1
|
Brown E, Barry T, Mai T, Harvey J. Clinical experience of a tattoo application device. Tech Innov Patient Support Radiat Oncol 2024; 30:100254. [PMID: 38784599 PMCID: PMC11112350 DOI: 10.1016/j.tipsro.2024.100254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/03/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction The use of tattoos for radiation therapy (RT) treatment is common practice. The Comfort Marker 2.0 (CQ Medical, Iowa, USA) has been designed to apply tattoos with a controlled depth injection, potentially resulting in tattoos that fade over time. The aim of this study was to investigate the clinical implementation of the Comfort Marker 2.0 tattoo device including the patient experience and clinical workflow. Methods Patients undergoing RT treatment for breast cancer were invited to participate in this prospective pilot study. Patients completed a questionnaire after the planning session rating the level of pain experienced during tattoo application. Staff rated ease of use after each patient recording any feedback regarding the device. To evaluate tattoo fading, patients were followed up at 6 and 12 months after treatment to assess if tattoos could be visualised. Results Between August and December 2021, 50 breast cancer patients were recruited to the study. All patients received at least 3 tattoos. The majority of patients (80%) rated their pain between not hurting or hurting a little. More than 85% of staff indicated the device was easy or very easy to use. The three most common areas staff identified for improvement were: cordless device (39.1%), pen size (20.3%) and consumable rubbish (13.0%). All tattoos remained visible at the final follow up appointment. Conclusion Clinical implementation of the Comfort Marker tattoo device has been successful. Overall, patients found the process reasonably painless and staff found the device easy to use, providing a consistent result.
Collapse
Affiliation(s)
- Elizabeth Brown
- Radiation Oncology Princess Alexandra Hospital – Ipswich Road, Brisbane, Australia
| | - Tamara Barry
- Radiation Oncology Princess Alexandra Hospital – Ipswich Road, Brisbane, Australia
| | - Tao Mai
- Radiation Oncology Princess Alexandra Hospital – Ipswich Road, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Jennifer Harvey
- Radiation Oncology Princess Alexandra Hospital – Ipswich Road, Brisbane, Australia
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
2
|
Sun K, Thao Dinh N, Lewin J, Grzeskowiak L, Mariano C, Bailey E, Lazarakis S, Hussainy SY. A Scoping Review of Oncosexology Policy and Practice Tools Focused on Adolescents and Young Adults. J Adolesc Young Adult Oncol 2024; 13:389-443. [PMID: 38563827 DOI: 10.1089/jayao.2023.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Background: Despite being considered a key component of quality-of-life, sexual health concerns in adolescents and young adults (AYA) patients with cancer (aged 15-39 years old) are often unmet due to barriers from both patients and health care professionals (HCPs). Investigation into policy and practice tools in this scope of practice is also limited. Aim: To review the literature on policy and practice tools in AYA oncosexology. Method: A scoping review was conducted using four databases: Medline, EMCARE, EMBASE, and PsycINFO, based on the Joanna Briggs Institute Scoping Review methodology. Retrieved articles were extracted into Covidence, followed by two screening rounds. Descriptive and basic content analyses were performed for evidence synthesis. Results: Seventy-four articles were included after screening rounds and citation searches. Overall, oncosexology policy and practice tools were categorized into screening tools (11 articles), guidelines (38 articles), training programs (15 articles), service delivery initiatives (5 articles), and the evaluation of their feasibility/challenges to implementation (5 articles). Among these, only ten articles were specifically about the AYA population. They helped identify and resolve sexual health concerns in AYA patients with cancer by providing strategies to overcome communication barriers, treatment options, and information resources for patients, and by advocating for more HCP education on this topic. Conclusion: The results warrant the need for more research, implementation and expansion of policy and practice tools for sexual health issues in AYA patients with cancer.
Collapse
Affiliation(s)
- Kexin Sun
- The University of Melbourne, Melbourne, Australia
| | - Nhu Thao Dinh
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Jeremy Lewin
- Department of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, Australia
- ONTrac at Peter Mac, Victorian Adolescent & Young Adult Cancer Service, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
| | - Luke Grzeskowiak
- Flinders University and South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Chiara Mariano
- Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Eliza Bailey
- Radiotherapy Department, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Smaro Lazarakis
- Health Sciences Library, Royal Melbourne Hospital, Parkville, Australia
| | - Safeera Y Hussainy
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
- Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of General Practice, School of Public Health and Preventative Medicine, Monash University, Parkville, Australia
| |
Collapse
|
3
|
Pehlivan MJ, Sherman KA, Wuthrich V, Gandhi E, Zagic D, Kopp E, Perica V. The effectiveness of psychological interventions for reducing poor body image in endometriosis, PCOS and other gynaecological conditions: a systematic review and meta-analysis. Health Psychol Rev 2024; 18:341-368. [PMID: 37675797 DOI: 10.1080/17437199.2023.2245020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/01/2023] [Indexed: 09/08/2023]
Abstract
Gynaecological conditions (e.g., endometriosis, PCOS) result in bodily changes that negatively impact body image. Psychological interventions (e.g., CBT, psychoeducation) have shown promise in reviews with the general population for alleviating body image concerns. This systematic review and meta-analysis aims to provide asynthesis of the impact of psychological interventions for reducing body image concerns for individuals with gynaecological conditions. Electronic databases were searched for relevant psychological intervention studies with body image outcomes. Twenty-one eligible studies were included in the systematic review (ten were included in a random-effects meta-analysis). Studies included participants (N = 1483, M = 71.85, SD = 52.79) with a range of gynaecological conditions, ages (Mage = 35.08, SD = 12.17) and cultural backgrounds. Most included studies reported at least one positive effect with the meta-analysis indicating psychological interventions were moderately superior to control conditions for reducing body image concerns (SMD -.41, 95% CI [-0.20 -0.62]). However, there was a high risk of bias and moderate heterogeneity. Results suggest psychological interventions may hold promise for reducing body image concerns among individuals gynaecological conditions in the short term. Further, preliminary support was found for the use of theory-guided psychological interventions delivered in group settings in particular, with further research needed on optimal intervention length and particular psychotherapeutic approach.
Collapse
Affiliation(s)
- Melissa J Pehlivan
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Kerry A Sherman
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Viviana Wuthrich
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Esther Gandhi
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Dino Zagic
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Emily Kopp
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Valentina Perica
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| |
Collapse
|
4
|
Rose L, Mallela T, Waters M, Novice M, Minta A, Akintilo L, Shipp D, Dulmage B. Cosmetic considerations after breast cancer treatment. Arch Dermatol Res 2024; 316:223. [PMID: 38787423 DOI: 10.1007/s00403-024-02898-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 04/16/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024]
Abstract
Treatments for breast cancer can have an array of adverse effects, including hair loss, scarring, and irritated skin. These physical outcomes can, in turn, lead to body image concerns, anxiety, and depression. Fortunately, there is growing evidence that certain cosmetic therapies can improve patient self-image. Here we review various cosmetic treatment options including hair camouflage, eyebrow and eyelash camouflage, treatments for hirsutism, nipple and areola tattooing, post-mastectomy scar tattooing, treatments for dry skin/xerosis, removal of post-radiation telangiectasias, and lightening of post-radiation hyperpigmentation. For each patient concern, we report potential procedures, clinical evidence of impact on quality of life, special considerations, and safety concerns. This article aims to equip dermatologists with resources so that they may effectively counsel breast cancer survivors who express treatment-related cosmetic concerns.
Collapse
Affiliation(s)
- Lucy Rose
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Teja Mallela
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Margo Waters
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Madison Novice
- The University of Michigan Medical School, Ann Arbor, MI, USA
| | - Abena Minta
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Lisa Akintilo
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York City, NY, USA
| | - Desmond Shipp
- Department of Dermatology, The Ohio State University Wexner Medical Center, 540 Officenter Place, Suite 240, Columbus, OH, 43230, USA
| | - Brittany Dulmage
- Department of Dermatology, The Ohio State University Wexner Medical Center, 540 Officenter Place, Suite 240, Columbus, OH, 43230, USA.
| |
Collapse
|
5
|
Abboah-Offei M, Bayuo J, Salifu Y, Afolabi O, Akudjedu TN. Experiences and perceptions of men following breast cancer diagnosis: a mixed method systematic review. BMC Cancer 2024; 24:179. [PMID: 38317128 PMCID: PMC10845771 DOI: 10.1186/s12885-024-11911-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/22/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Men with breast cancer experience unique physical and emotional challenges. However, a thorough understanding of these experiences including the psychosocial effects and supportive care needs have received less attention. In some settings, men with breast cancer experience stigma within the healthcare system and their care needs are not prioritised. This influences the level of professional support offered, consequently worsening their health and well-being outcomes. This review explored the variabilities in the experiences and treatment modalities of male breast cancer (MBC) across different contexts. METHODS All primary study designs including qualitative, quantitative, and mixed methods studies that reported on the experiences, treatment approaches and outcomes of MBC were included in this systematic review. Six databases (Embase, Medline, PsycINFO, Global Health, CINAHL and Web of Science) were searched for articles from January 2000 to September 2023. A results-based convergence synthesis was used for data analysis and reported using PRISMA guidelines. RESULTS Of the studies screened (n = 29,687), forty-four fulfilled the predetermined criteria and were included. Our findings relating to the experiences and treatment approaches of MBC are broadly themed into three parts. Theme 1-Navigating through a threat to masculinity: describes how males experienced the illness reflecting on detection, diagnosis, coming to terms with breast cancer, and disclosure. Theme 2- Navigating through treatment: captures the experiences of undergoing breast cancer treatment/ management following their diagnosis. Theme 3-Coping and support systems: describes how MBC patients coped with the disease, treatment process, aftercare/rehabilitative care, and the available support structures. CONCLUSIONS Men experience a myriad of issues following a breast cancer diagnosis, especially with their masculinity. Awareness creation efforts of MBC among the public and healthcare practitioners are urgently required, which could change the perception of men in promoting early diagnosis, adherence to treatments, post-treatment monitoring, oncological results and a better quality of life. Considerations for training, education and development of specialised guidelines for healthcare practitioners on MBC would provide the necessary knowledge and skills to enhance their practice through the adoption of person-centred and male-specific care strategies. Professional care intervention and support for MBC should not end after the diagnosis phase but should extend to the entire treatment continuum and aftercare including future research focusing on MBC specific clinical trials. TRIAL REGISTRATION PROSPERO Registration No. CRD42021228778.
Collapse
Affiliation(s)
- Mary Abboah-Offei
- School of Health and Social Care, Edinburgh Napier University, Sighthill Court, Sighthill Campus, Edinburgh, UK
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, Hongkong, China
| | - Yakubu Salifu
- International Observatory On End of Life Care (IOELC), Faculty of Health and Medicine, Division of Health Research, Lancaster University, Lancaster, LA1 4AT, UK.
| | - Oladayo Afolabi
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, WC2R 2LS, UK
| | - Theophilus N Akudjedu
- Institute of Medical Imaging & Visualisation, Department of Medical Science & Public Health, Faculty of Health & Social Science, Bournemouth University, Bournemouth, UK
| |
Collapse
|
6
|
Kang SJ, Choi GE. Cross-Cultural Adaptation and Validation of the Korean Version of the Body Image After Mastectomy Scale. Semin Oncol Nurs 2024; 40:151576. [PMID: 38262849 DOI: 10.1016/j.soncn.2023.151576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVE This study aimed to evaluate the psychometric properties and validity of the Korean version of the Body Image After Mastectomy Scale (K-BIMS). METHODS This validation study was divided into two phases. Phase 1 included the translation of the K-BIMS according to the World Health Organization recommendations, investigation of content validity by five experts, and a pilot study involving 10 participants for the final list of K-BIMS items. The study participants included 156 women who met the inclusion and exclusion criteria to verify the validity-reliability of the K-BIMS. Phase 2 included a validity-reliability analysis of the K-BIMS. This included convergent validity, known-group validity, construct validity assessed by confirmatory factor analysis, and item-total score correlation. We assessed internal consistency using the Cronbach α. RESULTS The K-BIMS confirmatory factor analysis demonstrated good fitness of indices and validity including content validity, convergent validity, and known-group validity was satisfactory. Internal consistency reliability was satisfying with a Cronbach α reliability of .89. CONCLUSIONS The results revealed that the K-BIMS is a valid and reliable instrument for assessing appearance-based behaviors and beliefs about body image distress among women who underwent reconstructive surgery after mastectomy. IMPLICATIONS FOR NURSING PRACTICE To identify individuals who exhibit maladaptive symptoms and are at risk of developing long-term body image problems, the K-BIMS can be used as a point-of-care screening tool. Therefore, the K-BIMS can be used as an early screening tool to proactively offer accessible and affordable solutions.
