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Andreu Y, Picazo C, Murgui S, Soto-Rubio A, García-Conde A, Romero R. Exploring the independent association of employment status to cancer survivors' health-related quality of life. Health Qual Life Outcomes 2023; 21:44. [PMID: 37170308 PMCID: PMC10176702 DOI: 10.1186/s12955-023-02124-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 04/29/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Having a job has been associated with better Health-Related Quality of Life (HRQOL) in cancer survivors. However, the sociodemographic and disease-related profiles characterizing the survivors being employed and those having better HRQOL largely overlap. The present study aims to discern the degree to which employment status is independently associated with cancer survivors' HRQOL or if it mainly reflects the impact of other sociodemographic and cancer-related variables. METHODS Cross-sectional study on a heterogeneous sample of 772 working-age survivors of adult-onset cancer. An instrument specifically designed to assess HRQOL in cancer survivors and Multivariate Variance Analysis (MANOVA) were used. RESULTS Survival phase, cancer type, and employment status showed the main effects on cancer survivors' HRQOL. In particular, being employed (vs unemployed) had the greatest positive association with HRQOL, affecting ten of the twelve HRQOL domains considered. Also, interaction effects highlighted the role of age (younger) and marital status (single) as risk factors for a greater negative impact of variables affecting the survivor's HRQOL. CONCLUSIONS The application of a multivariate methodology sheds new light on two relevant issues for the cancer survivor's HRQOL: (i) the existence of differences between diagnostic groups that are not attributed to other variables such as sex, and (ii) the important and independent role that employment status plays. Comprehensive cancer survivorship care should focus more on high-risk groups and include having a job as an essential aspect to consider and prompt. The fact that the employment status is susceptible to change represents a valuable opportunity to care for the wellbeing of this population.
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Affiliation(s)
- Y Andreu
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - C Picazo
- Psychology and Sociology Department, University of Zaragoza, Zaragoza, Spain.
| | - S Murgui
- Social Psychology Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - A Soto-Rubio
- Development and Education Psychology Department, Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - A García-Conde
- Psychology Unit - Valencian Institute of Oncology Foundation, Valencia, Spain
| | - R Romero
- Psychology Unit - Valencian Institute of Oncology Foundation, Valencia, Spain
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Alabdaljabar MS, Durani U, Thompson CA, Constine LS, Hashmi SK. The forgotten survivor: A comprehensive review on Non-Hodgkin lymphoma survivorship. Am J Hematol 2022; 97:1627-1637. [PMID: 36069675 DOI: 10.1002/ajh.26719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/15/2022] [Accepted: 08/23/2022] [Indexed: 01/31/2023]
Abstract
The number of non-Hodgkin lymphoma (NHL) survivors is increasing. With the advancement of NHL therapies, it is crucial to focus on the challenges these survivors may face. Three main categories are to be considered in NHL survivorship, including quality of life and uncertainty about the future, possible physical health complications (including cardiovascular disease, infertility, and subsequent neoplasms), and the impact of novel NHL treatments and their potential complications. The latter includes CAR T-cell therapy, monoclonal antibodies, checkpoint inhibitors, and hematopoietic stem cell transplantation. In this report, we aim to shed the light on these aspects and to discuss survivorship care plan for NHL.
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Affiliation(s)
| | - Urshila Durani
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Carrie A Thompson
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Louis S Constine
- Departments of Radiation Oncology and Pediatrics, University of Rochester Medical Center, New York City, New York, USA
| | - Shahrukh K Hashmi
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Sheikh Shakhbout Medical City / Mayo Clinic, Abu Dhabi, United Arab Emirates
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3
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Andreu Y, Martínez P, Soto-Rubio A, Pérez-Marín M, Cervantes A, Arribas L. Quality of life in cancer survivorship: Sociodemographic and disease-related moderators. Eur J Cancer Care (Engl) 2022; 31:e13692. [PMID: 36069249 DOI: 10.1111/ecc.13692] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 06/23/2022] [Accepted: 08/02/2022] [Indexed: 01/06/2023]
Abstract
RATIONALE To identify high-risk survivors in order to provide appropriate care. PURPOSE To analyse the quality of life (QOL) of cancer survivors using an instrument designed specifically for this population and considering different sociodemographic and disease-related characteristics as possible modulating variables. METHODS The Quality of Life in Adult Cancer Survivors (QLACS) was filled out by a large and heterogeneous sample of disease-free post-treatment Spanish cancer survivors (N = 1862). RESULTS QLACS scores were comparable to those obtained in other studies and indicative of worse QOL as a function of shorter elapsed time since the end of primary treatment. The best QOL was shown by prostate, and the worst by hematologic cancer survivors. Both systemic treatments (chemotherapy and hormone therapy) and the combination of radiotherapy and chemotherapy were associated with worse QOL. Likewise, younger age, female sex, unemployment status and not having a stable partner were associated with worse QOL. CONCLUSION Greater understanding of the QOL experienced by the already large and continuously growing population of cancer survivors is relevant for guiding both clinical practice and health policy. In addition, knowing the risk factors associated with worse QOL facilitates the development of targeted prevention programmes for those survivors who need it the most.
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Affiliation(s)
- Yolanda Andreu
- Department of Personality, Assessment and Psychological Treatments, Universitat de València, Valencia, Spain
| | - Paula Martínez
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
| | - Ana Soto-Rubio
- Department of Personality, Assessment and Psychological Treatments, Universitat de València, Valencia, Spain
| | - Marián Pérez-Marín
- Department of Personality, Assessment and Psychological Treatments, Universitat de València, Valencia, Spain
| | - Andrés Cervantes
- Medical Oncology Department, Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
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4
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Marte C, George LS, Rutherford SC, Ouyang DJ, Martin P, Leonard JP, Trevino KM. Unmet mental health needs in patients with advanced B-cell lymphomas. Palliat Support Care 2022; 20:328-333. [PMID: 35713350 PMCID: PMC9843817 DOI: 10.1017/s1478951521001164] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT Existing research on psychological distress and mental health service utilization has focused on common types of solid tumor cancers, leaving significant gaps in our understanding of patients experiencing rare forms of hematologic cancers. OBJECTIVE To examine distress, quality of life, and mental health service utilization among patients with aggressive, refractory B-cell lymphomas. METHOD Patients (n = 26) with B-cell lymphomas that relapsed after first- or second-line treatment completed self-report measures of distress (Hospital Anxiety and Depression Scale) and quality of life (Short-Form Health Survey, SF-12). Patients also reported whether they had utilized mental health treatment since their cancer diagnosis. RESULTS Approximately 42% (n = 11) of patients reported elevated levels of psychological distress. Of patients with elevated distress, only one quarter (27.2%; n = 3) received mental health treatment, while more than half did not receive mental health treatment (54.5%; n = 6), and 18.1% (n = 2) did not want treatment. Patients with elevated distress reported lower mental quality of life than patients without elevated distress [F (1, 25) = 15.32, p = 0.001]. SIGNIFICANCE OF THE RESULTS A significant proportion of patients with advanced, progressive, B-cell lymphomas may experience elevated levels of distress. Yet, few of these distressed patients receive mental health treatment. Findings highlight the need to better identify and address barriers to mental health service utilization among patients with B-cell lymphoma, including among distressed patients who decline treatment.
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Affiliation(s)
| | | | | | | | - Peter Martin
- Weill Cornell Medicine, New York, NY
- New York Presbyterian, New York, NY
| | - John P Leonard
- Weill Cornell Medicine, New York, NY
- New York Presbyterian, New York, NY
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5
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Øvlisen AK, Jakobsen LH, Kragholm KH, Nielsen RE, Nully Brown P, Dahl‐Sørensen RB, Frederiksen H, Mannering N, Josefsson PL, Ludvigsen Al‐Mashhadi A, Jørgensen JM, Dessau‐Arp A, Clausen MR, Pedersen RS, Torp‐Pedersen C, Severinsen MT, El‐Galaly TC. Mental health among patients with non-Hodgkin lymphoma: A Danish nationwide study of psychotropic drug use in 8750 patients and 43 750 matched comparators. Am J Hematol 2022; 97:749-761. [PMID: 35298039 PMCID: PMC9310853 DOI: 10.1002/ajh.26538] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/21/2022] [Accepted: 03/07/2022] [Indexed: 11/12/2022]
Abstract
Psychological distress following cancer diagnosis may lead to mental health complications including depression and anxiety. Non-Hodgkin lymphomas (NHLs) include indolent and aggressive subtypes for which treatment and prognosis differ widely. Incident use of psychotropic drugs (PDs-antidepressants, antipsychotics, and anxiolytics) and its correlation to lymphoma types can give insights into the psychological distress these patients endure. In this prospective matched cohort study, we used nationwide population-based registries to investigate the cumulative risk of PD use in NHL patients compared to a sex- and age-matched cohort from the Danish background population. In addition, contact patterns to psychiatric departments and incident intentional self-harm or completed suicide were explored. In total, 8750 NHL patients and 43 750 matched comparators were included (median age 68; male:female ratio 1.6). Median follow-up was 7.1 years. Two-year cumulative risk of PD use was higher in NHL patients (16.4%) as compared to the matched comparators (5.1%, p < .01); patients with aggressive NHL subtypes had the highest incidence. Prescription rates were higher in the first years after diagnosis but approached the rate of the matched population 5 years into survivorship in aggressive NHLs, whereas patients with indolent subtypes continued to be at higher risk. NHL patients had a slightly higher two-year risk of suicide/intentional self-harm (0.3%) as compared to the matched comparators (0.2%, p = .01). These results demonstrate that mental health complications among NHL patients are frequent. Routine assessment for symptoms of depression and anxiety should be consider as part of standard follow-up of NHL patients.
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Affiliation(s)
- Andreas Kiesbye Øvlisen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
| | - Lasse Hjort Jakobsen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
| | - Kristian Hay Kragholm
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Aalborg Denmark
- Department of Cardiology Aalborg University Hospital Aalborg Denmark
| | - René Ernst Nielsen
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Department of Psychiatry Aalborg University Hospital Aalborg Denmark
| | - Peter Nully Brown
- Department of Hematology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | | | | | | | | | | | | | | | | | | | - Christian Torp‐Pedersen
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Aalborg Denmark
- Department of Cardiology and Clinical Research Nordsjællands Hospital Hillerød Denmark
| | - Marianne Tang Severinsen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Clinical Cancer Research Unit Aalborg University Hospital Aalborg Denmark
| | - Tarec Christoffer El‐Galaly
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Clinical Cancer Research Unit Aalborg University Hospital Aalborg Denmark
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Agostinelli G, Muzzatti B, Serpentini S, Spina M, Annunziata MA. Cancer-Related Psychological Distress in Lymphoma Survivor: An Italian Cross-Sectional Study. Front Psychol 2022; 13:872329. [PMID: 35558708 PMCID: PMC9088809 DOI: 10.3389/fpsyg.2022.872329] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022] Open
Abstract
Cancer is becoming a chronic disease, and the number of cancer survivors continues to increase. Lymphoma survivors are also increasing in numbers, and anxiety and depression are among the consequences they face. This study aimed to explore psychological distress in a sample of 212 lymphoma survivors. Information through a socio-demographic form and the compilation of questionnaires to assess anxiety, depression, quality of life, and the impact of cancer on lymphoma survivors was collected and analyzed. In the sample examined, 17% of lymphoma survivors were anxiety caseness, and 12.3% were depression caseness, and of these, 8% presented with concomitant anxiety depression. This study identified some variables associated with psychological distress in lymphoma survivors: female sex; living as a couple; a diagnosis of Hodgkin lymphoma; systematic treatment and/or radiotherapy; sleep disorders; no regular physical activity; and present or past use of psychiatric drugs. Our cross-sectional study results suggest that some of the variables investigated may be useful in identifying lymphoma survivors who are more likely to report psychological distress. It is important to monitor psychological distress along the entire trajectory of survivorship in order to identify early the presence of anxiety and depression and to provide timely psychological support.
