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Health-related quality of life and psychological distress among cancer survivors in Southeast Asia: results from a longitudinal study in eight low- and middle-income countries. BMC Med 2017; 15:10. [PMID: 28081724 PMCID: PMC5234136 DOI: 10.1186/s12916-016-0768-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/08/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A better understanding of health-related quality of life (HRQoL) and psychological distress in cancer survivors can raise awareness, promote the development of policies in cancer survivorship care, and facilitate better targeted use of limited resources in low- and middle-income countries (LMICs). The main objectives of this paper were therefore to assess HRQoL and the prevalence of psychological distress amongst cancer survivors in Southeast Asia and identify risk factors of these outcomes. METHODS The ACTION study was a longitudinal study in eight LMICs in Southeast Asia with 5249 first time cancer survivors followed up at 1 year after diagnosis. HRQoL was assessed using the EORTC QLQ-C30 and EQ-5D. Psychological distress (anxiety and depression) was assessed using the Hospital Anxiety and Depression Scale. General linear models and multiple logistic regression were used to identify independent predictors of HRQoL and psychological distress. RESULTS One year after diagnosis, the mean EORTC QLQ-C30 global health score for survivors was 66.2 out of 100 (SD 22.0), the mean index score on the EQ-5D was 0.74 (SD 0.23), 37% of survivors had at least mild levels of anxiety, and 46% showed at least mild levels of depression. Poorest HRQoL and highest prevalence of anxiety and depression were seen in patients with lung cancer and lymphomas, while highest scores and least psychological distress were seen in female patients with breast and cervical cancer. The most significant predictor of poor HRQoL and psychological distress outcomes was cancer stage at diagnosis. Age, co-morbidities, treatment, and several socioeconomic factors were associated with HRQoL and psychological distress. CONCLUSIONS Cancer survivors in LMICs in Southeast Asia have impaired HRQoL and substantial proportions have psychological distress. Patients with advanced cancer stages at diagnosis and those in a poor socioeconomic position were most at risk of such poor outcomes. Supportive interventions for cancer patients that address wider aspects of patient wellbeing are needed, as well as policies that address financial and other barriers to timely treatment.
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202
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Soleimani MA, Lehto RH, Negarandeh R, Bahrami N, Nia HS. Relationships between Death Anxiety and Quality of Life in Iranian Patients with Cancer. Asia Pac J Oncol Nurs 2016; 3:183-191. [PMID: 27981157 PMCID: PMC5123493 DOI: 10.4103/2347-5625.182935] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: The purpose of the study was to examine relationships between death anxiety and quality of life (QOL) parameters of patients with cancer in the Iranian sociocultural context. Methods: A descriptive, correlational methodology was used. The sample included 330 patients. Demographics, health information, religious behaviors, death anxiety, and QOL data were collected. Results: Overall death anxiety levels were moderate with satisfactory overall QOL. Death anxiety was predictive of lowered QOL. Female patients had lower QOL and higher death anxiety compared to men Conclusions: Findings support that higher death anxiety negatively impacts QOL in an Iranian sample with cancer. Alleviation of existential concerns in vulnerable patients may palliate mental health distress associated with facing cancer and its challenging treatments.
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Affiliation(s)
- Mohammad A Soleimani
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Rebecca H Lehto
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Bahrami
- School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Hamid Sharif Nia
- School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Mazandaran, Iran
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203
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Deshields TL, Penalba V, Liu J, Avery J. Comparing the symptom experience of cancer patients and non-cancer patients. Support Care Cancer 2016; 25:1103-1109. [PMID: 27966024 DOI: 10.1007/s00520-016-3498-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 11/14/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Symptom burden is an established concept in oncology encompassing the presence and severity of symptoms experienced by cancer patients. Few studies have examined differences in symptom burden between cancer patients and non-cancer patients. This study seeks to examine the differences in symptom burden between cancer patients (CP) and non-cancer patients (NCP) in order to better understand symptom burden in both populations. METHODS Two groups of patients completed the Memorial Symptom Assessment Scale: 301 patients from a general medical clinic and 558 cancer patients from a cancer tumor registry. Participants provided demographic information-age, race/ethnicity, and sex and completed the Memorial Symptom Assessment Scale. Medical comorbidity was also measured. RESULTS Most symptoms were more common in CP, except for pain, which was more prevalent in the NCP (45% of CP vs. 54% of NCP, p < .05). There was no difference in prevalence for the following symptoms: dry mouth, mouth sores, feeling nervous, worry, cough, and dizziness. The CP had greater mean MSAS Total scores (0.53 vs. 0.43, p < .01), number of symptoms (9.11 vs. 6.13, p < .01), and psychological subscale scores (0.77 vs. 0.64, p < .05). There was no difference by group in the physical nor the GDI subscale scores. CONCLUSION The results of this study support the perception that cancer patients have greater symptom burden. There were some unexpected results, particularly in terms of pain, which was more common in NCP and other symptoms that were experienced equally in both patient populations.
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Affiliation(s)
- Teresa L Deshields
- Siteman Cancer, Barnes-Jewish Hospital, Washington University School of Medicine, 4921 Parkview Place, MS: 90-35-703, St. Louis, MO, 63110, USA.
