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Duan L, Tang C, Wang T, Hu J, Gao S, Zhang L, Zhang Y, Xu Q. Changes in Time Perception and Coping Strategies in Young Adults With Cancer: A Qualitative Study. Cancer Nurs 2024:00002820-990000000-00281. [PMID: 39150269 DOI: 10.1097/ncc.0000000000001398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
BACKGROUND A cancer diagnosis is a traumatic event. Youths, in the most crucial stage in a person's life course, are more susceptible to the influence of cancer. The diagnosis disrupts the original life and time plans of young adults with cancer, resulting in a reconstruction of time perception and changes in coping strategies. OBJECTIVE The aim of this study was to explore the changes in time perception and coping strategies in young adults with cancer. METHODS A phenomenological research methodology was used in the qualitative study. Thirty-one young adults with cancer were recruited. Semistructured interviews were conducted with them, and the interview data were analyzed using Colaizzi's 7-step analysis method. RESULTS The study revealed 3 themes related to changes in time perception: perceived alterations in the speed of time, changes in remaining available time, and shifts in time preferences. Five themes were identified regarding coping strategies for changes in time perception: self-regulation of emotions, establishing spiritual beliefs, planning time effectively, returning to family life, and closure of the inner self. CONCLUSIONS Identifying changes in time perception among young adults with cancer through the speed of time, remaining available time, and time preference and guiding patients in adopting positive coping strategies can offer more effective cancer support and care for patients. IMPLICATIONS FOR PRACTICE Healthcare professionals should pay attention to the changes in time perception in young adults with cancer and guide them to cope positively.
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Affiliation(s)
- Lisi Duan
- Author Affiliations: School of Nursing, Nanjing Medical University, Nanjing (Mrs Duan, Ms Wang, Dr Tang, and Mrs Xu); School of Medicine, Jiangsu University, Zhenjiang (Dr Hu); and Department of Surgery, The First Affiliated Hospital of Nanjing Medical University (Mrs Gao); and Departments of Nursing (Mrs L. Zhang) and Surgery (Mrs Y. Zhang), The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
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Matt GY, Sioson E, Shelton K, Wang J, Lu C, Zaldivar Peraza A, Gangwani K, Paul R, Reilly C, Acić A, Liu Q, Sandor SR, McLeod C, Patel J, Wang F, Im C, Wang Z, Sapkota Y, Wilson CL, Bhakta N, Ness KK, Armstrong GT, Hudson MM, Robison LL, Zhang J, Yasui Y, Zhou X. St. Jude Survivorship Portal: Sharing and Analyzing Large Clinical and Genomic Datasets from Pediatric Cancer Survivors. Cancer Discov 2024; 14:1403-1417. [PMID: 38593228 PMCID: PMC11294819 DOI: 10.1158/2159-8290.cd-23-1441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/08/2024] [Accepted: 03/26/2024] [Indexed: 04/11/2024]
Abstract
Childhood cancer survivorship studies generate comprehensive datasets comprising demographic, diagnosis, treatment, outcome, and genomic data from survivors. To broadly share this data, we created the St. Jude Survivorship Portal (https://survivorship.stjude.cloud), the first data portal for sharing, analyzing, and visualizing pediatric cancer survivorship data. More than 1,600 phenotypic variables and 400 million genetic variants from more than 7,700 childhood cancer survivors can be explored on this free, open-access portal. Summary statistics of variables are computed on-the-fly and visualized through interactive and customizable charts. Survivor cohorts can be customized and/or divided into groups for comparative analysis. Users can also seamlessly perform cumulative incidence and regression analyses on the stored survivorship data. Using the portal, we explored the ototoxic effects of platinum-based chemotherapy, uncovered a novel association between mental health, age, and limb amputation, and discovered a novel haplotype in MAGI3 strongly associated with cardiomyopathy specifically in survivors of African ancestry. Significance: The St. Jude Survivorship Portal is the first data portal designed to share and explore clinical and genetic data from childhood cancer survivors. The portal provides both open- and controlled-access features and will fulfill a wide range of data sharing needs of the survivorship research community and beyond. See co-corresponding author Xin Zhou discuss this research article, published simultaneously at the AACR Annual Meeting 2024: https://vimeo.com/932617204/7d99fa4958.