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Affiliation(s)
- Giulia Agostinelli
- Unit of Oncological Psychology - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Barbara Muzzatti
- Unit of Oncological Psychology - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | | | - Michele Spina
- Unit of Oncological Medicine - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
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Yang Z, Gong D, Huang F, Sun Y, Hu Q. Epidemiological Characteristics and the Development of Prognostic Nomograms of Patients With HIV-Associated Cutaneous T-Cell Lymphoma. Front Oncol 2022; 12:847710. [PMID: 35372067 PMCID: PMC8965059 DOI: 10.3389/fonc.2022.847710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background The incidence of human immunodeficiency virus (HIV) associated cutaneous T-Cell lymphoma (HIV-associated CTCL) is very low, and there is a lack of relevant epidemiological and clinical prognostic studies. Therefore, we aimed to study the epidemiological characteristics of HIV-associated CTCL and to construct and validate a nomogram predicting patient survival. Methods Demographic, clinical characteristics, and incidence data from the Surveillance, Epidemiology and End Results (SEER) database were screened for patients with HIV-associated CTCL. Independent prognostic factors in patients with HIV-associated CTCL were analyzed to establish nomograms of overall survival (OS) and disease-specific survival (DSS) rates of patients. The performance of the prediction model was validated by the consistency index (C-index), the area under the receiver operating characteristic curve (AUC), and calibration plots. Results A total of 883 eligible patients were screened for inclusion in this study and randomized to the training cohort (70%, n = 619) and the validation cohort (30%, n = 264). The age-adjusted average incidence rate per 100,000 persons per year for HIV-associated CTCL was 0.071 for the period 2004-2017, with an increasing incidence rate. The median age of the included patients was 59 years, of which male Caucasian held a majority. 99.5% of the patients had a tumor tissue subtype of mycosis fungoides, while the other tumor subtypes were sézary syndrome. The median OS for patients with HIV-associated CTCL was 162 months, and the OS rates at 1, 3, 5, and 10 years were 0.964, 0.904, 0.835, and 0.766, respectively. Univariate and multivariate COX regression analysis were performed, and prognostic indicators such as "Age", "Radiation", "Chemotherapy", "Summary stage", "Sequence number" were ultimately incorporated and used to establish nomograms of OS and DSS rates at 1, 3, 5 and 10 years for the training cohort. The C-index, AUC, and calibration plot confirmed that our prediction model had good accuracy. Conclusion While HIV-associated CTCL is very rare, its incidence has been on the rise in the last decade or so. We described the epidemiological characteristics and prognostic factors in patients with HIV-associated CTCL.
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Affiliation(s)
- Zheng Yang
- Department of Infectious Disease, Jingzhou Hospital, Yangtze University, Jingzhou, China
| | - Daoqing Gong
- Teaching Office, Jingzhou Hospital, Yangtze University, Jingzhou, China
| | - Fei Huang
- Department of Infectious Disease, Jingzhou Hospital, Yangtze University, Jingzhou, China
| | - Yi Sun
- Department of Dermatology, Jingzhou Hosiptal, Yangtze University, Jingzhou, China
| | - Qinming Hu
- Department of Infectious Disease, Jingzhou Hospital, Yangtze University, Jingzhou, China
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8
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Lee SF, Vellayappan BA, Wong LC, Chiang CL, Chan SK, Wan EYF, Wong ICK, Lambert PC, Rachet B, Ng AK, Luque-Fernandez MA. Cardiovascular diseases among diffuse large B-cell lymphoma long-term survivors in Asia: a multistate model study. ESMO Open 2022; 7:100363. [PMID: 35026723 PMCID: PMC8760397 DOI: 10.1016/j.esmoop.2021.100363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/26/2021] [Accepted: 12/03/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND We modeled the clinical course of a cohort of diffuse large B-cell lymphoma (DLBCL) patients with no prior cardiovascular diseases (CVDs) using a multistate modeling framework. PATIENTS AND METHODS Data on 2600 patients with DLBCL diagnosed between 2000 and 2018 and had received chemotherapy with or without radiotherapy were obtained from a population-wide electronic health database of Hong Kong. We used the Markov illness-death model to quantify the impact of doxorubicin and various risk factors (therapeutic exposure, demographic, comorbidities, cardiovascular risk factors, and lifestyle factors which included smoking) on the clinical course of DLBCL (transitions into incident CVD, lymphoma death, and other causes of death). RESULTS A total of 613 (23.6%) and 230 (8.8%) of 2600 subjects died of lymphoma and developed incident CVD, respectively. Median follow-up was 7.0 years (interquartile range 3.8-10.8 years). Older ages [hazard ratio (HR) for >75 versus ≤60 years 1.88; 95% confidence interval (CI) 1.25-2.82 and HR for 61-75 versus ≤60 years 1.60; 95% CI 1.12-2.30], hypertension (HR 4.92; 95% CI 2.61-9.26), diabetes (HR 1.43; 95% CI 1.09-1.87), and baseline use of aspirin (HR 5.30; 95% CI 3.93-7.16) were associated with an increased risk of incident CVD. In a subgroup of anticipated higher-risk patients (aged 61-75 years, smoked, had diabetes, and received doxorubicin), we found that they remained on average 7.9 (95% CI 7.2-8.8) years in the DLBCL state and 0.1 (95% CI 0.0-0.4) years in the CVD state, if they could be followed up for 10 years. The brief time in the CVD state is consistent with the high chance of death in patients who developed CVD. Other causes of death have overtaken DLBCL-related death after about 5 years. CONCLUSIONS In this Asian population-based cohort, we found that incident CVDs can occur soon after DLBCL treatment and continued to occur throughout survivorship. Clinicians are advised to balance the risks and benefits of treatment choices to minimize the risk of CVD.
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Affiliation(s)
- S F Lee
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong; Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong
| | - B A Vellayappan
- Department of Radiation Oncology, National University Cancer Institute, Singapore
| | - L C Wong
- Department of Radiation Oncology, National University Cancer Institute, Singapore
| | - C L Chiang
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong; Department of Clinical Oncology, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority, Hong Kong
| | - S K Chan
- Department of Clinical Oncology, The University of Hong Kong, Hong Kong
| | - E Y-F Wan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong
| | - I C-K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong; Research Department of Policy and Practice, School of Pharmacy, University College London, London, UK
| | - P C Lambert
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - B Rachet
- Department of Non-Communicable Disease Epidemiology, ICON Group, London School of Hygiene and Tropical Medicine, London, UK
| | - A K Ng
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - M A Luque-Fernandez
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Department of Non-Communicable Disease and Cancer Epidemiology, Instituto de Investigacion Biosanitaria de Granada (ibs.GRANADA), Andalusian School of Public Health, Granada, Spain.
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Shinohara M, Mahurin H, Tarabadkar E, Hippe D, Lachance K, Kim E, Loggers E. Health‐related quality of life in cutaneous T‐cell lymphoma: A cross‐sectional survey study. SKIN HEALTH AND DISEASE 2021; 1:e45. [PMID: 35663135 PMCID: PMC9060149 DOI: 10.1002/ski2.45] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/15/2021] [Accepted: 05/03/2021] [Indexed: 01/26/2023]
Affiliation(s)
- M.M. Shinohara
- Division of Dermatology University of Washington Seattle Washington USA
| | - H.M. Mahurin
- School of Medicine University of Washington Seattle Washington USA
| | - E. Tarabadkar
- Department of Dermatology Emory University Atlanta Georgia USA
| | - D.S. Hippe
- Department of Radiology University of Washington Seattle Washington USA
| | - K. Lachance
- Division of Dermatology University of Washington Seattle Washington USA
| | - E.J. Kim
- Department of Dermatology University of Pennsylvania Philadelphia Pennsylvania USA
| | - E.T. Loggers
- Clinical Research Division Fred Hutchinson Cancer Research Center Seattle Washington USA
- Division of Hematology/Oncology Department of Medicine University of Washington Seattle Washington USA
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Doxorubicin and subsequent risk of cardiovascular diseases among survivors of diffuse large B-cell lymphoma in Hong Kong. Blood Adv 2021; 4:5107-5117. [PMID: 33085755 DOI: 10.1182/bloodadvances.2020002737] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/09/2020] [Indexed: 02/01/2023] Open
Abstract
Evidence regarding the dose-related impact of doxorubicin on subsequent cardiovascular diseases (CVDs) in Asian patients with diffuse large B-cell lymphoma (DLBCL) without preexisting CVDs is lacking. From a territory-wide electronic database in Hong Kong, we identified adults who were diagnosed with DLBCL and treated with chemotherapy between 2000 and 2018. We evaluated the patients for incident CVDs (including ischemic heart disease, heart failure, and cardiomyopathy). We evaluated the cause-specific cumulative incidence (csCI) of CVD with levels of doxorubicin exposure by using flexible parametric competing risk analysis and adjusting for demographics, comorbidities, therapeutic exposure, cardiovascular risk factors, and lifestyle factors. Controls were age- and sex-matched to DLBCL patients. We analyzed 2600 patients and 13 000 controls. The adjusted cause-specific hazard ratio (HR) for CVD in patients treated with >500 mg doxorubicin compared with non-doxorubicin regimens was 2.65 (95% confidence interval [CI], 1.23-5.74; P = .013). The 5-, 10-, and 15-year csCIs were 8.2%, 11.3%, and 12.8% in patients vs 3.1%, 4.4%, and 5.2% in controls, respectively. Hypertension (HR, 6.20; 95% CI, 0.79-48.44; P = .082) and use of aspirin/angiotensin-converting enzyme inhibitor/beta-blocker at baseline (HR, 2.13-4.63; P < .001 to .002) might confer a higher risk of subsequent CVDs. In this Hong Kong population-based study, doxorubicin exposure (absolute dose >500 mg), together with hypertension or baseline use of medication for cardiovascular risk factors, was found to be associated with an increase in csCIs of CVDs. Tailoring therapeutic strategies to underlying CVD risk factors and risk-adapted monitoring and follow-up of susceptible DLBCL patients are advisable.
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11
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Patient-reported long-term quality of life after tisagenlecleucel in relapsed/refractory diffuse large B-cell lymphoma. Blood Adv 2021; 4:629-637. [PMID: 32074277 DOI: 10.1182/bloodadvances.2019001026] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/30/2019] [Indexed: 01/28/2023] Open
Abstract
The JULIET phase 2 trial evaluated a single infusion of tisagenlecleucel in adult patients with relapsed/refractory (r/r) diffuse large B-cell lymphoma (DLBCL). The objective of the current analysis was to evaluate patient-reported health-related quality of life (HRQoL) with a median follow-up of 19.3 months among patients infused with a single dose of tisagenlecleucel. Patients enrolled were ≥18 years of age with r/r DLBCL after ≥2 lines of therapy and had either undergone a failed autologous stem cell transplant or were ineligible for the procedure. Two validated HRQoL instruments, Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) and Short Form-36 (SF-36) Health Survey, were used to measure HRQoL at baseline and months 3, 6, 12, and 18. At data cutoff (21 May 2018), 115 patients had received tisagenlecleucel infusion. Among the 99 patients evaluated, overall response rate was 54%, and 40% of patients achieved complete response (CR). Initially, 108 patients completed the HRQoL assessments at baseline, including 57 patients who eventually achieved CR or partial response (PR). Further, 30 and 21 patients in clinical response who completed assessments at baseline also completed assessments at months 12 and 18, respectively. Patients who achieved CR or PR sustained HRQoL improvement in all FACT scores at all time points. SF-36 instruments showed improvement above the minimal clinically important differences on 5 of 8 subscales. Long-term follow-up in the phase 2 JULIET study demonstrated that patients with r/r DLBCL who respond to tisagenlecleucel therapy had sustained, clinically meaningful improvements in HRQoL. This trial was registered at www.clinicaltrials.gov as #NCT02445248.
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Ellis S, Brown RF, Thorsteinsson EB, Pakenham KI, Perrott C. Quality of life and fear of cancer recurrence in patients and survivors of non-Hodgkin lymphoma. PSYCHOL HEALTH MED 2021; 27:1649-1660. [PMID: 33928815 DOI: 10.1080/13548506.2021.1913756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Non-Hodgkin lymphoma (NHL) is a common haematological cancer that is comprised of approximately 30 subtypes, of which Waldenström Macroglobulinemia (WM) is a rare incurable form. It is typically managed using a watch-and-wait strategy that can contribute to illness uncertainty which may result in fear of cancer recurrence (FCR) and poor health-related quality of life (QOL). However, few studies have examined the correlates of FCR and QOL in NHL patients, including WM patients. One-hundred males and 92 females with a mean age of 62.7 years who were an average of 6.8 years from diagnosis completed the online questionnaire which asked about demographics, medical history, QOL, FCR, stress, anxiety and depression. Few NHL patients reported significant stress or affective distress, most had moderate-high QOL and 41% experienced recent FCR, relative to published cut-off scores. Poorer QOL was related to depression symptoms, FCR, higher illness burden (i.e. comorbidity) and fewer personal resources (i.e. unemployed), whereas FCR was related to shorter time since diagnosis and more depressive symptoms. Results suggest that FCR and depressive symptoms may adversely impact QOL, whereas a recent cancer diagnosis and depression-related pessimism may contribute to FCR.
