelphia, PA (TP Yeo, Cannaday, Nevler, Lavu, CJ Yeo)
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Li P, Hu Y, Scelo G, Myrskylä M, Martikainen P. Pre-existing psychological disorders, diabetes, and pancreatic cancer: A population-based study of 38,952 Finns. Cancer Epidemiol 2023; 82:102307. [PMID: 36459909 DOI: 10.1016/j.canep.2022.102307] [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: 05/30/2022] [Revised: 11/09/2022] [Accepted: 11/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND It remains unclear how pre-existing depression, anxiety, and diabetes of different durations are associated with the risk of pancreatic cancer, its clinical characteristics, treatment modalities, and subsequent survival. METHODS From a register-based random sample of Finns residing in Finland at the end of the period 1987-2007, 6492 patients diagnosed with primary pancreatic cancer in 2000-2014, and 32 460 controls matched for birth cohort and sex, were identified. Pre-existing depression, anxiety, and diabetes were ascertained from the records of prescribed medication purchases. Information on pancreatic cancer outcomes was obtained from the Finnish cancer register. Data were analyzed using logistic and Cox regressions. RESULTS The risk of developing pancreatic cancer was found to be associated with long-term anxiety (treatment started 36 + months before the cancer diagnosis) (odds ratio (OR): 1.13, 95% confidence interval (95%CI): 1.04-1.22) and long-term diabetes (OR 1.72, 95%CI 1.55-1.90), as well as with new-onset (treatment started 0-24 months before the cancer diagnosis) depression (OR 1.59, 95%CI 1.34-1.88), anxiety (OR 1.76, 95%CI 1.50-2.07), and diabetes (OR 3.92, 95%CI 3.44-4.48). However, the effects of these new-onset conditions were driven by cases that began treatment within 3 months before the cancer diagnosis (concomitant period). Patients with long-term depression, anxiety and diabetes and those with new-onset anxiety had a higher risk of not receiving standard treatments. Lower survival was found for pancreatic cancer patients with new-onset depression (hazards ratio (HR) 1.38, 95%CI 1.16-1.64). Survival was not associated with pre-existing anxiety or diabetes. CONCLUSIONS The associations between pancreatic cancer risk and pre-existing depression and anxiety were mostly driven by concomitant effects. Individuals with diabetes, regardless of duration, should be closely monitored for pancreatic cancer. Pancreatic cancer patients with new-onset depression should be targeted to improve their survival.
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Affiliation(s)
- Peng Li
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Yaoyue Hu
- School of Public Health, Chongqing Medical University, Chongqing, China.
| | - Ghislaine Scelo
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research, Rostock, Germany; Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Pekka Martikainen
- Max Planck Institute for Demographic Research, Rostock, Germany; Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
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117
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Yan J, Chen Y, Luo M, Hu X, Li H, Liu Q, Zou Z. Chronic stress in solid tumor development: from mechanisms to interventions. J Biomed Sci 2023; 30:8. [PMID: 36707854 PMCID: PMC9883141 DOI: 10.1186/s12929-023-00903-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/17/2023] [Indexed: 01/29/2023] Open
Abstract
Chronic stress results in disturbances of body hormones through the neuroendocrine system. Cancer patients often experience recurrent anxiety and restlessness during disease progression and treatment, which aggravates disease progression and hinders treatment effects. Recent studies have shown that chronic stress-regulated neuroendocrine systems secret hormones to activate many signaling pathways related to tumor development in tumor cells. The activated neuroendocrine system acts not only on tumor cells but also modulates the survival and metabolic changes of surrounding non-cancerous cells. Current clinical evidences also suggest that chronic stress affects the outcome of cancer treatment. However, in clinic, there is lack of effective treatment for chronic stress in cancer patients. In this review, we discuss the main mechanisms by which chronic stress regulates the tumor microenvironment, including functional regulation of tumor cells by stress hormones (stem cell-like properties, metastasis, angiogenesis, DNA damage accumulation, and apoptotic resistance), metabolic reprogramming and immune escape, and peritumor neuromodulation. Based on the current clinical treatment framework for cancer and chronic stress, we also summarize pharmacological and non-pharmacological therapeutic approaches to provide some directions for cancer therapy.
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Affiliation(s)
- Jiajing Yan
- grid.263785.d0000 0004 0368 7397MOE Key Laboratory of Laser Life Science & Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631 China
| | - Yibing Chen
- grid.207374.50000 0001 2189 3846Department of Gynecology and Obstetrics, First Affiliated Hospital, Genetic and Prenatal Diagnosis Center, Zhengzhou University, Zhengzhou, 450001 China
| | - Minhua Luo
- grid.263785.d0000 0004 0368 7397MOE Key Laboratory of Laser Life Science & Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631 China
| | - Xinyu Hu
- grid.263785.d0000 0004 0368 7397MOE Key Laboratory of Laser Life Science & Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631 China
| | - Hongsheng Li
- grid.410737.60000 0000 8653 1072Department of Breast Surgery, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, 510095 China
| | - Quentin Liu
- grid.488530.20000 0004 1803 6191State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510631 China ,grid.411971.b0000 0000 9558 1426Institute of Cancer Stem Cell, Dalian Medical University, Dalian, 116044 Liaoning China
| | - Zhengzhi Zou
- grid.263785.d0000 0004 0368 7397MOE Key Laboratory of Laser Life Science & Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, 510631 China ,grid.263785.d0000 0004 0368 7397Guangzhou Key Laboratory of Spectral Analysis and Functional Probes, College of Biophotonics, South China Normal University, Guangzhou, 510631 China
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Nucci D, Gianfredi V, Ferrara P, Santangelo OE, Varotto B, Feltrin A, Galiano A, Nardi M. Association between Malnutrition and Depression in Patients with Cancer: The Importance of Nutritional Status Evaluation in Cancer Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2295. [PMID: 36767661 PMCID: PMC9916136 DOI: 10.3390/ijerph20032295] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/21/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Cancer patients are at risk of several comorbid conditions, including nutritional issues and mental health illnesses. The objective of the current study was to estimate the prevalence, upon hospital admission, of depression and malnutrition among adults with cancer. A retrospective chart review was conducted using health information collected as part of routine assistance. Nutritional status was measured through structured tools, including body mass index (BMI), Nutrition Risk Screening (NRS) 2002, and dietary intake needs. Depression was assessed with the Hospital Anxiety and Depression Scale (HAD). Cancer site, disease stage, length of hospitalization, age, and sex were also considered. Multivariate analyses were used to investigate the association between malnutrition and depression. In summary, our study reveals that malnutrition increases the risk of depression among cancer patients. The findings can also be used in clinical oncology for the implementation of appropriate prevention and treatment interventions in order to reduce the extent of depression and thus improve cancer patients' quality of life and survival rate.
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Affiliation(s)
- Daniele Nucci
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
- CAPHRI Care and Public Health Research Institute, Maastricht University, 6211 Maastricht, The Netherlands
| | - Pietro Ferrara
- Center for Public Health Research, University of Milan-Bicocca, 20900 Monza, Italy
- IRCCS Istituto Auxologico Italiano, 20145 Milano, Italy
| | - Omar Enzo Santangelo
- Regional Health Care and Social Agency of Lodi, Azienda Socio Sanitaria Territoriale di Lodi (ASST Lodi), 26900 Lodi, Italy
| | - Beatrice Varotto
- Clinical Nutrition Unit, Department of Medicine-DIMED, University of Padova, 35128 Padua, Italy
| | - Alessandra Feltrin
- Hospital Psychology, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Antonella Galiano
- Department of Oncology, Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
| | - Mariateresa Nardi
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
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Marwaha S, Palmer E, Suppes T, Cons E, Young AH, Upthegrove R. Novel and emerging treatments for major depression. Lancet 2023; 401:141-153. [PMID: 36535295 DOI: 10.1016/s0140-6736(22)02080-3] [Citation(s) in RCA: 154] [Impact Index Per Article: 154.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/09/2022] [Accepted: 10/19/2022] [Indexed: 12/23/2022]
Abstract
Depression is common, costly, debilitating, and associated with increased risk of suicide. It is one of the leading global public health problems. Although existing available pharmacological treatments can be effective, their onset of action can take up to 6 weeks, side-effects are common, and recovery can require treatment with multiple different agents. Although psychosocial interventions might also be recommended, more effective treatments than those currently available are needed for people with moderate or severe depression. In the past 10 years, treatment trials have developed and tested many new targeted interventions. In this Review, we assess novel and emerging biological treatments for major depressive disorder, evaluate their putative brain and body mechanisms, and highlight how close each might be to clinical use.
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Affiliation(s)
- Steven Marwaha
- Institute for Mental Health, University of Birmingham, Birmingham, UK; Birmingham and Solihull Mental Health NHS Trust, Birmingham, UK
| | - Edward Palmer
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Trisha Suppes
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Emily Cons
- Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Allan H Young
- Centre for Affective Disorders, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, UK; Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, Edgbaston, UK.
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120
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Yang L, Yan C, Wang J. Effect of multi-disciplinary team care program on quality of life, anxiety, and depression in hepatocellular carcinoma patients after surgery: A randomized, controlled study. Front Surg 2023; 9:1045003. [PMID: 36684377 PMCID: PMC9852760 DOI: 10.3389/fsurg.2022.1045003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/08/2022] [Indexed: 01/09/2023] Open
Abstract
Objective Multi-disciplinary team (MDT) collaboration enables hepatocellular carcinoma (HCC) patients to achieve better survival through precise diagnosis and individualized treatment. This study aimed to further investigate the effect of MDT care program (MDT-CP) on quality of life (QoL), anxiety and depression in HCC patients after surgery. Methods Totally, 150 postoperative HCC patients were enrolled and randomized in a 1:1 ratio into the MDT-CP group (N = 76) to receive MDT care for 6 months and the normal care program (N-CP) group (N = 74) to receive routine care for 6 months. Results Quality of Life Questionnaire-Core 30 (QLQ-C30) global health status score at 1 month (M1), M3 and M6, QLQ-C30 functions score at M3 and M6 elevated while QLQ-C30 symptom score at M1 and M3 decreased in MDT-CP group compared with N-CP group (all P < 0.05). In addition, Hospital Anxiety and Depression Scale (HADS)-Anxiety score at M3 and M6, anxiety occurrence rate at M6, anxiety degree at M6, were all reduced in MDT-CP group compared with N-CP group (all P < 0.05). HADS-Depression score at M6, and depression occurrence rate at M3, were both lessened in MDT-CP group compared to N-CP group (both P < 0.05), while there was no distinction of depression degree at any time points between groups. Conclusion MDT-CP improves QoL, relieves anxiety and depression to a certain extent in HCC patients after surgery.