| | - Valentina Penalba
- Siteman Cancer, Barnes-Jewish Hospital, Washington University School of Medicine, 4921 Parkview Place, MS: 90-35-703, St. Louis, MO, 63110, USA
| | - Jingxa Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - James Avery
- Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA
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204
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Zick SM, Colacino J, Cornellier M, Khabir T, Surnow K, Djuric Z. Fatigue reduction diet in breast cancer survivors: a pilot randomized clinical trial. Breast Cancer Res Treat 2016; 161:299-310. [PMID: 27913933 DOI: 10.1007/s10549-016-4070-y] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/28/2016] [Indexed: 01/25/2023]
Abstract
PURPOSE Fatigue is a prevalent and burdensome effect of breast cancer. Fatigue has been linked to chronic inflammation, and diets high in antioxidant nutrients have been associated with lesser prevalence and severity of fatigue. Studies are needed, however, to test if antioxidant-rich diets could improve fatigue. METHODS Pilot, randomized, trial conducted between January 2014 and April 2015, to investigate if a 3-month diet rich in fruit, vegetables, whole grains, and omega-3 fatty acid-rich foods, named the fatigue reduction diet (FRD), improved fatigue and sleep compared to an attention control, named the general health curriculum (GHC). 30 stage 0 to III breast cancer survivors, who had completed cancer treatments, were randomized: 15 receiving the FRD and 15 the GHC. Primary outcome was change in fatigue, as measured by the brief fatigue Inventory, from baseline to 3 months analyzed using linear mixed models. Secondary analyses were changes in sleep quality, serum carotenoids, and fatty acids. RESULTS From baseline to 3-month fatigue improved by 44 ± 39% in FRD compared to 8 ± 34% in GHC (p = 0.01); sleep quality improved by 2.5 ± 3.3 points in FRD, and diminished by 0.9 ± 2.3 in GHC (p = 0.03); serum total carotenoids (p < 0.01), β-cryptoxanthin (p = 0.02), lutein (p = 0.05), zeaxanthin (p = 0.01), lycopene (p = 0.05), omega-3 fatty acids (p < 0.01), and ratio of omega-3:omega-6 fatty acids (p = 0.02) were significantly increased, and percent saturated fatty acids were decreased (p = 0.04) in FRD; γ-tocopherol was significantly increased in GHC (p = 0.03), and there was a significant visit by group difference for α-carotene between the study groups (p = 0.05). CONCLUSIONS The FRD intervention improved fatigue and sleep in breast cancer survivors compared to the GHC. FRD diet could provide a non-toxic treatment strategy for persistent fatigue.
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Affiliation(s)
- Suzanna Maria Zick
- Department Family Medicine, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48105, USA. .,Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, 6651 SPH I, Ann Arbor, MI, 48109-2029, USA.
| | - Justin Colacino
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, 6651 SPH I, Ann Arbor, MI, 48109-2029, USA.,Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, 6651 SPH I, Ann Arbor, MI, 48109-2029, USA
| | - Maria Cornellier
- Department Family Medicine, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48105, USA
| | - Tohfa Khabir
- Department Family Medicine, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48105, USA
| | - Katie Surnow
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, 1700 SPH I, Ann Arbor, MI, 48109-2029, USA
| | - Zora Djuric
- Department Family Medicine, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI, 48105, USA.,Department of Nutritional Sciences, University of Michigan School of Public Health, Cancer Center room 4306, Ann Arbor, MI, 48109-5936, USA
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205
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Grossert A, Urech C, Alder J, Gaab J, Berger T, Hess V. Web-based stress management for newly diagnosed cancer patients (STREAM-1): a randomized, wait-list controlled intervention study. BMC Cancer 2016; 16:838. [PMID: 27809796 PMCID: PMC5093991 DOI: 10.1186/s12885-016-2866-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 10/19/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Being diagnosed with cancer causes major psychological distress, yet the majority of newly diagnosed cancer patients lack psychological support. Internet interventions overcome many barriers for seeking face-to-face support and allow for independence in time and place. We assess efficacy and feasibility of the first web-based stress management intervention (STREAM: STREss-Aktiv-Mindern) for newly diagnosed, German-speaking cancer patients. METHODS/DESIGN In a prospective, wait-list controlled trial 120 newly diagnosed cancer patients will be included within 12 weeks of starting anti-cancer treatment and randomized between an immediate (intervention group) or delayed (control group) 8-week, web-based intervention. The intervention consists of eight modules with weekly written feedback by a psychologist ("minimal-contact") based on well-established stress management manuals including downloadable audio-files and exercises. The aim of this study is to evaluate efficacy in terms of improvement in quality of life (FACT-F), as well as decrease in anxiety and depression (HADS), as compared to patients in the wait-list control group. A sample size of 120 patients allows demonstrating a clinically relevant difference of nine points in the FACT score after the intervention (T2) with a two-sided alpha of 0.05 and 80 % power. As this is the first online stress management intervention for German-speaking cancer patients, more descriptive outcomes are equally important to further refine the group of patients with the largest potential for benefit who then will be targeted more specifically in future trials. These descriptive endpoints include: patients' characteristics (type of cancer, type of treatment, socio-demographic factors), dropout rate and dropout reasons, adherence and satisfaction with the program. DISCUSSION New technologies open new opportunities: minimal-contact psychological interventions are becoming standard of care in several psychological disorders, where their efficacy is often comparable to face-to-face interventions. With our study we open this field to the population of newly diagnosed cancer patients. We will not only assess clinical efficacy but also further refine the target population who has the most potential to benefit. An internet-based minimal-contact stress management program might be an attractive, time- and cost-effective way to effectively deliver psychological support to newly diagnosed cancer patients and an opportunity to include those who currently are not reached by conventional support. TRIAL REGISTRATION ClinicalTrials.gov NCT02289014 .
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Affiliation(s)
- Astrid Grossert
- Medical Oncology, University Hospital Basel, Petersgraben 4, CH, 4031, Basel, Switzerland.