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Affiliation(s)
- Susan Ellis
- University of Queensland, Brisbane, Australia
| | - Rhonda F Brown
- Research School of Psychology, The Australian National University, Canberra, Australia
| | | | | | - Colin Perrott
- School of Psychology, University of New England, Armidale, Australia
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Exploring health-related quality of life among non-Hodgkin's lymphoma survivors after completion of primary treatment: a cross-sectional study in Thailand. Support Care Cancer 2021; 29:6511-6522. [PMID: 33909148 DOI: 10.1007/s00520-021-06246-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/20/2021] [Indexed: 01/04/2023]
Abstract
PURPOSES To investigate health-related quality of life (HR-QoL) and its influencing factors among non-Hodgkin's lymphoma (NHL) survivors after completion of primary treatment. METHODS A cross-sectional study with 312 NHL survivors after completing primary treatment using self-reported data collected through face-to-face interviews or postal survey between May 2019 and December 2019. Sociodemographic factors, clinical characteristics, physical symptom distress, anxiety, depression, unmet supportive care needs, and adaptation (post-traumatic growth and post-traumatic stress disorder) were assessed. Data analysis included ANOVA tests to investigate HR-QoL among NHL survivors at different time points and GEE to assess predictors of HR-QoL. RESULTS The mean score of HR-QoL was 136.05 (SD 19.12). HR-QoL scores reported by NHL survivors in phase I (6 months or less post-treatment) were significantly lower than those in phase II (> 6 months-4 years), phase III (> 4-9 years), and phase IV (over 9 years post-treatment). Regarding HR-QoL domains, NHL survivors in phase I had significantly lower physical well-being and functional well-being scores than those in phases II, III, and IV; and significantly lower lymphoma domain score than those in phase III. GEE analysis showed that physical symptom distress, anxiety, depression, unmet supportive care needs, poor adaptation, and receiving chemotherapy disrupted HR-QoL (all P < .001). CONCLUSIONS Healthcare providers should re-prioritize intervention guidelines and survivorship care planning to promote HR-QoL among NHL survivors, particularly in phase I, through reducing physical and psychological symptom distress, addressing unmet needs, and enhancing adaptation outcomes.
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Hematological cancer survivors' experiences of participating in a shared care follow-up-an exploratory interview study. J Cancer Surviv 2021; 15:620-629. [PMID: 33405058 DOI: 10.1007/s11764-020-00955-y] [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: 03/23/2020] [Accepted: 10/10/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of the present study was to explore hematological cancer survivors' experiences of participating in a shared care follow-up based on alternating routine physician visits and nurse-led telephone consultations at the Department of Hematology, Aalborg University Hospital, Denmark. DESIGN The design was an exploratory qualitative interview study based on a semi-structured interview guide. METHOD Twelve patients who had participated in the shared care follow-up were interviewed. The interviews were recorded and transcribed. Data were analyzed using thematic analysis. RESULTS Our findings suggest that hematological patients found the nurse-led telephone consultations convenient and helped alleviate anxiety. Despite fewer visits to the hospital and less physical examinations, the patients' sense of security was maintained. Furthermore, completing questionnaires and the emotional and psychosocial focus in nurse consultations were considered beneficial. Finally, using the telephone was considered to be personal and an acceptable way of talking about topics of a sensitive nature. CONCLUSIONS Our findings suggest that hematological cancer survivors value alternating routine visits and nurse-led telephone consultations as part of cancer survivorship care as well as the emotional and psychological focus of the shared care follow-up. It seems that their sense of security was maintained due to retention of physical examinations. IMPLICATIONS FOR CANCER SURVIVORS The findings from this study underline the importance of the flexibility and adaptability of cancer follow-up in order to meet patients' needs and preferences. Furthermore, this study underlines the importance of cancer survivorship care that goes beyond disease-related support.
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15
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Pallotti F, Pelloni M, Faja F, Di Chiano S, Di Rocco A, Lenzi A, Lombardo F, Paoli D. Semen quality in non-Hodgkin lymphoma survivors: a monocentric retrospective study. Hum Reprod 2021; 36:16-25. [PMID: 33257989 DOI: 10.1093/humrep/deaa266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 09/03/2020] [Indexed: 11/15/2022] Open
Abstract
STUDY QUESTION How is semen quality affected by treatment in survivors of non-Hodgkin lymphoma (NHL)? SUMMARY ANSWER Before cancer treatment, most NHL subjects were normozoospermic and, while standard first-line treatments seemed compatible with post-treatment recovery after 18 months, salvage therapy followed by haematopoietic stem cell transplant caused permanent damage to spermatogenesis in many cases, with 66% azoospermic subjects in the long term. WHAT IS KNOWN ALREADY Testicular function has been widely investigated in relation to the most common malignancies in men of reproductive age, such as testicular cancer and Hodgkin lymphoma, but NHL has been somewhat under-investigated. The available reports generally show a post-treatment worsening of semen parameters in NHL survivors, but they involved small caseloads or a subgroup of broader caseloads, and their results are not comparable. STUDY DESIGN, SIZE, DURATION We conducted a retrospective analysis of 222 subjects who attended our University Hospital Sperm Bank between 2002 and 2017 for sperm cryopreservation after a diagnosis of NHL. PARTICIPANTS/MATERIALS, SETTING, METHODS The study included 222 patients with NHL who underwent sperm cryopreservation before any antineoplastic treatment. Subjects with any comorbidity and/or other conditions interfering with sperm parameters were excluded. All patients underwent a careful medical history and physical examination at the time of sperm cryopreservation (T0) and had at least one follow-up visit at 6 (T6), 12 (T12), 18 (T18) and/or 24 months (T24) or more than 24 months (T > 24), with a median follow-up of 47.5 months (range 28-140 months). Fertility information was collected through the administration of a questionnaire. MAIN RESULTS AND THE ROLE OF CHANCE Pre-treatment, more than 80% of NHL patients were normozoospermic and in 15.9% of cases had already fathered a child. Aggressive lymphomas were associated with worse baseline semen volume and total sperm number compared to indolent subtypes (P < 0.05). Post-treatment analyses showed that standard first-line treatments alone had a more favourable outcome than intensified regimens for semen parameters, with total sperm number returning to near-baseline values at 18 months (T0: 195.0 ± 189.8 versus T18: 113.4 ± 103.1, P = 0.278), and a 7.7% prevalence of azoospermia at 2 years. In this subgroup receiving standard first-line treatments, radiotherapy of the pelvis versus other 'high' sites (mediastinum, latero-cervical and axillary lymph nodes, etc.) was associated with an increased risk of developing post-treatment azoospermia (odds ratio 4.29, 95% CI 1.81-10.14; P = 0.001). Two-thirds of subjects who had relapsed or had disease progression after first-line treatment and then underwent salvage treatment ± haematopoietic stem cell transplant became azoospermic. Fertility data were available for 176 patients: 15.9% already had at least one child prior to the NHL diagnosis and 12.5% (22 patients) desired children after treatment. Fourteen patients achieved fatherhood: 12 through natural conception and two following ART. LIMITATIONS, REASONS FOR CAUTION The main limitations of the study are the lack of data on blood hormones for evaluation of testicular function as a whole and the non-compliance of several patients in attending follow-up visits at all time points, resulting in a reduced sample size for the treatment subgroup analyses. Furthermore, despite a good fertility questionnaire response rate (>80%), the low number of NHL survivors actively seeking fatherhood limits the generalization of results. WIDER IMPLICATIONS OF THE FINDINGS The increased survival of NHL patients of reproductive age makes it essential to focus on the testicular toxicity of the treatment. Sperm cryopreservation must be suggested before any treatment. Two years after first-line treatments, sperm number showed signs of recovery: this finding is of the utmost importance for oncofertility counselling, as it indicates that only a standard first-line chemotherapy in many patients may be compatible with at least a partial spermatogenesis recovery in the long term. Nonetheless, it is expected that up to 30% of subjects will require treatment intensification, which could result in permanent testicular damage; in such cases the use of banked semen might represent the patient's best chance for future fertility. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by a grant from the Italian Ministry of Education and Research (MIUR-PRIN 2015-2015XSNA83-002) and the 'Sapienza' University of Rome, Faculty of Medicine. The authors report no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Francesco Pallotti
- Laboratory of Seminology - Sperm Bank 'Loredana Gandini', Department of Experimental Medicine, 'Sapienza' University of Rome, Rome, Italy
| | - Marianna Pelloni
- Laboratory of Seminology - Sperm Bank 'Loredana Gandini', Department of Experimental Medicine, 'Sapienza' University of Rome, Rome, Italy
| | - Fabiana Faja
- Laboratory of Seminology - Sperm Bank 'Loredana Gandini', Department of Experimental Medicine, 'Sapienza' University of Rome, Rome, Italy
| | - Silvia Di Chiano
- Laboratory of Seminology - Sperm Bank 'Loredana Gandini', Department of Experimental Medicine, 'Sapienza' University of Rome, Rome, Italy
| | - Alice Di Rocco
- Department of Cellular Biotechnologies and Haematology, 'Sapienza' University of Rome, Rome, Italy
| | - Andrea Lenzi
- Laboratory of Seminology - Sperm Bank 'Loredana Gandini', Department of Experimental Medicine, 'Sapienza' University of Rome, Rome, Italy
| | - Francesco Lombardo
- Laboratory of Seminology - Sperm Bank 'Loredana Gandini', Department of Experimental Medicine, 'Sapienza' University of Rome, Rome, Italy
| | - Donatella Paoli
- Laboratory of Seminology - Sperm Bank 'Loredana Gandini', Department of Experimental Medicine, 'Sapienza' University of Rome, Rome, Italy
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Joshy G, Thandrayen J, Koczwara B, Butow P, Laidsaar-Powell R, Rankin N, Canfell K, Stubbs J, Grogan P, Bailey L, Yazidjoglou A, Banks E. Disability, psychological distress and quality of life in relation to cancer diagnosis and cancer type: population-based Australian study of 22,505 cancer survivors and 244,000 people without cancer. BMC Med 2020; 18:372. [PMID: 33256726 PMCID: PMC7708114 DOI: 10.1186/s12916-020-01830-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/27/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Improved survival means that cancer is increasingly becoming a chronic disease. Understanding and improving functional outcomes are critical to optimising survivorship. We quantified physical and mental health-related outcomes in people with versus without cancer, according to cancer type. METHODS Questionnaire data from an Australian population-based cohort study (45 and Up Study (n = 267,153)) were linked to cancer registration data to ascertain cancer diagnoses up to enrolment. Modified Poisson regression estimated age- and sex-adjusted prevalence ratios (PRs) for adverse person-centred outcomes-severe physical functional limitations (disability), moderate/high psychological distress and fair/poor quality of life (QoL)-in participants with versus without cancer, for 13 cancer types. RESULTS Compared to participants without cancer (n = 244,000), cancer survivors (n = 22,505) had greater disability (20.6% versus 12.6%, respectively, PR = 1.28, 95%CI = (1.25-1.32)), psychological (22.2% versus 23.5%, 1.05 (1.02-1.08)) and poor/fair QoL (15.2% versus 10.2%; 1.28 (1.24-1.32)). The outcomes varied by cancer type, being worse for multiple myeloma (PRs versus participants without cancer for disability 3.10, 2.56-3.77; distress 1.53, 1.20-1.96; poor/fair QoL 2.40, 1.87-3.07), lung cancer (disability 2.81, 2.50-3.15; distress 1.67, 1.46-1.92; poor/fair QoL 2.53, 2.21-2.91) and non-Hodgkin's lymphoma (disability 1.56, 1.37-1.78; distress 1.20, 1.05-1.36; poor/fair QoL 1.66, 1.44-1.92) and closer to those in people without cancer for breast cancer (disability 1.23, 1.16-1.32; distress 0.95, 0.90-1.01; poor/fair QoL 1.15, 1.05-1.25), prostate cancer (disability 1.11, 1.04-1.19; distress 1.09, 1.02-1.15; poor/fair QoL 1.15, 1.08-1.23) and melanoma (disability 1.02, 0.94-1.10; distress 0.96, 0.89-1.03; poor/fair QoL 0.92, 0.83-1.01). Outcomes were worse with recent diagnosis and treatment and advanced stage. Physical disability in cancer survivors was greater in all population subgroups examined and was a major contributor to adverse distress and QoL outcomes. CONCLUSIONS Physical disability, distress and reduced QoL are common after cancer and vary according to cancer type suggesting priority areas for research, and care and support.