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Samaroo K, Hosein A, Ali J. Perception of Survivorship Needs Among Breast Cancer Patients in Trinidad and Tobago. Cureus 2023; 15:e34394. [PMID: 36874708 PMCID: PMC9977196 DOI: 10.7759/cureus.34394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2023] [Indexed: 02/02/2023] Open
Abstract
The perception of survivorship among the cancer communities of the Caribbean is largely unknown. This study focused on determining the perception and interest in cancer survivorship among breast cancer (BC) patients in Trinidad and Tobago, as a preliminary, to introducing a pilot survivorship program and evaluating its impact on this patient population. Participants were given a questionnaire to determine needs, expectations and interest in survivorship care. Baseline measurable outcomes reported in this article include the following: 1. Participants' satisfaction with their medical care follow-up plan (if any), 2. Participants' satisfaction with the amount of information provided by healthcare providers, and 3. Participants' satisfaction with their physician's overall concern about their well-being, ranked on a 5-point Likert scale. Participants also reported on the advice/ guidelines provided by their physicians, after surgery and/or on completion of treatment, what they did to cope with BC, and their expectations of what could have been done to improve the quality of care received. A second questionnaire was then used to measure the level of interest in participating in a Cancer Survivorship Program (CSP) with components such as: nutrition, psychosocial development, spiritual well-being, and yoga and mindfulness. The level of interest was ranked by participants on a 5-point Likert scale. Fifteen themes emerged from participants' responses to the first questionnaire. Nutrition stood out as the module of highest interest, followed by psychosocial development among BC patients.
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Affiliation(s)
- Kristy Samaroo
- Biomedical Engineering, The University of Trinidad & Tobago, Port of Spain, TTO
| | - Amalia Hosein
- Biomedical Engineering, The University of Trinidad & Tobago, Port of Spain, TTO
| | - Jameel Ali
- Surgery, University of Toronto, Toronto, CAN.,Breast Surgical Oncology, St. James Medical Complex, Port of Spain, TTO
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Psychometric Evaluation of The Irritability Scale-Initial Version in Chinese Cancer Patients. Nurs Res 2023; 72:49-57. [PMID: 35997690 DOI: 10.1097/nnr.0000000000000615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Irritability is a common experience of depressed Chinese patients but is understudied and poorly measured. OBJECTIVE We aimed to assess psychometric properties of a new measure of irritability in Chinese cancer patients across the social and political spectrum. METHODS The Irritability Scale-Initial Version (TISi) was translated into Chinese and tested in two samples of Chinese cancer patients undergoing treatments: 52 patients in Beijing, China, between 2018 and 2019 and 65 patients in Taipei, Taiwan, in 2020. RESULTS The Chinese version of TISi demonstrated high internal consistency, high reliability based on the split-half method in the two samples, and satisfactory discriminant validity using the Chinese version of the 17-item Hamilton Rating Scale for Depression and the seven-item depression subscale of the Hospital Anxiety and Depression Scale in the Beijing sample. A confirmatory factor analysis produced factor loadings in both samples, which resembled a sample of American cancer patients. Three TISi items were loaded more highly on the physical instead of the original behavioral subscale in the Beijing sample. A possible influence of cultures was explained. CONCLUSION The Chinese version of TISi has satisfactory psychometric properties for assessing the level of irritability in Chinese cancer patients. Future large-sample studies are needed to further determine TISi's factorial structure, test-retest reliability, sensitivity to change, and predictive validity for depression in Chinese cancer patients.
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Binsaleh NK, Sherwani S, Eltayeb R, Qanash H, Bazaid AS, Althobiti M, Hazzazi MS, Rajendrasozhan S. Increased inflammatory cytokines and oxidative stress enhanced antibody production in breast and prostate cancer patients with COVID-19 related depression. Front Chem 2023; 11:1192074. [PMID: 37153524 PMCID: PMC10157473 DOI: 10.3389/fchem.2023.1192074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/10/2023] [Indexed: 05/09/2023] Open
Abstract
Cancer management is highly dependent on the immune status of the patient. During the COVID-19 pandemic, a large number of people suffered from anxiety and depression, especially cancer patients. The effect of depression on breast cancer (BC) and prostate cancer (PC) patients, during the pandemic has been analyzed in this study. Levels of proinflammatory cytokines (IFN-γ, TNF-α, and IL-6) and oxidative stress markers malondialdehyde (MDA) and carbonyl content (CC) were estimated in patients' serum samples. Serum antibodies against in vitro hydroxyl radical (•OH) modified pDNA (•OH-pDNA-Abs) were estimated using direct binding and inhibition ELISA. Cancer patients showed increased levels of proinflammatory cytokines (IFN-γ, TNF-α, and IL-6) and oxidative stress markers (MDA and CC levels), which were further significantly enhanced in cancer patients with depression compared to normal healthy (NH) individuals. Increased levels of •OH-pDNA-Abs were detected in breast cancer (0.506 ± 0.063) and prostate cancer (0.441 ± 0.066) patients compared to NH subjects. Serum antibodies were found to be significantly elevated in BC patients with depression (BCD) (0.698 ± 0.078) and prostate cancer patients with depression (PCD) (0.636 ± 0.058). Inhibition ELISA also exhibited significantly high percent inhibition in BCD (68.8% ± 7.8%) and PCD (62.9% ± 8.3%) subjects compared to BC (48.9% ± 8.1%), and PC (43.4% ± 7.5%) subjects. Cancer is characterized by enhanced oxidative stress and increased inflammation, which may be exaggerated with COVID-19 related depression. High oxidative stress and compromised antioxidant homeostasis exerts alterations in DNA, leading to formation of neo-antigens, subsequently leading to the generation of antibodies. COVID-19 pandemic related depression needs to be addressed globally for improved cancer patient care and cancer disease management.
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Affiliation(s)
- Naif K. Binsaleh
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
- *Correspondence: Naif K. Binsaleh,
| | - Subuhi Sherwani
- Department of Biology, Faculty of Sciences, University of Ha’il, Ha’il, Saudi Arabia
| | - Reem Eltayeb
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
| | - Husam Qanash
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
| | - Abdulrahman S. Bazaid
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, University of Ha’il, Ha’il, Saudi Arabia
| | - Maryam Althobiti
- Department of Clinical Laboratory Science, College of Applied Medical Science, Shaqra University, Shaqra, Saudi Arabia
| | - Mohannad S. Hazzazi
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Hematology Research Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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Pinheiro LC, Cho J, Rothman J, Zeng C, Wilson M, Kern LM, Tamimi RM, Safford MM. Diabetes and cancer co-management: patient-reported challenges, needs, and priorities. Support Care Cancer 2023; 31:145. [PMID: 36729259 PMCID: PMC9892662 DOI: 10.1007/s00520-023-07604-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/20/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Twenty percent of breast cancer survivors have co-occurring diabetes and face a 50% greater risk of 10-year mortality compared to survivors without diabetes. Individuals with cancer are often overwhelmed during cancer treatment and have less time for their diabetes, contributing to worse outcomes. We elicited perspectives of breast cancer survivors with diabetes regarding their specific needs for diabetes and cancer co-management. METHODS We conducted semi-structured interviews with women with breast cancer aged 40 + years at three New York City hospitals from May 2021 to March 2022. Eligible participants had type 2 diabetes or pre-diabetes. Interviews were audio-recorded, professionally transcribed, and coded by two independent reviewers. RESULTS We conducted interviews with 15 females with breast cancer of mean age 61.5 years (SD 7.2); 70% were Black, Hispanic, or Asian/Pacific Islander, and 20% had only a high school education. Most (73%) patients were insured by Medicaid or Medicare, and 73% underwent chemotherapy as part of their cancer care. Of the 15 participants, 60% reported that their glucose levels were of control during cancer treatment and nearly 50% reported glucose levels > 200 mg/dL. We identified distinct themes that reflect patient-reported challenges (worse glucose control after initiation of cancer treatment, lack of information on co-managing diabetes, negative psychosocial effects, burden of diabetes management during cancer care) and needs/priorities (designated provider to help, educational resources specific to diabetes and cancer, and individualized care plans). CONCLUSIONS Patients co-managing diabetes and cancer face challenges and have unmet needs that should be addressed to improve diabetes control during cancer treatment. Our findings can directly inform interventions aimed at improving glucose control in this population.
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Affiliation(s)
- Laura C. Pinheiro
- grid.5386.8000000041936877XDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, Box 331, New York, NY USA ,grid.5386.8000000041936877XDivision of Epidemiology, Department of Population Health Science, Weill Cornell Medicine, New York, NY USA
| | - Jacklyn Cho
- grid.36425.360000 0001 2216 9681Renaissance School of Medicine at Stony Brook University, NY Stony Brook, USA
| | - Julia Rothman
- grid.5386.8000000041936877XCornell University, Ithaca, NY USA
| | - Caroline Zeng
- grid.5386.8000000041936877XDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, Box 331, New York, NY USA
| | - Micayla Wilson
- grid.266093.80000 0001 0668 7243University of California Irvine, Irvine, CA USA
| | - Lisa M. Kern
- grid.5386.8000000041936877XDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, Box 331, New York, NY USA
| | - Rulla M. Tamimi
- grid.5386.8000000041936877XDivision of Epidemiology, Department of Population Health Science, Weill Cornell Medicine, New York, NY USA
| | - Monika M. Safford
- grid.5386.8000000041936877XDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, Box 331, New York, NY USA
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Zhu Y, Li C, Wu T, Wang Y, Hua R, Ma Y, Xie W. Associations of cumulative depressive symptoms with subsequent cognitive decline and adverse health events: Two prospective cohort studies. J Affect Disord 2023; 320:91-97. [PMID: 36183825 DOI: 10.1016/j.jad.2022.09.128] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/13/2022] [Accepted: 09/26/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The course of depression is variable; however, few studies examined the relationship between long-term cumulative depressive symptoms and adverse health outcomes in the elderly. METHODS In this cohort study, we used data from the Health and Retirement Study (HRS) over 24 years and the English Longitudinal Study of Ageing (ELSA) over 16 years. Cumulative depressive symptoms were estimated by calculating the areas under the curve based on the Center for Epidemiological Research Depression scale assessed at four examinations. Outcomes include cognitive decline, incident dementia, cardiovascular disease (CVD), cancer, and all-cause mortality. RESULTS A total of 8284 American (mean age: 60.1 years; male: 35.4 %) and 4314 British (60.1 years; 42.4 %) were included in the analysis. The median follow-up was 16.1 years in the HRS and 9.9 years in the ELSA. Similar results were observed in two cohorts. Comparing with the first tertile of cumulative depressive symptoms, the third tertile experienced faster cognitive decline (p = 0.013 in the ELSA and p < 0.001 in the HRS), increased risk of dementia (both p < 0.001), CVD (both p < 0.001) and all-cause mortality (p = 0.002 in the HRS). Strong dose-response relationships were observed. We did not found clearly association between cumulative depressive symptoms and incident cancer. CONCLUSIONS This study suggests that long-term cumulative depressive symptoms were associated with subsequent faster cognitive decline and greater risks for dementia, CVD and all-cause mortality, but not cancer. These findings provide insights on potential effective strategy that may improve health in the elderly, future clinical trials are needed to determine causality.