| | - Corinne Urech
- Obstetrics and Gynecology, University Hospital, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Judith Alder
- Clinical Psychology and Psychotherapy, University of Basel, Missionsstrasse 62, CH, 4055, Basel, Switzerland
| | - Jens Gaab
- Clinical Psychology and Psychotherapy, University of Basel, Missionsstrasse 62, CH, 4055, Basel, Switzerland
| | - Thomas Berger
- Clinical Psychology and Psychotherapy, University of Bern, Fabrikstrasse 8, CH, 3012, Bern, Switzerland
| | - Viviane Hess
- Medical Oncology, University Hospital Basel, Petersgraben 4, CH, 4031, Basel, Switzerland
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206
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Tisnado DM, Mendez-Luck C, Metz J, Peirce K, Montaño B. Perceptions of Survivorship Care among Latina Women with Breast Cancer in Los Angeles County. Public Health Nurs 2016; 34:118-129. [DOI: 10.1111/phn.12299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Diana M. Tisnado
- Department of Health Science; California State University, Fullerton; Fullerton California
| | | | - Jenifer Metz
- California Healthcare Collaborative; Los Angeles California
| | - Katelynn Peirce
- California State University, Fullerton; Fullerton California
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207
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Hawkins NA, Soman A, Buchanan Lunsford N, Leadbetter S, Rodriguez JL. Use of Medications for Treating Anxiety and Depression in Cancer Survivors in the United States. J Clin Oncol 2016; 35:78-85. [PMID: 28034075 DOI: 10.1200/jco.2016.67.7690] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose This study used population-based data to estimate the percentage of cancer survivors in the United States reporting current medication use for anxiety and depression and to characterize the survivors taking this type of medication. Rates of medication use in cancer survivors were compared with rates in the general population. Methods We analyzed data from the National Health Interview Survey, years 2010 to 2013, identifying cancer survivors (n = 3,184) and adults with no history of cancer (n = 44,997) who completed both the Sample Adult Core Questionnaire and the Adult Functioning and Disability Supplement. Results Compared with adults with no history of cancer, cancer survivors were significantly more likely to report taking medication for anxiety (16.8% v 8.6%, P < .001), depression (14.1% v 7.8%, P < .001), and one or both of these conditions combined (19.1% v 10.4%, P < .001), indicating that an estimated 2.5 million cancer survivors were taking medication for anxiety or depression in the United States at that time. Survivor characteristics associated with higher rates of medication use for anxiety included being younger than 65 years old, female, and non-Hispanic white, and having public insurance, a usual source of medical care, and multiple chronic health conditions. Survivor characteristics associated with medication use for depression were largely consistent with those for anxiety, with the exceptions that insurance status was not significant, whereas being widowed/divorced/separated was associated with more use. Conclusion Cancer survivors in the United States reported medication use for anxiety and depression at rates nearly two times those reported by the general public, likely a reflection of greater emotional and physical burdens from cancer or its treatment.
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Affiliation(s)
- Nikki A Hawkins
- Nikki A. Hawkins, Natasha Buchanan Lunsford, Steven Leadbetter, and Juan L. Rodriguez, Centers for Disease Control and Prevention; and Ashwini Soman, Northrop Grumman, Atlanta GA
| | - Ashwini Soman
- Nikki A. Hawkins, Natasha Buchanan Lunsford, Steven Leadbetter, and Juan L. Rodriguez, Centers for Disease Control and Prevention; and Ashwini Soman, Northrop Grumman, Atlanta GA
| | - Natasha Buchanan Lunsford
- Nikki A. Hawkins, Natasha Buchanan Lunsford, Steven Leadbetter, and Juan L. Rodriguez, Centers for Disease Control and Prevention; and Ashwini Soman, Northrop Grumman, Atlanta GA
| | - Steven Leadbetter
- Nikki A. Hawkins, Natasha Buchanan Lunsford, Steven Leadbetter, and Juan L. Rodriguez, Centers for Disease Control and Prevention; and Ashwini Soman, Northrop Grumman, Atlanta GA
| | - Juan L Rodriguez
- Nikki A. Hawkins, Natasha Buchanan Lunsford, Steven Leadbetter, and Juan L. Rodriguez, Centers for Disease Control and Prevention; and Ashwini Soman, Northrop Grumman, Atlanta GA
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208
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Hong F, Blonquist TM, Halpenny B, Berry DL. Patient-reported symptom distress, and most bothersome issues, before and during cancer treatment. PATIENT-RELATED OUTCOME MEASURES 2016; 7:127-35. [PMID: 27672346 PMCID: PMC5026183 DOI: 10.2147/prom.s95593] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Introduction Frequently reported symptoms and treatment side effects may not be the most bothersome issues to patients with cancer. The purpose of this study was to investigate patient-reported symptom distress and bothersome issues among participants with cancer. Methods Participants completed the Symptom Distress Scale-15 before treatment (T1) and during cancer treatment (T2) and reported up to two most bothersome issues among symptoms rated with moderate-to-severe distress. We compared symptom ratings and perceived bother and explored two approaches predicting patients’ most bothersome issues: worst absolute symptom score or worst change from pretreatment. Results Significantly, (P≤0.0002) more patients reported moderate-to-severe distress at T2 for eight of 13 symptoms. At T1, 81% of patients reported one and 56% reported multiple symptoms with moderate-to-severe distress, while at T2, 89% reported one and 69% reported multiple symptoms with moderate-to-severe distress. Impact on sexual activity/interest, pain, fatigue, and insomnia were the most prevalent symptoms with moderate-to-severe distress. Fatigue, pain, and insomnia were perceived most often as bothersome. When one symptom was rated moderate-to-severe, predictive accuracy of the absolute score was 46% and 48% (T1 & T2) and 38% with the change score (T2–T1). When two or more symptoms were rated moderate-to-severe, predictive accuracy of the absolute score was 76% and 79% (T1 & T2) and 70% with the change score (T2–T1). Conclusion More patients experienced moderate-to-severe symptom distress after treatment initiation. Patient identification of bothersome issues could not be assumed based on prevalence of symptoms reported with moderate-to-severe distress. The absolute symptom distress scores identified patients’ most bothersome issues with good accuracy, outperforming change scores.
