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Ton MD, Chan JSK, Satti DI, Peckham-Gregory EC, Mahal BA, Isrow D, Dee EC, Swami NS. Modifiable Lifestyle Risk Factors in Adult Survivors of Childhood Cancer: A Nationally Representative Study. Am J Clin Oncol 2024:00000421-990000000-00205. [PMID: 38913415 DOI: 10.1097/coc.0000000000001123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
OBJECTIVE Given the vulnerable health condition of adult childhood cancer survivors, it is essential that they develop positive health behaviors to minimize controllable health risks. Therefore, we evaluated if adult survivors of non-childhood cancer and childhood cancer differ in the odds of each modifiable risk factor compared with each other and compared with the general population. METHODS This nationally representative study leveraged the National Health Interview Survey (NHIS) sample from 2000 to 2018 and the Behavioral Risk Factor Surveillance System (BRFSS) sample from 2016 to 2021. Our study population included adults diagnosed with cancer when they were ≤14 years of age. Outcomes included physical activity, body mass index (BMI), current smoking, ever-smoking, alcohol use, and binge drinking. RESULTS Insufficient physical activity was not statistically significant in the BRFSS, but in the NHIS, childhood cancer survivors had significantly more insufficient physical activity compared with non-childhood cancer survivors (aOR 1.29, P=0.038) and the general population (aOR 1.40, P=0.006). Childhood cancer survivors also had a higher likelihood of being significantly underweight (aOR 1.84, P=0.018) and having ever-smoked (aOR 1.42, P=0.001) compared with the general population in the NHIS. There was a significantly higher likelihood of smoking among childhood cancer survivors in the BRFSS (aOR 2.02, P=0.004). CONCLUSIONS The likelihoods of many risky behaviors between adult childhood cancer survivors and general population controls were comparable, although rates of physical activity may be decreased, and rates of smoking may be increased among childhood cancer survivors. Targeted interventions are needed to promote healthy behaviors in this vulnerable population.
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Affiliation(s)
- Minh D Ton
- Department of Radiation Oncology, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, FL
| | - Jeffrey Shi Kai Chan
- Cardio-Oncology Research Unit, Cardiovascular Analytics Group, UK-China Collaboration, Hong Kong, Hong Kong
| | - Danish Iltaf Satti
- Shifa College of Medicine, Islamabad, Pakistan
- Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Erin C Peckham-Gregory
- Texas Children's Cancer and Hematology Center, Texas Children's Hospital
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX
- Center for Epidemiology and Population Health, Baylor College of Medicine, Houston, TX
| | - Brandon A Mahal
- Department of Radiation Oncology, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, FL
| | - Derek Isrow
- Department of Radiation Oncology, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, FL
| | | | - Nishwant S Swami
- Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA
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Bouwman E, Penson A, de Valk M, van den Oever SR, van der Pal HJH, van Dulmen-den Broeder E, Blijlevens NMA, Bresters D, Feijen EAM, van den Heuvel-Eibrink MM, van der Heiden-van der Loo M, Michel G, Ronckers CM, Teepen JC, Tissing WJE, Versluys BAB, Kremer LCM, Pluijm SMF, Loonen JJ. Unhealthy lifestyle behaviors, overweight, and obesity among childhood cancer survivors in the Netherlands: A DCCSS LATER study. Cancer 2024. [PMID: 38662406 DOI: 10.1002/cncr.35338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 02/20/2024] [Accepted: 03/18/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND The objective of this study was to examine the prevalence of unhealthy lifestyle behaviors, overweight, and obesity in Dutch childhood cancer survivors (CCSs) compared with sibling controls and the Dutch general population. Other aims were to assess associated factors of unhealthy lifestyle behaviors, overweight, and obesity and to identify subgroups of CCSs at risk for these unhealthy statuses. METHODS The authors included 2253 CCSs and 906 siblings from the Dutch Childhood Cancer Survivor Study-Late Effects After Childhood Cancer cohort, part 1, and added data from the Dutch general population. Questionnaire data were collected on overweight and obesity (body mass index >25.0 kg/m2), meeting physical activity guidelines (>150 minutes per week of moderate or vigorous exercises), excessive alcohol consumption (>14 and >21 alcoholic consumptions per week for women and men, respectively), daily smoking, and monthly drug use. Multivariable logistic regression analyses and two-step cluster analyses were performed to examine sociodemographic-related, health-related, cancer-related, and treatment-related associated factors of unhealthy lifestyle behaviors and to identify subgroups of CCSs at risk for multiple unhealthy behaviors. RESULTS CCSs more often did not meet physical activity guidelines than their siblings (30.0% vs. 19.3%; p < .001). Married as marital status, lower education level, nonstudent status, and comorbidities were common associated factors for a body mass index ≥25.0 kg/m2 and insufficient physical activity, whereas male sex and lower education were shared associated factors for excessive alcohol consumption, daily smoking, and monthly drug use. A subgroup of CCSs was identified as excessive alcohol consumers, daily smokers, and monthly drug users. CONCLUSIONS The current results emphasize the factors associated with unhealthy behaviors and the potential identification of CCSs who exhibit multiple unhealthy lifestyle behaviors.