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Affiliation(s)
- Yidan Zhu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Chenglong Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Tao Wu
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Yongqian Wang
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Rong Hua
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Yanjun Ma
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China.
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Zhang Y, Wu Y, Zhang Y, Cao D, He H, Cao X, Wang Y, Jia Z, Jiang J. Dietary inflammatory index, and depression and mortality risk associations in U.S. adults, with a special focus on cancer survivors. Front Nutr 2022; 9:1034323. [PMID: 36590206 PMCID: PMC9795013 DOI: 10.3389/fnut.2022.1034323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction A higher risk for depression and mortality is associated with the inflammatory potential of diet measured through the Dietary Inflammatory Index (DII). The roles of DII in the risk of depression and death in cancer survivors were unclear. We aimed to examine the association between energy-adjusted DII (E-DII) score and risk of depression, and mortality using data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES), with a special focus on cancer survivors. Methods The 24-h dietary recall interview was used as a basis to calculate the E-DII score and the Patient Health Questionnaire-9 (PHQ-9) was used to measure the depressive outcomes. Logistic regression analyses were performed to determine the association between quartiles of E-DII score and depression. Cox proportional hazard regression and competing risk analyses were used to estimate the risks of quartiles of E-DII score or depression on mortality. Results A total of 27,447 participants were included; including 24,694 subjects without cancer and 2,753 cancer survivors. The E-DII score and depression were not distributed differently between the two groups. However, the E-DII scores were positively associated with within each group's depression (all P trend < 0.001) and participants with higher E-DII scores had a higher risk of depression (subjects without cancer: ORQ4 vs Q1: 2.17, 95% CI: 1.75-2.70; cancer survivors: ORQ4 vsQ1: 1.78, 95% CI: 1.09-2.92). The median follow-up time were 87 person-months, a total of 1,701 (4.8%) and 570 (15.2%) all-cause deaths in subjects without cancer and cancer survivors were identified by the end of 2019. The highest E-DII scores quartile was associated with the highest risk of all-cause (HRQ4 vsQ1: 1.90, 95% CI: 1.54-2.35) and cardiovascular disease (CVD) cause death (HRQ4 vsQ1: 2.50, 95% CI: 1.69-2.3.7) in the subjects without cancer. Moreover, participants with depressive symptoms had higher all-cause mortality (HR: 1.29, 95% CI: 1.04-1.59). No significant correlation was found for E-DII scores or depression with all-cause, cancer-cause or CVD-cause mortality in cancer survivors. Conclusion Our findings demonstrate that E-DII score was positively associated with depression risk. A higher E-DII score or depressive symptom may increase the risks of all-cause and CVD-cause mortality only among general subjects.
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Affiliation(s)
- Yuzheng Zhang
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China,Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yanhua Wu
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Yangyu Zhang
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China,Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Donghui Cao
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Hua He
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China
| | - Xueyuan Cao
- Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, China
| | - Yuehui Wang
- Department of Geriatrics, The First Hospital of Jilin University, Changchun, China
| | - Zhifang Jia
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China,Zhifang Jia,
| | - Jing Jiang
- Division of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China,Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China,*Correspondence: Jing Jiang,
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Wang F, Zhao J, Li Y, Yang X, Wu D, Yang B, Zhang C, He Z, Du L, Zhu X, Ming D, Liu Y, Tang D. Acupuncture and acupressure with improved cancer-related depression of retrospective studies. Front Oncol 2022; 12:1036634. [PMID: 36578922 PMCID: PMC9791202 DOI: 10.3389/fonc.2022.1036634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction Acupuncture and acupressure are widely used for treating cancer pain and depression and recognized as safe and effective by the international medical community. In this study, we systematically evaluated the efficacy, safety, and clinical significance of acupuncture and acupressure in treating cancer-related depression. Methods We searched MEDLINE, PubMed, Science Direct, Google Scholar, Web of Science and Embase and Chinese-language databases for randomized clinical trials (RCTs). To assess efficacy, rating scales administered by clinicians or experts were preferred, including the Hamilton Depression Rating Scale (HAMD), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), and Quality of Life Questionnaire-Core 30 (QLQ-C30) and the total effective rate after treatment. In all, Sixteen RCTs involving 1019 cancer patients were included in the Meta-analysis. Results Eleven (69%) of these studies reported the post-treatment total effective rate. Three hundred fifty-three patients received antidepressants; the total effective rate was 72.5%. Three hundred sixty-one patients underwent acupuncture and acupressure; the total effective rate was 90%. Meta-analysis results showed I2 = 0%, no heterogeneity, (Z = 5.84, p < 0.00001); and combined OR = 3.55, (95% CI = 2.32 to 5.43). Discussion This study found that acupuncture and acupressure are as effective as medication in the treatment of cancer-related depression, provide a reliable basis for the clinical use of acupuncture to treat cancer-related depression, help promote nonpharmacological treatment for cancer-related complications. These approaches thus help reduce drug resistance and adverse reactions and improve patients' quality of life.
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Affiliation(s)
- Feiqing Wang
- Clinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China,Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Jianing Zhao
- Clinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Yanju Li
- Department of Hematology Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Xu Yang
- Clinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Dan Wu
- Clinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Bo Yang
- Clinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Chike Zhang
- Department of Hematology Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Zhixu He
- Department of Hematology Oncology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China,Key Laboratory of Adult Stem Cell Translational Research, Chinese Academy of Medical Sciences, Guizhou Medical University, Guiyang, Guizhou, China
| | - Liang Du
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaodong Zhu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China,Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China,*Correspondence: Xiaodong Zhu, ; Dong Ming, ; Yang Liu, ; Dongxin Tang,
| | - Dong Ming
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China,*Correspondence: Xiaodong Zhu, ; Dong Ming, ; Yang Liu, ; Dongxin Tang,
| | - Yang Liu
- Clinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China,Key Laboratory of Adult Stem Cell Translational Research, Chinese Academy of Medical Sciences, Guizhou Medical University, Guiyang, Guizhou, China,*Correspondence: Xiaodong Zhu, ; Dong Ming, ; Yang Liu, ; Dongxin Tang,
| | - Dongxin Tang
- Clinical Medical Research Center, The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China,*Correspondence: Xiaodong Zhu, ; Dong Ming, ; Yang Liu, ; Dongxin Tang,
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Liu R, Qiao N, Shi S, Li S, Wang Y, Song J, Jia W. Deficits in ascending pain modulation pathways in breast cancer survivors with chronic neuropathic pain: A resting-state fMRI study. Front Neurol 2022; 13:959122. [PMID: 36570451 PMCID: PMC9772282 DOI: 10.3389/fneur.2022.959122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose Breast cancer (BC) is the highest frequent malignancy in women globally. Approximately 25-60% of BC patients with chronic neuropathic pain (CNP) result from advances in treating BC. Since the CNP mechanism is unclear, the various treatment methods for CNP are limited. We aimed to explore the brain alternations in BC patients with CNP and the relationship between depression and CNP utilizing resting-state functional magnetic resonance imaging (rs-fMRI). Methods To collect the data, the female BC survivors with CNP (n = 20) and healthy controls (n = 20) underwent rs-fMRI. We calculated and compared the functional connectivity (FC) between the two groups using the thalamus and periaqueductal gray (PAG) as seed regions. Results Patients with BC showed increased depression and FC between the thalamus and primary somatosensory cortices (SI). Moreover, the Hospital Anxiety and Depression Scale-Depression (HADS-D) and pain duration were linked positively to the strength of FC from the thalamus to the SI. Furthermore, the thalamus-SI FC mediated the impact of pain duration on HADS-D. Conclusion In BC patients with CNP, the ascending pain regulation mechanism is impaired and strongly associated with chronic pain and accompanying depression. This research increased our knowledge of the pathophysiology of CNP in patients with BC, which will aid in determining the optimal therapeutic strategy for those patients.