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Affiliation(s)
- Fangxin Hong
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
| | - Traci M Blonquist
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Barbara Halpenny
- Department of Nursing and Patient Care Services, The Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Donna L Berry
- Department of Nursing and Patient Care Services, The Phyllis F. Cantor Center, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
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209
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Lengacher CA, Reich RR, Paterson CL, Ramesar S, Park JY, Alinat C, Johnson-Mallard V, Moscoso M, Budhrani-Shani P, Miladinovic B, Jacobsen PB, Cox CE, Goodman M, Kip KE. Examination of Broad Symptom Improvement Resulting From Mindfulness-Based Stress Reduction in Breast Cancer Survivors: A Randomized Controlled Trial. J Clin Oncol 2016; 34:2827-34. [PMID: 27247219 PMCID: PMC5012660 DOI: 10.1200/jco.2015.65.7874] [Citation(s) in RCA: 152] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The purpose of this randomized trial was to evaluate the efficacy of the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR[BC]) program in improving psychological and physical symptoms and quality of life among breast cancer survivors (BCSs) who completed treatment. Outcomes were assessed immediately after 6 weeks of MBSR(BC) training and 6 weeks later to test efficacy over an extended timeframe. PATIENTS AND METHODS A total of 322 BCSs were randomly assigned to either a 6-week MBSR(BC) program (n = 155) or a usual care group (n = 167). Psychological (depression, anxiety, stress, and fear of recurrence) and physical symptoms (fatigue and pain) and quality of life (as related to health) were assessed at baseline and at 6 and 12 weeks. Linear mixed models were used to assess MBSR(BC) effects over time, and participant characteristics at baseline were also tested as moderators of MBSR(BC) effects. RESULTS Results demonstrated extended improvement for the MBSR(BC) group compared with usual care in both psychological symptoms of anxiety, fear of recurrence overall, and fear of recurrence problems and physical symptoms of fatigue severity and fatigue interference (P < .01). Overall effect sizes were largest for fear of recurrence problems (d = 0.35) and fatigue severity (d = 0.27). Moderation effects showed BCSs with the highest levels of stress at baseline experienced the greatest benefit from MBSR(BC). CONCLUSION The MBSR(BC) program significantly improved a broad range of symptoms among BCSs up to 6 weeks after MBSR(BC) training, with generally small to moderate overall effect sizes.
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Affiliation(s)
- Cecile A Lengacher
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA.
| | - Richard R Reich
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Carly L Paterson
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Sophia Ramesar
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Jong Y Park
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Carissa Alinat
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Versie Johnson-Mallard
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Manolete Moscoso
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Pinky Budhrani-Shani
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Branko Miladinovic
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Paul B Jacobsen
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Charles E Cox
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Matthew Goodman
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
| | - Kevin E Kip
- Cecile A. Lengacher, Sophia Ramesar, Carissa Alinat, Manolete Moscoso, and Kevin E. Kip, University of South Florida College of Nursing; Jong Y. Park and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute; Branko Miladinovic and Charles E. Cox, University of South Florida Morsani College of Medicine, Tampa; Richard R. Reich, University of South Florida Sarasota-Manatee, Manatee; Versie Johnson-Mallard, University of Florida, College of Nursing, Gainesville, FL; Carly L. Paterson, National Cancer Institute, Rockville, MD; Pinky Budhrani-Shani, Texas Woman's University, Nelda C. Stark College of Nursing, Houston, TX; and Matthew Goodman, University of Virginia, Charlottesville, VA
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de Valois B, Asprey A, Young T. "The Monkey on Your Shoulder": A Qualitative Study of Lymphoedema Patients' Attitudes to and Experiences of Acupuncture and Moxibustion. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:4298420. [PMID: 27630734 PMCID: PMC5007335 DOI: 10.1155/2016/4298420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/10/2016] [Indexed: 01/08/2023]
Abstract
Background. Lymphoedema, a distressing consequence of cancer treatment, has significant negative impact on health-related quality of life. Multidisciplinary approaches are needed to improve physical and psychosocial wellbeing. Acupuncture and moxibustion (acu/moxa), two modalities of traditional East Asian medicine, may contribute to improved outcomes for cancer survivors with lymphoedema. Aim. To explore how patients with lymphoedema secondary to cancer treatment perceive and experience acu/moxa treatment. Design and Setting. A qualitative focus group study, nested in a 3-step mixed methods observational study, was carried out in a cancer drop-in and information centre in north-west London. Methods. Six focus groups and one telephone interview were conducted with 23 survivors of breast or head and neck cancer, who had completed up to 13 acu/moxa treatments. Scripts were transcribed, coded, and analysed to identify salient and overarching themes. Results. Participants described feeling disempowered by cancer treatment and subsequent diagnosis of lymphoedema. Acu/moxa was valued for its whole-person approach and for time spent with a practitioner who cared, listened, and responded. Participants reported changes in physical and psychosocial health, including increased energy levels and reduced pain and discomfort, and feelings of empowerment, personal control, and acceptance. Many were motivated to improve self-care. Conclusion. Many participants who received acu/moxa treatment reported improved wellbeing and a more proactive attitude towards self-care.
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Affiliation(s)
- Beverley de Valois
- Supportive Oncology Research Team, Lynda Jackson Macmillan Centre, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK
| | - Anthea Asprey
- University of Exeter Medical School, Magdalen Road, Exeter EX1 2LU, UK
| | - Teresa Young
- Supportive Oncology Research Team, Lynda Jackson Macmillan Centre, Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK
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211
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Playdon M, Ferrucci LM, McCorkle R, Stein KD, Cannady R, Sanft T, Cartmel B. Health information needs and preferences in relation to survivorship care plans of long-term cancer survivors in the American Cancer Society's Study of Cancer Survivors-I. J Cancer Surviv 2016; 10:674-85. [PMID: 26744339 PMCID: PMC5032143 DOI: 10.1007/s11764-015-0513-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 12/25/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE Survivorship care plans (SCPs) provide cancer patients and health care providers with a treatment summary and outline of recommended medical follow-up. Few studies have investigated the information needs and preferred sources among long-term cancer survivors. METHODS Cancer survivors of the ten most common cancers enrolled in the longitudinal Study of Cancer Survivors-I (SCS-I) completed a survey 9 years post-diagnosis (n = 3138); at time of diagnosis of the SCS-I cohort, SCPs were not considered usual care. We assessed participants' current desire and preferred sources for information across ten SCP items and evaluated factors associated with information need 9 years after diagnosis. RESULTS The proportion of long-term cancer survivors endorsing a need for cancer and health information 9 years post-diagnosis ranged from 43 % (cancer screening) to 9 % (consequences of cancer on ability to work). Print media and personalized reading materials were the most preferred information sources. Younger age, higher education, race other than non-Hispanic white, later cancer stage, having breast cancer, having ≥2 comorbidities, and self-reporting poor health were associated with greater informational need (p < 0.05). CONCLUSIONS/IMPLICATIONS FOR CANCER SURVIVORS Long-term cancer survivors continue to report health information needs for most SCP items and would prefer a print format; however, level of need differs by socio-demographic and cancer characteristics. Cancer survivors who did not previously receive a SCP may still benefit from receiving SCP content, and strategies for enabling dissemination to long-term survivors warrant further investigation.