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Affiliation(s)
- Grace Joshy
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia.
| | - Joanne Thandrayen
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia
| | - Bogda Koczwara
- Flinders University and Flinders Medical Centre, Adelaide, SA, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah Laidsaar-Powell
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Nicole Rankin
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Karen Canfell
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.,Cancer Research Division, Cancer Council New South Wales, Kings Cross, NSW, Australia.,Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | | | - Paul Grogan
- Cancer Research Division, Cancer Council New South Wales, Kings Cross, NSW, Australia
| | - Louise Bailey
- Primary Care Collaborative Cancer Clinical Trials Group Community Advisory Group, Melbourne, VIC, Australia.,Psycho-oncology Cooperative Research Group Community Advisory Group, Camperdown, NSW, Australia
| | - Amelia Yazidjoglou
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia.,Sax Institute, Haymarket, NSW, Australia
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17
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Pophali PA, Larson MC, Rosenthal AC, Robinson D, Habermann TM, Thanarajasingam G, Call T, Allmer C, Farooq U, Maurer MJ, Yost KJ, Cerhan JR, Thompson CA. The association of health behaviors with quality of life in lymphoma survivors. Leuk Lymphoma 2020; 62:271-280. [PMID: 33047636 DOI: 10.1080/10428194.2020.1830389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The impact of change in health behaviors (physical activity [PA], alcohol and smoking) on quality of life (QOL) in lymphoma survivors is not well understood. We evaluated the associations of health behaviors with QOL domains at diagnosis and at 3-year follow-up (FU3) in 2805 lymphoma survivors. We report clinically significant QOL score differences, defined as scores that exceeded a minimally important difference threshold and were statistically significant. Current smoking was associated with lower QOL at baseline (p < 0.01) and at FU3 (p < 0.01). Meeting the American Cancer Society PA guidelines was associated with better functional wellbeing and overall QOL at FU3 (p < 0.01). An increase in PA from baseline to FU3 was associated with improvement in physical, functional wellbeing and overall QOL at FU3 compared to baseline (p < 0.01). Thus, QOL in lymphoma survivors is associated with their health behaviors and active interventions to promote positive lifestyle changes in lymphoma survivors are needed.
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Affiliation(s)
- Priyanka A Pophali
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Division of Hematology, Oncology and Palliative Care, Department of Medicine, University of Wisconsin- Carbone Cancer Center, Madison, WI, USA
| | - Melissa C Larson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Allison C Rosenthal
- Division of Hematology/Oncology, Department of Internal Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Dennis Robinson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Thomas M Habermann
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Gita Thanarajasingam
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Timothy Call
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Cristine Allmer
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Umar Farooq
- Division of Hematology, Oncology and Bone Marrow Transplantation, University of Iowa, Iowa City, IA, USA
| | - Matthew J Maurer
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Kathleen J Yost
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - James R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Carrie A Thompson
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
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18
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Engin B, Keçici AS, Uzun AÖ, Yalçın M. Psychiatric comorbidity, depression, and anxiety levels and quality of life of the patients with mycosis fungoides. Dermatol Ther 2020; 33:e13922. [DOI: 10.1111/dth.13922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 06/25/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Burhan Engin
- Cerrahpaşa Medical Faculty, Department of Dermatology and Venerology İstanbul University‐Cerrahpaşa İstanbul Turkey
| | - Ayşegül Sevim Keçici
- Department of Dermatology University of Medical Sciences Haydarpasa Numune Training and Research Hospital Turkey
| | - Aslıhan Özge Uzun
- Cerrahpaşa Medical Faculty, Department of Dermatology and Venerology İstanbul University‐Cerrahpaşa İstanbul Turkey
| | - Murat Yalçın
- Department of Psychiatry University of Medical Sciences Erenkoy Training and Research Hospital for Psychiatry and Neurological Diseases İstanbul Turkey
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19
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Kenzik KM, Mehta A, Richman JS, Kilgore M, Bhatia S. Congestive heart failure in older adults diagnosed with follicular lymphoma: A population-based study. Cancer 2018; 124:4221-4230. [DOI: 10.1002/cncr.31695] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/11/2018] [Accepted: 06/25/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Kelly M. Kenzik
- Institute for Cancer Outcomes and Survivorship; University of Alabama at Birmingham; Birmingham Alabama
- Division of Hematology and Oncology; University of Alabama at Birmingham; Birmingham Alabama
| | - Amitkumar Mehta
- Division of Hematology and Oncology; University of Alabama at Birmingham; Birmingham Alabama
| | - Joshua S. Richman
- Department of Surgery; University of Alabama at Birmingham; Birmingham Alabama
| | - Meredith Kilgore
- Department of Health Care Organization and Policy; University of Alabama at Birmingham; Birmingham Alabama
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship; University of Alabama at Birmingham; Birmingham Alabama
- Division of Pediatric Hematology Oncology; University of Alabama at Birmingham; Birmingham Alabama
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20
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Lin VW, Blaylock B, Epstein J, Purdum A. Systematic literature review of health-related quality of life among aggressive non-Hodgkin lymphoma survivors. Curr Med Res Opin 2018; 34:1529-1535. [PMID: 29741105 DOI: 10.1080/03007995.2018.1474091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVE Studies have shown that a proportion of patients with aggressive non-Hodgkin lymphoma (NHL) treated with standard chemotherapy will have long-term life expectancy comparable to those in the age-adjusted general population. This systematic literature review summarizes current literature regarding health-related quality of life (HRQoL) of long-term (≥2 years) survivors of aggressive NHL. METHODS Electronic databases (without restriction on years) and abstracts from four major oncology and HRQoL conferences from 2014 to 2017 were searched. Studies were included if HRQoL or health utility was assessed at least 2 years after NHL diagnosis. Studies focusing on central nervous system lymphoma, or indolent NHL, were excluded. Results were categorized relative to baseline (improvement, deterioration or no change) and compared to the general population (better, comparable or worse). RESULTS Fourteen studies met the inclusion criteria. Twelve studies included ≥1 HRQoL instrument, and two measured health utilities using EQ-5D. Half of the studies showed improvement (5/10) and half no change (5/10) in overall HRQoL. Compared to the general population, overall HRQoL was more comparable when assessed at ≥3 years from baseline (3/3 better or comparable) versus assessment at <3 years (2/3 better or comparable). Six studies reported on the physical HRQoL domain with improvement in 4/6 studies and no change in 2/6 studies. CONCLUSIONS HRQoL of NHL survivors may improve from baseline and becomes more comparable to general population HRQoL with longer survival. Overall HRQoL improvement is driven mostly by improvements in the physical domain.
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Affiliation(s)
| | | | | | - Anna Purdum
- a Kite, A Gilead Company , Santa Monica , CA , USA
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21
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Islam MS. Treat patient, not just the disease: holistic needs assessment for haematological cancer patients. Oncol Rev 2018; 12:374. [PMID: 30283608 PMCID: PMC6151346 DOI: 10.4081/oncol.2018.374] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/20/2018] [Indexed: 12/25/2022] Open
Abstract
Haematological malignancies can have devastating effects on the patients' physical, emotional, psycho-sexual, educational and economic health. With the improvement of therapies patients with these malignancies are living longer, however significant proportion these patient show poor quality of life (QoL) due to various physical and psychological consequences of the disease and the treatments. Health-related QoL (HRQoL) is multi-dimensional and temporal, relating to a state of functional, physical, psychological and social/family well-being. Compared with the general population, HRQoL of these patients is worse in most dimensions. However without routine holistic need assessment (HNA), clinicians are unlikely to identify patients with clinically significant distress. Surviving cancer is a chronic life-altering condition with several factors negatively affecting their QoL, such as psychological problems, including depression and excessive fear of recurrence, as well as social aspects, such as unemployment and social isolation. These need to be adequately understood and addressed in the healthcare of long-term survivors of haematological cancer. Applying a holistic approach to patient care has many benefits and yet, only around 25% of cancer survivors in the UK receive a holistic needs assessment. The efforts of the last decade have established the importance of ensuring access to psychosocial services for haematological cancer survivors. We need to determine the most effective practices and how best to deliver them across diverse settings. Distress, like haematological cancer, is not a single entity, and one treatment does not fit all. Psychosocialoncology needs to increase its research in comparative effectiveness.
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Affiliation(s)
- Md Serajul Islam
- Department of Haematology, Guy's & St. Thomas Hospital, London.,Department of Haematology, Broomfield Hospital, Chelmsford, UK
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22
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Garg T, Connors JN, Ladd IG, Bogaczyk TL, Larson SL. Defining Priorities to Improve Patient Experience in Non-Muscle Invasive Bladder Cancer. Bladder Cancer 2018; 4:121-128. [PMID: 29430512 PMCID: PMC5798497 DOI: 10.3233/blc-170138] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: Although approximately 75% of bladder cancers are non-muscle invasive (NMIBC) at diagnosis, most research tends to focus on invasive disease (e.g., experiences related to radical cystectomy and urinary diversion). There is a lack of studies on quality of life, and especially qualitative research, in bladder cancer generally. As a result, relatively little is known about the experiences and needs of NMIBC patients. Objective: To understand patient experience, define care priorities, and identify targets for care improvement in NMIBC across the cancer continuum. Methods: Through focus groups, patients treated for NMIBC (stage <T2) were invited to share their care experiences including diagnosis, treatment, and survivorship. Transcripts were analyzed using conventional content analysis to identify themes and subthemes. Results: Twenty patients (16 male, 4 female, all white) participated in three focus groups. Five primary themes emerged: access to care, provider characteristics and communication, quality of life, goals of care/influences on decision-making, and role of social support. Patients with NMIBC desired timely access to care and honest and caring provider communication. They described urinary function and emotional quality of life changes resulting from diagnosis and treatment. Avoiding cystectomy and being alive for family were the major decision influencers. Conclusion: In this qualitative study, we identified access to care, provider characteristics and communication, quality of life, values/influences on decision-making, and social support as priority areas to improve patient experience in NMIBC. Care redesign efforts should focus on improving access, enhancing provider communication, reducing side effects, and supporting caregiver roles.
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Affiliation(s)
- Tullika Garg
- Department of Urology, Geisinger, Danville, PA, USA.,Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA
| | - Jill Nault Connors
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ilene G Ladd
- Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA
| | - Tyler L Bogaczyk
- Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA
| | - Sharon L Larson
- Department of Epidemiology and Health Services Research, Geisinger, Danville, PA, USA
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23
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Kang D, Cho J, Kim IR, Kim MK, Kim WS, Kim SJ. Health-Related Quality of Life in Non-Hodgkin Lymphoma Survivors: A Prospective Cohort Study. Cancer Res Treat 2017; 50:1051-1063. [PMID: 29121713 PMCID: PMC6192930 DOI: 10.4143/crt.2017.207] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 11/07/2017] [Indexed: 01/10/2023] Open
Abstract
PURPOSE We evaluated health-related quality of life (HRQOL) in long-term survivors of indolent and aggressive non-Hodgkin lymphoma (NHL). Materials and Methods TheHRQOLwas assessed by the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core 30 (EORTC QLQ-C30) at diagnosis in NHL patients between 2008 and 2011, and follow-up evaluation was conducted from June 2014 to February 2015 using EORTC QLQ-C30 and the quality of life in cancer survivors (QOL-CS) questionnaire. We used linear mixed models to compare changes in HRQOL between indolent and aggressive NHL over time. RESULTS The HRQOL of long-term survivors with aggressive NHL improved to the similar level of indolent NHL during the follow-up survey. However, survivors of NHL were found to fear the probability of relapse and second malignancy, and the degree of fear was not different between survivors with aggressive stage I/II or III/IV NHL (p > 0.05). Furthermore, a half of survivors reported impaired sense of psychosocial well-being regardless of aggressiveness and stage during follow-up survey. More than 65% of survivors thought they did not receive sufficient support from others, and patients who had financial difficulties at diagnosis were more frequently associated with suffering from insufficient support. Impaired physical and cognitive functioning at diagnosis was significantly associated with lack of life purpose in long-term survivors. CONCLUSION The HRQOL of aggressive NHL survivors improved to a similar level to that of indolent NHL. However, the majority of survivors still had fear of relapse, and psychosocial well-being remained unmet needs.