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Affiliation(s)
- Rui Liu
- Department of Chemoradiotherapy, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China,*Correspondence: Rui Liu
| | - Na Qiao
- Department of Breast Surgery, The First Hospital of Qiqihar, Qiqihar, Heilongjiang, China,Department of Breast Surgery, Affiliated Qiqihar Hospital, Southern Medical University, Qiqihar, Heilongjiang, China
| | - Shuwei Shi
- Department of Chemoradiotherapy, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Suyao Li
- Department of Chemoradiotherapy, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Yingman Wang
- Department of Chemoradiotherapy, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Jie Song
- Department of Chemoradiotherapy, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
| | - Wenting Jia
- Department of Chemoradiotherapy, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China
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Rodriguez-Loureiro L, Verdoodt F, Lefebvre W, Vanpoucke C, Casas L, Gadeyne S. Long-term exposure to residential green spaces and site-specific cancer mortality in urban Belgium: A 13-year follow-up cohort study. ENVIRONMENT INTERNATIONAL 2022; 170:107571. [PMID: 36219909 DOI: 10.1016/j.envint.2022.107571] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Residing in greener areas may decrease the burden of chronic diseases, but the association with cancer is unclear. We studied the associations between residential green spaces and site-specific cancer mortality in urban Belgium. METHODOLOGY We linked the 2001 Belgian census, register mortality data for 2001-2014, and environmental information (green spaces and air pollution) at baseline residence (2001). We included residents from the largest Belgian urban areas aged ≥ 30 years at baseline. Exposure to residential green spaces was assessed using the Normalized Difference Vegetation Index (NDVI), Urban Atlas, and perceived neighbourhood greenness (from the census). We used Cox proportional hazards models to obtain hazard ratios (HR) and their 95 % confidence intervals (95 %CI) of the mortality risk from lung, colorectal, breast (in women) and prostate cancer (in men) per interquartile range increment in residential green spaces. We further analyzed the role of outdoor air pollution and effect modification by age and socioeconomic position (SEP) in main associations. RESULTS 2,441,566 individuals were included at baseline. During follow-up, 1.2 % died from lung cancer, 0.6 % from colorectal cancer, 0.8 % from breast cancer, and 0.6 % from prostate cancer. After adjustment, higher exposure to green spaces was associated with a reduced mortality risk from lung cancer and breast cancer [e.g., for NDVI within 300 m, HR:0.946 (95 %CI:0.924,0.970), and HR:0.927 (95 %CI:0.892,0.963), respectively], but not with colorectal or prostate cancer mortality. For the latter, a suggestive hazardous effect of green spaces was found. Air pollution seemed to have only a marginal role. Beneficial effects of greenspace were generally stronger in < 65-year-old, but no clear trend by SEP was found. CONCLUSIONS Our findings suggest that residing in green areas could decrease mortality risk from lung and breast cancer, potentially independent from air pollution. Future studies should consider different indicators of greenspace exposure and investigate potential pathways underlying the associations.
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Affiliation(s)
| | - Freija Verdoodt
- Research Department, Belgian Cancer Registry, Brussels, Belgium
| | - Wouter Lefebvre
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | - Lidia Casas
- Social Epidemiology and Health Policy, Department of Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium; Institute for Environment and Sustainable Development (IMDO), University of Antwerp, Antwerp, Belgium
| | - Sylvie Gadeyne
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
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Andersen L, McHugh M, Ulrich CM, Meghani SH, Deng J. A systematic review of coping skill interventions to reduce anxiety and depressive symptoms among adults with hematologic malignancies. Eur J Oncol Nurs 2022; 61:102224. [PMID: 36375304 PMCID: PMC9714520 DOI: 10.1016/j.ejon.2022.102224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/08/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients with hematologic malignancies experience anxiety and depressive symptoms from diagnosis through survivorship. The aim of this systematic review is to determine if coping skill interventions can reduce anxiety and depressive symptoms for persons with hematologic cancer. METHODS Databases including PubMed, Embase, CINAHL, APA PyschInfo, Scopus, and Cochrane were searched in June of 2021 for coping skill interventional studies with adult patients with hematologic cancer and outcomes of anxiety and depressive symptoms. Search terms, definitions, and inclusion/exclusion criteria were guided by the Transactional Model of Stress and Coping, and quality appraisal utilized the Johns Hopkins Evidence Based Practice Appraisal tool. The study was registered in PROSPERO under "CRD42021262967." RESULTS Eleven studies met inclusion criteria with ten studies evaluating anxiety symptoms and nine studies evaluating depressive symptoms. Of ten studies with 449 participants evaluating anxiety, five studies showed significant reduction (p < 0.05), three found small to moderate effect size reductions not reaching statistical significance (p > 0.05), and only two showed no reduction in anxiety symptoms. Of nine studies with 429 participants evaluating depressive symptoms, three had significant reductions (p < 0.05), three reported small to moderate effect size reductions not reaching statistical significance (p > 0.05), and three found no effect on depressive symptoms. Coping interventions that were problem-focused as opposed to emotion-focused were most effective for both anxiety and depressive symptoms. CONCLUSION This systematic review finds evidence that problem-focused coping interventions reduce anxiety symptoms among patients with hematologic malignancies, with mixed evidence for reduction of depressive symptoms. Nurses and other clinicians caring for patients with hematologic cancers may employ coping skill interventions as a potential way to mitigate anxiety and depressive symptoms. PROSPERO REGISTRATION ID CRD42021262967.
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Affiliation(s)
- Lucy Andersen
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; The NewCourtland Center for Transitions and Health, Philadelphia, PA, USA.
| | - Molly McHugh
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; The NewCourtland Center for Transitions and Health, Philadelphia, PA, USA
| | - Connie M Ulrich
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; The NewCourtland Center for Transitions and Health, Philadelphia, PA, USA
| | - Salimah H Meghani
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA; The NewCourtland Center for Transitions and Health, Philadelphia, PA, USA
| | - Jie Deng
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
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Shi Y, Gu L, Zhang X, Chen M. Traditional Chinese medicine mediated tumor suppression via regulating psychological factors. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2022.100162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Is depression the missing link between inflammatory mediators and cancer? Pharmacol Ther 2022; 240:108293. [PMID: 36216210 DOI: 10.1016/j.pharmthera.2022.108293] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/14/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022]
Abstract
Patients with cancer are at greater risk of developing depression in comparison to the general population and this is associated with serious adverse effects, such as poorer quality of life, worse prognosis and higher mortality. Although the relationship between depression and cancer is now well established, a common underlying pathophysiological mechanism between the two conditions is yet to be elucidated. Existing theories of depression, based on monoamine neurotransmitter system dysfunction, are insufficient as explanations of the disorder. Recent advances have implicated neuroinflammatory mechanisms in the etiology of depression and it has been demonstrated that inflammation at a peripheral level may be mirrored centrally in astrocytes and microglia serving to promote chronic levels of inflammation in the brain. Three major routes to depression in cancer in which proinflammatory mediators are implicated, seem likely. Activation of the kynurenine pathway involving cytokines, increases tryptophan catabolism, resulting in diminished levels of serotonin which is widely acknowledged as being the hallmark of depression. It also results in neurotoxic effects on brain regions thought to be involved in the evolution of major depression. Proinflammatory mediators also play a crucial role in impairing regulatory glucocorticoid mediated feedback of the hypothalamic-pituitary-adrenal axis, which is activated by stress and considered to be involved in both depression and cancer. The third route is via the glutamatergic pathway, whereby glutamate excitotoxicity may lead to depression associated with cancer. A better understanding of the mechanisms underlying these dysregulated and other newly emerging pathways may provide a rationale for therapeutic targeting, serving to improve the care of cancer patients.
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Lutgendorf SK, Thaker PH, Goodheart MJ, Arevalo JM, Chowdhury MA, Noble AE, Dahmoush L, Slavich GM, Penedo FJ, Sood AK, Cole SW. Biobehavioral factors predict an exosome biomarker of ovarian carcinoma disease progression. Cancer 2022; 128:4157-4165. [PMID: 36251340 PMCID: PMC9744596 DOI: 10.1002/cncr.34496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Biobehavioral factors such as social isolation and depression have been associated with disease progression in ovarian and other cancers. Here, the authors developed a noninvasive, exosomal RNA profile for predicting ovarian cancer disease progression and subsequently tested whether it increased in association with biobehavioral risk factors. METHODS Exosomes were isolated from plasma samples from 100 women taken before primary surgical resection or neoadjuvant (NACT) treatment of ovarian carcinoma and 6 and 12 months later. Biobehavioral measures were sampled at all time points. Plasma from 76 patients was allocated to discovery analyses in which morning presurgical/NACT exosomal RNA profiles were analyzed by elastic net machine learning to identify a biomarker predicting rapid (≤6 months) versus more extended disease-free intervals following initial treatment. Samples from a second subgroup of 24 patients were analyzed by mixed-effects linear models to determine whether the progression-predictive biomarker varied longitudinally as a function of biobehavioral risk factors (social isolation and depressive symptoms). RESULTS An RNA-based molecular signature was identified that discriminated between individuals who had disease progression in ≤6 months versus >6 months, independent of clinical variables (age, disease stage, and grade). In a second group of patients analyzed longitudinally, social isolation and depressive symptoms were associated with upregulated expression of the disease progression propensity biomarker, adjusting for covariates. CONCLUSION These data identified a novel exosome-derived biomarker indicating propensity of ovarian cancer progression that is sensitive to biobehavioral variables. This derived biomarker may be potentially useful for risk assessment, intervention targeting, and treatment monitoring.
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Affiliation(s)
- Susan K. Lutgendorf
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - Premal H. Thaker
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
| | - Michael J. Goodheart
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - Jesusa M.G. Arevalo
- Division of Hematology/Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Mamur A. Chowdhury
- Departments of Gynecologic Oncology, Cancer Biology and Center for RNA Interference and Noncoding RNA, University of Texas M.D. Anderson Cancer Center, Houston TX
| | - Alyssa E. Noble
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA
| | - Laila Dahmoush
- Department of Pathology, University of Iowa, Iowa City, IA
| | - George M. Slavich
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Frank J. Penedo
- Department of Psychology and Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - Anil K. Sood
- Departments of Gynecologic Oncology, Cancer Biology and Center for RNA Interference and Noncoding RNA, University of Texas M.D. Anderson Cancer Center, Houston TX
| | - Steven W. Cole
- Division of Hematology/Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
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Pertl MM, Perez S, Collier S, Guinan E, Monahan G, Verling K, Wallace E, Walsh A, Doyle F. Effective maNagement of depression among patients witH cANCEr (ENHANCE): a protocol for a hybrid systematic review and network meta-analysis of randomised controlled trials of interventions for depressive symptoms. Syst Rev 2022; 11:239. [PMID: 36371235 PMCID: PMC9655794 DOI: 10.1186/s13643-022-02107-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 10/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Depression is common among patients with cancer and is associated with lower treatment participation, lower satisfaction with care, poorer quality of life, greater symptom burden and higher healthcare costs. Various types of interventions (e.g. pharmacological, psychotherapy) are used for the treatment of depression. However, evidence for these among patients with cancer is limited. Furthermore, the relative effectiveness and acceptability of different approaches are unknown because a direct comparison between all available treatments has not been carried out. We will address this by conducting a network meta-analysis (NMA) of interventions for depression among people with cancer using a hybrid overview of reviews and systematic review methodology. METHODS We will search for and extract data from systematic reviews of randomised controlled trials (RCTs) of depression interventions for patients with cancer from inception, before performing a supplemental search for more recent RCTs. We will include RCTs comparing pharmacological, psychotherapy, exercise, combination therapy, collaborative care or complementary and alternative medicine interventions with pill placebo, no treatment, waitlist, treatment as usual or minimal treatment control groups, or directly in head-to-head trials, among adults who currently have cancer or have a history of any cancer and elevated depressive symptoms (scores above a cut-off on validated scales or meeting diagnostic criteria). Our primary outcomes will be change in depressive symptoms (standardised mean difference) and intervention acceptability (% who withdrew). Our secondary outcomes will be 6-month change in depressive symptoms, health-related quality of life, adverse events and mortality. We will independently screen for eligibility, extract data and assess risk of bias using the RoB 2 tool. We will use frequentist random-effects multivariate NMA in Stata, rankograms and surface under the cumulative ranking curves to synthesise evidence and obtain a ranking of intervention groups. We will explore heterogeneity and inconsistency using local and global measures and evaluate the credibility of results using the Confidence in NEtwork Meta-Analysis (CINeMA) framework. DISCUSSION Our findings will provide the best available evidence for managing depression among patients with cancer. Such information will help to inform clinical guidelines, evidence-based treatment decisions and future research by identifying gaps in the current literature. SYSTEMATIC REVIEW REGISTRATION Submitted to PROSPERO (record number: 290145), awaiting registration.