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Affiliation(s)
- Mary Playdon
- Yale School of Public Health, Yale University, 55 Church Street, Suite 801, New Haven, CT, 06510, USA.
| | - Leah M Ferrucci
- Yale School of Public Health, Yale University, 55 Church Street, Suite 801, New Haven, CT, 06510, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Ruth McCorkle
- Yale Cancer Center, New Haven, CT, USA
- Yale School of Nursing, Yale University, New Haven, CT, USA
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Kevin D Stein
- Behavioral Research Center, American Cancer Society, Atlanta, GA, USA
| | - Rachel Cannady
- Behavioral Research Center, American Cancer Society, Atlanta, GA, USA
| | - Tara Sanft
- Yale Cancer Center, New Haven, CT, USA
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Brenda Cartmel
- Yale School of Public Health, Yale University, 55 Church Street, Suite 801, New Haven, CT, 06510, USA
- Yale Cancer Center, New Haven, CT, USA
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212
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Hagen KB, Aas T, Kvaløy JT, Eriksen HR, Søiland H, Lind R. Fatigue, anxiety and depression overrule the role of oncological treatment in predicting self-reported health complaints in women with breast cancer compared to healthy controls. Breast 2016; 28:100-6. [DOI: 10.1016/j.breast.2016.05.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 04/24/2016] [Accepted: 05/13/2016] [Indexed: 10/21/2022] Open
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213
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Trevino KM, Naik AD, Moye J. Perceived and Actual Change in Religion/Spirituality in Cancer Survivors: Longitudinal Relationships With Distress and Perceived Growth. PSYCHOLOGY OF RELIGION AND SPIRITUALITY 2016; 8:195-205. [PMID: 27453768 PMCID: PMC4956338 DOI: 10.1037/rel0000030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
This observational cohort study examined the relationships between actual and perceived R/S change at 12 months post cancer diagnosis with depression, anxiety, and perceived growth 6 months later. Older adult military veteran cancer survivors (n = 111) completed self-report surveys at 6, 12, and 18 months post cancer diagnosis. Perceived R/S change was assessed at 12 months postdiagnosis with "Have your religious or spiritual beliefs changed as a result of your cancer" (more R/S, less R/S, other). Actual R/S change was assessed at 6 and 12 months postdiagnosis on a single item, "I have faith in God or a Higher Power" (no, somewhat, yes). A notable minority reported perceived (18.9%) and actual (14.4%) change. Greater perceived R/S change predicted more severe symptoms of depression and anxiety and greater perceived growth at 18 months postdiagnosis; perceived growth was positively associated with anxiety. Cancer survivors who report R/S changes may benefit from spiritual and/or psychological support.
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Affiliation(s)
- Kelly M Trevino
- Department of Medicine, Weill Cornell Medical College, and New York Presbyterian Hospital, New York, New York
| | - Aanand D Naik
- Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, Texas, and Department of Medicine, Baylor College of Medicine
| | - Jennifer Moye
- VA Boston Healthcare System, Boston, Massachusetts, and Department of Psychiatry, Harvard Medical School
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214
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Liu S, Qiu G, Louie W. Use of Mindfulness Sitting Meditation in Chinese American Women in Treatment of Cancer. Integr Cancer Ther 2016; 16:110-117. [PMID: 27252075 PMCID: PMC5736067 DOI: 10.1177/1534735416649661] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background. Very few studies have been conducted to examine the prevalence, frequency, perceived effectiveness, and possible influencing factors of use of meditation in patients with cancer. Objectives. To examine use of mindfulness sitting medication (MSM) in Chinese American women in treatment of cancer, its relationship to specific symptom distress, and possible influencing factors of MSM. Methods. Volunteer participants were recruited through the American Cancer Society support groups. The participants completed a demographic data form, a researcher-developed criteria and checklist for MSM, and the Memorial Symptom Assessment Scale–Short Form. Results. Eighty-nine Chinese American women with a mean age of 58 years completed the questionnaires. Twenty-one patients (24%) reported the use of MSM during active treatment of cancer. Patients who had higher education, better income, better English proficiency, and health insurance were more likely to use MSM. Patients who had more symptom distress also reported to use more MSM. Most patients (20/21) who used meditation considered it effective. After controlling other variables, better English proficiency, breast cancer, and higher symptom distress predicted the use of MSM in Chinese American women in treatment of cancer. Conclusions. About 24% of Chinese American women used MSM in the treatment of cancer and most of them considered it effective. Symptom distress and English proficiency levels predicted the use of MSM. Implications for Practice. Given the effectiveness of MSM, oncology nurses could recommend using MSM in Chinese American women in treatment of cancer, especially for patients who had higher symptom distress.
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Affiliation(s)
- Shan Liu
- 1 Adelphi University College of Nursing and Public Health, Garden City, NY, USA
| | - Guang Qiu
- 2 The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Wendy Louie
- 3 New York Presbyterian Queen Hospital, Flushing, NY, USA
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Pearson EJM, Morris ME, McKinstry CE. Cancer-related fatigue: appraising evidence-based guidelines for screening, assessment and management. Support Care Cancer 2016; 24:3935-42. [PMID: 27116014 DOI: 10.1007/s00520-016-3228-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 04/17/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE There is inconsistent management of cancer-related fatigue (CRF) by health professionals worldwide. This research aims to identify the most appropriate guidelines for the management of cancer-related fatigue. METHODS A systematic search of international literature identified evidence-based clinical practice guidelines for CRF. Four reviewers independently appraised the highest quality guidelines using the AGREE-II instrument and National Heath and Medical Research Council (NHMRC) guideline standards. RESULTS Five guidelines met the inclusion criteria. Of these, the 2015 Canadian Association of Psychosocial Oncology (CAPO) CRF guidelines and the 2014 American Society of Clinical Oncology (ASCO) fatigue guidelines for cancer survivors were selected for in-depth appraisal. The CAPO guideline scored higher than the ASCO for five domains of the AGREE-II. For one domain, the differences were statistically significant (p ≤ 0.05). The CAPO guideline met 37 of 47 NHMRC mandatory guideline standards and the ASCO guideline met 20. The difference in the proportion of standards met was statistically significant for one domain (p ≤ 0.05). Both guidelines had low scores for applicability and implementation. CONCLUSIONS Currently, the CAPO guideline for cancer-related fatigue has the strongest evidence for use. To enhance implementation, further strategies for guideline dissemination and application are needed.