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Affiliation(s)
- Eline Bouwman
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Adriaan Penson
- Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud de Valk
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Helena J H van der Pal
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- PanCare, Bussum, The Netherlands
| | | | | | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
- Utrecht University and Utrecht Medical Center, Utrecht, The Netherlands
| | | | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Cécile M Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jop C Teepen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- University Medical Center Groningen, Groningen, The Netherlands
| | | | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Utrecht University and Utrecht Medical Center, Utrecht, The Netherlands
- Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Saskia M F Pluijm
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Guida F, Andreozzi L, Zama D, Prete A, Masetti R, Fabi M, Lanari M. Innovative strategies to predict and prevent the risk for malnutrition in child, adolescent, and young adult cancer survivors. Front Nutr 2023; 10:1332881. [PMID: 38188871 PMCID: PMC10771315 DOI: 10.3389/fnut.2023.1332881] [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: 11/03/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Children, adolescents, and young adult cancer survivors (CAYAs) constitute a growing population requiring a customized approach to mitigate the incidence of severe complications throughout their lifetimes. During cancer treatment, CAYAs cancer survivors undergo significant disruptions in their nutritional status, elevating the risks of mortality, morbidity, and cardiovascular events. The assessment of nutritional status during cancer treatment involves anthropometric and dietary evaluations, emphasizing the necessity for regular assessments and the timely identification of risk factors. Proactive nutritional interventions, addressing both undernutrition and overnutrition, should be tailored to specific age groups and incorporate a family-centered approach. Despite encouraging interventions, a notable evidence gap persists. The goal of this review is to comprehensively examine the existing evidence on potential nutritional interventions for CAYAs cancer survivors. We explore the evidence so far collected on the nutritional intervention strategies elaborated for CAYAs cancer survivors that should target both undernutrition and overnutrition, being age-specific and involving a family-based approach. Furthermore, we suggest harnessing artificial intelligence (AI) to anticipate and prevent malnutrition in CAYAs cancer survivors, contributing to the identification of novel risk factors and promoting proactive, personalized healthcare.
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Affiliation(s)
- Fiorentina Guida
- Paediatric Emergency Unit, Department of Medicine and Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - Laura Andreozzi
- Paediatric Emergency Unit, Department of Medicine and Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - Daniele Zama
- Paediatric Emergency Unit, Department of Medicine and Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - Arcangelo Prete
- Pediatric Oncology and Hematology Unit "Lalla Seragnoli", Pediatric Unit-IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Riccardo Masetti
- Pediatric Oncology and Hematology Unit "Lalla Seragnoli", Pediatric Unit-IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marianna Fabi
- Paediatric Emergency Unit, Department of Medicine and Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
| | - Marcello Lanari
- Paediatric Emergency Unit, Department of Medicine and Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy
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Wang Y, Ronckers CM, van Leeuwen FE, Moskowitz CS, Leisenring W, Armstrong GT, de Vathaire F, Hudson MM, Kuehni CE, Arnold MA, Demoor-Goldschmidt C, Green DM, Henderson TO, Howell RM, Ehrhardt MJ, Neglia JP, Oeffinger KC, van der Pal HJH, Robison LL, Schaapveld M, Turcotte LM, Waespe N, Kremer LCM, Teepen JC. Subsequent female breast cancer risk associated with anthracycline chemotherapy for childhood cancer. Nat Med 2023; 29:2268-2277. [PMID: 37696934 PMCID: PMC10504074 DOI: 10.1038/s41591-023-02514-1] [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: 01/11/2023] [Accepted: 07/26/2023] [Indexed: 09/13/2023]
Abstract