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Affiliation(s)
- Maria M Pertl
- Department of Health Psychology, School of Population Health, Royal College of Surgeons in Ireland (RCSI), 123 St. Stephen's Green, Dublin, 2, Ireland.
| | - Sergio Perez
- School of Social Work and Social Policy, Trinity College Dublin (TCD), Dublin, 2, Ireland
| | - Sonya Collier
- Psycho-Oncology Unit, St. James's Hospital Dublin, Dublin, 8, Ireland
| | - Emer Guinan
- Trinity Exercise Oncology Research Group, Discipline of Physiotherapy, Faculty of Health Sciences, TCD, Dublin, 2, Ireland
| | | | | | - Emma Wallace
- Department of General Practice, , University College Cork, Cork, Ireland
| | - Aisling Walsh
- Department of Public Health and Epidemiology, School of Population Health, RCSI, 123 St. Stephen's Green, Dublin, 2, Ireland
| | - Frank Doyle
- Department of Health Psychology, School of Population Health, Royal College of Surgeons in Ireland (RCSI), 123 St. Stephen's Green, Dublin, 2, Ireland
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Polfer EM, Alici Y, Baser RE, Healey JH, Bartelstein MK. What Proportion of Patients With Musculoskeletal Sarcomas Demostrate Symptoms of Depression or Anxiety? Clin Orthop Relat Res 2022; 480:2148-2160. [PMID: 35901433 PMCID: PMC9556120 DOI: 10.1097/corr.0000000000002295] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/06/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND It is estimated that the 12-month prevalence of depression in the United States is 8.6%, and for anxiety it is 2.9%. Although prior studies have evaluated depression and anxiety in patients with carcinoma, few have specifically evaluated patients with sarcoma, who often have unique treatment considerations such as mobility changes after surgery. QUESTIONS/PURPOSES We evaluated patients with sarcoma seen in our orthopaedic oncology clinic to determine (1) the proportion of patients with depression symptoms, symptom severity, how many patients triggered a referral to mental health professionals based upon our prespecified cutoff scores on the nine-item Patient Health Questionnaire (PHQ-9), and if their symptoms varied by disease state; (2) the proportion of patients with anxiety symptoms, symptom severity, how many patients triggered a referral to mental health professionals based upon our prespecified cutoff scores on the seven-item Generalized Anxiety Disorder Scale (GAD-7), and if they symptoms varied by disease state; (3) whether other factors were associated with the proportion and severity of symptoms of anxiety or depression, such as tumor location in the body (axial skeleton, upper extremity, or lower extremity), general type of tumor (bone or soft tissue), specific diagnosis, use of chemotherapy, length of follow-up (less than 1 year or greater than 1 year), and gender; and (4) what proportion of patients accepted referrals to mental health professionals, when offered. METHODS This study was a cross-sectional survey study performed at a single urban National Cancer Institute-designated Comprehensive Cancer Center from April 2021 until July 2021. All patients seen in the orthopaedic clinic 18 years of age and older with a diagnosis/presumed diagnosis of sarcoma were provided the PHQ-9 as well as the GAD-7 in our clinic. We did not track those who elected not to complete the surveys. Surveys were scored per survey protocol (each question was scored from 0 to 3 and summed). Specifically, PHQ-9 scores the symptoms of depression as 5 to 9 (mild), 10 to 14 (moderate), 15 to 19 (moderately severe), and 20 to 27 (severe). The GAD-7 scores symptoms of anxiety as 5 to 9 (mild), 10 to 14 (moderate), and 15 to 21 (severe). Patients with PHQ-9 or GAD-7 scores of 10 to 14 were referred to social work and those with scores 15 or higher were referred to psychiatry. Patients with thoughts of self-harm were referred regardless of score. Patients were divided based on disease state: patients during their initial management; patients with active, locally recurrent disease; patients with active metastatic disease; patients with prior recurrence or metastatic lesions who were subsequently treated and now have no evidence of disease (considered to be patients with discontinuous no evidence of disease); patients with no evidence of disease; and patients with an active, noncancerous complication but otherwise no evidence of disease. We additionally looked at the association of gender, chemotherapy administration, and tumor location on survey responses. Data are summarized using descriptive statistics. Differences across categories of disease state were tested for statistical significance using Kruskal-Wallis tests for continuous variables and Fisher exact tests for categorical variables as well as pairwise Wilcoxon rank sum tests. RESULTS Overall, symptoms of depression were seen in 35% (67 of 190) of patients, at varying levels of severity: 19% (37 of 190) had mild symptoms, 9% (17 of 190) had moderate symptoms, 6% (12 of 190) had moderately severe symptoms, and 1% (1 of 190) had severe symptoms. Depresssion symptoms severe enough to trigger a referral were seen in 17% (32 of 190) of patients overall. Patients scored higher on the PHQ-9 during their initial treatment or when they had recurrent or metastatic disease, and they were more likely to trigger a referral during those timepoints as well. The mean PHQ-9 was 5.7 ± 5.8 during initial treatment, 6.1 ± 4.9 with metastatic disease, and 7.4 ± 5.2 with recurrent disease as compared with 3.2 ± 4.2 if there was no evidence of disease (p = 0.001). Anxiety symptoms were seen in 33% (61 of 185) of patients: 17% (32 of 185) had mild symptoms, 8% (14 of 185) had moderate symptoms, and 8% (15 of 185) had severe symptoms. Anxiety symptoms severe enough to trigger a referral were seen in 16% (29 of 185) of patients overall. Patients scored higher on the GAD-7 during initial treatment and when they had recurrent disease or an active noncancerous complication. The mean GAD-7 was 6.3 ± 3.2 in patients with active noncancerous complications, 6.8 ± 5.8 in patients during initial treatment, and 8.4 ± 8.3 in patients with recurrent disease as compared with 3.1 ± 4.2 in patients with no evidence of disease (p = 0.002). Patients were more likely to trigger a referral during initial treatment (32% [9 of 28]) and with recurrent disease (43% [6 of 14]) compared with those with no evidence of disease (9% [9 of 97]) and those with discontinuous no evidence of disease (6% [1 of 16]; p = 0.004). There was an increase in both PHQ-9 and GAD-7 scores among patients who had chemotherapy. Other factors that were associated with higher PHQ-9 scores were location of tumor (upper extremity versus lower extremity or axial skeleton) and gender. Another factor that was associated with higher GAD-7 scores included general category of diagnosis (bone versus soft tissue sarcoma). Specific diagnosis and length of follow-up had no association with symptoms of depression or anxiety. Overall, 22% (41 of 190) of patients were offered referrals to mental health professionals; 73% (30 of 41) accepted the referral. CONCLUSION When treating patients with sarcoma, consideration should be given to potential concomitant psychiatric symptoms. Screening, especially at the highest-risk timepoints such as at the initial diagnosis and the time of recurrence, should be considered. Further work should be done to determine the effect of early psychiatric referral on patient-related outcomes and healthcare costs. LEVEL OF EVIDENCE Level III, therapeutic study.
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Affiliation(s)
- Elizabeth M. Polfer
- Department of Orthopaedics, William Beaumont Army Medical Center, Fort Bliss, TX, USA
| | - Yesne Alici
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Raymond E. Baser
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John H. Healey
- Orthopaedic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Meredith K. Bartelstein
- Orthopaedic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Xue D, Li N, Li L, Huang Y, Men K, Meng Q, Zhang S. Sarcopenia is an independent risk factor for depression in patients with advanced lung cancer. Support Care Cancer 2022; 30:9659-9665. [PMID: 36203065 DOI: 10.1007/s00520-022-07384-w] [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: 06/08/2022] [Accepted: 10/02/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Depression is the most prevalent psychological issue among cancer patients and can seriously affect patients' life and disease prognosis and even lead to suicide. Sarcopenia is a manifestation of cancer cachexia, a chronic progressive process. It is accompanied by a sustained decrease in skeletal muscle mass, muscle strength, and physical function and likewise has various negative effects on the patient. This study aimed to evaluate sarcopenia and other factors that may affect depression in patients with lung cancer and to further analyze and discuss. METHODS A total of 104 eligible patients were enrolled in this cross-sectional study, using the Hamilton Depression Scale to assess depression, obtaining the psoas muscle index (PMI) by computed tomography (CT), and performing the diagnosis of sarcopenia. Clinical and personal characteristics were collected by electronic medical records. RESULTS We evaluated a total of 104 hospitalized cancer patients in this analysis, with mean age = 57.8 ± 11.0 years, and 65.38% (68) were female. We found that up to 31.7% (33) of the participants had depression and 61.5% (64) of the participants had sarcopenia, and no statistical differences were found among depressed and non-depressed patients in relation to age, smoking, gender, performance status, and pathology. Patients with sarcopenia have more than four times the risk of suffering from depression than patients without sarcopenia (OR = 4.133, 95%CI = 1.390-12.287; p = 0.011). Similarly, the possibility of depression in patients with PD (progressive disease) as efficacy evaluation increased by 13.482 times (95%CI = 2.121-85.679, p = 0.006). CONCLUSION In individuals with terminal lung cancer, depression and sarcopenia are prevalent. A strong association between the two is now thought to exist. Sarcopenia and efficacy evaluation are independent risk factors for depression. The correlation between sarcopenia and depression underscores the need for early intervention by our clinicians.