Collapse
Affiliation(s)
- Sook Jung Kang
- College of Nursing/ Associate Professor, Ewha Womans University, Seodaemun-gu, Seoul, Republic of Korea
| | - Goh Eun Choi
- College of Nursing/PhD student, Clinical Instructor, Ewha Womans University, Seodaemun-gu, Seoul, Republic of Korea.
| |
Collapse
|
7
|
Wondimagegnehu A, Assefa M, Teferra S, Kantelhardt EJ, Zebrack B, Addissie A. A Qualitative Study on Psychosocial Challenges of Patients With Cancer in Ethiopia Using the Social-Ecological Model. QUALITATIVE HEALTH RESEARCH 2024:10497323231219409. [PMID: 38229470 DOI: 10.1177/10497323231219409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Cancer diagnosis and treatment can be physically arduous, disrupting patients' social and work lives. Understanding the extent of these problems is key to addressing patients' needs, but specific psychosocial challenges have not yet been well studied in resource-limited settings. A qualitative study was conducted in the capital and two regions of Ethiopia with the aim of exploring psychosocial challenges among cancer patients. A total of 14 in-depth interviews (IDIs) and 16 focus group discussions (FGDs) were done with cancer patients, health professionals, community representatives, and religious leaders. Four separate interview guides were used to facilitate the interviews and discussions. All transcribed documents, field notes, and reflexive memos were entered into NVivo 12 software, and deductive thematic analysis using the social-ecological model was applied to summarize the main findings. At an individual level, emotional distress, suicidal risk, denial, and refusal of treatment were identified immediately after diagnosis while hopelessness, feeling depressed, and fear of death were commonly reported psychosocial challenges during the course of treatment. Involvement of family members in major treatment decisions was recognized at an interpersonal level. Our result also revealed that cancer patients had strong social support from family members and close friends. In the community, traditional medicine and religious rituals were considered an alternative treatment for cancer. The findings indicate that counselling and psychoeducation are crucial for cancer patients, family members, and close friends. Awareness creation programmes should be delivered through collaboration with religious leaders and traditional healers.
Collapse
Affiliation(s)
- Abigiya Wondimagegnehu
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
| | - Mathewos Assefa
- Department of Oncology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eva J Kantelhardt
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
- Department of Gynecology, Martin-Luther-University, Halle, Germany
| | - Bradley Zebrack
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Adamu Addissie
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University, Halle, Germany
| |
Collapse
|
8
|
Graboyes EM, Kistner-Griffin E, Hill EG, Maurer S, Balliet W, Williams AM, Padgett L, Yan F, Rush A, Johnson B, McLeod T, Dahne J, Ruggiero KJ, Sterba KR. Mechanism underlying a brief cognitive behavioral treatment for head and neck cancer survivors with body image distress. Support Care Cancer 2023; 32:32. [PMID: 38102496 PMCID: PMC10798060 DOI: 10.1007/s00520-023-08248-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Body image distress (BID) among head and neck cancer (HNC) survivors is a debilitating toxicity associated with depression, anxiety, stigma, and poor quality of life. BRIGHT (Building a Renewed ImaGe after Head & neck cancer Treatment) is a brief cognitive behavioral therapy (CBT) that reduces BID for these patients. This study examines the mechanism underlying BRIGHT. METHODS In this randomized clinical trial, HNC survivors with clinically significant BID were randomized to receive five weekly psychologist-led video tele-CBT sessions (BRIGHT) or dose-and delivery matched survivorship education (attention control [AC]). Body image coping strategies, the hypothesized mediators, were assessed using the Body Image Coping Skills Inventory (BICSI). HNC-related BID was measured with the Inventory to Measure and Assess imaGe disturbancE-Head and Neck (IMAGE-HN). Causal mediation analyses were used to estimate the mediated effects of changes in BICSI scores on changes in IMAGE-HN scores. RESULTS Among 44 HNC survivors with BID allocated to BRIGHT (n = 20) or AC (n = 24), mediation analyses showed that BRIGHT decreased avoidant body image coping (mean change in BICSI-Avoidance scale score) from baseline to 1-month post-intervention relative to AC (p = 0.039). Decreases in BICSI-Avoidance scores from baseline to 1-month resulted in decreases in IMAGE-HN scores from baseline to 3 months (p = 0.009). The effect of BRIGHT on IMAGE-HN scores at 3 months was partially mediated by a decrease in BICSI-Avoidance scores (p = 0.039). CONCLUSIONS This randomized trial provides preliminary evidence that BRIGHT reduces BID among HNC survivors by decreasing avoidant body image coping. Further research is necessary to confirm these results and enhance the development of interventions targeting relevant pathways to reduce BID among HNC survivors. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT03831100 .
Collapse
Affiliation(s)
- Evan M Graboyes
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
- Hollings Cancer Center, MUSC, Charleston, SC, USA.
| | - Emily Kistner-Griffin
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, MUSC, Charleston, SC, USA
| | - Elizabeth G Hill
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, MUSC, Charleston, SC, USA
| | - Stacey Maurer
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Wendy Balliet
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Amy M Williams
- Office of Physician Well-Being and Professionalism, Corewell Health, Detroit, MI, USA
| | - Lynne Padgett
- Veteran Affairs Office of Research and Development, Washington, DC, USA
| | - Flora Yan
- Department of Otolaryngology-Head & Neck Surgery, Temple University School of Medicine, Philadelphia, USA
| | - Angie Rush
- Head and Neck Cancer Alliance, Charleston, SC, USA
| | - Brad Johnson
- Head and Neck Cancer Alliance, Charleston, SC, USA
| | - Taylor McLeod
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Jennifer Dahne
- Hollings Cancer Center, MUSC, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kenneth J Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Katherine R Sterba
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, MUSC, Charleston, SC, USA
| |
Collapse
|
9
|
Ospina Serrano AV. Overview of sexual dysfunction in patients with cancer. Clin Transl Oncol 2023; 25:3369-3377. [PMID: 37633856 DOI: 10.1007/s12094-023-03311-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/28/2023]
Abstract
Among survivor's patients with cancer, sexual dysfunction (SD) is a common treatment-related disturbance that significantly affects their quality of life. The disorder can be a short-term effect, but frequently it can be permanent and patients often do not receive adequate support to overcome the problem. The characteristics of SD may differ depending on the type of neoplasm and oncological treatment. The most common long-term effects are those related to treatment-induced menopause, ablative oncologic surgery, and altered gonadal function. Breast, prostate, and gynecologic cancers are the tumors most commonly associated with disturbances in sexual health, although there is evidence of SD in patients with other types of neoplasms. It is necessary for the healthcare team caring for oncological patients to be aware of the characteristics of sexual dysfunction in this population. This will make it possible to offer patients a comprehensive and personalized approach to improve their quality of life.
Collapse
Affiliation(s)
- Aylen Vanessa Ospina Serrano
- Instituto Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro Majadahonda, Calle Manuel de Falla 1, 28222, Madrid, Spain.
| |
Collapse
|
10
|
Franzoi IG, Granieri A, Sauta MD, Agnesone M, Gonella M, Grimaldi C, Vallauri I, Boglione A, Vana F, Bergnolo P, Comandone A. The psychological impact of sarcoma on affected patients. Psychooncology 2023; 32:1787-1797. [PMID: 37930090 DOI: 10.1002/pon.6240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/09/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Sarcoma diagnosis and its treatment trajectory may deeply affect the somatopsychic balance of patients and their caregivers. This systematic review aimed at deepening the understanding of sarcoma's impact on the entire family unit involved in the illness experience on a physical (e.g. fatigue), psychological (e.g. mental health, affective regulation, defense mechanisms), and interpersonal (e.g. social isolation, loneliness) level. METHODS The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification and subsequent inclusion of 44 articles focused on sarcoma patients. Results were classified into seven categories: Quality of Life, worries and distress, anxiety and depression, suicide ideation, financial and occupational consequences, unmet needs, and coping strategies. Our search identified only one study focusing on informal caregivers, thus we could not perform a systematic review on these results. RESULTS Our findings underlined the traumatic impact of the sarcoma diagnosis. Patients can experience an impoverished emotional life, somatization, social withdrawal, difficulty in decision-making, increased feelings of discouragement and demoralization, and profound experiences of helplessness and vulnerability. Moreover, they seemed to display anxiety and depression and might present a higher suicide incidence than the general population. CONCLUSION Our review highlighted that the psychosocial aftermath of sarcoma patients should guide institutions and healthcare professionals toward the design of assessment and intervention models that could contemplate the different dimensions of their suffering. Furthermore, it points out that there is still a lack of evidence regarding the psychosocial impact affecting sarcoma patients' caregivers.
Collapse
Affiliation(s)
| | | | | | - Monica Agnesone
- S.S Psychology, Local Health Authority "Città di Torino", Turin, Italy
| | - Marco Gonella
- Department of Psychology, University of Turin, Turin, Italy
- S.S Psychology, Local Health Authority "Città di Torino", Turin, Italy
| | | | - Irene Vallauri
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Federica Vana
- Department of Oncology, San Giovanni Bosco Hospital, Turin, Italy
| | - Paola Bergnolo
- Department of Oncology, San Giovanni Bosco Hospital, Turin, Italy
| | | |
Collapse
|
11
|
Nakamura M, Ohba T, Sasaki R, Saito F, Yamaguchi M, Motohara T, Mabe H, Lu X, Katabuchi H, Kondoh E. Advantages and limitations of estrogen replacement therapy on hypogonadal survivors of childhood cancer. Int J Clin Oncol 2023; 28:1563-1572. [PMID: 37646971 DOI: 10.1007/s10147-023-02405-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Hypogonadism is a significant late complication in childhood cancer survivors (CCS). The aim of this study was to elucidate the advantages and limitations of estrogen replacement therapy (ERT) for CCS with hypogonadism. METHODS Seventeen CCS were divided into two groups: gonadal hypogonadism (GH) group (n = 8) and central hypogonadism (CH) group (n = 9). Pearson correlation coefficients were used to investigate the impact of cancer management on final height, bone density, and uterine development. RESULTS Seven of GH group had hematologic malignancies, and all of them underwent total body irradiation before bone marrow transplantation. The GH group showed significant positive correlations between the onset age of disease treatment and final height (p < 0.05, R = 0.712) and uterine size following ERT (p < 0.05, R = 0.775). All CCS in the CH group had brain tumors, and seven of them received chemotherapy. There were trends towards positive and negative correlations between the onset age of disease treatment and final height (p = 0.09, R = 0.598) or uterine size (p = 0.07, R = - 0.669), respectively. A negative correlation trend was observed between the age at ERT initiation and final height (p = 0.07, R = - 0.769) or bone density (p = 0.18, R = - 0.626) in six CH patients who received growth hormone therapy. Five CCS in both groups experienced osteoporosis, despite receiving ERT. CONCLUSION Individualized management strategies beyond ERT are essential to reduce long-term complications in CCS with hypogonadism, considering the type and timing of cancer treatment.
Collapse
Affiliation(s)
- Miwa Nakamura
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan.
| | - Takashi Ohba
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan
| | - Rumi Sasaki
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan
| | - Fumitaka Saito
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan
| | - Munekage Yamaguchi
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan
| | - Takeshi Motohara
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan
| | - Hiroyo Mabe
- Department of Pediatrics, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Xi Lu
- Department of Public Health, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hidetaka Katabuchi
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan
| | - Eiji Kondoh
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-Ku, Kumamoto City, Kumamoto, 860-8556, Japan
| |
Collapse
|
12
|
Tollow P, Ogden J, McCabe CS, Harcourt D. Physical appearance and well-being in adults with incurable cancer: a thematic analysis. BMJ Support Palliat Care 2023; 13:e163-e169. [PMID: 33246936 DOI: 10.1136/bmjspcare-2020-002632] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/16/2020] [Accepted: 11/05/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Existing research has established the importance of appearance concerns for individuals with cancer and identified appearance as an important factor in dying with dignity. No research, however, has explored in depth the role of appearance in the experiences of individuals who have incurable cancer. This research aims to explore patients' experiences and perspectives in relation to the role of appearance issues in adults with incurable cancer. METHODS Semi-structured interviews were conducted with 24 adults with incurable cancer (20 women, 4 men; mean age 54.5, SD 11.32). RESULTS Thematic analysis generated three themes: 'Identity: Embodying Cancer', 'Communication: Wearing your illness' and 'Support: Holistic Care'. Appearance was felt to be an important element of identity, which was often dominated by cancer, leading to feelings of separation from the participant's previous self. Appearance changes also influenced the way in which individuals communicated with their external world, forcing discussion of their diagnosis, and increasing focus on their cancer, with participants having to manage the emotional impact of this on loved ones, as well as the impact on their legacy. Finally, participants highlighted the positive impact of appearance-related support in their well-being and identified peer connections and refocusing on the self as key elements of such support. CONCLUSIONS Appearance changes play an important role in the experiences of individuals with incurable cancer with regards to both identity and communication and challenged participants' ability to maintain normalcy. Further psychosocial support relating to appearance concerns was considered necessary to promote dignity and provide truly holistic patient care.
Collapse
Affiliation(s)
- Philippa Tollow
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Jane Ogden
- School of Psychology, University of Surrey, Guildford, UK
| | - Candida S McCabe
- Dorothy House Hospice, Winsley, UK
- University of the West of England, Bristol, UK
- Florence Nightingale Foundation, London, UK
| | - Diana Harcourt
- Centre for Appearance Research, University of the West of England, Bristol, UK
| |
Collapse
|
13
|
Byrne E, Gaffey J, Hayden L, Daly A, Gallagher P, Dunne S. Body image and cancer-related lymphoedema: A systematic review. Psychooncology 2023; 32:1528-1538. [PMID: 37681525 DOI: 10.1002/pon.6215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE Cancer-related lymphoedema is a common side effect of cancer, affecting 24%-49% of people with cancer. Body image contributes to the well-being of individuals with this condition. This systematic review aimed to explore, for the first time, the state of the science concerning body image in cancer-related lymphoedema, including how body image is measured and variables associated with body image concerns. METHODS Six databases were systematically searched for peer-reviewed articles describing empirical quantitative studies where body image was measured with a reliable and valid measurement tool in adults with cancer-related lymphoedema. RESULTS Nine studies with 977 participants were included. The studies involved individuals who had experienced breast, head and neck, melanoma, and urogenital cancers and developed lymphoedema. There was considerable heterogeneity in body image measures used, precluding meta-analysis. The following variables were associated with increased body image concern: higher body integrity beliefs, experience of physical changes (e.g. pain) and differences in sensation and function, including changes in appearance related thoughts, feelings and emotions. Several studies described behavioural and psychological interventions which positively impacted body image outcomes in individuals with lymphoedema relating to specific cancers. CONCLUSION Regular screening for body image concerns could encourage more positive body image awareness in individuals with cancer-related lymphoedema and lessen some of its associated negative consequences. Future longitudinal and individual differences research in this area is important to inform intervention development. There is also need for a more standardised approach to the study and measurement of body image in people with cancer-related lymphoedema.