Anthracycline-based chemotherapy is associated with increased subsequent breast cancer (SBC) risk in female childhood cancer survivors, but the current evidence is insufficient to support early breast cancer screening recommendations for survivors treated with anthracyclines. In this study, we pooled individual patient data of 17,903 survivors from six well-established studies, of whom 782 (4.4%) developed a SBC, and analyzed dose-dependent effects of individual anthracycline agents on developing SBC and interactions with chest radiotherapy. A dose-dependent increased SBC risk was seen for doxorubicin (hazard ratio (HR) per 100 mg m-2: 1.24, 95% confidence interval (CI): 1.18-1.31), with more than twofold increased risk for survivors treated with ≥200 mg m-2 cumulative doxorubicin dose versus no doxorubicin (HR: 2.50 for 200-299 mg m-2, HR: 2.33 for 300-399 mg m-2 and HR: 2.78 for ≥400 mg m-2). For daunorubicin, the associations were not statistically significant. Epirubicin was associated with increased SBC risk (yes/no, HR: 3.25, 95% CI: 1.59-6.63). For patients treated with or without chest irradiation, HRs per 100 mg m-2 of doxorubicin were 1.11 (95% CI: 1.02-1.21) and 1.26 (95% CI: 1.17-1.36), respectively. Our findings support that early initiation of SBC surveillance may be reasonable for survivors who received ≥200 mg m-2 cumulative doxorubicin dose and should be considered in SBC surveillance guidelines for survivors and future treatment protocols.
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Affiliation(s)
- Yuehan Wang
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
| | - Cécile M Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
- Division of Childhood Cancer Epidemiology (EpiKiK), Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | | | | | | | - Florent de Vathaire
- Radiation Epidemiology Team, INSERM U1018, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | - Claudia E Kuehni
- Childhood Cancer Research Group, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Pediatric Hematology and Oncology, University Children's Hospital Bern, University of Bern, Bern, Switzerland
| | - Michael A Arnold
- Department of Pathology and Laboratory Medicine, Children's Hospital Colorado, Aurora, CO, USA
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Charlotte Demoor-Goldschmidt
- Radiation Epidemiology Team, INSERM U1018, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- Department of Pediatric Hematology and Oncology, University-Hospital of Angers, Angers, France
- Radiotherapy Department, Francois Baclesse Center, Caen, France
| | | | - Tara O Henderson
- University of Chicago Medicine Comer Children's Hospital, Chicago, IL, USA
| | - Rebecca M Howell
- University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | | | - Joseph P Neglia
- University of Minnesota Masonic Cancer Center, Minneapolis, MN, USA
| | | | | | | | | | - Lucie M Turcotte
- University of Minnesota Masonic Cancer Center, Minneapolis, MN, USA
| | - Nicolas Waespe
- Childhood Cancer Research Group, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Pediatric Hematology and Oncology, University Children's Hospital Bern, University of Bern, Bern, Switzerland
- CANSEARCH research platform in pediatric oncology and hematology of the University of Geneva, Geneva, Switzerland
| | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands
| | - Jop C Teepen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Choi E, Becker H, Lu Q, Roth M. Sex differences in comorbid conditions, health behaviors, health care utilization, and health-related quality of life among young adult cancer survivors. Support Care Cancer 2023; 31:181. [PMID: 36820926 DOI: 10.1007/s00520-023-07650-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 02/19/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE Although cancer experiences and health-related quality of life (HRQOL) differ by sex, little is known about how sex affects comorbid conditions, health behaviors, health service utilization, and HRQOL in young adult (YA) cancer survivors. We sought to determine the relationship of sex to these factors in this population. METHODS This matched case-control, cross-sectional study used data from the Texas Behavioral Risk Factor Surveillance System for 2015-2019. YA survivors aged 18-39 years, were matched to controls. Chi-square and multiple logistic regressions were used to assess the relationship between sex and the measured factors. RESULTS The analysis included 276 YA survivors and 828 controls. Male survivors were more likely than male controls to have a depressive disorder (OR = 3.06, p = 0.007), smoke (OR = 3.87, p < 0.001), and forgo health care because of cost (OR = 5.60, p < 0.001). Female survivors were more likely than female controls to have at least one comorbidity (OR = 3.52, p < 0.001), forgo health care because of cost (OR = 3.03, p < 0.001), and report poorer HRQOL (aORs = 1.52-2.22, p < 0.05). Female survivors were more likely to have at least one comorbid condition (aOR = 1.70, p = 0.02) than male survivors. CONCLUSION YA cancer survivors differed in their health outcomes from both the general population and by sex. Tailored, sex-based interventions are needed to decrease long-term morbidity and improve HROQL in this population.