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Affiliation(s)
- Gavriel Y. Matt
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Edgar Sioson
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Kyla Shelton
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Jian Wang
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Congyu Lu
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Airen Zaldivar Peraza
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Karishma Gangwani
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Robin Paul
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Colleen Reilly
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Aleksandar Acić
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Qi Liu
- School of Public Health, University of Alberta, Edmonton, Canada.
| | - Stephanie R. Sandor
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Clay McLeod
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Jaimin Patel
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Fan Wang
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Cindy Im
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.
| | - Zhaoming Wang
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Yadav Sapkota
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Carmen L. Wilson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Nickhill Bhakta
- Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Gregory T. Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Melissa M. Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee.
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Jinghui Zhang
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee.
- School of Public Health, University of Alberta, Edmonton, Canada.
| | - Xin Zhou
- Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, Tennessee.
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May M. How virtual reality therapy is shaping mental health. Nat Med 2024; 30:1797-1799. [PMID: 38834887 DOI: 10.1038/d41591-024-00032-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
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Low CE, Loke S, Rana S, Sim B, Ho CSH. Prevalence and incidence of suicide, suicidal ideation and self-harm in caregivers of cancer patients: A systematic review and meta-analysis. Gen Hosp Psychiatry 2024; 90:35-43. [PMID: 38936297 DOI: 10.1016/j.genhosppsych.2024.06.011] [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: 02/03/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE Caregiving burden is set to increase with the rising incidence of cancer globally. The meta-analysis seeks to investigate the prevalence of suicide, suicidal ideation and self-harm among the caregivers of patients with cancer (CPCs). METHODS This PRISMA-adherent systematic review involved a systematic search of PubMed, Embase, Cochrane and PsycINFO for all studies that evaluated the prevalence of suicide, suicidal ideation and self-harm in CPCs. Random effects meta-analyses were used for primary analysis. RESULTS Eleven studies were included. Meta-analyses indicated that the prevalence of suicidal ideation in CPCs was 11% (95%CI:6-18), suicide prevalence was 6% (95%CI:3-12), and self-harm prevalence was 15% (95%CI:8-26). Subgroup analyses revealed that CPCs above the age of 50 experienced a greater prevalence of suicidal ideation (17%, 95%CI:10-28) as compared to CPCs below 50 (6%, 95%CI:3-12). Family caregivers particularly spouses were also found to have a higher prevalence of suicidal ideation (17%, 95%CI:13-23), as compared to children (5%, 95%CI:2-10) or mothers (3%, 95%CI:1-8). Systematic review found that having a pre-existing mental health condition and lower socioeconomic status increased likelihood of suicidality. CONCLUSION We highlight the need for more support of CPCs at risk of suicidality. Additional research is warranted to identify other risk and protective factors.
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Affiliation(s)
- Chen Ee Low
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sean Loke
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sounak Rana
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ben Sim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cyrus Su Hui Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, National University Hospital, Singapore.
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Wu T, Fu W, Xue Y, Zhu L, Ma X, Wei Y, Li H, Wang Y, Kang M, Fang Y, Zhang H. Health-related quality of life in children with childhood acute myeloid leukemia in China: A five-year prospective study. Heliyon 2024; 10:e31948. [PMID: 38841441 PMCID: PMC11152954 DOI: 10.1016/j.heliyon.2024.e31948] [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: 02/26/2024] [Revised: 05/24/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024] Open
Abstract
Purpose This study aims to identify the key factors influencing health-related quality of life (HRQoL) of pediatric acute myeloid leukemia (AML) patients following their initial diagnosis and examine their impact on the five-year survival prognosis. Methods A chart review and follow-up were conducted for children with AML who participated in a prospective cohort study between 2017 and 2020. We identified factors influencing HRQoL through Pediatric Quality of Life Inventory™ (PedsQL™ 4.0), PedsQL™ Cancer Module 3.0 (CM 3.0) and PedsQL™ Family Impact Module 2.0 (FIM 2.0), as well as assessed the impact of impaired HRQoL on the overall outcomes of patients. Results Sixty-four subjects enrolled in the study had complete HRQoL outcome data, and 61 of them completed the 5-year follow-up. In CM 3.0, age was positively associated with parental proxy reports (p = 0.040), whereas divorced families were negatively associated with child self-reports (p = 0.045). A positive medical history correlates with FIM 2.0 (p = 0.025). Residence (p = 0.046), the occupation of caregivers (p = 0.014), disease severity (p = 0.024), and the only child (p = 0.029) exhibited statistically significant associations with the impairment of HRQoL. Impaired HRQoL scores shown by the PedsQL™4.0 parent proxy report (p = 0.013) and FIM 2.0 (p = 0.011) were associated with a reduced 5-year survival rate. Conclusions This study demonstrated that early impairment of HRQoL in pediatric acute myeloid leukemia patients has predictive value for long-term prognosis. Once validated, these findings may provide some guidance to clinicians treating children with AML.