Collapse
Affiliation(s)
- Emma Byrne
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Jane Gaffey
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Lucy Hayden
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Adam Daly
- School of Psychology, Dublin City University, Dublin, Ireland
| | | | - Simon Dunne
- School of Psychology, Dublin City University, Dublin, Ireland
| |
Collapse
|
14
|
Graboyes EM, Kistner-Griffin E, Hill EG, Maurer S, Balliet W, Williams AM, Padgett L, Yan F, Rush A, Johnson B, McLeod T, Dahne J, Ruggiero KJ, Sterba KR. Mechanism Underlying a Brief Cognitive Behavioral Treatment for Head and Neck Cancer Survivors with Body Image Distress. RESEARCH SQUARE 2023:rs.3.rs-3303379. [PMID: 37720013 PMCID: PMC10503855 DOI: 10.21203/rs.3.rs-3303379/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Purpose Body image distress (BID) among head and neck cancer (HNC) survivors is a debilitating toxicity associated with depression, anxiety, stigma, and poor quality of life. BRIGHT (Building a Renewed ImaGe after Head & neck cancer Treatment) is a brief cognitive behavioral therapy (CBT) that reduces BID for these patients. This study examines the mechanism underlying BRIGHT. Methods In this randomized clinical trial, HNC survivors with clinically significant BID were randomized to receive 5 weekly psychologist-led video tele-CBT sessions (BRIGHT) or dose-and delivery matched survivorship education (attention control [AC]). Body image coping strategies, the hypothesized mediators, were assessed using the Body Image Coping Skills Inventory (BICSI). HNC-related BID was measured with the IMAGE-HN. Causal mediation analyses were used to estimate the mediated effects of changes in BICSI scores on changes in IMAGE-HN scores. Results Among 44 HNC survivors with BID, mediation analyses showed that BRIGHT decreased avoidant body image coping (mean change in BICSI-Avoidance scale score) from baseline to 1-month post-intervention relative to AC (p = 0.039). Decreases in BICSI-Avoidance scores from baseline to 1-month decreased IMAGE-HN scores from baseline to 3-months (p = 0.009). The effect of BRIGHT on IMAGE-HN scores at 3-months was partially mediated by a decrease in BICSI-Avoidance scores (p = 0.039). Conclusions This randomized trial provides preliminary evidence that BRIGHT reduces BID among HNC survivors by decreasing avoidant body image coping. Further research is necessary to confirm these results and enhance the development of interventions targeting relevant pathways to reduce BID among HNC survivors. Trial Registration This trial was registered on ClinicalTrials.gov identifier NCT03831100 on February 5, 2019.
Collapse
|
15
|
Graboyes EM, Kistner-Griffin E, Hill EG, Maurer S, Balliet W, Williams AM, Padgett L, Yan F, Rush A, Johnson B, McLeod T, Dahne J, Ruggiero KJ, Sterba KR. Efficacy of a brief cognitive behavioral therapy for head and neck cancer survivors with body image distress: secondary outcomes from the BRIGHT pilot randomized clinical trial. J Cancer Surviv 2023:10.1007/s11764-023-01454-6. [PMID: 37644354 PMCID: PMC10902187 DOI: 10.1007/s11764-023-01454-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Body image distress (BID) among head and neck cancer (HNC) survivors leads to depression, social isolation, stigma, and poor quality of life. BRIGHT (Building a Renewed ImaGe after Head and neck cancer Treatment) is a brief, tailored cognitive behavioral therapy (CBT) that reduces HNC-related BID. This trial examines the effect of BRIGHT on psychosocial outcomes among HNC survivors with BID. METHODS In this pilot randomized trial, HNC survivors with clinically significant BID were randomized to 5 weekly psychologist-led tele-CBT sessions (BRIGHT) or dose and delivery-matched survivorship education (attention control [AC]). Secondary psychosocial outcomes were assessed using validated patient-reported outcomes at baseline and 1 and 3-month post-intervention. RESULTS Among 44 HNC survivors with BID, BRIGHT resulted in a greater reduction in depression relative to AC (mean model-based 1-month difference in Δ PROMIS SF v1.0-Depression 8a score, -3.4; 90% CI, -6.4 to -0.4; 3-month difference, -4.3; 90% CI, -7.8 to -0.8). BRIGHT also decreased shame and stigma relative to AC (mean model-based 3-month difference in Δ Shame and Stigma Scale score, -9.7; 90% CI, -15.2 to -4.2) and social isolation (mean model-based 3-month difference in Δ PROMIS SF v2.0 Social Isolation 8a score, -2.9; 90% CI, -5.8 to -0.1). CONCLUSIONS In this planned secondary analysis of a pilot RCT, BRIGHT improved a broad array of psychosocial outcomes among HNC survivors with BID. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03831100 . IMPLICATIONS FOR CANCER SURVIVORS These promising preliminary data suggest the need for a large efficacy trial evaluating the effect of BRIGHT on psychosocial outcomes among HNC survivors with BID.
Collapse
Affiliation(s)
- Evan M Graboyes
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.
| | - Emily Kistner-Griffin
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Elizabeth G Hill
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| | - Stacey Maurer
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Wendy Balliet
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Amy M Williams
- Office of Physician Well-Being and Professionalism, Corewell Health, Detroit, MI, USA
| | - Lynne Padgett
- Veteran Affairs Office of Research and Development, Washington, DC, USA
| | - Flora Yan
- Department of Otolaryngology-Head & Neck Surgery, Temple University School of Medicine, Philadelphia, USA
| | - Angie Rush
- Head and Neck Cancer Alliance, Charleston, SC, USA
| | - Brad Johnson
- Head and Neck Cancer Alliance, Charleston, SC, USA
| | - Taylor McLeod
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Jennifer Dahne
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kenneth J Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Katherine R Sterba
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
| |
Collapse
|
16
|
Anne Thamar Louis L, Fortin J, Roy CA, Brunet A, Aimé A. Body image interventions within breast cancer care: A systematic review and concept analysis. J Psychosoc Oncol 2023; 42:427-447. [PMID: 37609854 DOI: 10.1080/07347332.2023.2249879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
There needs to be a consensus regarding the definition of body image in oncology the literature. This lack of agreement leads to conflicting results in psychosocial interventions aimed to improve body image among breast cancer patients. Through an instrumentalist approach, this systematic review aims to analyze how body image as a concept is described and operationalized in breast cancer studies with the focus to enhance body image through psychosocial interventions. Databases were searched in October 2022 and updated in February 2023 to find empirical studies reporting psychosocial intervention targeting body image efficacy. The results from 24 studies show many similarities and differences between the definitions (e.g. characteristics) and questionnaires (e.g. Cronbach's alpha coefficient) used to evaluate this concept. Most definitions include thoughts, feelings, and behaviors related to body image. Finally, the psychosocial implications are discussed. This systematic review is registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022326393).
Collapse
Affiliation(s)
- Lunie Anne Thamar Louis
- Psychosocial Research Division, Research Center of the Douglas Mental Health University Institute, Verdun, Canada
| | - Justine Fortin
- Psychosocial Research Division, Research Center of the Douglas Mental Health University Institute, Verdun, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| | - Carol-Anne Roy
- Psychosocial Research Division, Research Center of the Douglas Mental Health University Institute, Verdun, Canada
| | - Alain Brunet
- Psychosocial Research Division, Research Center of the Douglas Mental Health University Institute, Verdun, Canada
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Annie Aimé
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, Canada
| |
Collapse
|
17
|
Vagnini D, Sorge A, Acquati C, Colafemmina FA, Saita E. Implementing the framed portrait experience with Italian breast cancer survivors: a pilot study assessing short term effects of an existential approach to body image, coping skills, and self-efficacy. J Cancer Surviv 2023:10.1007/s11764-023-01438-6. [PMID: 37597069 DOI: 10.1007/s11764-023-01438-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/23/2023] [Indexed: 08/21/2023]
Abstract
PURPOSE Breast cancer (BC) and its treatments significantly impact the psychological wellbeing of women. Interventions offered during cancer survivorship have documented positive consequences for quality of life. However, limited evidence is available regarding the implementation of therapeutic photography. This study investigated the efficacy of the framed portrait experience (FPE) when implemented to BC survivors. METHODS A quasi-experimental study was conducted. Participants were enrolled in a non-randomized pre-post intervention with a comparison group. Forty BC survivors were recruited using a convenience sampling approach; of these, 20 were subsequently allocated to the intervention (FPE group) and 20 to the comparison group. Participants were assessed at pretest and posttest (3 weeks later) using self-reported measures of body image, coping, self-esteem, and self-efficacy. Independent samples t-tests compared group composition at pretest. Mixed between-within 2 × 2 repeated-measures ANOVAs examined pretest-posttest changes in the variables of interest. RESULTS No differences were detected between groups at pretest. A significant interaction effect on body image, problem-focused coping, emotion-focused coping, and in self-efficacy competence subscale (p < 0.05) was identified. Post hoc pairwise comparisons with the Bonferroni correction indicated improvement on these domains in the FPE group vs. comparison group. Additionally, significant main effects of time on self-efficacy total score and magnitude subscale (p < 0.05) were found. CONCLUSIONS Preliminary results support the efficacy of FPE, but further research is needed. IMPLICATIONS FOR CANCER SURVIVORS Existential approaches inclusive of self-portraits and illness narratives can be utilized to support BC survivors in the management of the psychological consequences of the illness.
Collapse
Affiliation(s)
- Denise Vagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
| | - Antonia Sorge
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, USA
- Department of Clinical Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA
- Department of Health Disparities Research, The UT MD Anderson Cancer Center, Houston, TX, USA
| | | | - Emanuela Saita
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| |
Collapse
|
18
|
Graboyes EM, Kistner-Griffin E, Hill EG, Maurer S, Balliet W, Williams AM, Padgett L, Yan F, Rush A, Johnson B, McLeod T, Dahne J, Ruggiero KJ, Sterba KR. Efficacy of a Brief Cognitive Behavioral Therapy for Head and Neck Cancer Survivors with Body Image Distress: Secondary Outcomes from the BRIGHT Pilot Randomized Clinical Trial. RESEARCH SQUARE 2023:rs.3.rs-3222601. [PMID: 37609318 PMCID: PMC10441452 DOI: 10.21203/rs.3.rs-3222601/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Purpose: Body image distress (BID) among head and neck cancer (HNC) survivors leads to depression, social isolation, stigma, and poor quality of life. BRIGHT ( B uilding a R enewed I ma G e after H ead & neck cancer T reatment) is a brief, tailored cognitive behavioral therapy (CBT) that reduces HNC-related BID. This trial examines the effect of BRIGHT on psychosocial outcomes among HNC survivors with BID. Methods: In this pilot randomized trial, HNC survivors with clinically significant BID were randomized to 5 weekly psychologist-led tele-CBT sessions (BRIGHT) or dose-and delivery matched survivorship education (attention control [AC]). Secondary psychosocial outcomes were assessed using validated patient-reported outcomes at baseline and 1- and 3-months post-intervention. Results: Among 44 HNC survivors with BID, BRIGHT resulted in a greater reduction in depression relative to AC (mean model-based 1-month difference in Δ PROMIS SF v1.0-Depression 8a score, -3.4; 90% CI, -6.4 to -0.4; 3-month difference, -4.3; 90% CI, -7.8 to -0.8). BRIGHT also decreased shame and stigma relative to AC (mean model-based 3-month difference in Δ Shame and Stigma Scale score, -9.7; 90% CI, -15.2 to -4.2) and social isolation (mean model-based 3-month difference in Δ PROMIS SF v2.0 Social Isolation 8a score, -2.9; 90% CI, -5.8 to -0.1). Conclusions: In this planned secondary analysis of a pilot RCT, BRIGHT improved a broad array of psychosocial outcomes among HNC survivors with BID. Implications for Cancer Survivors: These promising preliminary data suggest the need for a large efficacy trial evaluating the effect of BRIGHT on psychosocial outcomes among HNC survivors with BID. Trial Registration: ClinicalTrials.gov identifier: NCT03831100.