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Affiliation(s)
- Eunju Choi
- Department of Nursing, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA. .,Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
| | - Heather Becker
- School of Nursing, The University of Texas at Austin, 1710 Red River St., Austin, TX, 78712, USA
| | - Qian Lu
- Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Michael Roth
- Department of Pediatric Patient Care, Division of Pediatrics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
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Ida H, Alicia GK, Anna F, Irene L, Anna N, Helena M, Maria E, Emir H, Hannah N. Quality of life among female childhood cancer survivors with and without premature ovarian insufficiency. J Cancer Surviv 2023; 17:101-109. [PMID: 33469826 PMCID: PMC9971100 DOI: 10.1007/s11764-021-00987-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/02/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Due to an increase in survival, a growing population of childhood cancer survivors (CCS) is present. However, female CCS are at risk of developing premature ovarian insufficiency (POI) after cancer treatment. POI involves a decreased chance of conceiving and the increased infertility state has a large impact on affected individuals' health and mental life. The objective of this study was to investigate health state and well-being among female CCS with and without POI and healthy controls (HC). METHODS Female CCS treated in southern Sweden between 1964 and 2008 were included. Each patient was matched with a HC. The final study population included 167 female CCS and 164 HC that were examined between October 2010 and January 2015 at the Reproductive Medicine Centre at Skåne University Hospital in Malmö, Sweden. All participants, except for two HCs, answered an EQ-5D-3L questionnaire for measuring health state including a visual analogue scale (VAS) for estimating well-being. RESULTS There were 22 CCS with POI, none of the HC had POI. The mean health state differed among groups (unadjusted: P = 0.002; adjusted: P = 0.007). A difference in mean experienced well-being among groups was noted (unadjusted: P = 0.003; adjusted: P = 0.012). Lowest well-being was found in the CCS group with POI (P = 0.024). CONCLUSIONS Female CCS have a significantly decreased health state and well-being. Female CCS with POI additionally have the lowest self-estimated well-being. IMPLICATIONS FOR CANCER SURVIVORS Female CCS with POI should be identified early in order to give them adequate information and support.
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Affiliation(s)
- Hjelmér Ida
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Malmo, Sweden
| | - Gustafsson Kylberg Alicia
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Malmo, Sweden
| | - Fridenborg Anna
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Malmo, Sweden
| | - Leijonhufvud Irene
- Department of Translational Medicine, Reproductive Medicine Centre, Skåne University Hospital, Lund University, Malmo, Sweden
| | - Nyström Anna
- Department of Pediatrics, Pediatric Endocrinology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Mörse Helena
- Department of Pediatrics, Pediatric Oncology and Hematology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Elfving Maria
- Department of Pediatrics, Pediatric Endocrinology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Henic Emir
- Department of Translational Medicine, Reproductive Medicine Centre, Skåne University Hospital, Lund University, Malmo, Sweden
| | - Nenonen Hannah
- Department of Translational Medicine, Molecular Genetic Reproductive Medicine, Clinical Research Centre, Lund University, Malmo, Sweden.
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Cheung YT, Ma CT, Li MCH, Zhou KR, Loong HHF, Chan ASY, Wong KC, Li CK. Associations between Lifestyle Factors and Neurocognitive Impairment among Chinese Adolescent and Young Adult (AYA) Survivors of Sarcoma. Cancers (Basel) 2023; 15:cancers15030799. [PMID: 36765757 PMCID: PMC9913447 DOI: 10.3390/cancers15030799] [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: 12/07/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The effect of lifestyle on neurocognitive impairment among cancer survivors remain an understudied area. This study explored the association between lifestyle factors and neurocognitive outcomes (specifically, attention, memory, processing speed and cognitive flexibility) in AYA survivors (aged 15-39 years) of sarcoma. METHODS This study recruited 116 AYA survivors (age 28.2 (SD = 8.2) years), who were diagnosed with osteosarcoma (49%) or soft-tissue sarcoma (51%) at age 13.3 (SD = 7.2) years. The neurocognitive battery included measures of attention, memory, motor-processing speed, and cognitive flexibility. Survivors reported health-damaging practices, which included: physical inactivity, smoking, alcohol intake, inadequate sleep (<7 h of actual sleep/day), sleep-related fatigue (Multidimensional Fatigue Scale) and long working hours (>9 h/day). General linear modeling was conducted to examine the association between lifestyle factors and neurocognitive outcomes, adjusting for age at diagnosis, sex, education attainment and clinical/treatment variables. RESULTS At 14.9 (SD = 7.6) years post-diagnosis, survivors demonstrated impairment in attentiveness (4.3-13.0%), processing speed (34.5%) and cognitive flexibility (18.1%). Nearly half (45.7%) had developed a chronic health condition (CHC). Low physical activity (estimate = -0.97, p = 0.003) and sleep-related fatigue (estimate = -0.08, p = 0.005) were associated with inattention. Survivors who worked >9 h/day (n = 15) demonstrated worse attention (estimate = 5.42, p = 0.023) and cognitive flexibility (estimate = 5.22, p = 0.005) than survivors who worked ≤9 h/day (n = 66). Interaction analysis (CHCs*physical activity) showed that survivors who developed CHCs and reported low physical activity had worse attention (p = 0.032) and cognitive-flexibility (p = 0.019) scores than other subgroups. CONCLUSION Treatment-related CHCs, coupled with continued physical inactivity, may exacerbate inattention and executive dysfunction among survivors. Long working hours and sleep-related fatigue are associated with worse functioning; this finding should be validated with prospective assessment of work-related stressors and objective sleep measures.