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Affiliation(s)
- Dinglong Xue
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Ning Li
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Lijun Li
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yaru Huang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Kaiya Men
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Qingwei Meng
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China.
| | - Shuai Zhang
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China.
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Wood CJ, Polley M, Barton JL, Wicks CL. Therapeutic Community Gardening as a Green Social Prescription for Mental Ill-Health: Impact, Barriers, and Facilitators from the Perspective of Multiple Stakeholders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013612. [PMID: 36294204 PMCID: PMC9603302 DOI: 10.3390/ijerph192013612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/12/2022] [Accepted: 10/17/2022] [Indexed: 05/03/2023]
Abstract
The UK government has invested £5.77 million in green social prescribing to prevent and tackle mental ill-health. Therapeutic community gardening, one type of green social prescription, provides a range of health outcomes. However, for increased accessibility, a greater understanding of how it impacts mental health and the facilitators and barriers to referral, uptake, and attendance by individuals with mental health problems is required. We conducted and thematically analysed interviews with thirteen stakeholders including social prescribing link workers and garden staff; and focus groups with twenty garden members. The mechanisms by which therapeutic community gardening were suggested to impact mental health were by engaging members with nature and the outdoors, providing hope for the future and facilitating social support and relationships. Factors facilitating referral, uptake, and attendance included a holistic and person-centred approach, which is flexible around health needs. Barriers included awareness of the full offering of therapeutic community gardens and accessibility, in terms of physical location and waiting lists. Given that nature-based interventions have the potential to protect and enhance population health and offer cost savings through reduced reliance on other health services; overcoming these barriers is key to ensuring that therapeutic community gardening is more widely available as an additional mental health treatment.
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Affiliation(s)
- Carly J. Wood
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Colchester CO4 3SQ, UK
- Correspondence:
| | - Marie Polley
- Marie Polley Consultancy Ltd., Hitchin SG4 0AP, UK
| | - Jo L. Barton
- School of Sport, Rehabilitation and Exercise Science, University of Essex, Colchester CO4 3SQ, UK
| | - Claire L. Wicks
- School of Health and Social Care, University of Essex, Colchester CO4 3SQ, UK
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Pacheco-Barcia V, Gomez D, Obispo B, Mihic Gongora L, Hernandez San Gil R, Cruz-Castellanos P, Gil-Raga M, Villalba V, Ghanem I, Jimenez-Fonseca P, Calderon C. Role of sex on psychological distress, quality of life, and coping of patients with advanced colorectal and non-colorectal cancer. World J Gastrointest Oncol 2022; 14:2025-2037. [PMID: 36310711 PMCID: PMC9611434 DOI: 10.4251/wjgo.v14.i10.2025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/24/2022] [Accepted: 08/25/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Patients with advanced gastrointestinal cancer must cope with the negative effects of cancer and complications.
AIM To evaluate psychological distress, quality of life, and coping strategies in patients with advanced colorectal cancer compared to non-colorectal cancer based on sex.
METHODS A prospective, transversal, multicenter study was conducted in 203 patients; 101 (50%) had a colorectal and 102 (50%) had digestive, non-colorectal advanced cancer. Participants completed questionnaires evaluating psychological distress (Brief Symptom Inventory-18), quality of life (EORTC QLQ-C30), and coping strategies (Mini-Mental Adjustment to Cancer) before starting systemic cancer treatment.
RESULTS The study included 42.4% women. Women exhibited more depressive symptoms, anxiety, functional limitations, and anxious preoccupation than men. Patients with non-colorectal digestive cancer and women showed more somatization and physical symptoms than subjects with colorectal cancer and men. Men with colorectal cancer reported the best health status.
CONCLUSION The degree of disease acceptance in gastrointestinal malignancies may depend on sex and location of the primary digestive neoplasm. Future interventions should specifically address sex and tumor site differences in individuals with advanced digestive cancer.
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Affiliation(s)
- Vilma Pacheco-Barcia
- Department of Medical Oncology, School of Medicine, Alcala University (UAH), Hospital Central de la Defensa Gómez Ulla, Madrid 28047, Spain
| | - David Gomez
- Department of Medical Oncology, Hospital Universitario de Navarra, Pamplona 31008, Spain
| | - Berta Obispo
- Department of Medical Oncology, Hospital Universitario Infanta Leonor, Madrid 28031, Spain
| | - Luka Mihic Gongora
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo 33011, Spain
| | | | | | - Mireia Gil-Raga
- Department of Medical Oncology, Hospital General Universitario de Valencia, CIBERONC, Valencia 46014, Spain
| | - Vicente Villalba
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona 08007, Spain
| | - Ismael Ghanem
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid 28046, Spain
| | - Paula Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo 33007, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona 08007, Spain
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Oh J, Lee HS, Jeon S, Kim D, Seok JH, Park WC, Kim JJ, Yoon CI. Risk of developing depression from endocrine treatment: A nationwide cohort study of women administered treatment for breast cancer in South Korea. Front Oncol 2022; 12:980197. [PMID: 36203445 PMCID: PMC9530937 DOI: 10.3389/fonc.2022.980197] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundAlthough previous studies demonstrated no association between depression and tamoxifen in patients with breast cancer, there is still a limited amount of long-term follow-up data. This study aimed to evaluate the relationship between endocrine treatment and the risk of depression.MethodsThis nationwide population-based cohort study used data obtained over a 14-year period (January 2007 to December 2021) from the Korean National Health Insurance claims database. All female patients with breast cancer were included. We examined the incidence of depression in patients who underwent endocrine treatment, and those who did not undergo endocrine treatment constituted the control group.ResultsThe data from 11,109 patients who underwent endocrine treatment and 6,615 control patients between 2009 and 2010 were analyzed. After performing matching for comorbidities and age, both groups comprised 6,532 patients. The median follow-up were 119.71 months. Before and after matching was performed, the endocrine treatment was not a significant risk factor for developing depression (p=0.7295 and p=0.2668, respectively), nor was it a significant factor for an increased risk for suicide attempt (p=0.6381 and p=0.8366, respectively).ConclusionsUsing a real-world population-based cohort, this study demonstrated that there is no evidence that the endocrine treatment increases the risk of depression.
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Affiliation(s)
- Jooyoung Oh
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Soyoung Jeon
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Dooreh Kim
- Division of Breast Surgery, Department of Surgery, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jeong-Ho Seok
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Woo-Chan Park
- Division of Breast Surgery, Department of Surgery, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae-Jin Kim
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Chang Ik Yoon
- Division of Breast Surgery, Department of Surgery, Seoul St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
- *Correspondence: Chang Ik Yoon,
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140
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Haque R, Reading S, Irwin MR, Chen LH, Slezak J. Antidepressant medication use and prostate cancer recurrence in men with depressive disorders. Cancer Causes Control 2022; 33:1363-1372. [PMID: 36083407 PMCID: PMC9519663 DOI: 10.1007/s10552-022-01623-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022]
Abstract
Purpose Whether treating prostate cancer survivors with a depressive disorder with antidepressants can affect their cancer outcomes is unknown. We evaluated the association between antidepressant use and prostate cancer recurrence, in survivors with comorbid depressive disorders. Methods We conducted a longitudinal cohort study of 10,017 men with prostate cancer (stages I–II) diagnosed who also had a comorbid depressive disorder followed a maximum of 22 years, and examined rates of biochemical recurrence by antidepressant medication use. We conducted multivariable Cox models based on time-dependent antidepressant drug use status, and examined the risk of biochemical recurrence by cumulative duration of antidepressant use. Results Of these 10,017 survivors, 1842 (18%) experienced biochemical recurrence over 69,500 person-years of follow-up. The prostate cancer biochemical recurrence rate was greater with antidepressant non-use (31.3/1000 person-years) compared to antidepressant use (23.5/1000 person-years). In Cox proportional hazards multivariable adjusted models, non-use of antidepressants was associated with a 34% increased risk of biochemical recurrence compared to antidepressant use (HR = 1.34, 95% CI: 1.24–1.44). Longer use of antidepressants was associated with a lower biochemical recurrence risk (P trend test < 0.001). Conclusion Untreated depressive disorders in prostate cancer patients may be associated with an increased risk of biochemical recurrence.
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Affiliation(s)
- Reina Haque
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, 2nd Floor, Pasadena, CA, 91101, USA. .,Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, 91101, USA.
| | - Stephanie Reading
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, 2nd Floor, Pasadena, CA, 91101, USA
| | - Michael R Irwin
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, 90095, USA
| | - Lie Hong Chen
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, 2nd Floor, Pasadena, CA, 91101, USA
| | - Jeff Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 South Los Robles, 2nd Floor, Pasadena, CA, 91101, USA
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Lan B, Lv D, Yang M, Sun X, Zhang L, Ma F. Psychological distress and quality of life in Chinese early-stage breast cancer patients throughout chemotherapy. JOURNAL OF THE NATIONAL CANCER CENTER 2022; 2:155-161. [PMID: 39036454 PMCID: PMC11256606 DOI: 10.1016/j.jncc.2022.06.002] [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: 11/06/2021] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022] Open
Abstract
Background Breast cancer survivors with psychological problems have higher mortality than those without. Therefore, it is important to monitor and manage their psychological status. This study mainly aimed to dynamically estimate the prevalence of anxiety and depression and to clarify the factors associated with anxiety and depression of patients undergoing adjuvant chemotherapy. The secondary objective was to investigate the relationship between depression and anxiety and quality of life (QOL) in Chinese early-stage breast cancer patients. Methods In a prospective observational single-center cohort study with early-stage breast cancer patients (n = 290), depression and anxiety severity, QOL, and social support were measured using the Hospital Anxiety and Depression Scale (HADS), the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) scale, and the Chinese version of the Social Support Rating Scale (SSRS), respectively. Canonical correlations were applied to identify correlates between anxiety and depression and demographic and clinical variables. One-way repeated measure analysis of covariance (RMANCOVA) was used to analyze dynamic changes in anxiety, depression, and QOL. Relationships between anxiety and depression and QOL were analyzed using two-way RMANCOVA. Results The overall anxiety and depression prevalence rates were 35.2% and 44.1%, respectively. Age (P = 0.042), surgical method (P = 0.009), social support (P = 0.001), and breast cancer family history (P = 0.045) were significantly associated with depression. The number of children (P = 0.048) was significantly associated with anxiety. FACT-B scores differed between anxiety and depression and nonanxiety and depression groups, and patients with higher HADS depression and anxiety scores had lower FACT-B scores during chemotherapy (P < 0.001). Conclusions We observed dynamic changes in anxiety and depression and QOL and associated factors of anxiety and depression. These findings can provide guidance for psychological monitoring and support for breast cancer patients during the postoperative chemotherapy period.