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Affiliation(s)
- Danbee Kang
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Juhee Cho
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Im Ryung Kim
- Cancer Education Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Kyung Kim
- Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Korea
| | - Won Seog Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Kim
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.,Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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24
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Oberoi DV, White VM, Seymour JF, Prince HM, Harrison S, Jefford M, Winship I, Hill DJ, Bolton D, Millar J, Wong Doo N, Kay A, Giles G. Distress and unmet needs during treatment and quality of life in early cancer survivorship: A longitudinal study of haematological cancer patients. Eur J Haematol 2017; 99:423-430. [DOI: 10.1111/ejh.12941] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2017] [Indexed: 01/22/2023]
Affiliation(s)
| | - Victoria M. White
- Cancer Council Victoria; Melbourne Vic. Australia
- Deakin University; Burwood Vic. Australia
| | - John F. Seymour
- The University of Melbourne; Parkville Vic. Australia
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
| | - H. Miles Prince
- The University of Melbourne; Parkville Vic. Australia
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
| | - Simon Harrison
- The University of Melbourne; Parkville Vic. Australia
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
| | - Michael Jefford
- The University of Melbourne; Parkville Vic. Australia
- Peter MacCallum Cancer Centre; Melbourne Vic. Australia
| | | | - David J. Hill
- Cancer Council Victoria; Melbourne Vic. Australia
- The University of Melbourne; Parkville Vic. Australia
| | | | | | | | - Anne Kay
- North Eastern Melbourne Integrated Cancer Service; Heidelberg Vic. Australia
| | - Graham Giles
- Cancer Council Victoria; Melbourne Vic. Australia
- The University of Melbourne; Parkville Vic. Australia
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25
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Ciavarella S, Minoia C, Quinto AM, Oliva S, Carbonara S, Cormio C, Cox MC, Bravo E, Santoro F, Napolitano M, Spina M, Loseto G, Guarini A. Improving Provision of Care for Long-term Survivors of Lymphoma. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2017; 17:e1-e9. [PMID: 28916153 DOI: 10.1016/j.clml.2017.08.097] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 07/21/2017] [Accepted: 08/07/2017] [Indexed: 12/11/2022]
Abstract
The progressive improvement of lymphoma therapies has led to a significant prolongation of patient survival and life expectancy. However, lymphoma survivors are at high risk of experiencing a range of early and late adverse effects associated with the extent of treatment exposure. Among these, second malignancies and cardiopulmonary diseases can be fatal, and neurocognitive dysfunction, endocrinopathy, muscle atrophy, and persistent fatigue can affect patients' quality of life for decades after treatment. Early recognition and reduction of risk factors and proper monitoring and treatment of these complications require well-defined follow-up criteria, close coordination among specialists of different disciplines, and a tailored model of survivorship care. We have summarized the major aspects of therapy-related effects in lymphoma patients, reviewed the current recommendations for follow-up protocols, and described a new hospital-based model of survivorship care provision from a recent multicenter Italian experience.
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Affiliation(s)
- Sabino Ciavarella
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy.
| | - Carla Minoia
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Angela Maria Quinto
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Stefano Oliva
- Cardiology Unit, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Santa Carbonara
- Cardiology Unit, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Claudia Cormio
- Psycho-oncology Service, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Maria Christina Cox
- Hematology Unit, Azienda Ospedaliera-Universitaria "Sant'Andrea", Rome, Italy
| | - Elena Bravo
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - Filippo Santoro
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | | | - Michele Spina
- IRCCS-Centro di Riferimento Oncologico di Aviano, Aviano, Italy
| | - Giacomo Loseto
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Attilio Guarini
- Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori "Giovanni Paolo II", Bari, Italy
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26
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Vallance JK, Buman MP, Lynch BM, Boyle T. Reallocating time to sleep, sedentary, and active behaviours in non-Hodgkin lymphoma survivors: associations with patient-reported outcomes. Ann Hematol 2017; 96:749-755. [PMID: 28197722 DOI: 10.1007/s00277-017-2942-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 02/02/2017] [Indexed: 01/19/2023]
Abstract
The purpose of this study was to examine potential effects of reallocating time between sleep, sedentary and active behaviours on fatigue symptoms and quality of life in a sample of non-Hodgkin lymphoma survivors. Non-Hodgkin lymphoma survivors identified from the Western Australian Cancer Registry (N = 149) (response rate = 36%; median age = 64 years) wore an Actigraph® GT3X+ accelerometer for 7 days and completed the Fatigue Scale, the Functional Assessment of Cancer Therapy-General and the Pittsburgh Sleep Quality Index. We used isotemporal substitution methods in linear regression models to examine the potential effects of reallocating time between sleep, sedentary and activity behaviours on fatigue and quality of life. Data collection was conducted in Western Australia in 2013. Significant differences were observed for fatigue symptoms when 30 min per day of bouted moderate-to-vigorous physical activity (10 min) was reallocated from 30 min per day of sleep (5.7 points, 95% CI = 1.8, 9.7), sedentary time bouts (20 min) (5.7 points, 95% CI = 1.6, 9.7), sedentary time non-bouts (5.1 points, 95% CI = 1.0, 9.3) or light intensity activity (5.5 points, 95% CI = 1.5, 9.5). Isotemporal substitution effects of reallocating sedentary time, sleep and light physical activity with bouted physical activity was significantly associated with fatigue, but not quality of life. Findings from the present study may aid in the development and delivery of health behaviour interventions that are more likely to influence the health outcome of interest.
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Affiliation(s)
- Jeff K Vallance
- Faculty of Health Disciplines, Centre for Nursing and Health Studies, Athabasca University, 1 University Drive, Athabasca, AB, Canada.
| | - Matthew P Buman
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA
| | - Brigid M Lynch
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VC, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Terry Boyle
- British Columbia Cancer Agency, University of British Columbia, Vancouver, BC, Canada.,School of Public Health, Curtin University, Perth, WA, Australia
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27
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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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28
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Alawi EM, Mathiak KA, Panse J, Mathiak K. Health-related quality of life in patients with indolent and aggressive non-Hodgkin lymphoma. COGENT PSYCHOLOGY 2016. [DOI: 10.1080/23311908.2016.1169582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Eliza M. Alawi
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, RWTH Aachen University, Pauwelsstr. 30, Aachen 52074, Germany
- Jülich-Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich, Aachen, Germany
| | - Krystyna A. Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, RWTH Aachen University, Pauwelsstr. 30, Aachen 52074, Germany
- Jülich-Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Jens Panse
- Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation Medical, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Aachen, RWTH Aachen University, Pauwelsstr. 30, Aachen 52074, Germany
- Jülich-Aachen Research Alliance (JARA)-Translational Brain Medicine, Jülich, Aachen, Germany
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29
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Cognitive function and its relationship to other psychosocial factors in lymphoma survivors. Support Care Cancer 2016; 25:905-913. [PMID: 27837322 DOI: 10.1007/s00520-016-3480-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 11/01/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study was to estimate the prevalence of cognitive disturbance in lymphoma survivors and to explore relationships between cognitive function and other psychosocial factors. METHODS A package of standardized questionnaires was sent to 622 lymphoma patients treated at the Ottawa Hospital in the preceding 5 years. Patients with central nervous system involvement were excluded. The questionnaires addressed cognitive function, pain, insomnia, fatigue, and mood. Of the patients in the sampling frame, 54 % responded to the survey and 42 % met inclusion/exclusion criteria. Sixteen percent (99/622) agreed to undergo computerized neuropsychological testing with CNS vital signs (CNSVS). Scores on the objective and subjective cognitive measures were compared to those of a healthy female control group from a previous study. RESULTS The lymphoma group scored significantly lower than the controls on a cognitive rating scale (p = .018) and on CNSVS (p = .035). The difference on the CNSVS was primarily due to poorer attention and executive function scores in the lymphoma patients. The patients also had a higher frequency of impairment on both the objective (p = .009) and subjective (p < .001) cognitive measures. Among the lymphoma survivors, fatigue and anxiety were related to subjective cognitive disturbance (p < .001 for both), whereas pain was the only psychosocial measure associated with objective cognitive performance (p < .001). CONCLUSIONS These results suggest that cognitive disturbance may be a significant survivorship issue for lymphoma patients and should be more thoroughly investigated in this population.
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30
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Hanf M, Chiron D, de Visme S, Touzeau C, Maisonneuve H, Jardel H, Pellat-Deceunynck C, Amiot M, le Gouill S. The REFRACT-LYMA cohort study: a French observational prospective cohort study of patients with mantle cell lymphoma. BMC Cancer 2016; 16:802. [PMID: 27737650 PMCID: PMC5064959 DOI: 10.1186/s12885-016-2844-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 10/06/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Mantle Cell Lymphoma (MCL) is often associated with progression, temporary response to therapy and a high relapse rate over time resulting in a poor long-term prognosis. Because MCL is classified as an incurable disease, therapeutic resistance is of great interest. However, knowledge about the biological mechanisms underlying resistance associated with MCL therapies and about associated predictors remains poor. The REFRACT-LYMA Cohort, a multicenter prospective cohort of patients with MCL, is set up to address this limitation. We here describe the study background, design and methods used for this cohort. METHODS/DESIGN The REFRACT-LYMA Cohort Study aims at including all patients (>18 years old) who are diagnosed with MCL in any stage of the disease and treated in specialized oncology centers in three public hospitals in Northwestern France. Any such patient providing a signed informed consent is included. All subjects are followed up indefinitely, until refusal to participate in the study, emigration or death. The REFRACT-LYMA follow-up is continuous and collects data on socio-economic status, medical status, MCL therapies and associated events (resistance, side effects). Participants also complete standardized quality of life (QOL) questionnaires. In addition, participants are asked to donate blood samples that will support ex vivo analysis of expression and functional assays required to uncover predictive biomarkers and companion diagnostics. If diagnostic biopsies are performed during the course of the disease, extracted biological samples are kept in a dedicated biobank. DISCUSSION To our knowledge, the REFRACT-LYMA Cohort Study is the first prospective cohort of patients with MCL for whom "real-life" medical, epidemiological and QOL data is repeatedly collected together with biological samples during the course of the disease. The integrative cohort at mid-term will be unique at producing a large variety of data that can be used to conceive the most effective personalized therapy for MCL patients. Additionally, the REFRACT-LYMA Cohort puts the medical care of MCL patients in a health and pharmacoeconomic perspective.
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Affiliation(s)
- Matthieu Hanf
- INSERM CIC 1413, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - David Chiron
- INSERM, UMR892 - CNRS, UMR 6299, Université de Nantes, Nantes, France
| | - Sophie de Visme
- INSERM CIC 1413, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Cyrille Touzeau
- INSERM, UMR892 - CNRS, UMR 6299, Université de Nantes, Nantes, France.,Service d'Hématologie Clinique, Unité d'Investigation Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Hervé Maisonneuve
- Service de Médecine Onco-hématologie, Centre Hospitalier Départemental de La Roche sur Yon, La Roche sur Yon, France
| | - Henry Jardel
- Service de Médecine interne - Maladies hématologiques - Maladies infectieuses, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Catherine Pellat-Deceunynck
- INSERM, UMR892 - CNRS, UMR 6299, Université de Nantes, Nantes, France.,Service d'Hématologie Clinique, Unité d'Investigation Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Martine Amiot
- INSERM, UMR892 - CNRS, UMR 6299, Université de Nantes, Nantes, France.,Service d'Hématologie Clinique, Unité d'Investigation Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Steven le Gouill
- INSERM CIC 1413, Centre Hospitalier Universitaire de Nantes, Nantes, France. .,INSERM, UMR892 - CNRS, UMR 6299, Université de Nantes, Nantes, France. .,Service d'Hématologie Clinique, Unité d'Investigation Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France. .,CHU de Nantes, Place Alexis Ricordeau, 44000, Nantes, France.