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Affiliation(s)
| | - Meg E Morris
- School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Carol E McKinstry
- Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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216
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Bours MJL, van der Linden BWA, Winkels RM, van Duijnhoven FJ, Mols F, van Roekel EH, Kampman E, Beijer S, Weijenberg MP. Candidate Predictors of Health-Related Quality of Life of Colorectal Cancer Survivors: A Systematic Review. Oncologist 2016; 21:433-52. [PMID: 26911406 PMCID: PMC4828113 DOI: 10.1634/theoncologist.2015-0258] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 12/16/2015] [Indexed: 12/23/2022] Open
Abstract
UNLABELLED The population of colorectal cancer (CRC) survivors is growing and many survivors experience deteriorated health-related quality of life (HRQoL) in both early and late post-treatment phases. Identification of CRC survivors at risk for HRQoL deterioration can be improved by using prediction models. However, such models are currently not available for oncology practice. As a starting point for developing prediction models of HRQoL for CRC survivors, a comprehensive overview of potential candidate HRQoL predictors is necessary. Therefore, a systematic literature review was conducted to identify candidate predictors of HRQoL of CRC survivors. Original research articles on associations of biopsychosocial factors with HRQoL of CRC survivors were searched in PubMed, Embase, and Google Scholar. Two independent reviewers assessed eligibility and selected articles for inclusion (N = 53). Strength of evidence for candidate HRQoL predictors was graded according to predefined methodological criteria. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) was used to develop a biopsychosocial framework in which identified candidate HRQoL predictors were mapped across the main domains of the ICF: health condition, body structures and functions, activities, participation, and personal and environmental factors. The developed biopsychosocial ICF framework serves as a basis for selecting candidate HRQoL predictors, thereby providing conceptual guidance for developing comprehensive, evidence-based prediction models of HRQoL for CRC survivors. Such models are useful in clinical oncology practice to aid in identifying individual CRC survivors at risk for HRQoL deterioration and could also provide potential targets for a biopsychosocial intervention aimed at safeguarding the HRQoL of at-risk individuals. IMPLICATIONS FOR PRACTICE More and more people now survive a diagnosis of colorectal cancer. The quality of life of these cancer survivors is threatened by health problems persisting for years after diagnosis and treatment. Early identification of survivors at risk of experiencing low quality of life in the future is thus important for taking preventive measures. Clinical prediction models are tools that can help oncologists identify at-risk individuals. However, such models are currently not available for clinical oncology practice. This systematic review outlines candidate predictors of low quality of life of colorectal cancer survivors, providing a firm conceptual basis for developing prediction models.
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Affiliation(s)
- Martijn J L Bours
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Bernadette W A van der Linden
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Renate M Winkels
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | | | - Floortje Mols
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands Netherlands Comprehensive Cancer Organization, Netherlands Cancer Registry, Eindhoven, The Netherlands
| | - Eline H van Roekel
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organization, Netherlands Cancer Registry, Eindhoven, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
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Kanera IM, Bolman CAW, Willems RA, Mesters I, Lechner L. Lifestyle-related effects of the web-based Kanker Nazorg Wijzer (Cancer Aftercare Guide) intervention for cancer survivors: a randomized controlled trial. J Cancer Surviv 2016; 10:883-97. [PMID: 26984534 PMCID: PMC5018034 DOI: 10.1007/s11764-016-0535-6] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 03/03/2016] [Indexed: 11/26/2022]
Abstract
Purpose The web-based Kanker Nazorg Wijzer (Cancer Aftercare Guide) responds to the needs of cancer survivors and oncology care providers to improve the counseling related to self-management of lifestyle and psychosocial challenges. In present study, overall intervention effects and the effects of using specific components were evaluated on vegetable, fruit, whole grain bread, and fish consumption, physical activity (PA), and smoking behavior. Methods Cancer survivors from 21 Dutch hospitals were recruited for a randomized controlled trial (N = 432). Intervention effects after 6 months were evaluated using multilevel linear regression analysis (complete cases and intention-to-treat). By conducting moderation analyses, additional effects of following the behavior-related modules were explored. The false discovery rate correction was applied to account for multiple testing. Results After 6 months, 409 participants completed follow-up (dropout = 11.5 %). Indications were found that access to the intervention may result in increases of moderate PA and vegetable intake. The moderate PA increase was meaningful: 74.74 min p/w higher increase in the intervention condition. Effect sizes of moderate PA (d = .25) and vegetable (d = .37) consumption were comparable to prior effective interventions. Visiting behavior-related modules affected moderate PA, fruit, and fish consumption. However, after correction for multiple testing, significances expired. No significant intervention effect was found on smoking behavior due to low numbers of smokers. Implications for Cancer Survivors Although the effectiveness was only shown only to a limited extend, this study provided several indications that this theory-based, comprehensive, and personalized eHealth intervention provides valuable content to complement usual cancer aftercare.