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Affiliation(s)
- Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Correspondence: ; Tel.: +852-3943-6833; Fax: +852-2603-5295
| | - Chung Tin Ma
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Michael Can Heng Li
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Keary Rui Zhou
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Herbert Ho Fung Loong
- Department of Clinical Oncology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Agnes Sui Yin Chan
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Kwok Chuen Wong
- Department of Orthopaedics & Traumatology, Prince of Wales Hospital, Hong Kong, China
| | - Chi Kong Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, China
- Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
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Santamaría Torres A, Rozo Guzmán AN, Trujillo Naranjo MC, Carreño Moreno SP. El hermano del niño con cáncer merece ser visible. REVISTA LATINOAMERICANA DE BIOÉTICA 2022. [DOI: 10.18359/rlbi.5436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
El hermano sano en situaciones de cáncer infantil es con frecuencia un sujeto invisible para su familia, los profesionales de la salud y las instituciones. El objetivo de este trabajo fue mapear e integrar la literatura científica acerca de la experiencia del hermano del niño diagnosticado con cáncer. Se desarrolló una Scoping Review de 28 artículos publicados entre 2016 y 2020, en los idiomas español, inglés y portugués. Se incluyeron 12 estudios cualitativos, 15 cuantitativos y un estudio mixto. Frente a los hallazgos, se identificó que hay cambios en las relaciones entre hermanos, parentales y sociales, además de cambios personales y una oferta limitada de apoyo a los hermanos del niño con cáncer. Se concluye que el cáncer infantil afecta directamente a los miembros de la familia, incluido al hermano sano, quien enfrenta cambios drásticos en su vida que implican nuevas necesidades, sentimientos y conductas de riesgo. Se requiere una mayor investigación y abordaje acerca del impacto del cáncer infantil en hermanos sanos, así como el diseño de intervenciones que pongan de manifiesto la necesidad de hacer visible a este sujeto que sufre el daño colateral del cáncer infantil y que ha sido descuidado por su familia y por los profesionales en salud.
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Marchak JG, Christen S, Mulder RL, Baust K, Blom JMC, Brinkman TM, Elens I, Harju E, Kadan-Lottick NS, Khor JWT, Lemiere J, Recklitis CJ, Wakefield CE, Wiener L, Constine LS, Hudson MM, Kremer LCM, Skinner R, Vetsch J, Lee JL, Michel G. Recommendations for the surveillance of mental health problems in childhood, adolescent, and young adult cancer survivors: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Lancet Oncol 2022; 23:e184-e196. [PMID: 35358467 PMCID: PMC9639707 DOI: 10.1016/s1470-2045(21)00750-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/06/2021] [Accepted: 12/16/2021] [Indexed: 12/27/2022]
Abstract
Survivors of childhood, adolescent, and young adult (diagnosed when <25 years of age) cancer are at risk of mental health problems. The aim of this clinical practice guideline is to harmonise international recommendations for mental health surveillance in survivors of childhood, adolescent, and young adult cancer. This guideline was developed by a multidisciplinary panel of experts under the sponsorship of the International Guideline Harmonization Group. We evaluated concordance among existing survivorship clinical practice guidelines and conducted a systematic review following evidence-based methods. Of 7249 studies identified, 76 articles from 12 countries met the inclusion criteria. Recommendations were formulated on the basis of identified evidence in combination with clinical considerations. This international clinical practice guideline strongly recommends mental health surveillance for all survivors of childhood, adolescent, and young adult cancers at every follow-up visit and prompt referral to mental health specialists when problems are identified. Overall, the recommendations reflect the necessity of mental health surveillance as part of comprehensive survivor-focused health care.