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Affiliation(s)
- Bo Lan
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dan Lv
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Yang
- Comprehensive Oncology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoying Sun
- Department of Medical Oncology, Cancer Hospital of Huanxing Chaoyang District, Beijing, China
| | - Li Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Fei Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Varela‐Moreno E, Rivas‐Ruiz F, Padilla‐Ruiz M, Alcaide‐García J, Zarcos‐Pedrinaci I, Téllez T, Larrea‐Baz NF, Baré M, Bilbao A, Sarasqueta C, Morales‐Suárez‐Varela MM, Aguirre U, Quintana JM, Redondo M, Group CARESSS. Influence of depression on survival of colorectal cancer patients drawn from a large prospective cohort Depression and survival in colorectal cancer patients. Psychooncology 2022; 31:1762-1773. [DOI: 10.1002/pon.6018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Esperanza Varela‐Moreno
- Research Unit Costa del Sol Health Agency Marbella Andalucía Spain
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Biomedical Research Institute of Málaga (IBIMA) Malaga Spain
| | - Francisco Rivas‐Ruiz
- Research Unit Costa del Sol Health Agency Marbella Andalucía Spain
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
| | - María Padilla‐Ruiz
- Research Unit Costa del Sol Health Agency Marbella Andalucía Spain
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Biomedical Research Institute of Málaga (IBIMA) Malaga Spain
| | - Julia Alcaide‐García
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Medical Oncology Service Costa del Sol Health Agency Marbella Spain
- Intercenter Clinical Management Unit of Medical Oncology Regional and Virgen de la Victoria University Hospital of Málaga Malaga Spain
| | - Irene Zarcos‐Pedrinaci
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Biomedical Research Institute of Málaga (IBIMA) Malaga Spain
- Medical Oncology Service Costa del Sol Health Agency Marbella Spain
| | - Teresa Téllez
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Biomedical Research Institute of Málaga (IBIMA) Malaga Spain
- Department of Surgical Specialties Biochemistry and Immunology Faculty of Medicine University of Málaga Malaga Spain
| | - Nerea Fernández‐de Larrea‐Baz
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Area of Environmental Epidemiology and Cancer National Epidemiology Centre Carlos III Health Institute (ISCIII) Madrid Spain
- CIBER of Epidemiology and Public Health (CIBERESP) Institute of Health Carlos III Madrid Spain
| | - Marisa Baré
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Clinical Epidemiology and Cancer Screening Parc Taulí University Hospital Sabadell Barcelona Spain
| | - Amaia Bilbao
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Osakidetza Basque Health Service Research Unit Basurto Universitary Hospital Bilbao Bizkaia Spain
- Kronikgune Institute for Health Services Research Barakaldo Spain
| | - Cristina Sarasqueta
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Biodonostia Health Research Institute Donostia Universitary Hospital Donostia‐San Sebastian Guipuzkoa Spain
| | - María Manuela Morales‐Suárez‐Varela
- Unit of Public Health and Environmental Care Department of Preventive Medicine University of Valencia Valencia Spain
- CIBER of Epidemiology and Public Health (CIBERESP) Institute of Health Carlos III Madrid Spain
| | - Urko Aguirre
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Research Unit Galdakao‐Usansolo Hospital Galdakao Spain
| | - José María Quintana
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Research Unit Galdakao‐Usansolo Hospital Galdakao Spain
| | - Maximino Redondo
- Research Unit Costa del Sol Health Agency Marbella Andalucía Spain
- Health Services Research Network on Chronic Diseases ‐ REDISSEC Malaga Spain
- Biomedical Research Institute of Málaga (IBIMA) Malaga Spain
- Department of Surgical Specialties Biochemistry and Immunology Faculty of Medicine University of Málaga Malaga Spain
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143
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Yang CM, Sung FC, Mou CH, Liao CH, Wang PH, Shieh SH. Anxiety and depression risk in Taiwan women with breast cancer and cervical cancer. Front Oncol 2022; 12:946029. [PMID: 36059620 PMCID: PMC9437326 DOI: 10.3389/fonc.2022.946029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/13/2022] [Indexed: 12/24/2022] Open
Abstract
Background Studies comparing mental disorder risks between women with breast cancer and cervical cancer are lacking. This study compared risks of developing anxiety and depression between women with breast cancer (BC cohort) and women with cervical cancer (CC cohort) using insurance claims data of Taiwan. Methods From the 2000 to 2016 data, we identified a BC cohort and BC controls (N = 96,862) and a CC cohort and CC controls (N = 26,703), matched by propensity scores. Incident mental disorders and the Cox method estimated the related cancer cohort to control cohort hazard ratios (HRs), and 95% confidence intervals (CIs) were estimated by the end of 2016. Results Compared to the CC cohort, the BC cohort had slightly higher incident anxiety (15.9 versus 15.5 per 1,000 person-years) and depression (6.92 vs. 6.28 per 1,000 person-years). These mental disorders were higher in respective cancer cohorts than controls. The BC cohort to BC control adjusted HRs of anxiety and depression were 1.29 (95% CI = 1.25-1.33) and 1.78 (95% CI = 1.69-1.87), respectively. The corresponding adjusted HRs for the CC cohort were 1.12 (95% CI = 1.06-1.18) and 1.29 (95% CI = 1.18-1.41). The combined incidence rates of both disorders were 1.4-fold greater in the BC cohort than in BC controls (22.8 vs. 15.8 per 1,000 person-years), and 1.2-fold greater in the CC cohort than in the CC controls (21.7 vs. 18.3 per 1,000 person-years). Conclusion Women with breast cancer or cervical cancer are at an elevated likelihood of developing anxiety and depression disorders. These incident disorders are slightly higher in those with breast cancer.
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Affiliation(s)
- Chiu-Ming Yang
- Department of Health Services Administration, China Medical University College of Public Health, Taichung, Taiwan
- Department of Public Health, China Medical University College of Public Health, Taichung, Taiwan
| | - Fung-Chang Sung
- Department of Health Services Administration, China Medical University College of Public Health, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Chih-Hsin Mou
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Hui Liao
- Department of Psychiatry, China Medical University College of Medicine, Taichung, Taiwan
| | - Po-Hui Wang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shwn-Huey Shieh
- Department of Health Services Administration, China Medical University College of Public Health, Taichung, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan
- Department of Nursing, Asia University, Taichung, Taiwan
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144
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Venkataramany BS, Sutton JM. The Importance of Social Determinants of Health for Cancer Patients in the Era of COVID-19. Cureus 2022; 14:e27993. [PMID: 36120243 PMCID: PMC9469753 DOI: 10.7759/cureus.27993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has proven to be a challenge for public health professionals, researchers, clinicians, and patients. One group that has experienced significant difficulties during this time is cancer patients. Data regarding this vulnerable population is scarce, despite novel information about vaccine efficacy, therapeutics, mutations, and comorbidities. In this article, we discuss the need for a greater study of social determinants of health (SDOH) for cancer patients in the context of the COVID-19 pandemic. The effects of SDOH on population health are generally well-understood, but their effects on cancer patients are poorly understood. We further pose questions that may be starting points for the investigation of SDOH in cancer patients during this time. Using SDOH as a tool for more effective clinical care will promote the development of targeted interventions to study and improve outcomes in this population.
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145
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Tian F, Fang F, Shen Q, Ye W, Valdimarsdóttir UA, Song H. Stress-related disorders and subsequent cancer risk and mortality: a population-based and sibling-controlled cohort study in Sweden. Eur J Epidemiol 2022; 37:947-958. [PMID: 35962878 PMCID: PMC9529708 DOI: 10.1007/s10654-022-00898-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/01/2022] [Indexed: 12/02/2022]
Abstract
Prior research has suggested a potential role of psychological stress on cancer development while the role of familial factors on this association is underexplored. We conducted a nationwide cohort study including 167,836 individuals with a first-onset stress-related disorder (including post-traumatic stress disorder, acute stress reaction, adjustment disorder and other stress reactions) diagnosed between 1981 and 2016 in Sweden (i.e., exposed patients), 1,631,801 birth year- and sex-matched unexposed individuals, and 179,209 unaffected full siblings of the exposed patients. Cox models were used to estimate the hazard ratios (HRs) of newly diagnosed cancer and cancer-related death, beyond 1 year after diagnosis of stress-related disorders. We further examined the potential mediation roles of behavior-related morbidities in the associations of stress-related disorders with smoking or alcohol-related cancer incidence and mortality. We found modestly elevated risks of cancer incidence and mortality among exposed patients compared with matched unexposed individuals (incidence: HR = 1.03, 95% CI 1.01–1.06; mortality: HR = 1.13, 95% CI 1.07–1.18), while not when comparing with full siblings (incidence: HR = 1.03, 95% CI 0.99–1.08; mortality: HR = 1.09, 95% CI 1.00-1.19). Similarly, the suggested elevations in incidence and mortality of individual cancer sites (or groups) in the population-based comparison attenuated towards null in the between-sibling comparison. The risk elevations for smoking or alcohol-related cancers in the population-based comparison (incidence: HR = 1.18, 95% CI 1.11–1.24; mortality: HR = 1.20, 95% CI 1.12–1.29) were partially mediated by alcohol-related morbidities during follow-up. Collectively, our findings suggest that the association between stress-related disorders and cancer risk and mortality is largely explained by familial factors, including shared behavioral hazards.