Collapse
|
19
|
Chow PI, Sheffield C, Cohn WF. Evaluating the impact of patients' psychological and physical problems on their interest in participating in research at a cancer center with a rural catchment area. Contemp Clin Trials 2023; 131:107245. [PMID: 37257725 PMCID: PMC10527526 DOI: 10.1016/j.cct.2023.107245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Cancer patients' participation in research trials is essential to improving their care and treatment. In a large sample of adults recently diagnosed with cancer, the aim of the current study is to investigate the relationship between cancer patients' interest in research and the psychological and physical problems they experience resulting from their cancer diagnosis. METHOD We analyzed data from 906 cancer patients collected during routine clinical care. Correlational analyses focused on the relationship between patients' psychological and physical problems and their interest in research. Hierarchical binary logistic regression analyses tested whether patients' psychological/physical problems as a block predicted their interest in research, above and beyond their sociodemographic characteristics. RESULTS Higher levels of patients' anxiety, fear of cancer treatment, difficulty managing emotions, worry, suicidal/homicidal ideation, fatigue, problems related to physical appearance, sleep difficulty, and changes to weight/appetite, were associated with a greater interest in research. Patients' psychological/physical problems, as a block, incrementally predicted their interest in research (Δχ2 = 24.34, df = 14, p = .04, Δr2=0.05), though none of the individual psychological/physical problems were found to be significant predictors. A higher level of education was significantly positively associated with an increased likelihood of being interested in research (OR = 1.26, 95%CI = 1.09, 1.46, p = .001). CONCLUSION Cancer patients' problems stemming from their diagnosis can be important factors in their decision to participate in research. Depending on the needs of the trial in question, researchers may want to account for patients' level of symptom burden in deciding who to approach for enrollment in a research trial.
Collapse
Affiliation(s)
- Philip I Chow
- University of Virginia School of Medicine, Charlottesville, VA, USA; University of Virginia Cancer Center, Charlottesville, VA, USA.
| | - Christina Sheffield
- University of Virginia Cancer Center, Charlottesville, VA, USA; University of Virginia Health System, Charlottesville, VA, USA
| | - Wendy F Cohn
- University of Virginia School of Medicine, Charlottesville, VA, USA; University of Virginia Cancer Center, Charlottesville, VA, USA
| |
Collapse
|
20
|
Graboyes EM, Barbon CEA. Optimizing Function and Appearance After Head and Neck Reconstruction: Measurement and Intervention. Otolaryngol Clin North Am 2023:S0030-6665(23)00074-9. [PMID: 37246027 DOI: 10.1016/j.otc.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Approximately 50% of head and neck cancer (HNC) survivors are left with dysphagia as a result of treatment sequele, and 25% of survivors experience clinically significant body image distress (BID). Both dysphagia and BID adversely affect quality of life and should be tracked using validated clinician- and patient-reported outcome measures such as the Performance Status Scale for Head and Neck Cancer, MD Anderson Dysphagia Inventory, and Inventory to Measure and Assess imaGe disturbancE-Head & Neck (IMAGE-HN). Subjective and objective evaluation measures are critical to dysphagia workup and management. Building a renewed image after head and neck cancer treatment, a brief telemedicine-based cognitive behavioral therapy, has become the first evidence-based treatment for BID among HNC survivors.
Collapse
Affiliation(s)
- Evan M Graboyes
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425, USA; Department of Public Health Sciences, Medical University of South Carolina
| | - Carly E A Barbon
- Department of Head & Neck Surgery, University of Texas MD Anderson Cancer Center, Unit 1445, 1515 Holcombe Boulevard, Houston, TX 77030-400, USA.
| |
Collapse
|
21
|
Reis AD, Pereira PTVT, Filha JGLC, Rodrigues EF, Laranjeira IP, Ramallo BT, Castro MRD, Rossi FE, Júnior IFF, Garcia JBS. Effect of Combined Training on Body Image, Body Composition and Functional Capacity in Patients with Breast Cancer: Controlled Clinical Trial. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2023; 45:242-252. [PMID: 37339643 PMCID: PMC10281770 DOI: 10.1055/s-0043-1770126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
OBJECTIVE Evaluate the effect of combined training on body image (BI), body composition and functional capacity in patients with breast cancer. As also the relationship of BI with body composition and functional capacity. METHODS This was a Controlled Clinical Trial study, this study including 26 patients with breast cancer (30 to 59 years). The training group (n = 13) underwent 12 weeks of training, including three 60-min sessions of aerobic exercise and resistance training, and two sessions of flexibility training per week; each flexibility exercise lasted 20s. The Control Group (n = 13) received only the standard hospital treatment. Participants were evaluated at baseline and after 12 weeks. BI (primary outcomes) was assessed using the Body Image After Breast Cancer Questionnaire; Body composition was estimated with the indicators: Body mass index; Weight, Waist hip Ratio; Waist height ratio; Conicity index; Reciprocal ponderal index; Percentage of fat; Circumference of the abdomen and waist; Functional capacity by cardiorespiratory fitness (cycle ergometer) and strength (manual dynamometer). The statistic was performed in the Biostatistics and Stata 14.0 (α = 5%). RESULTS The patients in the training group showed a reduction in the limitation dimension (p = 0.036) on BI, However, an increase in waist circumference was observed in both groups. In addition an increase in VO2max (p < 0.001) and strength in the right (p = 0.005) and left arms (p = 0.033). CONCLUSION Combined training demonstrates to be an effective and non-pharmacological strategy to patients with breast cancer, with improvement on BI and functional capacity, changing related variables negatively when there is no physical training.
Collapse
|
22
|
Zhu F, Zhang W, Liu C, Qiang W, Lu Q. Association of self-compassion and body image disturbance among young breast cancer patients: Mediating effect of body surveillance and body shame. Asia Pac J Oncol Nurs 2023; 10:100199. [PMID: 36923469 PMCID: PMC10009058 DOI: 10.1016/j.apjon.2023.100199] [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: 10/19/2022] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
Objective To examine whether body surveillance and body shame mediated the association between self-compassion and body image disturbance among young breast cancer patients. Methods In this cross-sectional descriptive study, a total of 310 young women with breast cancer were recruited by convenience sampling. All of them completed self-report measurements of demographic and clinical characteristics, self-compassion scale, body image self-rating questionnaire for breast cancer and body surveillance scale, and body shame scale between September and December 2021 at a tertiary cancer hospital in Tianjin, China. Data analysis was performed with correlation analysis and structural equation modeling to verify relationships between key variables. Results Less self-compassion was significantly associated with greater body image disturbance, while a positive correlation was found between body image disturbance, body surveillance, and body shame. Self-compassion indirectly negative predicted body image disturbance via the chain mediation of body surveillance and body shame. Conclusions The links of self-compassion and body image disturbance were mediated by body surveillance and body shame. Reducing patients' excessive body surveillance and body shame by improving their ability of self-compassion may be an effective measure to reduce body image disturbance.
Collapse
Affiliation(s)
- Fei Zhu
- School of Nursing, Hebei University, Baoding, Hebei Province, China
| | - Wan Zhang
- School of Nursing, Hebei University, Baoding, Hebei Province, China
| | - Chunlei Liu
- School of Nursing, Hebei University, Baoding, Hebei Province, China
| | - Wanmin Qiang
- Nursing Department, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Qian Lu
- Division of Medical & Surgical Nursing, School of Nursing, Peking University, Beijing, China
| |
Collapse
|
23
|
Boing L, de Bem Fretta T, Stein F, Lyra VB, Moratelli JA, da Silveira J, Dos Santos Saraiva PS, Bergmann A, Lynch BM, de Azevedo Guimarães AC. Can mat Pilates and belly dance be effective in improving body image, self-esteem, and sexual function in patients undergoing hormonal treatment for breast cancer? A randomized clinical trial. Arch Womens Ment Health 2023; 26:141-151. [PMID: 36715766 DOI: 10.1007/s00737-023-01294-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/18/2023] [Indexed: 01/31/2023]
Abstract
The purpose of this study is to examine the effects of a 16-week exercise intervention (mat Pilates or belly dance) on body image, self-esteem and sexual function in breast cancer survivors receiving hormone therapy. Seventy-four breast cancer survivors were randomly allocated into mat Pilates, belly dance, or control group. The physical activity groups received a 16-week intervention, delivered 3 days a week, and 60 min a session. The control group received three education sessions. Data collection occurred at baseline, post-intervention, 6 and 12 months of follow-up with a questionnaire including body image (Body Image After Breast Cancer Questionnaire), self-esteem (Rosenberg Self-Esteem Scale), and sexual function (Female Sexual Function Index) measures. The belly dance group significantly improved body image on limitations scale in the short term and long term, the mat Pilates significantly improved body image on limitations only in the long term, and the control group significantly decreased body image on limitations in the long term. The belly dance group experienced reduced discomfort and pain during sexual relations in the short and long term. All groups showed a significant improvement in self-esteem, but orgasm sub-scale scores declined over time. No adverse events were found for any of the exercise intervention groups. Belly dance seem to be more effective than mat Pilates and control group in improving limitations of body image and sexual discomfort in the short term for breast cancer survivors. ClinicalTrials.gov (NCT03194997) - "Pilates and Dance to Breast Cancer Patients Undergoing Treatment".
Collapse
Affiliation(s)
- Leonessa Boing
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | | | - Francine Stein
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil
| | - Vanessa Bellani Lyra
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil
| | - Jéssica Amaro Moratelli
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil
| | - Juliana da Silveira
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil.
| | - Patrícia Severo Dos Santos Saraiva
- College of Health and Sport Science, Santa Catarina State University, Pascoal Simone, 358 - Coqueiros, 88080350, Florianopolis, SC, Brazil
| | - Anke Bergmann
- Clinical Epidemiology, National Institute of Cancer, Rio de Janeiro, Brazil
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | | |
Collapse
|
24
|
Gresham MS, Mann H, Ward GM, Payne MA. Gender differences in the laryngectomee experience. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:406-418. [PMID: 36398466 DOI: 10.1111/1460-6984.12797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Laryngectomy is a pivotal event in patients. lives, with pervasive and far-reaching effects. Understanding gender differences in these effects may improve care of laryngectomy patients. This paper describes gender differences in the experience after laryngectomy. AIM To explore the similarities and differences in the laryngectomee experience based on gender. METHODS & PROCEDURES Four gender-matched focus groups were conducted; dialogue was audio recorded, transcribed and studied using interpretative phenomenological analysis (IPA). OUTCOMES & RESULTS A total of 17 laryngectomees, eight female and nine male, age range 41-80 years, participated in focus groups. Laryngectomy represented a turning point in the lives of both genders. Four themes emerged: perception of loss, adjusting to alaryngeal communication, finding a positive outlook and re-establishing the self. Themes applied to both genders, with subthemes demonstrating similarities and differences between men and women. CONCLUSIONS & IMPLICATIONS Men and women experienced destabilization after laryngectomy related to perceived losses and shifts in identity. Men described navigating from physical disability toward recovery of function, while women described an emotional journey concerning loss and rediscovery of meaning in their lives. Understanding the laryngectomee experience in better detail, which includes recognizing gender differences and rejecting a one-size-fits-all approach, may facilitate more effective preoperative counselling and post-operative support from providers. WHAT THIS PAPER ADDS What is already known on the subject Patients who undergo total laryngectomy often struggle with problems with physical, emotional, and social functioning and decreased quality of life. As the literature currently stands, the understanding of the experience of laryngectomees has primarily focused on the perspective of a singular gender. Thus, this is the first qualitative study specifically investigating differences in the laryngectomee experience between men and women. What this paper adds to existing knowledge This study finds that women and men both endorse significant mental and physical changes following laryngectomy; however, their perception of their experience differed by gender. Women endorsed alteration to meaningful life and men demonstrated distress related to loss of physical functioning; both genders described laryngectomy as a formative event that helped them rediscover joy and redefine themselves for the better. What are the potential or actual clinical implications of this work? Our findings suggest men and women have distinct mental and emotional struggles after laryngectomy despite similar physical changes. This suggests that tailoring care with consideration of these gender differences, including preoperative counselling, post-operative support and gender-matched visitors or support groups, may help beneficial in recovery after laryngectomy.
Collapse
Affiliation(s)
| | - Hayley Mann
- University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | | | | |
Collapse
|
25
|
Chu Q, Wong CCY, He G, Yang J, Chen C, He Y. Walking activity and emotional distress among breast cancer survivors: the parallel mediating effects of posttraumatic growth and body image. Support Care Cancer 2023; 31:180. [PMID: 36820904 DOI: 10.1007/s00520-023-07640-7] [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: 09/02/2022] [Accepted: 02/13/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE Although the antidepressant effects of physical activity have been well established, the underlying psychological mechanisms are understudied among cancer survivors. The present study aims to examine the parallel mediating effects of posttraumatic growth and body image on the association between walking activity and emotional distress (anxiety and depression) among Chinese breast cancer survivors. METHODS Chinese breast cancer survivors (n = 235) completed a cross-sectional questionnaire that assessed walking activity, anxiety, depression, posttraumatic growth, and body image over the past week. Path analysis was conducted to test the hypothesized mediation model. RESULTS The hypothesized model was supported: walking activity was positively associated with posttraumatic growth and body image satisfaction, which were then negatively associated with anxiety and depression. After controlling for the mediators, the direct effect of physical activity on depression was still significant, whereas the direct effect of physical activity on anxiety was no longer significant. CONCLUSION Our findings suggest that posttraumatic growth and body image may be essential psychological pathways underlying the association between walking activity and emotional distress among Chinese breast cancer survivors. Researchers and health practitioners should consider supplementing physical activity interventions with mental health services that facilitate psychological growth and a positive body image to enhance the potential psychological benefits of physical activity.