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31
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Ng DLC, Leong YC, Gan GG. Quality of life amongst lymphoma survivors in a developing country. Support Care Cancer 2016; 24:5015-5023. [PMID: 27460016 DOI: 10.1007/s00520-016-3364-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 07/18/2016] [Indexed: 01/10/2023]
Abstract
PURPOSE The survival for patients with lymphoma has improved over the past decades with the introduction of novel agents. Quality of life of these survivors is now being studied with focus on minimising the late effects of chemotherapy and improving psychosocial support. This study aims to determine the prevalence of anxiety and depression of lymphoma survivors and to investigate the possible association between these disorders and quality of life. METHODS Patients with previous diagnosis of lymphoma who remained in remission were recruited from a major hospital in Malaysia. Quality of life of these patients was measured using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ C30). Anxiety and depression symptoms were assessed using Hospital Anxiety and Depression scale (HADS). RESULTS A total of 156 patients participated in this study. Eighteen percent (18 %) of patients had symptoms of anxiety, and 10 % had symptoms of depression. Patients who had higher depression scores were older, of lower education level and had more than one comorbidity illness. Patients with anxiety were associated with lower overall quality of life (QOL) score, lower emotional and cognitive functioning and complained more of fatigue and insomnia (p < 0.05). Patients who had depression were associated with lower physical functioning and complained more of insomnia (p < 0.05). CONCLUSION It is important for the treating physicians to ensure follow-up of lymphoma survivors for any psychological disorders in order early counseling and support can be provided. This may improve patients' quality of life.
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Affiliation(s)
- Diana L C Ng
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Y C Leong
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Gin Gin Gan
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
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Conte C, Rueter M, Laurent G, Bourrel R, Lapeyre-Mestre M, Despas F. Psychotropic drug initiation during the first diagnosis and the active treatment phase of B cell non-Hodgkin's lymphoma: a cohort study of the French national health insurance database. Support Care Cancer 2016; 24:4791-9. [PMID: 27435321 DOI: 10.1007/s00520-016-3331-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/06/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Patients with B cell non-Hodgkin's lymphomas (B-NHLs) are known to be at risk of developing psychological disorders. The aims of this study were to measure the incidence of psychotropic drug use during the diagnosis and the active treatment phase in comparison with controls from the general population, and to identify factors associated with this use. METHODS B-NHL patients were selected through the French national health insurance database in the Midi-Pyrénées region (southwestern France) from January 1, 2011, to April 31, 2013. Patients with a previous history of B-NHL and/or psychotropic drug treatment were excluded. RESULTS Among 745 newly diagnosed B-NHL patients, psychotropic treatment was initiated in 31.5 % (95 % CI [28.1-34.9]), compared to 7.6 % (95 % CI [7.57-7.64]) in the general population during the same period. This incidence was comparable in colorectal cancer patients (33.5 %) but higher than that in patients with myocardial infarction (23.5 %) or with a first knee replacement surgery (22.4 %). Anxiolytics and hypnotics were the most frequently used drugs. Median duration of treatment was 37 days for anxiolytics and 58 days for hypnotics, with 20.8 % of patients remaining under treatment at 8 months. Factors associated with psychotropic drug initiation were young age, health care consumption in the year before diagnosis, and initial care at a university hospital. CONCLUSION The high rate of psychotropic drug initiation reflects a high level of anxiety at the initial phase of B-NHL patients' trajectory. This pharmacoepidemiological study reveals inappropriate use in some patients, which should now be investigated in lymphoma survivorship.
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Affiliation(s)
- Cécile Conte
- Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine, Université Paul Sabatier, Toulouse, France.,Laboratoire de Pharmacologie Médicale et Clinique, CHU de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France.,UMR1027, Inserm, Université Paul Sabatier, Toulouse, France.,INSERM CIC 1436 Toulouse, Centre d'Investigation Clinique de Toulouse, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Manuela Rueter
- Laboratoire de Pharmacologie Médicale et Clinique, CHU de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France
| | - Guy Laurent
- UMR1027, Inserm, Université Paul Sabatier, Toulouse, France.,Departement d'Hématologie et de Médecine Interne, Institut Universitaire du Cancer-Oncopole, 1 Avenue Irène Joliot-Curie, Toulouse, France
| | - Robert Bourrel
- Caisse Nationale d'Assurance Maladie Midi-Pyrénées, 3 Boulevard Léopold Escande, 31105, Toulouse, France
| | - Maryse Lapeyre-Mestre
- Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine, Université Paul Sabatier, Toulouse, France.,Laboratoire de Pharmacologie Médicale et Clinique, CHU de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France.,UMR1027, Inserm, Université Paul Sabatier, Toulouse, France.,INSERM CIC 1436 Toulouse, Centre d'Investigation Clinique de Toulouse, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Fabien Despas
- Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine, Université Paul Sabatier, Toulouse, France. .,Laboratoire de Pharmacologie Médicale et Clinique, CHU de Toulouse, 37 allées Jules Guesde, 31000, Toulouse, France. .,UMR1027, Inserm, Université Paul Sabatier, Toulouse, France. .,INSERM CIC 1436 Toulouse, Centre d'Investigation Clinique de Toulouse, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
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33
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Beaven AW, Samsa G, Zimmerman S, Smith SK. Quality of Life is Similar between Long-term Survivors of Indolent and Aggressive Non-Hodgkin Lymphoma. Cancer Invest 2016; 34:279-85. [PMID: 27379565 DOI: 10.1080/07357907.2016.1194427] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Differences in quality of life (QOL) of long-term survivors of aggressive or indolent subtypes of non-Hodgkin lymphoma (NHL) have not been frequently evaluated. We assessed these differences by analyzing results of a large QOL survey of long-term NHL survivors. We hypothesized that the incurable nature of indolent NHL would relate to worse QOL in long-term survivors while the potentially cured long-term survivors of aggressive lymphoma would have better QOL. We found that QOL was similar between the two groups. Results suggest that patients with indolent NHL are coping well with their disease, yet experience some overall feelings of life threat.
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Affiliation(s)
- Anne W Beaven
- a Div. of Hematologic Malignancy and Cellular Therapy , Duke University Medical Center Durham , NC , USA
| | - Greg Samsa
- b Department of Biostatistics and Bioinformatics , Duke University Medical Center , Durham , NC , USA
| | - Sheryl Zimmerman
- c Cecil G. Sheps Center for Health Services Research and the School of Social Work , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
| | - Sophia K Smith
- d Duke University School of Nursing , Durham , NC , USA.,e Duke Cancer Institute , Durham , NC , USA
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34
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Compaci G, Rueter M, Lamy S, Oberic L, Recher C, Lapeyre-Mestre M, Laurent G, Despas F. Ambulatory Medical Assistance--After Cancer (AMA-AC): A model for an early trajectory survivorship survey of lymphoma patients treated with anthracycline-based chemotherapy. BMC Cancer 2015; 15:781. [PMID: 26498342 PMCID: PMC4619467 DOI: 10.1186/s12885-015-1815-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 10/16/2015] [Indexed: 12/21/2022] Open
Abstract
Background Cancer survivorship has emerged as an important aspect of oncology due to the possibility of physical and psychosocial complications. The purpose of this study was to assess the feasibility of the Ambulatory Medical Assistance for After Cancer (AMA-AC) procedure for monitoring lymphoma survivorship during the first year after chemotherapy. Methods AMA-AC is based on systematic general practitioner (GP) consultations and telephone interventions conducted by a nurse coordinator (NC) affiliated to the oncology unit, while an oncologist acts only on demand. Patients are regularly monitored for physical, psychological and social events, as well as their health-related quality of life (HRQoL). Inclusion criteria were patients newly diagnosed with non-Hodgkin or Hodgkin lymphomas, who had been treated with anthracycline-based chemotherapy and were in complete remission after treatment. Results All 115 patients and 113 collaborating GPs agreed to participate in the study. For patients who achieved one year of disease-free survival (n = 104) their assessments (438 in total) were fully completed. Eleven were excluded from analysis (9 relapses and 2 deaths). The most frequent complications when taking into account all grades were arthralgia (64.3 %) and infections (41.7 %). About one third of patients developed new diseases with cardiovascular complications as the most common. Psychological disorders such as anxiety, depression and post-traumatic stress disorder were diagnosed in 42.6 % of patients. The data collected showed that Hodgkin lymphoma patients, females, and patients with lower HRQoL (mental component) at study entry were at greater risk for developing at least one psychological disorder. Conclusion This study showed that AMA-AC is a feasible and efficient procedure for monitoring lymphoma survivorship in terms of GP and patient participation rates and adherence, and provides a high quality of operable data. Hence, the AMA-AC procedure may be transferable into clinical daily practice as an alternative to standard oncologist-based follow-up. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1815-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gisèle Compaci
- Department of Hematology - Internal Medicine, Toulouse University Hospital, Cancer University Institute of Toulouse Oncopole, Toulouse, France.
| | - Manuela Rueter
- INSERM Unit 1027 (The French National Institute of Health and Medical Research), Faculty of Medicine, Toulouse, France. .,Service of Medical and Clinical Pharmacology, Center of Pharmacovigilance, Pharmaco-epidemiology and Information on Drugs, Toulouse University Hospital, 37 Allées Jules Guesde, 31000, Toulouse, France.
| | - Sébastien Lamy
- INSERM Unit 1027 (The French National Institute of Health and Medical Research), Faculty of Medicine, Toulouse, France. .,Service of Medical and Clinical Pharmacology, Center of Pharmacovigilance, Pharmaco-epidemiology and Information on Drugs, Toulouse University Hospital, 37 Allées Jules Guesde, 31000, Toulouse, France. .,Department of Epidemiology, Health Economics and Public Health, Faculty of Medicine, University of Toulouse III Paul Sabatier, Toulouse, France.
| | - Lucie Oberic
- Department of Hematology - Internal Medicine, Toulouse University Hospital, Cancer University Institute of Toulouse Oncopole, Toulouse, France.
| | - Christian Recher
- Department of Hematology - Internal Medicine, Toulouse University Hospital, Cancer University Institute of Toulouse Oncopole, Toulouse, France. .,INSERM Unit 1037 (The French National Institute of Health and Medical Research), Center of Cancer Research, Toulouse, France.
| | - Maryse Lapeyre-Mestre
- INSERM Unit 1027 (The French National Institute of Health and Medical Research), Faculty of Medicine, Toulouse, France. .,Service of Medical and Clinical Pharmacology, Center of Pharmacovigilance, Pharmaco-epidemiology and Information on Drugs, Toulouse University Hospital, 37 Allées Jules Guesde, 31000, Toulouse, France. .,Laboratory of Medical and Clinical Pharmacology Faculty of Medicine, University III Paul Sabatier, Toulouse, France.
| | - Guy Laurent
- Department of Hematology - Internal Medicine, Toulouse University Hospital, Cancer University Institute of Toulouse Oncopole, Toulouse, France. .,INSERM Unit 1027 (The French National Institute of Health and Medical Research), Faculty of Medicine, Toulouse, France.
| | - Fabien Despas
- INSERM Unit 1027 (The French National Institute of Health and Medical Research), Faculty of Medicine, Toulouse, France. .,Service of Medical and Clinical Pharmacology, Center of Pharmacovigilance, Pharmaco-epidemiology and Information on Drugs, Toulouse University Hospital, 37 Allées Jules Guesde, 31000, Toulouse, France. .,Laboratory of Medical and Clinical Pharmacology Faculty of Medicine, University III Paul Sabatier, Toulouse, France.
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Westby RP, Berg CJ, Leach C. Gender, race, BMI, and social support in relation to the health-related quality of life of cancer survivors: a report from the American Cancer Society's Study of Cancer Survivors II (SCS-II). Qual Life Res 2015; 25:409-421. [PMID: 26289021 DOI: 10.1007/s11136-015-1084-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 12/13/2022]
Abstract
PURPOSE We examined the main and interactive effects of race, BMI, and social support on physical and mental health-related quality of life (HRQoL) among male and female cancer survivors using the stress and coping theory to inform findings. METHODS HRQoL issues among 1768 cancer survivors were examined using the American Cancer Society's cross-sectional Study of Cancer Survivors II. Two-step multiple linear regressions were conducted to assess the physical and mental HRQoL of male and female cancer survivors, respectively. RESULTS The average age of participants was 67.36 (SD = 11.51); the majority were female (53.3 %; n = 941) and non-Hispanic White (85.9 %; n = 1517). The average BMI measurement for participants was 28.33 (SD = 5.90), with 41.3 % (n = 729) overweight and 30.3 % (n = 535) obese. Higher BMI was significantly associated with lower physical HRQoL across gender, while social support had significant main effects on physical and mental HRQoL across gender. Race moderated the relationship between social support and physical HRQoL among female cancer survivors and between BMI and mental HRQoL for both genders. CONCLUSIONS The results of this study contribute a unique gender- and racial-specific perspective to cancer survivorship research. While the buffering hypothesis of the stress and coping theory was not supported, the main effects of BMI and social support on HRQoL were different across gender and race.