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Affiliation(s)
| | | | | | | | - Xiaopeng Ma
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Yuting Wei
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Huimin Li
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Yaping Wang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Meiyun Kang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Yongjun Fang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Heng Zhang
- Department of Hematology and Oncology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
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Li M, Sara G, Roder D, O'Brien TA. Mental Health Service Contact Following Cancer Diagnosis and Associations with Cancer Mortality: Results from a Linked Population-Based Study of Adolescents and Young Adults in New South Wales. J Adolesc Young Adult Oncol 2024; 13:481-491. [PMID: 38261413 DOI: 10.1089/jayao.2023.0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
Purpose: To assess the mental health conditions, as indicated by mental health service contact in adolescents and young adults (AYAs) diagnosed with cancer in New South Wales (NSW) and associations with cancer mortality. Methods: In 3998 NSW AYAs diagnosed with cancer in 2005-2017, mental health service contacts were obtained from hospital inpatient records and specified medical and pharmaceutical insurance claims. Odds of postcancer mental health contact were assessed by precancer mental contacts using logistic regression adjusted for sociodemographic and cancer characteristics. The risk of cancer-specific mortality related to postcancer mental health contacts was estimated using competing risk regression. Results: The prevalence of mental health service contacts in the 5 years postcancer diagnosis was 27.0%, higher than the corresponding precancer prevalence of 21.4%. The most common mental health conditions were depression and anxiety. The odds of having a mental health contact postcancer diagnosis were higher in patients with a precancer mental health service contact (adjusted odds ratio 5.69, confidence intervals [95% CIs]: 4.90-6.75). The 5-year cancer-specific survival was 87.9% (95% CI: 85.8-89.8) for patients with a mental health service contact postcancer, which was lower than the 93.9% (95% CI: 93.0-94.7) for patients without this contact. The subhazard ratio (SHR) for cancer mortality in patients having mental health service contact postcancer diagnosis was 1.67 (95% CI: 1.29-2.15), adjusted for sociodemographic characteristics, cancer stage, and precancer mental health status. Conclusion: The prevalence of mental health service contact increased after a cancer diagnosis. Mental health care should be a continued priority for AYA cancer patients, particularly for high-risk groups.
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Affiliation(s)
- Ming Li
- Cancer Institute, NSW Cancer Institute, Eveleigh, Australia
- University of South Australia, Cancer Epidemiology and Population Health, Adelaide, Australia
| | - Grant Sara
- NSW Ministry of Health, System Information and Analytics Branch, Sydney, Australia
- University of Sydney, Faculty of Medicine and Health, Sydney, Australia
| | - David Roder
- Cancer Institute, NSW Cancer Institute, Eveleigh, Australia
- University of South Australia, Cancer Epidemiology and Population Health, Adelaide, Australia
| | - Tracey A O'Brien
- Cancer Institute, NSW Cancer Institute, Eveleigh, Australia
- University of NSW, Faculty of Medicine and Health, Sydney, Australia
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Pao M, Horowitz L. Palliative care and suicidality: Complicated conversations at two ends of the spectrum. Pediatr Blood Cancer 2024; 71:e30956. [PMID: 38511908 PMCID: PMC11039356 DOI: 10.1002/pbc.30956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/22/2024]
Affiliation(s)
- Maryland Pao
- Office of the NIMH Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Lisa Horowitz
- Office of the NIMH Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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Low CE, Pillay RM, Teo FJJ, Loh CYL, Yau CE, Yan Bin Lee AR, Ho CSH, Chen MZ. Educational interventions to reduce depression and anxiety in older adults with cancer in the community: a systematic review, meta-analysis and meta-regression of randomised controlled trials. Age Ageing 2024; 53:afae111. [PMID: 38821857 DOI: 10.1093/ageing/afae111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Older adults make up half of those with cancer and are prone to mood disorders, such as depression and severe anxiety, resulting in negative repercussions on their health-related quality-of-life (HRQOL). Educational interventions have been shown to reduce adverse psychological outcomes. We examined the