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10
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Sato S, Li N, Dixon SB, Kato M, Zhang H, Li CK, Howell RM, Leisenring WM, Bhatia S, Oeffinger KC, Armstrong GT, Yasui Y, Krull KR, Cheung YT. Functional Outcomes and Social Attainment in Asian/Pacific Islander Childhood Cancer Survivors in the United States: A Report from the Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev 2021; 30:2244-2255. [PMID: 34607839 DOI: 10.1158/1055-9965.epi-21-0628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/27/2021] [Accepted: 09/23/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Given the relatively small population of Asians or Pacific Islanders (API) in the United States, studies describing long-term outcomes in API survivors of childhood cancer are limited. This study compared functional outcomes between API versus non-Hispanic White (NHW) survivors. METHODS This study included 203 API 5-year survivors [age at follow-up: 29.2 (SD = 6.3) years] and 12,186 NHW survivors [age at follow-up 31.5 (SD = 7.3) years] from the Childhood Cancer Survivor Study. Self-reported functional outcomes of neurocognitive function, emotional distress, quality of life, and social attainment were compared between the two groups using multivariable regression, adjusted for sex, age at diagnosis and evaluation, cancer diagnosis, and neurotoxic treatment. RESULTS No statistically significant race/ethnicity-based differences were identified in neurocognitive and emotional measures. API survivors reported, on average, less bodily pain than NHW survivors [mean 54.11 (SD = 8.98) vs. 51.32 (SD = 10.12); P < 0.001]. NHW survivors were less likely to have attained at least a college degree than API survivors [OR = 0.50; 95% confidence interval (CI) = 0.34-0.73]. API survivors were more likely than NHW survivors to be never-married (OR = 2.83; 95% CI = 1.93-4.13) and to live dependently (OR = 3.10; 95% CI = 2.02-4.74). Older age (>45 years), brain tumor diagnosis, and higher cranial radiation dose were associated with poorer functional outcomes in API survivors (all, P < 0.05). CONCLUSIONS We observed differences in social attainment between API and NHW survivors, although statistically significant differences in neurocognitive and emotional outcomes were not identified. IMPACT Future studies should evaluate whether racial/ethnic differences in environmental and sociocultural factors may have differential effects on health and functional outcomes.
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Affiliation(s)
- Satomi Sato
- Division of Health and Behavioral Sciences, St. Luke's International University, Tokyo, Japan
| | - Nan Li
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Stephanie B Dixon
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Miho Kato
- Department of Children's Cancer Data Management, National Center for Child Health and Development, Tokyo, Japan
| | - Hui Zhang
- Department of Hematology/Oncology, Shanghai Children's Medical Center, Shanghai, P.R. China.,Department of Hematology & Oncology, Guangzhou Women and Children's Medical Center, Guangzhou, P.R. China
| | - Chi Kong Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China.,Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China
| | - Rebecca M Howell
- Department of Radiation Physics, Division of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas
| | - Wendy M Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Smita Bhatia
- School of Medicine Institute for Cancer Outcomes and Survivorship, University of Alabama Birmingham, Birmingham, Alabama
| | | | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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11
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Hudson MM, Bhatia S, Casillas J, Landier W. Long-term Follow-up Care for Childhood, Adolescent, and Young Adult Cancer Survivors. Pediatrics 2021; 148:peds.2021-053127. [PMID: 34462344 PMCID: PMC9014377 DOI: 10.1542/peds.2021-053127] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Progress in therapy has made survival into adulthood a reality for most children, adolescents, and young adults with a cancer diagnosis today. Notably, this growing population remains vulnerable to a variety of long-term therapy-related sequelae. Systematic ongoing follow-up of these patients is, therefore, important to provide for early detection of and intervention for potentially serious late-onset complications. In addition, health counseling and promotion of healthy lifestyles are important aspects of long-term follow-up care to promote risk reduction for physical and emotional health problems that commonly present during adulthood. Both general and subspecialty health care providers are playing an increasingly important role in the ongoing care of childhood cancer survivors, beyond the routine preventive care, health supervision, and anticipatory guidance provided to all patients. This report is based on the guidelines that have been developed by the Children's Oncology Group to facilitate comprehensive long-term follow-up of childhood, adolescent, and young adult cancer survivors (www.survivorshipguidelines.org).