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Affiliation(s)
- Ruth P Westby
- Department of Behavioral Science and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA. .,ICF International, 3 Corporate Square, Suite 370, Atlanta, GA, 30329, USA.
| | - Carla J Berg
- Department of Behavioral Science and Health Education, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Corinne Leach
- Behavioral Research Center (BRC), American Cancer Society, Atlanta, GA, USA
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Bryant AL, Smith SK, Zimmer C, Crandell J, Jenerette CM, Bailey DE, Zimmerman S, Mayer DK. An exploratory path model of the relationships between positive and negative adaptation to cancer on quality of life among non-Hodgkin lymphoma survivors. J Psychosoc Oncol 2015; 33:310-31. [PMID: 25751114 DOI: 10.1080/07347332.2015.1020978] [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: 10/23/2022]
Abstract
Adaptation is an ongoing, cognitive process with continuous appraisal of the cancer experience by the survivor. This exploratory study tested a path model examining the personal (demographic, disease, and psychosocial) characteristics associated with quality of life (QOL) and whether or not adaptation to living with cancer may mediate these effects. This study employed path analysis to estimate adaptation to cancer. A cross-sectional sample of NHL survivors (N = 750) was used to test the model. Eligible participants were ≥ 18 years, at least 2 years post-diagnosis, and living with or without active disease. Sixty-eight percent of the variance was accounted for in QOL. The strongest effect (-0.596) was direct by negative adaptation, approximately 3 times that of positive adaptation (0.193). The strongest demographic total effects on QOL were age and social support; <65 years of age had better QOL and better adaptation compared to those ≥ 65. Of the disease characteristics, comorbidity score had the strongest direct effect on QOL; each additional comorbidity was associated with a 0.309 standard deviation decline on QOL. There were no fully mediated effects through positive adaptation alone. Our exploratory findings support the coexistence of positive and negative adaptations perception as mediators of personal characteristics of the cancer experience. Negative adaptation can affect QOL in a positive way. Cancer survivorship is simultaneously shaped by both positive and negative adaptation with future research and implications for practice aimed at improving QOL.
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Affiliation(s)
- Ashley Leak Bryant
- a School of Nursing, University of North Carolina at Chapel Hill , Chapel Hill , NC , USA
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Seland M, Holte H, Bjøro T, Schreiner T, Bollerslev J, Loge JH, Fosså SD, Kiserud CE. Chronic fatigue is prevalent and associated with hormonal dysfunction in long-term non-Hodgkin lymphoma survivors treated with radiotherapy to the head and neck region. Leuk Lymphoma 2015; 56:3306-14. [DOI: 10.3109/10428194.2015.1036258] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Posluszny DM, Dew MA, Beckjord E, Bovbjerg DH, Schmidt JE, Low CA, Lowery A, Nutt SA, Arvey SR, Rechis R. Existential challenges experienced by lymphoma survivors: Results from the 2010 LIVESTRONG Survey. J Health Psychol 2015; 21:2357-66. [PMID: 25845834 DOI: 10.1177/1359105315576352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We sought to examine the existential challenges that cancer survivors may experience as they strive to make meaning, regain their self-identity, cope with fear of recurrence, and experience feelings of grief and guilt. Lymphoma survivors (n = 429) completed the 2010 LIVE STRONG: survey and provided responses about meaning, cancer worry, security, identity, grief, guilt, and perceived functional impairment due to these concerns. Most survivors (73%-86%) endorsed existential concerns, with 30-39 percent reporting related perceived functional impairment. Concerns were associated with being female, younger, unmarried, and having undergone stem cell transplantation. Lymphoma survivors experience existential challenges that impact their life even years after diagnosis.
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Wagner LI, Zhao F, Hong F, Williams ME, Gascoyne RD, Krauss JC, Advani RH, Go RS, Habermann TM, Leach JW, O'Connor B, Schuster SJ, Cella D, Horning SJ, Kahl BS. Anxiety and health-related quality of life among patients with low-tumor burden non-Hodgkin lymphoma randomly assigned to two different rituximab dosing regimens: results from ECOG trial E4402 (RESORT). J Clin Oncol 2015; 33:740-8. [PMID: 25605841 DOI: 10.1200/jco.2014.57.6801] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE The purpose of this study was to compare illness-related anxiety among participants in the Rituximab Extended Schedule or Retreatment Trial (RESORT) randomly assigned to maintenance rituximab (MR) versus rituximab re-treatment (RR). A secondary objective was to examine whether the superiority of MR versus RR on anxiety depended on illness-related coping style. PATIENTS AND METHODS Patients (N = 253) completed patient-reported outcome (PRO) measures at random assignment to MR or RR (baseline); at 3, 6, 12, 24, 36, and 48 months after random assignment; and at rituximab failure. PRO measures assessed illness-related anxiety and coping style, and secondary end points including general anxiety, worry and interference with emotional well-being, depression, and health-related quality of life (HRQoL). Patients were classified as using an active or avoidant illness-related coping style. Independent sample t tests and linear mixed-effects models were used to identify treatment arm differences on PRO end points and differences based on coping style. RESULTS Illness-related anxiety was comparable between treatment arms at all time points (P > .05), regardless of coping style (active or avoidant). Illness-related anxiety and general anxiety significantly decreased over time on both arms. HRQoL scores were relatively stable and did not change significantly from baseline for both arms. An avoidant coping style was associated with significantly higher anxiety (18% and 13% exceeded clinical cutoff points at baseline and 6 months, respectively) and poorer HRQoL compared with an active coping style (P < .001), regardless of treatment arm assignment. CONCLUSION Surveillance until RR at progression was not associated with increased anxiety compared with MR, regardless of coping style. Avoidant coping was associated with higher anxiety and poorer HRQoL.
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Affiliation(s)
- Lynne I Wagner
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada.
| | - Fengmin Zhao
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Fangxin Hong
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Michael E Williams
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Randy D Gascoyne
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - John C Krauss
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Ranjana H Advani
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Ronald S Go
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Thomas M Habermann
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Joseph W Leach
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Brian O'Connor
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Stephen J Schuster
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - David Cella
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Sandra J Horning
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Brad S Kahl
- Lynne I. Wagner and David Cella, Northwestern University Feinberg School of Medicine, Chicago, IL; Fengmin Zhao, Fangxin Hong, Dana-Farber Cancer Institute, Boston, MA; Michael E. Williams, University of Virginia, Charlottesville, VA; John C. Krauss, University of Michigan, Ann Arbor, MI; Ranjana H. Advani, Stanford University, Stanford; Sandra J. Horning, Genentech, South San Francisco, CA; Ronald S. Go, Gunderson Health System, La Crosse; Brad S. Kahl, University of Wisconsin, Madison, WI; Thomas M. Habermann, Mayo Clinic, Rochester; Joseph W. Leach, Metro Minnesota Community Clinical Oncology Program, Minneapolis, MN; Brian O'Connor, Frederick Memorial Health System, Frederick, MD; Stephen J. Schuster, University of Pennsylvania, Philadelphia, PA; and Randy D. Gascoyne, British Columbia Cancer Agency, Vancouver, BC, Canada
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Kiserud CE, Seland M, Holte H, Fosså A, Fosså SD, Bollerslev J, Bjøro T, Loge JH. Fatigue in male lymphoma survivors differs between diagnostic groups and is associated with latent hypothyroidism. Acta Oncol 2015; 54:49-59. [PMID: 25140862 DOI: 10.3109/0284186x.2014.948057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Few studies have explored fatigue in different groups of lymphoma survivors and the association with hormonal dysfunctions. The aims were to analyze associations between fatigue and thyroid and gonadal function in male lymphoma survivors. In addition, the impact of chronic fatigue on work situation and daily functioning were explored. PATIENTS AND METHODS This cross-sectional study included male lymphoma survivors diagnosed in 1980-2002, aged ≤ 50 years at diagnosis and > 18 years at survey in 2007. The participants (n = 233, median age at survey: 48 years, median observation time: 15 years) completed questionnaires assessing levels of fatigue, chronic fatigue (duration ≥ 6 months), mental distress, daily functioning and work situation. Levels of thyroid and gonadal hormones were assessed. The participants were grouped according to diagnosis: Hodgkin lymphoma (HL, n = 131), aggressive/very aggressive non-Hodgkin lymphoma (NHL) (n = 67) and indolent NHL (n = 35). Thyroid hormones were categorized as normal (n = 174) or latent hypothyroidism (elevated thyroid stimulating hormone, n = 59). Gonadal hormones were categorized as normal (n = 111), elevated follicle stimulating hormone only (n = 45), primary (n = 35) or secondary hypogonadism (n = 42). Uni- and multivariate regression analyses were performed. A p value < 0.05 indicated the level of significance. RESULTS The survivors of HL and aggressive/very aggressive NHL had similar fatigue levels and similar prevalence of chronic fatigue (HL: 31%, aggressive/very aggressive; NHL: 27%). Survivors of indolent NHL had lower fatigue levels and prevalence of chronic fatigue (11%). Latent hypothyroidism was associated with increased fatigue levels (p = 0.042). Gonadal function was not associated with levels of fatigue or chronic fatigue. Mental distress was associated with increasing fatigue levels and chronic fatigue (p < 0.001). We found negative associations between chronic fatigue, daily functioning and work status. CONCLUSIONS Fatigued lymphoma survivors should be investigated for thyroid function. The negative impact of chronic fatigue on daily functioning and work status emphasizes the importance of maintaining the effort in understanding the mechanisms behind fatigue.
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Affiliation(s)
- Cecilie E Kiserud
- National Advisory Unit on Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital , Oslo , Norway
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Tuinman MA, Van Nuenen FM, Hagedoorn M, Hoekstra-Weebers JEHM. Distress, problems and referral wish of cancer patients: differences according to relationship status and life phase. Psychooncology 2014; 24:699-704. [DOI: 10.1002/pon.3712] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 09/03/2014] [Accepted: 09/26/2014] [Indexed: 01/11/2023]
Affiliation(s)
- Marrit A. Tuinman
- Health Psychology Section; University of Groningen, University Medical Center Groningen (UMCG); Groningen the Netherlands
| | - F. M. Van Nuenen
- Comprehensive Cancer Center Netherlands; location Groningen; the Netherlands
- Wenckebach Institute; University of Groningen, University Medical Center Groningen (UMCG); Groningen the Netherlands
| | - M. Hagedoorn
- Health Psychology Section; University of Groningen, University Medical Center Groningen (UMCG); Groningen the Netherlands
| | - J. E. H. M. Hoekstra-Weebers
- Comprehensive Cancer Center Netherlands; location Groningen; the Netherlands
- Wenckebach Institute; University of Groningen, University Medical Center Groningen (UMCG); Groningen the Netherlands
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Kim Y, Shaffer KM, Rocha-Lima C, Milton A, Carver CS. Exploring the role of ethnicity on perceptions of cancer and physical health recovery during the first year of survivorship. J Health Psychol 2014; 21:1331-8. [DOI: 10.1177/1359105314552304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined the role of ethnicity (Black vs White) in the extent to which patients’ appraisal of the impact of cancer on themselves and their family members relates to their physical health. Colorectal cancer patients provided self-reports for study variables at 2 and 12 months post-diagnosis ( N = 60). Hierarchical regression analysis revealed that African American patients’ perception of the cancer as disruptive to their family, but not to themselves, related to poorer health recovery, which association was absent among Whites ( p < .02). Findings suggest that cancer-related family stress plays a different role between two ethnic groups in elucidating their health recovery during the early survivorship.