effect of educational interventions on the severity of psychological outcomes in older adults with cancer (OAC) in the community. METHOD This PRISMA-adherent systematic review involved a search of PubMed, MedLine, Embase and PsycINFO for randomised controlled trials (RCTs) that evaluated educational interventions impacting the severity of depression, anxiety and HRQOL in OAC. Random effects meta-analyses and meta-regressions were used for the primary analysis. RESULTS Fifteen RCTs were included. Meta-analyses showed a statistically insignificant decrease in the severity of depression (SMD = -0.30, 95%CI: -0.69; 0.09), anxiety (SMD = -0.30, 95%CI: -0.73; 0.13) and improvement in overall HRQOL scores (SMD = 0.44, 95%CI: -0.16; 1.04). However, subgroup analyses revealed that these interventions were particularly effective in reducing the severity of depression and anxiety in specific groups, such as OAC aged 60-65, those with early-stage cancer, those with lung cancer and those treated with chemotherapy. A systematic review found that having attained a higher education and income level increased the efficacy of interventions in decreasing the severity of adverse psychological outcomes. CONCLUSION Although overall meta-analyses were statistically insignificant, subgroup meta-analyses highlighted a few specific subgroups that the educational interventions were effective for. Future interventions can be implemented to target these vulnerable groups.
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Affiliation(s)
- Chen Ee Low
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Renish M Pillay
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Finn Jing Jie Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Chun En Yau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Cyrus Su Hui Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Matthew Zhixuan Chen
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore
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Low CE, Yau CE, Tan RY, Ong VCS, Ho RCM, Ho CSH, Lee ARYB, Chen MZ. Association of depression with all-cause and cancer-specific mortality in older adults with cancer: Systematic review, meta-analysis, and meta-regression. J Geriatr Oncol 2024; 15:101700. [PMID: 38218674 DOI: 10.1016/j.jgo.2023.101700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/30/2023] [Accepted: 12/22/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION The incidence and mortality of cancer is increasing worldwide with studies reporting that cumulative risk of cancer rises as age increases. Against the backdrop of the increasing prevalence of cancer amongst older patients, we conducted a systematic review and meta-analysis examining the depression-mortality relationship in older adults with cancer (OAC). MATERIALS AND METHODS This PRISMA-adherent systematic review involved a systematic search of PubMed, Medline, EMBASE, and PsycINFO for prospective and retrospective cohort studies comparing the risk of all-cause and cancer-related mortality among OAC with depression. Random effects meta-analyses and meta-regressions were used for the primary analysis. RESULTS From 5,280 citations, we included 14 cohort studies. Meta-analyses of hazard ratios (HRs) showed an increased incidence of all-cause mortality in OAC with depression (pooled HR: 1.40; 95% confidence interval [CI]: 1.25, 1.55). Subgroup analyses of other categorical study-level characteristics were insignificant. While risk of cancer-related mortality in OAC with depression was insignificantly increased with a pooled HR of 1.21 (95% CI: 0.98, 1.49), subgroup analysis indicated that risk of cancer-related mortality in OAC with depression significantly differed with cancer type. Our systematic review found that having fewer comorbidities, a higher education level, greater socioeconomic status, and positive social supportive factors lowered risk of all-cause mortality in OAC with depression. DISCUSSION Depression in OAC significantly increases risk of all-cause mortality and cancer-related mortality among different cancer types. It is imperative for healthcare providers and policy makers to recognize vulnerable subgroups among older adults with cancer to individualize interventions.
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Affiliation(s)
- Chen Ee Low
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chun En Yau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ren Ying Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Roger Chun Man Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, National University Hospital, Singapore
| | - Cyrus Su Hui Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, National University Hospital, Singapore
| | | | - Matthew Zhixuan Chen
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore.