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Affiliation(s)
- Melissa M. Hudson
- Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Smita Bhatia
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
| | | | - Wendy Landier
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
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12
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Keng A, Stewart DE, Sheehan KA. Neuropsychiatric Symptoms After Brain Tumor Resection in Children and Adolescents: A Scoping Review. J Acad Consult Liaison Psychiatry 2021; 63:110-118. [PMID: 34229094 DOI: 10.1016/j.jaclp.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/23/2021] [Accepted: 06/26/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Brain tumors are one of the most common solid tumors in pediatric populations, with their treatments having significant neuropsychiatric impact. OBJECTIVE The objective of this study was to review the literature on neuropsychiatric sequelae after surgical resection of brain tumors in children and adolescents. METHODS Using a scoping method, we reviewed empirical articles describing pediatric patients with brain tumors who underwent partial or total resection and examined major neuropsychiatric domains postoperatively over time. RESULTS The initial search yielded 15,543 articles. After duplicate removal, abstract screening, and review, 44 articles were included. Cognitive deficits were the most widely studied outcomes and found to be associated with tumor location, operative variables, perioperative complications, treatment types, and psychosocial factors. Cerebellar mutism, or posterior fossa syndrome, commonly co-occurred with emotional and behavioral dysregulation after posterior fossa resections. Depression, anxiety, and somatization were frequently grouped together as "distress," with higher rates among pediatric patients with brain tumor than among healthy peers. Problematic school behaviors, antisocial, and attention-deficit traits were increased; however, several other behaviors (e.g., risky sexual behaviors, substance use) were equal or lower when compared to peers. Posttraumatic stress disorder was highly prevalent and often interfered with social functioning. Delirium, eating disorders, and longer-term outcomes received inadequate attention. CONCLUSION Identifying risk factors of neuropsychiatric sequelae and their impact after pediatric brain tumor resection is important for prognostication and the development of tailored management strategies for these children and adolescents.
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Affiliation(s)
- Alvin Keng
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - Donna E Stewart
- Centre for Mental Health, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Kathleen Ann Sheehan
- Centre for Mental Health, University Health Network, University of Toronto, Toronto, ON, Canada
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13
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Salchow J, Koch B, Mann J, von Grundherr J, Elmers S, Dwinger S, Escherich G, Vettorazzi E, Reer R, Sinn M, Baumann F, Bokemeyer C, Stein A, Jensen W. Effects of a structured counselling-based intervention to improve physical activity behaviour of adolescents and young adult cancer survivors - the randomized phase II Motivate AYA - MAYA trial. Clin Rehabil 2021; 35:1164-1174. [PMID: 33685232 PMCID: PMC8273535 DOI: 10.1177/0269215521997974] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective: To explore whether a structured counselling-based intervention increases vigorous physical activity behaviour of adolescent and young adult cancer survivors. Design: Randomized controlled phase II trial. Setting: University Cancer Center Hamburg, Germany. Subjects: Eighty-nine participants (mean age 24.1 ± 6.3) were randomized to control (n = 44) or intervention group (n = 45). Interventions: The intervention group was consulted about physical activity behaviour via interview (week 0), and telephone counselling (weeks 1, 3 and 12). The control group only received general physical activity guidelines for cancer survivors (week 0). Main measures: The primary outcome was the rate of participants with ⩾9 metabolic equivalent (MET)-hours per week of vigorous activity post-intervention, measured with the International Physical Activity Questionnaire. Secondary outcomes included assessing physical activity behaviour (e.g. amount and type of physical activity) and quality of life. Assessments were completed in weeks 0 (baseline), 12 (post-intervention) and 52 (follow-up). Results: Sixty-nine participants completed the post-intervention- and 47 the follow-up-assessment. The rate of participants performing vigorous physical activity increased from baseline to post-intervention for both without differing significantly (P = 0.541). Both increased their total metabolic equivalent from baseline to post-intervention (intervention group from 55.2 ± 43.7 to 61.7 ± 29.4, control group from 75.3 ± 81.4 to 88.3 ± 80.2). At follow-up the intervention group (73.7 ± 80.2) was more active than baseline when compared to the control group (78.5 ± 50.0). Conclusions: A structured counselling-based physical activity intervention did not significantly impact the level of vigorous physical activity behaviour in adolescent and young adult cancer survivors.