Collapse
Affiliation(s)
- Qiao Chu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227 South Chongqing Rd, Shanghai, 200025, China
| | - Celia C Y Wong
- College of Brockport, State University of New York, Brockport, NY, USA
| | - Gan He
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227 South Chongqing Rd, Shanghai, 200025, China
| | - Jinhuan Yang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227 South Chongqing Rd, Shanghai, 200025, China
| | - Chen Chen
- Shanghai Jing'an District Jiangning Road Community Health Service Center, Shanghai, 200040, China.
| | - Yaping He
- School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227 South Chongqing Rd, Shanghai, 200025, China. .,Center for Health Technology Assessment, Shanghai Jiao Tong University China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China.
| |
Collapse
|
26
|
Ahn J, Suh EE. Body acceptance in women with breast cancer: A concept analysis using a hybrid model. Eur J Oncol Nurs 2023; 62:102269. [PMID: 36709718 DOI: 10.1016/j.ejon.2023.102269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/20/2023] [Indexed: 01/23/2023]
Abstract
BACKGROUND Women with breast cancer undergo drastic physical changes which can impact their body image. Accepting the altered body has recently been highlighted as the key to body image improvement, however, there is no clear definition or conceptualization of it. This study clarified the concept of body acceptance in women with breast cancer, using a hybrid model. METHODS In the theoretical phase, the attributes and working definitions of the concept were identified through an extensive literature review. Individual in-depth interviews were conducted during the fieldwork phase to elucidate the concept and verify the attributes derived from the theoretical phase. Finally, in the final analytic phase, the findings were compared and integrated. RESULTS The theoretical and fieldwork phases included 20 out of the 579 articles extracted from the literature search and five women who had undergone breast cancer surgery, respectively. Body acceptance was defined as "acknowledging, normalizing, and overcoming changes in body appearance and function caused by breast cancer and its treatment". CONCLUSIONS Body acceptance has been identified as a key factor directly related to the overall quality of life. This study provides a theoretical basis for developing effective interventions and consequently facilitates their provision in practice.
Collapse
Affiliation(s)
- Jeonghee Ahn
- College of Nursing, Seoul National Univeristy, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Eunyoung E Suh
- College of Nursing, Research Institute of Nursing Science, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| |
Collapse
|
27
|
Wang H, Nicklaus K, Jewett E, Rehani E, Chen TA, Engelmann J, Bordes MC, Chopra D, Reece GP, Lee ZH, Markey MK. Assessing saliency models of observers' visual attention on acquired facial differences. J Med Imaging (Bellingham) 2023; 10:S11908. [PMID: 37091297 PMCID: PMC10118307 DOI: 10.1117/1.jmi.10.s1.s11908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/03/2023] [Indexed: 04/25/2023] Open
Abstract
Purpose Saliency models that predict observers' visual attention to facial differences could enable psychosocial interventions to help patients and their families anticipate staring behaviors. The purpose of this study was to assess the ability of existing saliency models to predict observers' visual attention to acquired facial differences arising from head and neck cancer and its treatment. Approach Saliency maps predicted by graph-based visual saliency (GBVS), an artificial neural network (ANN), and a face-specific model were compared to observer fixation maps generated from eye-tracking of lay observers presented with clinical facial photographs of patients with a visible or functional impairment manifesting in the head and neck region. We used a linear mixed-effects model to investigate observer and stimulus factors associated with the saliency models' accuracy. Results The GBVS model predicted many irrelevant regions (e.g., shirt collars) as being salient. The ANN model underestimated observers' attention to facial differences relative to the central region of the face. Compared with GBVS and ANN, the face-specific saliency model was more accurate on this task; however, the face-specific model underestimated the saliency of deviations from the typical structure of human faces. The linear mixed-effects model revealed that the location of the facial difference (midface versus periphery) was significantly associated with saliency model performance. Model performance was also significantly impacted by interobserver variability. Conclusions Existing saliency models are not adequate for predicting observers' visual attention to facial differences. Extensions of face-specific saliency models are needed to accurately predict the saliency of acquired facial differences arising from head and neck cancer and its treatment.
Collapse
Affiliation(s)
- Haoqi Wang
- The University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
- The University of Texas MD Anderson Cancer Center, Department of Plastic Surgery, Houston, Texas, United States
| | - Krista Nicklaus
- The University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
- The University of Texas MD Anderson Cancer Center, Department of Plastic Surgery, Houston, Texas, United States
| | - Eloise Jewett
- The University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Eeshaan Rehani
- The University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
| | - Tzuan A. Chen
- University of Houston, HEALTH Research Institute, Houston, Texas, United States
- University of Houston, Department of Psychological, Health, and Learning Sciences, Houston, Texas, United States
| | - Jeff Engelmann
- Rogers Behavioral Health, Oconomowoc, Wisconsin, United States
| | - Mary Catherine Bordes
- The University of Texas MD Anderson Cancer Center, Department of Plastic Surgery, Houston, Texas, United States
| | - Deepti Chopra
- The University of Texas MD Anderson Cancer Center, Department of Psychiatry, Houston, Texas, United States
| | - Gregory P. Reece
- The University of Texas MD Anderson Cancer Center, Department of Plastic Surgery, Houston, Texas, United States
| | - Z-Hye Lee
- The University of Texas MD Anderson Cancer Center, Department of Plastic Surgery, Houston, Texas, United States
| | - Mia K. Markey
- The University of Texas at Austin, Department of Biomedical Engineering, Austin, Texas, United States
- The University of Texas MD Anderson Cancer Center, Department of Imaging Physics, Houston, Texas, United States
| |
Collapse
|
28
|
Abakay H, Dogan H, Atilabey Güç A, Talay Çalış H. Association of lower extremity lymphedema with pelvic floor functions, sleep quality, kinesiophobia, body image in patients with gynecological cancers. Women Health 2023; 63:27-34. [PMID: 36514896 DOI: 10.1080/03630242.2022.2155900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The aim was to investigate the relationship between lower extremity lymphedema and pelvic floor functions, sleep quality, kinesiophobia, body image in patients with gynecological cancer the effect of lymphedema severity on pelvic floor dysfunction (PFD), sleep quality, fear of movement, and body image in patients with lower extremity lymphedema after gynecologic cancer. A total of 103 patients (52 patients with lymphedema and 51 patients without lymphedema) after gynecologic cancer surgery were included in March-June 2022. Bilateral circumferential measurements were taken with a tape measure at different levels to create groups. These measurements determined limb volumes by summing segment volumes derived from the truncated cone formula. For data collection, all patients were presented with the Gynecologic Cancer Lymphedema Questionnaire (GCLQ), the Global Pelvic Floor Bother Questionnaire (GPFBQ), the Pittsburgh Sleep Quality Index (PSQI), the Tampa Scale of Kinesiophobia (TSK) and the Body Image Scale (BIS) one time. The severity of lymphedema symptoms was quite high in patients with lymphedema (GCLQ Total: 13.6) (p < .05). Patients with lymphedema had higher GCLQ total scores, GPFBQ1 (stress urinary incontinence), GPFBQ4 (urge urinary incontinence), GPFBQ8 (fecal incontinence), kinesiophobia and, body image scores than patients without lymphedema (p < .05). The sleep quality levels of patients with lymphedema and patients without lymphedema were similar (p > .05). A significant negative correlation was found between GLCQ total score and body image (p < .05). There was a positive correlation between kinesiophobia and pelvic floor symptoms and a negative correlation between kinesiophobia and body image (p < .05). In this study, it was observed that in patients who developed lymphedema after gynecologic cancer surgery, pelvic floor symptoms and kinesiophobia increased and the severity of lymphedema negatively affected body image. Reducing lymphedema in these patients may improve pelvic floor health, mobility, and body image.
Collapse
Affiliation(s)
- Hanife Abakay
- Sarikaya School of Physiotherapy and Rehabilitation, Yozgat Bozok University, Yozgat, Turkey
| | - Hanife Dogan
- Sarikaya School of Physiotherapy and Rehabilitation, Yozgat Bozok University, Yozgat, Turkey
| | | | | |
Collapse
|
29
|
Grossert A, Meffert C, Hess V, Rochlitz C, Pless M, Hunziker S, Wössmer B, Geuter U, Meinlschmidt G, Schaefert R. Group-based body psychotherapy improves appreciation of body awareness in post-treatment cancer patients: A non-randomized clinical trial. Front Psychol 2023; 14:956493. [PMID: 37089722 PMCID: PMC10117640 DOI: 10.3389/fpsyg.2023.956493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 03/13/2023] [Indexed: 04/25/2023] Open
Abstract
Introduction Cancer-related impairments often co-occur with bodily disturbances. Body psychotherapy (BPT) can improve bodily wellbeing, yet evidence in cancer survivors is scarce. Hence, we aimed to evaluate whether blended group BPT alleviates bodily disturbances in post-treatment cancer patients. Methods We conducted a bi-center study (registered in ClinicalTrials.gov, under No. NCT03707548), applying a pre-post convergent parallel design of weekly group BPT interspersed with smartphone-based ambulatory interventions using a waiting-period comparator. We included patients with completed curatively intended treatment for malignant neoplasms, suffering from bodily disturbances. The primary outcome was body image disturbances. Secondary outcomes were experiencing and appreciating body awareness, mental wellbeing, and health-related quality of life. Results Forty patients (mean age 51.7 years) attended group BPT. Mixed-effect linear regression models contrasting intervention with the waiting period did not show statistically significant differences regarding the primary outcome [Pre-post difference contrasts: 1.44, 95% confidence interval (CI): -1.51 to 4.93, p = 0.339]. However, patients showed greater improvements in appreciating body awareness, measured by the "Body Mindfulness Questionnaire" (BMQ), from pre- to post-intervention as compared to the waiting period (pre-post difference contrasts: 7.31 95% CI: 4.15-10.47, Bonferroni-Holm corrected q = 0.0002). Discussion We found no evidence that blended group BPT was effective in improving body image disturbances in post-treatment cancer patients, but found indications for an increase in body awareness appreciation. Clinical trial registration ClinicalTrials.gov, identifier NCT03707548.
Collapse
Affiliation(s)
- Astrid Grossert
- Department of Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Basel, Switzerland
- Medical Center of Oncology and Hematology, Department of Psycho-Oncology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Cornelia Meffert
- Department of Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Viviane Hess
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Christoph Rochlitz
- Department of Medical Oncology, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Miklos Pless
- Department of Medical Oncology, Winterthur Cantonal Hospital, Winterthur, Switzerland
| | - Sabina Hunziker
- Department of Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Brigitta Wössmer
- Department of Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Outpatient Clinic for Psychotherapy, Olten, Switzerland
| | - Ulfried Geuter
- Institute for Sports and Motology, University of Marburg, Marburg, Germany
| | - Gunther Meinlschmidt
- Department of Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
- Department of Digital and Blended Psychosomatics and Psychotherapy, Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Division of Clinical Psychology and Cognitive Behavioral Therapy, International Psychoanalytic University Berlin, Berlin, Germany
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Rainer Schaefert
- Department of Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
- *Correspondence: Rainer Schaefert, ; orcid.org/0000-0002-3077-7289
| |
Collapse
|
30
|
Graboyes EM, Maurer S, Balliet W, Li H, Williams AM, Osazuwa-Peters N, Yan F, Padgett L, Rush A, Ruggiero KJ, Sterba KR. Efficacy of a Brief Tele-Cognitive Behavioral Treatment vs Attention Control for Head and Neck Cancer Survivors With Body Image Distress: A Pilot Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2023; 149:54-62. [PMID: 36454561 PMCID: PMC9716435 DOI: 10.1001/jamaoto.2022.3700] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 10/01/2022] [Indexed: 12/05/2022]
Abstract
Importance Although 1 in 4 head and neck cancer (HNC) survivors experience clinically significant body image distress (BID), a psychosocial morbidity that adversely affects quality of life, effective interventions for these patients are lacking. Objective To evaluate the acceptability and preliminary efficacy of BRIGHT (Building a Renewed ImaGe after Head and neck cancer Treatment), a brief tele-cognitive behavioral therapy, at reducing BID among HNC survivors. Design, Setting, and Participants This parallel-group pilot randomized clinical trial recruited adult HNC survivors with BID between August 13, 2020, and December 9, 2021, from the Medical University of South Carolina HNC clinic during a routine survivorship encounter. Data were analyzed from May 3 to June 16, 2022. Interventions BRIGHT consisted of 5 weekly psychologist-led video tele-cognitive behavioral therapy sessions. Attention control (AC) consisted of dose- and delivery-matched survivorship education. Main Outcomes and Measures Change in HNC-related BID was assessed using IMAGE-HN (Inventory to Measure and Assess imaGe disturbancE-Head and Neck), a validated patient-reported outcome (score range, 0-84, with higher scores indicating greater HNC-related BID). Clinical response rate was measured as the proportion of patients with a clinically meaningful change in IMAGE-HN scores. Results Of the 44 HNC survivors with BID allocated to BRIGHT (n = 20) or AC (n = 24), the median (range) age was 63 (41-80) years, and 27 patients (61%) were female. Patients rated BRIGHT's acceptability highly (all metrics had a mean rating of ≥4.5/5), and 19 of 20 patients (95%) receiving BRIGHT were likely or highly likely to recommend it to other HNC survivors with BID. BRIGHT decreased HNC-related BID from baseline to 1 month postintervention relative to AC (mean model-based difference in change in IMAGE-HN score, -7.9 points; 90% CI, -15.9 to 0.0 points) and from baseline to 3 months postintervention relative to AC (mean model-based difference in change in IMAGE-HN score, -17.1 points; 90% CI, -25.6 to -8.6 points). At 3 months postintervention, the clinical response rate of BRIGHT was 6.6-fold higher than AC (model-based odds ratio, 6.6; 90% CI, 2.0-21.8). The improvement in HNC-related BID for BRIGHT vs AC at 3 months was clinically significant, and the effect size was large (Cohen d, -0.9; 90% CI, -1.4 to -0.4). Conclusions and Relevance In this pilot randomized clinical trial, BRIGHT was acceptable, may result in a clinically meaningful improvement in HNC-related BID, and showed a high clinical response rate. These promising preliminary data support conducting a large efficacy trial to establish BRIGHT as the first evidence-based treatment for HNC survivors with BID. Trial Registration ClinicalTrials.gov Identifier: NCT03831100.