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Affiliation(s)
- Iris M. Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Catherine A. W. Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Roy A. Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
| | - Ilse Mesters
- CAPHRI School for Public Health and Primary Care, Optimizing Patient Care, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P. O. Box 2960, 6401 DL Heerlen, The Netherlands
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218
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Willems RA, Bolman CAW, Mesters I, Kanera IM, Beaulen AAJM, Lechner L. Short-term effectiveness of a web-based tailored intervention for cancer survivors on quality of life, anxiety, depression, and fatigue: randomized controlled trial. Psychooncology 2016; 26:222-230. [PMID: 26988800 DOI: 10.1002/pon.4113] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/11/2016] [Accepted: 02/11/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the short-term effectiveness of the web-based computer-tailored intervention Kanker Nazorg Wijzer (Cancer Aftercare Guide). The intervention aims to support cancer survivors with managing psychosocial and lifestyle-related issues. In this study, the impact on quality of life, anxiety, depression, and fatigue were evaluated. METHODS Cancer survivors were recruited through 21 Dutch hospitals (November 2013-June 2014). Outcome measures included quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30), anxiety and depression (Hospital Anxiety and Depression Scale), and fatigue (Checklist Individual Strength). In a randomized controlled trial with an intervention group (n = 231) and a waiting list control group (n = 231), the short-term effectiveness was evaluated through multilevel linear regression analyses, controlling for selective dropout, baseline differences, and several demographic and disease-related characteristics. RESULTS In total, 188 participants of the intervention group and 221 of the control group completed the 6-month measurement (dropout = 11.5%). The intervention was effective in reducing depression (B = -0.63, p = 0.007, f2 = 0.019, d = 0.21) and fatigue (B = -4.36, p = 0.020, f2 = 0.013, d = 0.21). In addition, effects were found for emotional (B = 3.47, p = 0.022, f2 = 0.013, d = 0.15) and social functioning (B = 3.95, p = 0.011, f2 = 0.017, d = 0.15), although this evidence was less strong. There were indications that the effects of fatigue and social functioning were influenced by module use. CONCLUSIONS While effect sizes were small, they can be considered as clinically relevant. With the Cancer Aftercare Guide being an effective, low-intensive, and easy accessible intervention, it could serve as a first step in stepped care for needs assessment and initial support for psychosocial problems that are present after cancer treatment. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Roy A Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Catherine A W Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Ilse Mesters
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Iris M Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Audrey A J M Beaulen
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
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219
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Koleck TA, Conley YP. Identification and prioritization of candidate genes for symptom variability in breast cancer survivors based on disease characteristics at the cellular level. BREAST CANCER-TARGETS AND THERAPY 2016; 8:29-37. [PMID: 27022301 PMCID: PMC4790538 DOI: 10.2147/bctt.s88434] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Research is beginning to suggest that the presence and/or severity of symptoms reported by breast cancer survivors may be associated with disease-related factors of cancer. In this article, we present a novel approach to the identification and prioritization of biologically plausible candidate genes to investigate relationships between genomic variation and symptom variability in breast cancer survivors. Cognitive dysfunction is utilized as a representative breast cancer survivor symptom to elucidate the conceptualization of and justification for our cellular, disease-based approach to address symptom variability in cancer survivors. Initial candidate gene identification was based on genes evaluated as part of multigene expression profiles for breast cancer, which are commonly used in the clinical setting to characterize the biology of cancer cells for the purpose of describing overall tumor aggressiveness, prognostication, and individualization of therapy. A list of genes evaluated within five multigene expression profiles for breast cancer was compiled. In order to prioritize candidate genes for investigation, genes used in each profile were compared for duplication. Twenty-one genes (BAG1, BCL2, BIRC5, CCNB1, CENPA, CMC2, DIAPH3, ERBB2, ESR1, GRB7, MELK, MKI67, MMP11, MYBL2, NDC80, ORC6, PGR, RACGAP1, RFC4, RRM2, and SCUBE2) are utilized in two or more profiles, including five genes (CCNB1, CENPA, MELK, MYBL2, and ORC6) used in three profiles. To ensure that the parsimonious 21 gene set is representative of the more global biological hallmarks of cancer, an Ingenuity Pathway Analysis was conducted. Evaluation of genes known to impact pathways involved with cancer development and progression provide a means to evaluate the overlap between the biological underpinnings of cancer and symptom development within the context of cancer.
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Affiliation(s)
- Theresa A Koleck
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yvette P Conley
- Department of Human Genetics, School of Nursing and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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220
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Husson O, Mols F, van de Poll-Franse LV, Thong MSY. The course of fatigue and its correlates in colorectal cancer survivors: a prospective cohort study of the PROFILES registry. Support Care Cancer 2015; 23:3361-71. [PMID: 26123601 PMCID: PMC4584107 DOI: 10.1007/s00520-015-2802-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 06/08/2015] [Indexed: 12/29/2022]
Abstract
PURPOSE Colorectal cancer (CRC) survivors who remain fatigued during long-term follow-up are at risk for worse health outcomes and need relevant interventions most. The aim of this study is to prospectively assess cancer-related fatigue (CRF) and four categories of CRF correlates (clinical characteristics, demographic characteristics, behavior/well-being, functional status). METHODS CRC survivors diagnosed between 2000 and 2009, as registered in the population-based Eindhoven Cancer Registry, completed the Fatigue Assessment Scale at three annual time points. Linear mixed models were used to assess the course of CRF and identify its correlates. RESULTS CRF levels were relatively stable over time. Being female, young (≤65 years of age), and single; having a low educational level; treatment with chemotherapy; and having one or more comorbid conditions were associated with higher CRF scores. Years since diagnosis, radiotherapy, and disease stage were not related to CRF over time. Significant between- and within-subject effects were found for all well-being factors (social, emotional, and cognitive functioning, and global quality of life), symptoms (anxiety, depression, pain, and insomnia), and functional status (physical and role functioning, physical activity levels) in relation to CRF. The differences in CRF levels could, for a large part, be attributed to differences in behavior/well-being (59 %), functional status (37 %), and, to a lesser extent, to sociodemographic (4 %) and clinical characteristics (8 %). CONCLUSION This study showed that sociodemographic and clinical factors were associated with CRF levels over time among CRC survivors; however, behavior/well-being and functional status explained a larger part of the variance in levels of CRF.
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Affiliation(s)
- Olga Husson
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, The Netherlands.