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Affiliation(s)
- Youngmee Kim
- University of Miami, USA
- Sylvester Comprehensive Cancer Center, USA
- Center for Advanced Study in the Behavioral Sciences, USA
| | | | - Caio Rocha-Lima
- Sylvester Comprehensive Cancer Center, USA
- University of Miami Miller School of Medicine, USA
| | | | - Charles S Carver
- University of Miami, USA
- Sylvester Comprehensive Cancer Center, USA
- Center for Advanced Study in the Behavioral Sciences, USA
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Zimmer P, Mierau A, Bloch W, Strüder HK, Hülsdünker T, Schenk A, Fiebig L, Baumann FT, Hahn M, Reinart N, Hallek M, Elter T. Post-chemotherapy cognitive impairment in patients with B-cell non-Hodgkin lymphoma: a first comprehensive approach to determine cognitive impairments after treatment with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone or rituximab and bendamustine. Leuk Lymphoma 2014; 56:347-52. [DOI: 10.3109/10428194.2014.915546] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Health-related quality of life and persistent symptoms in relation to (R-)CHOP14, (R-)CHOP21, and other therapies among patients with diffuse large B-cell lymphoma: results of the population-based PHAROS-registry. Ann Hematol 2014; 93:1705-15. [DOI: 10.1007/s00277-014-2099-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 04/28/2014] [Indexed: 12/22/2022]
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Oerlemans S, Issa DE, van den Broek EC, Nijziel MR, Coebergh JWW, Mols F, van de Poll-Franse LV. Impact of therapy and disease-related symptoms on health-related quality of life in patients with follicular lymphoma: results of the population-based PHAROS-registry. Eur J Haematol 2014; 93:229-38. [PMID: 24702126 DOI: 10.1111/ejh.12335] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The increasing number of longer living patients with follicular lymphoma (FL) and serious side effects of treatment urged us to study the health-related quality of life (HRQoL) and persistent (treatment-related) symptoms in unselected patients after different treatment modalities and compare HRQoL of patients with a normative population. METHODS The population-based Eindhoven Cancer Registry was used to select patients diagnosed with FL during 2004-2010. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) was completed twice, with a 1-yr interval. This questionnaire was also completed by an age- and sex-matched normative population (N = 580). Detailed data on treatment were extracted from the cancer registry and Population-based HAematological Registry for Observational Studies (PHAROS). RESULTS Of the 181 patients who were invited, 148 responded (82%, T1). Patients treated with immunochemotherapy reported clinically relevant higher mean fatigue scores than those who underwent radiotherapy (P = 0.02). No differences were observed on the other HRQoL scales between treatment groups. Mean HRQoL scores were worse for FL patients treated with immunochemotherapy compared with a normative population (P < 0.01). A quarter to 50% of patients persistently reported to be slowed down, lethargic, or persistently worried about future health or was limited in social activities. Subsequently, patients reporting these symptoms/worries had a lower global health status/HRQoL. CONCLUSION Alertness for persistent symptoms that occur during and after treatment of FL patients is needed and may help to avoid lasting negative influence on their HRQoL.
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Affiliation(s)
- Simone Oerlemans
- Comprehensive Cancer Centre Netherlands, Eindhoven Cancer Registry, Eindhoven, The Netherlands; Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
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Petranovic D, Pilcic G, Valkovic T, Sotosek Tokmadzic V, Laskarin G. Perforin- and granulysin-mediated cytotoxicity and interleukin 15 play roles in neurocognitive impairment in patients with acute lymphoblastic leukaemia. Med Hypotheses 2014; 83:122-6. [PMID: 24735844 DOI: 10.1016/j.mehy.2014.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Accepted: 03/24/2014] [Indexed: 10/25/2022]
Abstract
Acute lymphoblastic leukaemia (ALL) is an aggressive disease. The course of disease is regulated by pro-inflammatory agents, and malignant cell infiltration of tissues plays a deleterious role in disease progression, greatly impacting quality of life, especially in the cognitive domains. Our hypothesis is that significant serum concentrations of interleukin 15 (IL-15) are responsible for higher expression of adhesion molecules on endothelial cells of blood-brain barrier (BBB) which allow leukaemia cells and/or normal lymphocytes the infiltration into the brain. In brain tissue these cells could be stimulated to release perforin and granulysin causing induction of apoptosis in brain cells that are involved in complex neural signalling mediated by neurotransmitters, and consequent fine cognitive impairment. Such changes could be detected early, even before notable clinical psycho-neurological or radiological changes in patients with ALL. To evaluate this hypothesis we propose measuring cognitive function using Complex Reactiometer Drenovac (CRD) scores in patients with ALL. The expression of different adhesion molecules on BBB as well as presence and distribution of different lymphocytes in brain tissue will be analyzed. We will then correlate CRD scores with levels of IL-15 and the percentages of T cells, natural killer T cells, and natural killer cells expressing perforin and/or granulysin proteins. CRD is a scientifically recognised and highly sensitive psychometric laboratory test based on the complex chronometric mathematical measuring of speed of reaction to various stimuli. It provides an objective assessment of cognitive functions from the most complex mental activities to the simplest reaction reflexes. Early recognition of cognitive dysfunction might be important when selecting the most appropriate chemotherapy and/or radiotherapy regimens, and could allow for the implementation of preventive measures against further deterioration in cognitive function and quality of life in patients with ALL.
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Affiliation(s)
- Duska Petranovic
- Department of Internal Medicine, Hematology, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia
| | - Gorazd Pilcic
- Department of Internal Medicine, Hematology, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia
| | - Toni Valkovic
- Department of Internal Medicine, Hematology, Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia
| | - Vlatka Sotosek Tokmadzic
- Department of Physiology and Immunology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia; Department of Anesthesiology, Reanimatology and Intensive Care, Faculty of Medicine, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia
| | - Gordana Laskarin
- Department of Physiology and Immunology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, B. Branchetta 20, Croatia; Division of Cardiology, Hospital for Medical Rehabilitation of the Hearth and Lung Diseases and Rheumatism "Thalassotherapia-Opatija", 51410 Opatija, M. Tita 188, Croatia.
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Quality of life more impaired in younger than in older diffuse large B cell lymphoma survivors compared to a normative population: a study from the population-based PROFILES registry. Ann Hematol 2013; 93:811-9. [DOI: 10.1007/s00277-013-1980-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 11/27/2013] [Indexed: 01/04/2023]
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Gender-specific quality of life after cancer in young adulthood: a comparison with the general population. Qual Life Res 2013; 23:1377-86. [PMID: 24197479 DOI: 10.1007/s11136-013-0559-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2013] [Indexed: 11/12/2022]
Abstract
PURPOSE Over the last years, adolescents and young adults with cancer (AYA) have moved strongly into scientific focus. However, there have only been a few studies about the quality of life of the AYA group, and gender differences have very rarely been examined. METHODS A cross-sectional study was conducted with young adult cancer patients who were aged 18-39 years at the time of survey and had completed their acute treatment. We used the quality of life questionnaire European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). The EORTC QLQ-C30 contains five function scales (physical, role, emotional, cognitive and social), nine symptom scales and a global quality of life scale. The patient sample was compared to a gender- and age-matched representative sample (REP). RESULTS Compared to the general population (N = 585), significantly poorer quality of life (p = .001) was observed for the 117 young cancer patients (40 male, 77 female) on all scales and items of the EORTC QLQ-C30. Analyses of variance with the factors group (AYA vs. REP) and gender showed interaction effects for the physical (p < .012), emotional (p < .029) and cognitive function scales (p < .008) and fatigue (p < .026) as well as for the items insomnia (p < .011), constipation (p < .037) and financial difficulties (p < .026). The pattern of the interaction was that female cancer patients reported the lowest quality of life outcomes. The same effects were found for the three calculated sum scales function, symptom and total. CONCLUSIONS Results clearly indicate that young adult cancer patients have a reduced quality of life in comparison with the general population even long after the treatment of their disease is complete. Women had a lower quality of life than men. Age-specific interventions should be offered that lead to improvements in quality of life for this age group. And future studies should clarify what factors lead to women's quality of life being worse than men's.
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Arora NK, Jensen RE, Sulayman N, Hamilton AS, Potosky AL. Patient-physician communication about health-related quality-of-life problems: are non-Hodgkin lymphoma survivors willing to talk? J Clin Oncol 2013; 31:3964-70. [PMID: 24062408 DOI: 10.1200/jco.2012.47.6705] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To investigate non-Hodgkin lymphoma (NHL) survivors' willingness to discuss health-related quality-of-life (HRQOL) problems with their follow-up care physician. PATIENTS AND METHODS Willingness to discuss HRQOL problems (physical, daily, emotional, social, and sexual functioning) was examined among 374 NHL survivors, 2 to 5 years postdiagnosis. Survivors were asked if they would bring up HRQOL problems with their physician and indicate reasons why not. Logistic regression models examined the association of patient sociodemographics, clinical characteristics, follow-up care variables, and current HRQOL scores with willingness to discuss HRQOL problems. RESULTS Overall, 94%, 82%, 76%, 43%, and 49% of survivors would initiate discussions of physical, daily, emotional, social, and sexual functioning, respectively. Survivors who indicated their physician "always" spent enough time with them or rated their care as "excellent" were more willing to discuss HRQOL problems (P < .05). Survivors reporting poorer physical health were less willing to discuss their daily functioning problems (P < .001). Men were more willing to discuss sexual problems than women (P < .001). One in three survivors cited "nothing can be done" as a reason for not discussing daily functioning problems, and at least one in four cited "this was not their doctor's job" and a preference to "talk to another clinician" as reasons for not discussing emotional, social, and sexual functioning. CONCLUSION NHL survivors' willingness to raise HRQOL problems with their physician varied by HRQOL domain. For some domains, even when survivors were experiencing problems, they may not discuss them. To deliver cancer care for the whole patient, interventions that facilitate survivor-clinician communication about survivors' HRQOL are needed.
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Affiliation(s)
- Neeraj K Arora
- Neeraj K. Arora, National Cancer Institute, Bethesda, MD; Roxanne E. Jensen, Nadiyah Sulayman, and Arnold L. Potosky, Georgetown University, Washington, DC; and Ann S. Hamilton, University of Southern California, Los Angeles, CA
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The impact of comorbidity on Health-Related Quality of Life among cancer survivors: analyses of data from the PROFILES registry. J Cancer Surviv 2013; 7:602-13. [PMID: 23918453 DOI: 10.1007/s11764-013-0299-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 07/01/2013] [Indexed: 12/31/2022]
Abstract
PURPOSE The aim of this study was to assess the difference in explained variance of Health-Related Quality of Life (HRQoL) between comorbidity, sociodemographic characteristics and cancer characteristics. This association was assessed among thyroid cancer, colorectal cancer, and (non-)Hodgkin's lymphoma patients. METHODS Data from three large population-based surveys on survivors of thyroid cancer, colorectal cancer, and (non-)Hodgkin's lymphoma were used. Cancer-specific HRQoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) of which physical function, emotional function, fatigue, and pain were included in the analyses. Comorbidity was assessed using the Self-reported Comorbidity Questionnaire. The association between comorbidity and HRQoL was assessed with multivariate linear regression models. Semi-partial R (2) was reported to assess the amount of variance in HRQoL explained by comorbidity in comparison with sociodemographic and cancer characteristics. RESULTS In total, 3,792 cancer survivors were included in this analysis. The variance in HRQoL subscales explained by comorbidity was higher compared with sociodemographic and cancer characteristics for physical function (11-17 vs. 2-4 and 1-2 %, respectively) and emotional function (7-17 vs. 1-3 and 1-3 %, respectively), regardless of cancer type. In addition, comorbidity explained 7-20 and 11-13 % of the variance in pain and fatigue, respectively, compared to 0-4 % for both sociodemographic and cancer characteristics. Osteoarthritis and back pain were strongly associated with physical function and pain, while depression was strongly associated with emotional function. Depression and back pain were strongly associated with fatigue. CONCLUSIONS This study showed that comorbidity explained more variance in physical and emotional function, pain, and fatigue in comparison with sociodemographic and cancer characteristics in cancer survivors, regardless of cancer type. Our findings emphasize the importance of adjusting for the presence of comorbid diseases when assessing HRQoL in cancer survivors. IMPLICATION FOR CANCER SURVIVORS Cancer survivors suffering from comorbid diseases experience lower levels of health-related quality of life. Clinicians should become more aware of the impact of comorbidity on HRQoL and provide necessary psychological support to assist self-management of comorbid diseases.
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