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Marín-Chollom AM, Beaucant P, King C, Pervil I, Rubin LR, Revenson TA. The integration of the cancer experience into identity: Perspectives from young adults. J Health Psychol 2024:13591053241240932. [PMID: 38566369 DOI: 10.1177/13591053241240932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
The study explored how young adults with cancer create a cancer identity across the illness trajectory. Young adults with hematological cancers (n = 53, ages 20-39) completed a semi-structured interview and brief questionnaire. Deductive thematic analysis was used to code interviews. Four identity categories (Acceptance, Enrichment, Engulfment, and Rejection) were coded and linked to the cancer stage (pre-treatment, active treatment, post-treatment). Pre-treatment, there was minimal expression about identity. Acceptance during active treatment involved identity work around disclosure and the integration of pre-cancer identity with the treatment experience. Post-treatment, acceptance involved actively making sense of the cancer experience and its long-term impact; Enrichment was more frequent post-treatment. Engulfment was expressed most during treatment. Individuals who remained engulfed post-treatment expressed difficulties moving beyond the patient's identity. Rejection of a cancer identity was rarely expressed. Understanding how young adults integrate the cancer experience into their identity may suggest intervention strategies.
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Yau CE, Low CE, Ong NY, Rana S, Chew LJR, Tyebally SM, Chai P, Yeo TC, Chan MY, Lee MX, Tan LL, Koo CY, Lee ARYB, Sia CH. Non-Vitamin K Antagonist Oral Anticoagulants versus Low Molecular Weight Heparin for Cancer-Related Venous Thromboembolic Events: Individual Patient Data Meta-Analysis. Cancers (Basel) 2023; 15:5887. [PMID: 38136433 PMCID: PMC10741613 DOI: 10.3390/cancers15245887] [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: 11/06/2023] [Revised: 12/09/2023] [Accepted: 12/16/2023] [Indexed: 12/24/2023] Open
Abstract
Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in cancer patients. Low molecular weight heparin (LMWH) has been the standard of care but new guidelines have approved the use of non-vitamin K antagonist oral anticoagulants (NOAC). By conducting an individual patient data (IPD) meta-analysis of randomised controlled trials (RCTs) comparing the outcomes of NOAC versus LMWH in cancer patients, we aim to determine an ideal strategy for the prophylaxis of VTE and prevention of VTE recurrence. Three databases were searched from inception until 19 October 2022. IPD was reconstructed from Kaplan-Meier curves. Shared frailty, stratified Cox and Royston-Parmar models were fit to compare the outcomes of venous thromboembolism recurrence and major bleeding. For studies without Kaplan-Meier curves, aggregate data meta-analysis was conducted using random-effects models. Eleven RCTs involving 4844 patients were included. Aggregate data meta-analysis showed that administering NOACs led to a significantly lower risk of recurrent VTE (RR = 0.65; 95%CI: 0.50-0.84) and deep vein thrombosis (DVT) (RR = 0.60; 95%CI: 0.40-0.90). In the IPD meta-analysis, NOAC when compared with LMWH has an HR of 0.65 (95%CI: 0.49-0.86) for VTE recurrence. Stratified Cox and Royston-Parmar models demonstrated similar results. In reducing risks of recurrent VTE and DVT among cancer patients, NOACs are superior to LMWHs without increased major bleeding.
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Affiliation(s)
- Chun En Yau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (C.E.Y.); (C.E.L.); (S.R.); (L.J.R.C.); (P.C.); (T.-C.Y.); (M.Y.C.); (A.R.Y.B.L.)
| | - Chen Ee Low
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (C.E.Y.); (C.E.L.); (S.R.); (L.J.R.C.); (P.C.); (T.-C.Y.); (M.Y.C.); (A.R.Y.B.L.)
| | - Natasha Yixuan Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (C.E.Y.); (C.E.L.); (S.R.); (L.J.R.C.); (P.C.); (T.-C.Y.); (M.Y.C.); (A.R.Y.B.L.)
| | - Sounak Rana
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (C.E.Y.); (C.E.L.); (S.R.); (L.J.R.C.); (P.C.); (T.-C.Y.); (M.Y.C.); (A.R.Y.B.L.)
| | - Lucas Jun Rong Chew
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (C.E.Y.); (C.E.L.); (S.R.); (L.J.R.C.); (P.C.); (T.-C.Y.); (M.Y.C.); (A.R.Y.B.L.)
| | - Sara Moiz Tyebally
- Division of Cardiology, Department of Medicine, Ng Teng Fong General Hospital, Singapore 609606, Singapore
| | - Ping Chai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (C.E.Y.); (C.E.L.); (S.R.); (L.J.R.C.); (P.C.); (T.-C.Y.); (M.Y.C.); (A.R.Y.B.L.)