Collapse
Affiliation(s)
- Evan M. Graboyes
- Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Medical University of South Carolina, Charleston
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston
| | - Stacey Maurer
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston
| | - Wendy Balliet
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston
| | - Hong Li
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston
| | - Amy M. Williams
- Department of Family Medicine, Henry Ford Health, Detroit, Michigan
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Flora Yan
- Department of Otolaryngology–Head and Neck Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Lynne Padgett
- Office of Research and Development, US Department of Veteran Affairs, Washington, DC
| | - Angie Rush
- Head and Neck Cancer Alliance, Charleston, South Carolina
| | | | - Katherine R. Sterba
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston
| |
Collapse
|
31
|
Giantsoudi D, Lalonde A, Barra C, Vanbenthuysen L, Taghian AG, Gierga DP, Jimenez RB. Tattoo-Free Setup for Patients With Breast Cancer Receiving Regional Nodal Irradiation. Pract Radiat Oncol 2023; 13:e20-e27. [PMID: 35948179 DOI: 10.1016/j.prro.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE Patients undergoing regional nodal irradiation (RNI) with either 3-dimensional conformal radiation therapy (3DCRT) planning or volumetric modulated arc therapy (VMAT) receive permanent tattoos to assist with daily setup alignment and verification. With the advent of surface imaging, tattoos may not be necessary to ensure setup accuracy. We compared the accuracy of conventional tattoo-based setups to those without reference to tattoos. METHODS AND MATERIALS Forty-eight patients receiving RNI at our institution from July 2019 to December 2020 were identified. All patients received tattoos per standard of care. Twenty-four patients underwent setup using tattoos for initial positioning followed by surface and x-ray imaging. A subsequent 24 patients underwent positioning using surface imaging followed by x-ray imaging without reference to tattoos. Patient cohorts were balanced by treatment technique and use of deep inspiration breath hold. Treatment (including setup and delivery) time and x-ray-based shifts after surface imaging were recorded. RESULTS Among patients in the tattoo group receiving 3DCRT RNI, the average treatment time per fraction was 21.35 versus 19.75 minutes in the 3DCRT RNI no-tattoo cohort (P = .03). Mean 3D vector shifts for patients in the tattoo cohort were 5.6 versus 4.4 mm in the no-tattoo cohort. The average treatment time per fraction for the tattoo VMAT RNI cohort was 23.16 versus 20.82 minutes in the no-tattoo VMAT RNI cohort (P = .08). Mean 3D vector shifts for the patients in the tattoo VMAT cohort were 5.5 versus 7.1 mm in the no-tattoo VMAT cohort. Breath hold technique and body mass index did not affect accuracy in a consistent or clinically relevant way. CONCLUSIONS Using a combination of surface and x-ray imaging, without reference to tattoos, provides excellent accuracy in alignment and setup verification among patients receiving RNI for breast cancer, regardless of treatment technique and with reduced treatment time. Skin-based tattoos are no longer warranted for patients receiving supine RNI.
Collapse
Affiliation(s)
- Drosoula Giantsoudi
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Arthur Lalonde
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Colleen Barra
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Liam Vanbenthuysen
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Alphonse G Taghian
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - David P Gierga
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Rachel B Jimenez
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
| |
Collapse
|
32
|
Validation of the Japanese version of the Body Image Scale for bladder cancer patients. Sci Rep 2022; 12:21544. [PMID: 36513724 PMCID: PMC9747706 DOI: 10.1038/s41598-022-25669-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
The Body Image Scale (BIS) is a 10-item tool that measures the body images of cancer patients. This study aims to validate the Japanese version of the BIS for bladder cancer patients. A multicenter cross-sectional survey was used to identify the participants, which included Japanese bladder cancer patients. The percentage of missing responses, internal consistency, and known-group validity were evaluated. The correlations between the BIS and two HRQOL instruments (the Bladder Cancer Index and the SF-12) were assessed to determine convergent validity. Among 397 patients, 221 patients were treated by transurethral resection of bladder tumor (TURBT) endoscopically, 49 patients underwent cystectomy with neobladder, and 127 patients underwent cystectomy involving stoma. The percentage of missing responses in the BIS ranged from 8.1 to 15.6%. Cronbach's α coefficient was 0.924. Higher BIS scores indicate negative body image, and the median BIS score for patients with native bladders after TURBT (0.5) was significantly lower than those of the patients with neobladder (4.0) and stoma formation (7.0), which indicated the discriminatory ability of the BIS. Each domain of the Bladder Cancer Index and the role summary score of the SF-12 correlated to the BIS scores, which confirmed the convergent validity. A range of BIS scores were identified among patients who reported similar physical summary scores and mental summary scores of the SF-12. This study confirmed the reliability and validity of the Japanese version of the BIS for bladder cancer patients.
Collapse
|
33
|
Samela T, Bartoletti R, Antinone V, Aloisi D, Papanikolaou ES, Quintavalle C, De Galitiis F, Abeni D, Marchetti P. Cross-Cultural Adaptation and Preliminary Validation of Upper Limb Lymphedema Quality of Life Questionnaire (ULL-27) in Italian Female Patients with Breast Cancer-Related Lymphedema. Lymphat Res Biol 2022; 20:651-658. [PMID: 35404129 DOI: 10.1089/lrb.2021.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose: Lymphedema is one of the most recurrent problems reported by breast cancer survivors, which negatively affects quality of life (QoL). The Upper Limb Lymphedema Quality of Life Questionnaire (ULL-27) is a tool that assesses the QoL in patients with breast cancer-related lymphedema. At present, an Italian adaptation does not exist. The aim of this study is to perform a preliminary cross-cultural validation of the Italian version of the ULL-27. Materials and Methods: A forward-backward translation and cross-cultural adaptation have been performed. One hundred twenty women with lymphedema were evaluated using the Italian version of the ULL-27. The mean age was 60.25 (±11.88) years, and mean body-mass index was 26.35 (5.13) kg/m2. The Functional Assessment of Cancer Therapy-Breast (FACT-B) was analyzed using Pearson's correlation analysis with the ULL-27 to indicate convergent and external construct validity. Cronbach's alpha and factor analysis were used to assess the questionnaire's structure. Results: The internal consistency for the total score of the Italian ULL-27 was high (0.90). Content validity was good because items were understandable for all participants. The alpha coefficients for subscale scores were high. External construct validity was confirmed by expected correlations with comparator scales. However, the factor structure of ULL-27 does not seem to completely reflect the original scale. Conclusions: The Italian version of ULL-27 has good internal consistency and validity. It is a reliable tool for evaluating the QoL of these patients, but additional data should be collected to clarify the factorial structure and test-retest reliability of the scale.
Collapse
Affiliation(s)
- Tonia Samela
- IDI-IRCCS, Istituto Dermopatico dell'Immacolata, Rome, Italy
| | | | | | - Daniele Aloisi
- IDI-IRCCS, Istituto Dermopatico dell'Immacolata, Rome, Italy
| | | | | | | | - Damiano Abeni
- IDI-IRCCS, Istituto Dermopatico dell'Immacolata, Rome, Italy
| | - Paolo Marchetti
- IDI-IRCCS, Istituto Dermopatico dell'Immacolata, Rome, Italy
| |
Collapse
|
34
|
Dunne S, Fitch M, Semple C. Editorial: Body image following cancer treatment. Front Psychol 2022; 13:1068977. [DOI: 10.3389/fpsyg.2022.1068977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
|
35
|
A Negative Body Image among Adolescent and Young Adult (AYA) Cancer Survivors: Results from the Population-Based SURVAYA Study. Cancers (Basel) 2022; 14:cancers14215243. [PMID: 36358662 PMCID: PMC9655157 DOI: 10.3390/cancers14215243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 12/05/2022] Open
Abstract
Simple Summary Adolescent and young adult (AYA) cancer survivors diagnosed with cancer between ages 18–39 years often experience negative body changes, such as scars, amputation, hair loss, disfigurement, body weight changes, skin buns, and physical movement limitations. A negative body image could have negative implications for the self-esteem, self-identity, and social relationships of AYAs. Despite the possible long-term effects of cancer on body image, within the AYA literature, limited studies focus on AYA cancer survivors in a quantitative way. Therefore, the aim of our population-based cross-sectional study was to examine the prevalence, and association of a negative body image with sociodemographic, clinical, and psychosocial factors, among AYA survivors 5–20 years after diagnosis. Raising awareness and integrating supportive care for those who experience a negative body image into standard AYA survivorship care is warranted. Future longitudinal research could help to identify when and how this support for AYA survivors can be best utilized. Abstract Adolescent and young adult (AYA) cancer survivors (18–39 years at diagnosis) often experience negative body changes such as scars, amputation, and disfigurement. Understanding which factors influence body image among AYA survivors can improve age-specific care in the future. Therefore, we aim to examine the prevalence, and association of a negative body image with sociodemographic, clinical, and psychosocial factors, among AYA cancer survivors (5–20 years after diagnosis). A population-based cross-sectional cohort study was conducted among AYA survivors (5–20 years after diagnosis) registered within the Netherlands Cancer Registry (NCR) (SURVAYA-study). Body image was examined via the EORTC QLQ-C30 and QLQ-SURV100. Multivariable logistic regression models were used. Among 3735 AYA survivors who responded, 14.5% (range: 2.6–44.2%), experienced a negative body image. Specifically, AYAs who are female, have a higher Body Mass Index (BMI) or tumor stage, diagnosed with breast cancer, cancer of the female genitalia, or germ cell tumors, treated with chemotherapy, using more maladaptive coping strategies, feeling sexually unattractive, and having lower scores of health-related Quality of Life (HRQoL), were more likely to experience a negative body image. Raising awareness and integrating supportive care for those who experience a negative body image into standard AYA survivorship care is warranted. Future research could help to identify when and how this support for AYA survivors can be best utilized.
Collapse
|
36
|
Li M. Associations of body image with depressive symptoms and PTG among breast cancer patients: The mediating role of social support. Front Psychol 2022; 13:953306. [PMID: 36312105 PMCID: PMC9614141 DOI: 10.3389/fpsyg.2022.953306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background Cancer diagnosis and treatment usually trigger positive and negative psychological health outcomes. Social support is a coping resource for psychological health outcomes. However, little research is available on the relationships between social support, body image, and overall psychological health outcomes in breast cancer (BC) patients. This study aimed to estimate the prevalence of depressive symptoms and post-traumatic growth (PTG) and examine the mediating roles of social support between body image and depressive symptoms and PTG among BC patients, respectively. Methods A cross-sectional study was conducted in the Northeast China from December 2015 to August 2017. All the participants were diagnosed with BC and underwent surgery. This study was conducted with 405 BC patients from the First Affiliated Hospital of China Medical University. Participants completed the Center for Epidemiologic Studies Depression scale, Post Traumatic Growth Inventory, Body Image Scale, and Perceived Social Support Scale. The associations of social support, body image with depressive symptoms, and PTG were examined by hierarchical linear regression analysis. Asymptotic and resampling strategies were used to explore the mediating role of social support. Results The prevalence of depressive symptoms was 88.1%, and 67.2% of the patients had moderate-high PTG, 52.84% of the patients had body concerns, and 264 (65.19%) patients had high-level social support. Body image was positively associated with depressive symptoms (β = 0.445, P < 0.001) and social support was negatively associated with depressive symptoms (β = −0.219, P < 0.001). Body image was negatively associated with PTG (β = −0.095, P = 0.023), whereas social support was positively associated with PTG (β = 0.533, P < 0.001). Social support significantly mediated the associations among body image, depressive symptoms (effect size = 0.057), and PTG (effect size = −0.304), respectively. Conclusions Social support played mediating role in the relationships between body image and depressive symptoms and PTG. The interventions based on social support and body image should be included in psychological health prevention.
Collapse
|
37
|
Abstract
Over the past decade, cancer incidence has increased globally while its mortality has decreased. Accordingly, healthcare practitioners aim to provide comprehensive care to cancer patients. The biopsychosocial model suggests medical professionals' understanding of how psychosocial factors influence the entire course of cancer is critical. However, until now, an integrative review summarising the full scope of these psychosocial domains has been lacking. This review substantiates that cancer patients, survivors, their caregivers, and oncology professionals face substantial psychosocial challenges. Cancer patients and survivors may experience deterioration of self-concept, disturbance of body image, sexual problems and difficulties in social relationships while attempting to cope with casual issues. The burdens of care provision and the impact on the health of caregivers of cancer patients are also noteworthy. Improving the quality of patient-doctor communication and overcoming burnout are significant challenges for oncology healthcare professionals.