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Affiliation(s)
- Fan Tian
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, 610041, Chengdu, China.,West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.,Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Qing Shen
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Unnur A Valdimarsdóttir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Guo Xue Lane 37, 610041, Chengdu, China. .,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland. .,Med-X Center for Informatics, Sichuan University, Chengdu, China.
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146
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Fodor LA, Todea D, Podina IR. Core Fear of Cancer recurrence symptoms in Cancer Survivors: a network approach. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03500-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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147
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Kuhlman KR, Irwin MR, Ganz PA, Cole SW, Manigault AW, Crespi CM, Bower JE. Younger women are more susceptible to inflammation: A longitudinal examination of the role of aging in inflammation and depressive symptoms. J Affect Disord 2022; 310:328-336. [PMID: 35561889 DOI: 10.1016/j.jad.2022.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 04/17/2022] [Accepted: 05/05/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The degree to which effects of inflammation on mood and behavior vary across the lifespan remains relatively unexplored despite well-established, age-related alterations in both the immune and central nervous systems. Further, the implications of this developmental process within different symptom domains warrants careful consideration. METHODS Women diagnosed with breast cancer (n = 188; ages 27-89) provided blood samples and reported depressive symptoms prior to adjuvant treatment, at the end of adjuvant treatment, and 6-, 12-, and 18-months after completing adjuvant treatment via the CES-D. Blood was assayed for C-reactive Protein (CRP) and interleukin (IL)-6. We used mixed linear effect models to estimate within- and between-person effects of CRP or IL-6 on 4 domains of depressive symptoms: depressed affect, low positive affect, somatic complaints, and interpersonal problems. RESULTS High average inflammation was associated with elevated somatic complaints (CRP p = .009, IL-6: p = .05), interpersonal problems (CRP p = .002, IL-6 p < .001), and positive affect (IL-6 p = .03), but only among the youngest women in the sample (age 50 or younger). Younger women also reported more depressed affect at assessments when inflammation was higher (CRP p = .045, IL-6 p = .09). CONCLUSIONS The association between inflammation and specific depressive symptoms is dynamic and varies across the lifespan, which may help clarify apparent inconsistencies in the extant literature as well as inform more precise interventions targeting this pathway.
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Affiliation(s)
- Kate R Kuhlman
- Department of Psychological Science, School of Social Ecology, University of California, Irvine, Irvine, CA, USA; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Development, University of California Los Angeles, Los Angeles, CA, USA; Institute for Interdisciplinary Salivary Bioscience, School of Social Ecology, University of California Irvine, Irvine, CA, USA.
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Development, University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Patricia A Ganz
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Steve W Cole
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Development, University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andrew W Manigault
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Catherine M Crespi
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Julienne E Bower
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Development, University of California Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA; Jonsson Comprehensive Cancer Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
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148
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Chayadi E, Baes N, Kiropoulos L. The effects of mindfulness-based interventions on symptoms of depression, anxiety, and cancer-related fatigue in oncology patients: A systematic review and meta-analysis. PLoS One 2022; 17:e0269519. [PMID: 35834503 PMCID: PMC9282451 DOI: 10.1371/journal.pone.0269519] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 05/20/2022] [Indexed: 11/25/2022] Open
Abstract
Objective Mindfulness-based interventions (MBIs) are increasingly being integrated into oncological treatment to mitigate psychological distress and promote emotional and physical well-being. This review aims to provide the most recent evaluation of Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Cancer Recovery (MBCR) treatments, in reducing symptoms of depression, anxiety and CRF in oncology populations. Methods A search using the following search terms was conducted: (mindful* OR mindfulness* OR mindfulness-based* OR MBI* OR MBCT OR MBSR OR MBCR) AND (Oncol* OR cancer OR neoplasm OR lymphoma OR carcinoma OR sarcoma) to obtain relevant publications from five databases: PsycINFO, PubMed, Embase, and MEDLINE by EC, and ProQuest Dissertations & Theses Global from January 2000 to February 2022. 36 independent studies (n = 1677) were evaluated for their overall effect sizes (using random-effects models), subgroup analyses, and quality appraisals. Evaluations were performed separately for non-randomized (K = 20, n = 784) and randomized controlled trials (K = 16, n = 893). Results The results showed that MBIs have significant medium effects in reducing symptoms of depression (Hedges’ g = 0.43), anxiety (Hedges’ g = 0.55) and CRF (Hedges’ g = 0.43), which were maintained at least three months post-intervention. MBIs were also superior in reducing symptoms of anxiety (Hedges’ g = 0.56), depression (Hedges’ g = 0.43), and CRF (Hedges’ g = 0.42) in oncology samples relative to control groups. The superiority of MBIs to control groups was also maintained at least three months post-intervention for anxiety and CRF symptoms, but not for depressive symptoms. The risk of bias of the included studies were low to moderate. Conclusions This review found that MBIs reduced symptoms of depression, anxiety and CRF in oncology populations. Systematic review registration PROSPERO: International Prospective Register of Systematic Reviews: CRD42020143286.
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Affiliation(s)
- Ellentika Chayadi
- Faculty of Medicine, Dentistry, and Health Sciences, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Naomi Baes
- Faculty of Medicine, Dentistry, and Health Sciences, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Litza Kiropoulos
- Faculty of Medicine, Dentistry, and Health Sciences, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
- * E-mail:
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149
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Uveal melanoma and marital status: a relationship that affects survival. Int Ophthalmol 2022; 42:3857-3867. [PMID: 35821361 PMCID: PMC9617958 DOI: 10.1007/s10792-022-02406-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
Background Marital status influences the presentation and outcome of various cancers. We explored the relationship between marital status and survival of uveal melanoma (UM) and factors influencing this relationship. Methods We conducted a retrospective cohort study on patients diagnosed with UM and registered in the Surveillance Epidemiology and End Results program between 1973 and 2017. Cox regression model was conducted to calculate the hazard ratio of overall and cancer-specific survival rate and delineate the effect of each confounder. Results The study involved 10,557 patients with a male-to-female ratio of 1:1.1. Most of the diagnosed patients were aged between 40 and 79 years (81%). Married patients (62%) represented the majority, followed by singles (12%), widowed (11%), and then divorced patients (7%). Single patients were the youngest group (mean age of 59.3 years) while widowed patients were the oldest (mean age of 75.8 years). In the Cox regression model for overall survival, married and single patients exhibited the best overall survival (no significant difference in between them), both surpassing divorced and widowed patients. Married patients were at a significantly lower risk to die from UM than divorced patients. Female patients and younger age groups showed the best overall and cancer-specific survival. Conclusion Maintained marriages improved the survival of UM patients. Widowed and divorced patients should be included in specially designed support programs during their cancer management. Supplementary Information The online version contains supplementary material available at 10.1007/s10792-022-02406-2.
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150
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Liu Y, Cao X, Zhao X, Shi X, Lei M, Qin H. Quality of Life and Mental Health Status Among Cancer Patients With Metastatic Spinal Disease. Front Public Health 2022; 10:916004. [PMID: 35865242 PMCID: PMC9294283 DOI: 10.3389/fpubh.2022.916004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate the quality of life and mental health status and further to identify relevant risk factors among advanced cancer patients with spine metastases. This study prospectively included and analyzed 103 advanced cancer patients with spine metastases. Patient's basic information, lifestyles, comorbidities, tumor characteristics, therapeutic strategies, economic conditions, quality of life, anxiety, and depression were collected. Patient's quality of life was assessed using the Functional Assessment of Cancer Therapy-General Scale (FACT-G), and anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS). Subgroup analysis was performed based on different age groups, and a multivariate analysis was performed to test the ability of 20 potential risk factors to predict quality of life, anxiety, and depression. The mean total FACT-G score was only 61.38 ± 21.26. Of all included patients, 52.43% had skeptical or identified anxiety and 53.40% suffered from skeptical or identified depression. Patients had an age of 60 or more and <70 years had the lowest FACT-G score (54.91 ± 19.22), highest HADS anxiety score (10.25 ± 4.22), and highest HADS depression score (10.13 ± 4.94). After adjusting all other potential risk factors, age was still significantly associated with quality of life (OR = 0.57, 95%CI: 0.38–0.86, p < 0.01) and depression (OR = 1.55, 95%CI: 1.00–2.42, p = 0.05) and almost significantly associated with anxiety (OR = 1.52, 95%CI: 0.94–2.43, p = 0.08). Besides, preference to eating vegetables, time since knowing cancer diagnosis, surgical treatment at primary cancer, hormone endocrine therapy, and economic burden due to cancer treatments were found to be significantly associated with the quality of life. A number of comorbidities and economic burden due to cancer treatments were significantly associated with anxiety. Advanced cancer patients with spine metastases suffer from poor quality of life and severe anxiety and depression, especially among patients with an age of 60 or more and <70 years. Early mental health care and effective measures should be conducted to advanced cancer patients with spine metastases, and more attention should be paid to take care of patients with an age of 60 or more and <70 years in terms of their quality of life and mental health status.
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Affiliation(s)
- Yaosheng Liu
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing, China
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, PLA General Hospital, Beijing, China
- Department of Orthopedic Surgery, The Fifth Medical Center of PLA General Hospital, Fifth School of Clinical Medicine, Anhui Medical University, Hefei, China
| | - Xuyong Cao
- Department of Orthopedic Surgery, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Xiongwei Zhao
- Department of Orthopedic Surgery, The Fifth Medical Center of PLA General Hospital, Fifth School of Clinical Medicine, Anhui Medical University, Hefei, China
- Department of Orthopedic Surgery, The Fifth Medical Center of PLA General Hospital, Beijing, China
| | - Xiaolin Shi
- Department of Orthopedic Surgery, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
- Xiaolin Shi
| | - Mingxing Lei
- National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, PLA General Hospital, Beijing, China
- Chinese PLA Medical School, Beijing, China
- Department of Orthopedic Surgery, Hainan Hospital of PLA General Hospital, Sanya, China
- Mingxing Lei
| | - Haifeng Qin
- Senior Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing, China
- *Correspondence: Haifeng Qin
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