- Department of Cardiology, National University Heart Centre, Singapore 119074, Singapore; (L.-L.T.); (C.-Y.K.)
| | - Tiong-Cheng Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (C.E.Y.); (C.E.L.); (S.R.); (L.J.R.C.); (P.C.); (T.-C.Y.); (M.Y.C.); (A.R.Y.B.L.)
- Department of Cardiology, National University Heart Centre, Singapore 119074, Singapore; (L.-L.T.); (C.-Y.K.)
| | - Mark Y. Chan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (C.E.Y.); (C.E.L.); (S.R.); (L.J.R.C.); (P.C.); (T.-C.Y.); (M.Y.C.); (A.R.Y.B.L.)
- Department of Cardiology, National University Heart Centre, Singapore 119074, Singapore; (L.-L.T.); (C.-Y.K.)
| | - Matilda Xinwei Lee
- Department of Haematology-Oncology, National University Cancer Institute, Singapore 119228, Singapore;
| | - Li-Ling Tan
- Department of Cardiology, National University Heart Centre, Singapore 119074, Singapore; (L.-L.T.); (C.-Y.K.)
| | - Chieh-Yang Koo
- Department of Cardiology, National University Heart Centre, Singapore 119074, Singapore; (L.-L.T.); (C.-Y.K.)
| | - Ainsley Ryan Yan Bin Lee
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (C.E.Y.); (C.E.L.); (S.R.); (L.J.R.C.); (P.C.); (T.-C.Y.); (M.Y.C.); (A.R.Y.B.L.)
| | - Ching-Hui Sia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (C.E.Y.); (C.E.L.); (S.R.); (L.J.R.C.); (P.C.); (T.-C.Y.); (M.Y.C.); (A.R.Y.B.L.)
- Department of Cardiology, National University Heart Centre, Singapore 119074, Singapore; (L.-L.T.); (C.-Y.K.)
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12
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Gentile A, Ficarra S, Ortega-Gómez S, Jiménez-Pavón D, Asimakopoulou Z, Vantarakis A, Tavares P, Vaz V, Thaller J, Papakonstantinou S, Kirkar M, Glorioso F, Galioto M, Lo Mauro M, Bianco A. Choose the healthy way! Physical activity as a tool to improve mental health in young cancer survivors. Acta Oncol 2023; 62:1589-1591. [PMID: 37837211 DOI: 10.1080/0284186x.2023.2270154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023]
Affiliation(s)
- Ambra Gentile
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Salvatore Ficarra
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Sonia Ortega-Gómez
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cadiz, Spain
| | - Zoi Asimakopoulou
- Department of Public Health, Medical School, University of Patras, Patras, Greece
| | - Apostolos Vantarakis
- Department of Public Health, Medical School, University of Patras, Patras, Greece
| | - Paula Tavares
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Vasco Vaz
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Joshua Thaller
- Department of Health Consulting, Research and Science, Outdoor Against Cancer, Munich, Germany
| | | | - Musa Kirkar
- Centro Internazionale per la Promozione dell'educazione e lo Sviluppo (CEIPES), Palermo, Italy
| | - Francesca Glorioso
- Lega Italiana per la lotta Contro i Tumori (LILT Palermo), Palermo, Italy
| | - Marina Galioto
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Mario Lo Mauro
- Medical Oncology Unit, Ospedale Buccheri-La Ferla Fatebenefratelli, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
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13
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Rosenberg AR, Muriel AC. Poor Mental Health Among Survivors of Childhood Cancer-Risk Factors and a Call for Intervention. JAMA Pediatr 2023; 177:758-759. [PMID: 37345507 DOI: 10.1001/jamapediatrics.2023.2162] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Affiliation(s)
- Abby R Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Anna C Muriel
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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