Collapse
Affiliation(s)
- Youyang Wang
- Department of Psychological Medicine, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, China
| | - Wei Feng
- Department of Psychological Medicine, Fudan University Shanghai Cancer Center, Shanghai, China,Department of Oncology, Shanghai Medical College of Fudan University, Shanghai, China
| |
Collapse
|
38
|
Weingarden H, Wilhelm S, Jacobs JM, Carrellas J, Cetrulo C, Austen WG, Colwell AS. Prospective examination of psychological risk and maintenance factors for body image distress after mastectomy with immediate breast reconstruction. Body Image 2022; 42:120-125. [PMID: 35691103 PMCID: PMC9398976 DOI: 10.1016/j.bodyim.2022.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
Reconstructive breast surgery aims to improve body image following mastectomy, yet many women experience ongoing body image distress (BID). The relationship between the esthetic outcome of reconstructive surgery with BID has been underexplored in mastectomy. This study aimed to assess whether reconstruction outcome following mastectomy is associated with post-surgery BID, and to examine potential psychological risk and maintenance factors for BID above reconstruction outcome. In 49 women undergoing mastectomy with immediate breast reconstruction, we prospectively assessed hypothesized pre-surgery psychological risk factors and post-surgery maintenance factors for post-surgery BID. Reconstruction outcome was assessed via blind surgeon ratings of post-surgery photographs. Surgeon-rated reconstruction outcome was uncorrelated with BID, or with patients' ratings of surgical outcome. Higher pre-surgery depressive symptoms and lower pre-surgery patient expectations for reconstruction predicted greater post-surgery BID, above reconstruction outcome. Post-surgery body checking also predicted greater BID, above reconstruction outcome. Results suggest that the medical team cannot assume their perception of reconstruction outcome matches the patient's view or degree of BID. If replicated, results point to potential psychological risk and maintenance factors that are stronger predictors of post-reconstruction BID, highlighting opportunities for light-touch prevention and intervention to reduce BID after mastectomy with breast reconstruction.
Collapse
Affiliation(s)
- Hilary Weingarden
- Massachusetts General Hospital, 185 Cambridge St., Suite 2000, Boston, MA 02114, United States.
| | - Sabine Wilhelm
- Massachusetts General Hospital, 185 Cambridge St., Suite 2000, Boston, MA 02114, United States.
| | - Jamie M Jacobs
- Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, United States.
| | - Julia Carrellas
- Massachusetts General Hospital, 185 Cambridge St., Suite 2000, Boston, MA 02114, United States.
| | - Curtis Cetrulo
- Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, United States.
| | | | - Amy S Colwell
- Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114, United States.
| |
Collapse
|
39
|
Emotional Distress and Financial Toxicity in Younger Adult Patients Undergoing Oncologic Surgery. Ann Surg 2022; 276:694-700. [PMID: 35838403 DOI: 10.1097/sla.0000000000005593] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There has been an alarming increase in the number of young adults diagnosed with cancer. The emotional, psychosocial, and financial distress experienced by newly diagnosed young adults undergoing cancer surgery remains largely unknown. METHODS A validated biopsychosocial distress screening tool (SupportScreen®) was administered to patients diagnosed with cancer prior to surgery between 2009 and 2017 in a National Cancer Institute Comprehensive Cancer Center. Patients were stratified into younger adults ≤45 years (YA) and older adults >45 years (OA). Descriptive statistics and logistic regression were used to analyze distress outcomes. RESULTS In total, 4,297 patients were identified, with YA comprising 13.3% (n=573) of the cohort. YA reported higher emotional distress, including increased anxiety (33.8% vs. 27.4%, P=0.002), greater fear of procedures (26.7% vs. 22%, P=0.018), and difficulty managing emotions (26% vs. 20.7%, P=0.006). YA struggled more frequently to manage work/school (29.5% vs. 19.3%, P<0.001), finding resources (17.8% vs. 11.8%, P<0.001), changes in physical appearance (22.2% vs. 13.4%, P<0.001), fatigue (36% vs. 27.3%, P<0.001), and ability to have children (18.4% vs. 3%, P<0.001). Financial toxicity was significantly higher in the YA group (40.5% vs. 28%, P<0.001). While income level was strongly protective against emotional distress and financial toxicity in OAs, it was less protective against the risk of financial toxicity in YA. Younger age was an independent predictor of financial toxicity in a model adjusted to income (OR-1.52, P=0.020). CONCLUSION Younger adults in the prime of their personal and professional years of productivity require special attention when undergoing surgical evaluation for cancer. Resource allocation and counseling interventions should be integrated as part of their routine care to expedite their return to optimal physical and holistic health and mitigate psychosocial distress and financial toxicity.
Collapse
|
40
|
Silk AW, Barker CA, Bhatia S, Bollin KB, Chandra S, Eroglu Z, Gastman BR, Kendra KL, Kluger H, Lipson EJ, Madden K, Miller DM, Nghiem P, Pavlick AC, Puzanov I, Rabinowits G, Ruiz ES, Sondak VK, Tavss EA, Tetzlaff MT, Brownell I. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of nonmelanoma skin cancer. J Immunother Cancer 2022; 10:e004434. [PMID: 35902131 PMCID: PMC9341183 DOI: 10.1136/jitc-2021-004434] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 12/21/2022] Open
Abstract
Nonmelanoma skin cancers (NMSCs) are some of the most commonly diagnosed malignancies. In general, early-stage NMSCs have favorable outcomes; however, a small subset of patients develop resistant, advanced, or metastatic disease, or aggressive subtypes that are more challenging to treat successfully. Recently, immune checkpoint inhibitors (ICIs) have been approved by the US Food and Drug Administration (FDA) for the treatment of Merkel cell carcinoma (MCC), cutaneous squamous cell carcinoma (CSCC), and basal cell carcinoma (BCC). Although ICIs have demonstrated activity against NMSCs, the routine clinical use of these agents may be more challenging due to a number of factors including the lack of predictive biomarkers, the need to consider special patient populations, the management of toxicity, and the assessment of atypical responses. With the goal of improving patient care by providing expert guidance to the oncology community, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel of experts to develop a clinical practice guideline (CPG). The expert panel drew on the published literature as well as their own clinical experience to develop recommendations for healthcare professionals on important aspects of immunotherapeutic treatment for NMSCs, including staging, biomarker testing, patient selection, therapy selection, post-treatment response evaluation and surveillance, and patient quality of life (QOL) considerations, among others. The evidence- and consensus-based recommendations in this CPG are intended to provide guidance to cancer care professionals treating patients with NMSCs.
Collapse
Affiliation(s)
- Ann W Silk
- Merkel Cell Carcinoma Center of Excellence, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Christopher A Barker
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Shailender Bhatia
- Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Kathryn B Bollin
- Hematology and Medical Oncology, Scripps MD Anderson Cancer Center, San Diego, California, USA
| | - Sunandana Chandra
- Hematology Oncology Division, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Zeynep Eroglu
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | - Brian R Gastman
- Melanoma and High-Risk Skin Cancer Program, Cleveland Clinic Cancer Center, Cleveland, Ohio, USA
| | - Kari L Kendra
- Division Of Medical Oncology, The Ohio State University, Columbus, Ohio, USA
| | - Harriet Kluger
- Yale Cancer Center, Yale University, New Haven, Connecticut, USA
| | - Evan J Lipson
- Bloomberg Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Kathleen Madden
- Melanoma/Cutaneous Oncology Program, New York University Langone Perlmutter Cancer Center, New York, New York, USA
| | - David M Miller
- Department of Medicine and Department of Dermatology, Massachusetts General Cancer Center, Boston, Massachusetts, USA
| | - Paul Nghiem
- Division of Dermatology, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Anna C Pavlick
- Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Igor Puzanov
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Guilherme Rabinowits
- Department of Hematology/Oncology, Miami Cancer Institute/Baptist Health South Florida, Miami, Florida, USA
| | - Emily S Ruiz
- Mohs and Dermatologic Surgery Center, Dana-Farber/Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Vernon K Sondak
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA
| | | | - Michael T Tetzlaff
- Dermopathology Division, University of California San Francisco, San Francisco, California, USA
| | - Isaac Brownell
- Dermatology Branch, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
41
|
Salley JR, Day AT, Balachandra S, Mehr J, Sumer BD, Sher DJ, Mayfield Arnold E, Danphuong Ho E, Lee SC, Eary R. Adherence to the American Cancer Society Head and Neck Cancer Survivorship Care Guideline According to Chart Review: A Nested Retrospective Cohort Pilot Study. Ann Otol Rhinol Laryngol 2022; 132:481-491. [PMID: 35723192 DOI: 10.1177/00034894221098471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this study was to explore adherence to the American Cancer Society (ACS) Head and Neck Cancer (HNC) Survivorship Care Guideline and their outlined 33 recommendations among posttreatment HNC survivors. METHODS A bi-institutional, retrospective, nested cohort study of mucosal or salivary gland HNC survivors diagnosed in 2018 was designed. Guideline adherence was assessed via retrospective chart review between 0 and 13 months after completion of oncologic treatment according to 4 categories: (1) problem assessed, (2) problem diagnosed, (3) management offered; (4) problem treated. Adherence was defined as meeting a recommendation subcategory at least once over the 13-month period. RESULTS Among 60 randomly selected HNC survivors, a total of 38 were included in the final cohort after exclusion of individuals with ineligible cancers and those who died or were lost to follow-up over the study period. Approximately 95% of HNC survivors were assessed for HNC recurrence and screened for lung cancer. Certain common problems such as xerostomia, dysphagia, and hypothyroidism were screened for and managed in ≥70% of eligible survivors. Conversely, screening for other second primary cancers and assessment of a majority of other physical and psychosocial harms occurred in <70% of survivors, and in many cases none to a slim minority of survivors (eg, sleep apnea and sleep disturbance, body and self-image concerns). Only 5% of survivors received a survivorship care plan. CONCLUSION Overall adherence to the ACS HNC Survivorship Care Guideline in early posttreatment survivors was suboptimal. Interventions are needed to better implement and operationalize these guideline recommendations.
Collapse
Affiliation(s)
- Jordan R Salley
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Andrew T Day
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | | | - Joshua Mehr
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - Baran D Sumer
- Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX, USA
| | - David J Sher
- Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, USA
| | | | - Esther Danphuong Ho
- Department of Family and Community Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Simon Craddock Lee
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, TX, USA
| | - Rebecca Eary
- Department of Family and Community Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
42
|
Schmidt ME, Goldschmidt S, Hermann S, Steindorf K. Late effects, long-term problems and unmet needs of cancer survivors. Int J Cancer 2022; 151:1280-1290. [PMID: 35657637 DOI: 10.1002/ijc.34152] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 11/11/2022]
Abstract
Great efforts are being made in cancer treatment, with impressive improvement in survival. The situation concerning research and care for long-term problems and late effects in the growing population of cancer survivors, however, is unsatisfactory. Therefore, in the FiX survey 1,348 disease-free survivors about 4 years after diagnosis of different cancer types were asked to rate existing burdens and support received for them along a list of 36 potential problems. Health-related quality of life (HRQoL) was assessed with the EORTC QLQ-C30. Determinants of burdens were explored using logistic regression analysis. While cancer survivors' global HRQoL, physical and role function ratings were comparable or better than age- and sex-matched reference values of the general population, emotional and cognitive function was worse, especially among women (p<.01). Most frequently reported problems with at least moderate burden were loss of physical performance (36.3%), fatigue (35.1%), sexual problems (34.7%), sleep problems (34,1%), arthralgia (33.8%), anxiety (28.0%), neuropathy (25.6%), memory problems (23.0%) and concentration problems (21.9%). Burdened survivors often rated received support as poor, especially regarding support for problems that physicians might consider medically non-threatening, or for which no effective pharmacologic or medical treatment is known. Determinants for burden included higher age, female gender, having ever received chemotherapy and overweight/obesity. In conclusion, a significant number of cancer survivors suffer from long-term or late effects and have unmet care needs. Awareness of health care professionals should be increased for these issues. The results of our study can contribute to the development of targeted survivorship plans. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer; German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Siri Goldschmidt
- Division of Physical Activity, Prevention and Cancer; German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.,Medical Faculty of the University of Heidelberg, Germany
| | - Silke Hermann
- Epidemiological Cancer Registry Baden-Württemberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer; German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| |
Collapse
|
43
|
Brunet J, Price J, Harris C. Body image in women diagnosed with breast cancer: A grounded theory study. Body Image 2022; 41:417-431. [PMID: 35526352 DOI: 10.1016/j.bodyim.2022.04.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/13/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022]
Abstract
Using a Straussian grounded theory methodology, we explored the meaning women attribute to body image and how they understand their breast cancer experience as influencing their body image to develop a grounded theory of body image for women diagnosed with breast cancer. Interviews were conducted with 27 women who had completed treatment for breast cancer in Canada. Data were analyzed through a process of open, axial, and selective coding using constant comparison techniques and memo-writing. A grounded theory of body image for women diagnosed with breast cancer was developed around the core category of body image: what it means to women, which was underpinned by six themes and 17 subthemes. This theory explains how women diagnosed with breast cancer define body image and illustrates intrapersonal and interpersonal factors that can undermine or support their body image, along with strategies they used to manage their body image. This theory can guide research and practice aimed at enhancing body image and minimizing its consequences for women diagnosed with breast cancer.