- Comprehensive Cancer Centre the Netherlands (CCCN), Eindhoven Cancer Registry, Eindhoven, The Netherlands.
| | - Floortje Mols
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands (CCCN), Eindhoven Cancer Registry, Eindhoven, The Netherlands
| | - Lonneke V van de Poll-Franse
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands (CCCN), Eindhoven Cancer Registry, Eindhoven, The Netherlands
| | - Melissa S Y Thong
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands (CCCN), Eindhoven Cancer Registry, Eindhoven, The Netherlands
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Knobf M, Cooley M, Duffy S, Doorenbos A, Eaton L, Given B, Mayer D, McCorkle R, Miaskowski C, Mitchell S, Sherwood P, Bender C, Cataldo J, Hershey D, Katapodi M, Menon U, Schumacher K, Sun V, Ah D, LoBiondo-Wood G, Mallory G. The 2014–2018 Oncology Nursing Society Research Agenda. Oncol Nurs Forum 2015; 42:450-65. [DOI: 10.1188/15.onf.450-465] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Willems RA, Bolman CAW, Mesters I, Kanera IM, Beaulen AAJM, Lechner L. The Kanker Nazorg Wijzer (Cancer Aftercare Guide) protocol: the systematic development of a web-based computer tailored intervention providing psychosocial and lifestyle support for cancer survivors. BMC Cancer 2015; 15:580. [PMID: 26260318 PMCID: PMC4532144 DOI: 10.1186/s12885-015-1588-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 07/30/2015] [Indexed: 12/14/2022] Open
Abstract
Background After primary treatment, many cancer survivors experience psychosocial, physical, and lifestyle problems. To address these issues, we developed a web-based computer tailored intervention, the Kanker Nazorg Wijzer (Cancer Aftercare Guide), aimed at providing psychosocial and lifestyle support for cancer survivors. The purpose of this article is to describe the systematic development and the study design for evaluation of this theory and empirical based intervention. Methods/design For the development of the intervention, the steps of the Intervention Mapping protocol were followed. A needs assessment was performed consisting of a literature study, focus group interviews, and a survey study to get more insight into cancer survivors’ health issues. This resulted in seven problem areas that were addressed in the intervention: cancer-related fatigue, return to work, anxiety and depression, social relationships and intimacy, physical activity, diet, and smoking. To address these problem areas, the principles of problem-solving therapy and cognitive behavioral therapy are used. At the start of the intervention, participants have to fill in a screening questionnaire. Based on their answers, participants receive tailored advice about which problem areas deserve their attention. Participants were recruited from November 2013 through June 2014 by hospital staff from 21 hospitals in the Netherlands. Patients were selected either during follow-up visits to the hospital or from reviews of the patients’ files. The effectiveness of the intervention is being tested in a randomized controlled trial consisting of an intervention group (n = 231) and waiting list control group (n = 231) with a baseline measurement and follow-up measurements at 3, 6, and 12 months. Discussion Using the Intervention Mapping protocol resulted in a theory and evidence-based intervention providing tailored advice to cancer survivors on how to cope with psychosocial and lifestyle issues after primary treatment. Trial registration Dutch Trial Register NTR3375
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Affiliation(s)
- Roy A Willems
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
| | - Catherine A W Bolman
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
| | - Ilse Mesters
- CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Iris M Kanera
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
| | - Audrey A J M Beaulen
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
| | - Lilian Lechner
- Faculty of Psychology and Educational Sciences, Open University of the Netherlands, P.O. Box 2960, 6401 DL, Heerlen, The Netherlands.
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Liu S, Sun Y, Louie W. Symptom distress and its association with traditional Chinese medicine use in Chinese American women with cancer. Oncol Nurs Forum 2015; 42:E24-32. [PMID: 25542331 DOI: 10.1188/15.onf.e24-e32] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To identify symptom distress related to cancer for a group of Chinese American women in treatment, and to examine their use of various forms of traditional Chinese medicine (TCM) and their relationships to specific symptoms they identified. DESIGN Cross-sectional, correlational. SETTING American Cancer Society Asian Initiatives support groups in the state of New York. SAMPLE 97 Chinese American women residing in New York with a mean age of 57 years; the time since diagnosis of cancer ranged from two months to 24 years. The type of diagnosis for the majority of women was breast cancer. METHODS A self-reported questionnaire including a demographic data form, a researcher-developed checklist for types of TCM, and the Memorial Symptom Assessment Scale Short Form (MSAS-SF) were administered. The MSAS-SF has three subscales: global distress index, psychological symptom distress scale, and physical symptom distress scale. MAIN RESEARCH VARIABLES Symptoms, symptom distress, and types of TCM. The descriptive statistics and Mann-Whitney U tests were applied for data analysis. FINDINGS Chinese American women with cancer in treatment reported multiple symptoms, and the three MSAS-SF distress subscale scores indicated moderate symptom distress. Symptoms were positively associated with the use of TCM. CONCLUSIONS Chinese American women in treatment for cancer reported multiple symptoms and moderate symptom distress. Participants with specific symptoms tended to use specific forms of TCM. IMPLICATIONS FOR NURSING High prevalence of psychological symptoms for Chinese American women with cancer suggests that oncology nurses should work with mental health providers for symptom management of this population. Oncology nurses also need to stay informed of the growing body of evidence on the benefits of TCM for patients with cancer. Future studies should include an emphasis on the improvement in methodologic quality for studies that investigate using TCM in participants with cancer.
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Affiliation(s)
- Shan Liu
- College of Nursing and Public Health, Adelphi University, Garden City, NY
| | - Yiyuan Sun
- College of Nursing and Public Health, Adelphi University, Garden City, NY
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Reeder-Hayes KE, Wheeler SB, Mayer DK. Health disparities across the breast cancer continuum. Semin Oncol Nurs 2015; 31:170-7. [PMID: 25951746 DOI: 10.1016/j.soncn.2015.02.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To provide a brief overview of disparities across the spectrum of breast cancer incidence, treatment, and long-term care during the survivorship period. DATA SOURCES Review of the literature including research reports, review articles, and clinically based articles available through PubMed and CINAHL. CONCLUSION Minority women generally experience worse breast cancer outcomes despite a lower incidence of breast cancer than whites. A variety of factors contribute to this disparity, including advanced stage at diagnosis, higher rates of aggressive breast cancer subtypes, and lower receipt of appropriate therapies including surgery, chemotherapy, and radiation. Disparities in breast cancer care also extend into the survivorship trajectory, including lower rates of endocrine therapy use among some minority groups, as well as differences in follow-up and survivorship care. IMPLICATIONS FOR NURSING PRACTICE Breast cancer research should include improved minority representation and analyses by race, ethnicity, and socioeconomic status. While we cannot yet change the biology of this disease, we can encourage adherence to screening and treatment and help address the many physical, psychological, spiritual, and social issues minority women face in a culturally sensitive manner.
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