Collapse
Affiliation(s)
- Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada; Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Institut du savoir Montfort, Hôpital Montfort, Ottawa, Ontario, Canada; School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
| | - Jenson Price
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Cheryl Harris
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
44
|
Eliminating tattoos for short course palliative radiation therapy: Set-up error, satisfaction and cost. J Med Imaging Radiat Sci 2022; 53:S56-S62. [PMID: 35523652 DOI: 10.1016/j.jmir.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/10/2022] [Accepted: 04/05/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Palliative patients are living longer thanks to advancements in systemic therapies and radiotherapy technologies. Prior to image guided radiotherapy, permanent ink tattoos were used to ensure set up accuracy. Permanent marks can cause psychological damage, physical pain and can reduce a patient's quality of life. In recent years, image guided radiation therapy (IGRT) has become standard practice and may eliminate the need for permanent tattoos in this patient population. METHODS Twenty-five patients were consecutively chosen from the Palliative Radiation Oncology Program (PROP). Each received 5 fractions of radiotherapy commencing within 72 hours of CT simulation. In place of permanent tattoos, patients were marked with permanent marker and an adherent transparent film dressing (Tegaderm TM ) was placed over the mark. Patients were educated on maintaining the marks and dressing. Daily cone beam CT (CBCT) isocentre mismatch values were compared with 25 patients who received tattoos for radiotherapy to similar body regions. Radiation therapist concerns, cost, variations in isocentre shift values and additional imaging requirements were obtained. RESULTS Isocentre shift values were similar (p<0.05) for Tegaderm TM vs. tattoo patients in the anterior-posterior (AP) and right-left (RL) directions. The mean shift value in the superior-inferior (SI) direction was larger for Tegaderm TM than for tattoos (p=0.01), however the magnitude was only 2 mm, which is clinically insignificant as these shifts were prior to IGRT guided correction. No patient required a repeat CBCT or a resimulation. The cost of the Tegaderm TM dressing was substantially less than the tattoo group. Radiation Therapists' satifaction with Tegaderm TM was overall high, however some expressed concerns with their durability and longevity. CONCLUSIONS We found that the use of Tegaderm TM dressing did not result in increased set-up time, mismatch error or additional imaging procedures (CBCT or CTsimulation) and moreover cost substantially less than permanent ink tattoos.
Collapse
|
45
|
Saita E, Ferraris G, Acquati C, Molgora S, Sorge A, Valenti F, Grassi MM, Vagnini D. Dyadic Profiles of Couples Coping With Body Image Concerns After Breast Cancer: Preliminary Results of a Cluster Analysis. Front Psychol 2022; 13:869905. [PMID: 35401315 PMCID: PMC8983958 DOI: 10.3389/fpsyg.2022.869905] [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: 02/05/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Breast cancer treatments have multiple adverse effects, including concerns about body appearance and function that are experienced by most patients. Altered body image negatively affects mental health, social, and relationship functioning. While the relationship with a partner is critical for patients’ psychological wellbeing and partners can promote positive body image, limited research has investigated individual and relational factors affecting the experience of both. This cross-sectional study aimed at (1) exploring rates of body image concerns among breast cancer patients, and (2) identifying dyadic profiles among participating dyads. Couples composed by patients who had undergone surgery and their romantic partners (n = 32) were recruited from the Breast Unit of a hospital in northern Italy. Both partners completed measures of personality characteristics (BFQ-2), psychological distress (HADS), coping flexibility (PACT), dyadic coping (DCQ), and closeness (IOS). Body image (BIS) and adjustment to cancer (Mini-MAC) measures were completed by patients only. K-mean cluster analyses identified 2-cluster solution among patients and partners, respectively. “Active patients” (cluster-1) reported low rates of body image concerns (p < 0.001), anxious preoccupation, negative dyadic coping, and self-oriented stress communication (p < 0.05), compared to “worried patients” (cluster-2). “Comfortable partners” (cluster-1) reported lower anxiety and depression (p < 0.001), self-oriented negative dyadic coping and closeness (p < 0.05) than “uncomfortable partners” (cluster-2). Three different dyadic profiles emerged: functional, dysfunctional, and ambivalent. Significant variations (p < 0.05) by anxiety, depression, and delegating dyadic coping existed. Results indicate there are groups of couples at greater risk for impaired psychological distress and body image concerns, which should be addressed in the context of dyadic psychosocial interventions.
Collapse
Affiliation(s)
- Emanuela Saita
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, United States.,Department of Clinical Sciences, College of Medicine, University of Houston, Houston, TX, United States.,Department of Health Disparities Research, The UT MD Anderson Cancer Center, Houston, TX, United States
| | - Sara Molgora
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Antonia Sorge
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | | | | | - Denise Vagnini
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| |
Collapse
|
46
|
Nikita, Rani R, Kumar R. Body image distress among cancer patients: needs for psychosocial intervention development. Support Care Cancer 2022; 30:6035-6043. [PMID: 35412075 PMCID: PMC9002224 DOI: 10.1007/s00520-022-07049-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/06/2022] [Indexed: 11/07/2022]
Abstract
Objectives This study examines the body image distress among patients with head and neck cancer (HNC) visiting a tertiary care hospital for follow-ups. Design A cross-sectional survey purposively enrolled 170 head and neck cancer (HNC) patients who had undergone cancer surgery at a newly established tertiary care hospital, North India. Methods A structured pre-tested socio-demographic and clinical profile checklist and the Derriford Appearance Scale-24 (DAS-24) were used to collect information. An appropriate descriptive and inferential statistic was applied to compute the findings. Results The median age of the participants was 46.0 years, and 80% of the participants were unemployed. The mean body image distress score was 57.95 (SD = 10.3, 47–66.75, range 42–77). The body image distress shows a significant association with age (p < .001), gender (p = 0.003), and working status (p = 0.032) of the HNC patients. Multilinear regression reported gender as an independent predictor (95% CI: 0.615–8.646, p = 0.025) for body image distress in HNC patients. Conclusions HNC patients reported substantial body image distress due to changes in body appearance. Female patients who had undergone surgery at young age reported higher body image distress. Recommending cosmetic surgery and nurse-led psychosocial nursing intervention on routine follow-ups are other potential strategies to improve facial appearance to overcome the negative impact of body image.
Collapse
Affiliation(s)
- Nikita
- All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India, 751029
| | - Ruchika Rani
- Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India, 249203
| | - Rajesh Kumar
- Department of Nursing, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India, 249203.
| |
Collapse
|
47
|
|
48
|
Body Image Issues in Patients With Colorectal Cancer: A Scoping Review. Cancer Nurs 2022; 46:233-247. [PMID: 35349543 DOI: 10.1097/ncc.0000000000001085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Stomas in colorectal cancer (CRC) survivors lead to body image problems. Advances in treatment help reduce the rate of stoma formation, but body image distress is still frequently experienced in CRC survivors. OBJECTIVES This review is aimed toward mapping and describing the state of knowledge regarding body image in patients with CRC. METHODS A systematic literature search complying with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines was conducted. Screening and data extraction were performed by 2 reviewers independently for all potentially eligible studies. RESULTS A total of 56 eligible articles were selected. The majority of these studies were quantitative studies (85%). The eligible studies were classified into 4 broad categories: instruments used to assess body image, prevalence of body image distress, factors related to body image, and impact of body image distress. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-CR38) colorectal questionnaire was the most common measurement tool found among the reviewed studies (70%), and body image distress was reported by 25.5% to 86% of participants. Excluding gender, age, type of surgery, adjuvant therapy, time from diagnosis, social support, and stoma status, changes in bowel habits was identified as affecting the body image of patients with CRC. CONCLUSION Changing bowel habits emerged as a significant factor causing body image distress for CRC survivors. IMPLICATIONS FOR PRACTICE Clinicians should raise awareness about body image distress in patients with CRC, focus on finding effective measures and interventions intended to help alleviate symptoms of bowel dysfunction, and prepare patients to adapt to altered bowel functions.
Collapse
|
49
|
An J, Zhou K, Li M, Li X. Assessing the relationship between body image and quality of life among rural and urban breast cancer survivors in China. BMC Womens Health 2022; 22:61. [PMID: 35246115 PMCID: PMC8896367 DOI: 10.1186/s12905-022-01635-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/07/2022] [Indexed: 01/18/2023] Open
Abstract
Background Breast cancer survivors experience altered body image and quality of life (QoL) due to the disease and its treatment. The multidimensional nature of body image and QoL makes their relationships complex. This study aimed to examine the associations between the two concepts in Chinese breast cancer survivors and test whether these associations are moderated by rural–urban residence. Methods A cross-sectional design was adopted. Breast cancer survivors were recruited via a convenience sampling method. Two validated questionnaires (the Body Image Self-Rating Questionnaire for Breast Cancer and 36-item Short-Form Health Survey) and questions assessing demographic and clinical covariates were administered. Multiple linear regressions were used to assess the relationship between body image and QoL domains and to examine the moderating effect of rural–urban residence. Results In our sample of 354 breast cancer survivors, half (50.28%) lived in rural areas. After adjusting for demographic and clinical variables, better perception of body image-related sexual activity change, role change, and psychological change was significantly associated with better physical (β ranged from − 0.15 to − 0.11, p < 0.05) and mental (β ranged from − 0.46 to − 0.34, p < 0.001) well-being. Better perception of body image-related social and behavior change was significantly associated only with better mental well-being (β ranged from − 0.40 to − 0.33, p < 0.001). The association between body image and mental well-being was much stronger in urban subjects (b = − 0.38, p < 0.001) than in rural subjects (b = − 0.20, p < 0.001). Conclusions Our findings suggest that multidimensional body image is associated with physical and mental well-being in Chinese breast cancer survivors. Body image appears to play a larger role in urban breast cancer survivors’ mental well-being. Our results indicate that incorporating interventions that address body image issues would be advantageous for survivorship care to enhance QoL in breast cancer survivors. Furthermore, rural–urban differences should be considered in the strategic design of survivorship care programs in rural and urban settings.
Collapse
Affiliation(s)
- Jinghua An
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China
| | - Kaina Zhou
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China
| | - Minjie Li
- Nethersole School of Nursing, The Chinese University of Hong Kong, Central Ave, Shatin, Hong Kong, SAR
| | - Xiaomei Li
- School of Nursing, Health Science Center of Xi'an Jiaotong University, Yanta West Road 76, Xi'an, 710061, Shaanxi, China.
| |
Collapse
|
50
|
Goyal N, Day A, Epstein J, Goodman J, Graboyes E, Jalisi S, Kiess AP, Ku JA, Miller MC, Panwar A, Patel VA, Sacco A, Sandulache V, Williams AM, Deschler D, Farwell DG, Nathan C, Fakhry C, Agrawal N. Head and neck cancer survivorship consensus statement from the American Head and Neck Society. Laryngoscope Investig Otolaryngol 2022; 7:70-92. [PMID: 35155786 PMCID: PMC8823162 DOI: 10.1002/lio2.702] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/15/2021] [Accepted: 11/10/2021] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES To provide a consensus statement describing best practices and evidence regarding head and neck cancer survivorship. METHODS Key topics regarding head and neck cancer survivorship were identified by the multidisciplinary membership of the American Head and Neck Society Survivorship, Supportive Care & Rehabilitation Service. Guidelines were generated by combining expert opinion and a review of the literature and categorized by level of evidence. RESULTS Several areas regarding survivorship including dysphonia, dysphagia, fatigue, chronic pain, intimacy, the ability to return to work, financial toxicity, lymphedema, psycho-oncology, physical activity, and substance abuse were identified and discussed. Additionally, the group identified and described the role of key clinicians in survivorship including surgical, medical and radiation oncologists; dentists; primary care physicians; psychotherapists; as well as physical, occupational, speech, and respiratory therapists. CONCLUSION Head and neck cancer survivorship is complex and requires a multidisciplinary approach centered around patients and their caregivers. As survival related to head and neck cancer treatment improves, addressing post-treatment concerns appropriately is critically important to our patient's quality of life. There continues to be a need to define effective and efficient programs that can coordinate this multidisciplinary effort toward survivorship.
Collapse
Affiliation(s)
- Neerav Goyal
- Department of Otolaryngology—Head and Neck SurgeryThe Pennsylvania State University, College of MedicineHersheyPennsylvaniaUSA
| | - Andrew Day
- Department of Otolaryngology—Head and Neck SurgeryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Joel Epstein
- Department of SurgeryCedars SinaiLos AngelesCaliforniaUSA
- City of HopeCaliforniaDuarteUSA
| | - Joseph Goodman
- Ear, Nose and Throat CenterGeorge Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Evan Graboyes
- Department of Otolaryngology—Head and Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Scharukh Jalisi
- Department of OtolaryngologyBeth Israel DeaconessBostonMassachusettsUSA
| | - Ana P. Kiess
- Department of Radiation Oncology and Molecular Radiation SciencesJohns Hopkins MedicineBaltimoreMarylandUSA
| | - Jamie A. Ku
- Head and Neck InstituteCleveland ClinicClevelandOhioUSA
| | - Matthew C. Miller
- Department of OtolaryngologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Aru Panwar
- Department of Head and Neck Surgical Oncology, Methodist Estabrook Cancer CenterNebraska Methodist HospitalOmahaNebraskaUSA
| | - Vijay A. Patel
- Department of OtolaryngologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Assuntina Sacco
- Department of Medical OncologyUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Vlad Sandulache
- Department of Otolaryngology—Head and Neck SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Amy M. Williams
- Department of Otolaryngology—Head and Neck SurgeryHenry Ford Health SystemDetroitMichiganUSA
| | - Daniel Deschler
- Department of Otolaryngology–Head and Neck SurgeryMassachusetts Eye and EarBostonMassachusettsUSA
| | - D. Gregory Farwell
- Department of Otolaryngology—Head and Neck SurgeryUniversity of California DavisDavisCaliforniaUSA
| | - Cherie‐Ann Nathan
- Department of Otolaryngology—Head and Neck SurgeryLouisiana State UniversityShreveportLouisianaUSA
| | - Carole Fakhry
- Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Nishant Agrawal
- Department of Surgery, Section of Otolaryngology—Head and Neck SurgeryUniversity of Chicago Pritzker School of MedicineChicagoIllinoisUSA
| |
Collapse
|