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Affiliation(s)
- Jannike Salchow
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Barbara Koch
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Mann
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia von Grundherr
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon Elmers
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Dwinger
- Department for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eik Vettorazzi
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rüdiger Reer
- Institute of Human Movement Science, Faculty of Psychology and Human Movement, University of Hamburg, Hamburg, Germany
| | - Marianne Sinn
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Freerk Baumann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University Hospital of Cologne, Cologne, Nordrhein-Westfalen, Germany
| | - Carsten Bokemeyer
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Stein
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wiebke Jensen
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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14
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Schulte F, Forbes C, Wurz A, Patton M, Russell KB, Pluijm S, Krull KR. Childhood Cancer Survivorship: Daily Challenges. Pediatr Clin North Am 2020; 67:1083-1101. [PMID: 33131536 DOI: 10.1016/j.pcl.2020.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Survivors of childhood cancer are at risk of experiencing fatigue, pain, lower levels of physical activity, increased engagement in risky health behavior, and poor social adjustment, after finishing treatment. Risks are more pronounced for survivors of specific diagnoses or receiving specific treatment protocols. Interventions to address these outcomes are in their infancy. Future research should focus on exploring the antecedents and consequences of these outcomes. In the meantime, researchers and cancer centers should attempt to provide high-quality and accessible health information to survivors through various media outlets to encourage healthy behaviors.
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Affiliation(s)
- Fiona Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada.
| | - Caitlin Forbes
- University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Amanda Wurz
- University of Calgary, Calgary, Alberta, Canada
| | | | | | - Saskia Pluijm
- Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Kevin R Krull
- St. Jude Children's Research Hospital, Memphis, TN, USA
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15
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Berkman AM, Robert RS, Roth M, Askins MA. A review of psychological symptoms and post-traumatic growth among adolescent and young adult survivors of childhood cancer. J Health Psychol 2020; 27:990-1005. [PMID: 33153307 DOI: 10.1177/1359105320971706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The majority of childhood cancer patients survive well into adulthood, but remain at risk for psychological late effects that can impact overall health and quality of life. The current narrative review summarizes the literature on psychological late effects, including anxiety, depression, psychological distress, post-traumatic stress disorder, suicidality, psychoactive medication use, and post-traumatic growth in survivors of childhood cancers. While results were mixed, many studies demonstrated that psychological symptoms occurred at levels higher than would be expected in the general population. Treatment, environmental, and behavioral risk factors, as well as symptom onset and trajectory merit further investigation.
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Affiliation(s)
| | | | - Michael Roth
- The University of Texas MD Anderson Cancer Center, USA
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16
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Peng L, Yam PPY, Yang LS, Sato S, Li CK, Cheung YT. Neurocognitive impairment in Asian childhood cancer survivors: a systematic review. Cancer Metastasis Rev 2020; 39:27-41. [PMID: 31965433 DOI: 10.1007/s10555-020-09857-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Childhood cancer survivors are at higher risk of developing neurocognitive deficits due to the intensive treatment they received at an early age. Most studies on childhood cancer survivorship have so far focused on the Western populations. Due to the ethnic, genetic, environmental, and cultural differences, clinical data of the Western populations may not be representative of Asian countries. This scoping review systematically summarized the existing clinical evidence of the neurocognitive impairment of Asian childhood cancer survivors. We searched the Embase and Medline databases for studies assessing the neurocognitive functions of survivors in Asia, who were diagnosed with cancer before the age of 19 and completed active treatment. The literature search identified 13 studies involving 2212 participants from five Asian countries: South Korea (n = 4, 30.8%), Taiwan (n = 3, 23.1%), Japan (n = 3, 23.1%), Hong Kong (n = 2, 15.4%), and Thailand (n = 1, 7.7%). The included studies focused on CNS tumors (n = 10, 76.9%), hematological malignancies (n = 7, 53.8%), or heterogeneous cancer diagnoses (n = 3, 23.1%). Collectively, mild-to-moderate impairment in intelligence was observed in 10.0 to 42.8% of survivors, which seemed higher than the reported rate in Western survivors. We speculate that the ethnic and genetic variations in drug responses and susceptibility to adverse chronic toxicities may have contributed to the differences in the prevalence and severity of neurocognitive impairment between these two populations. To better understand the effects of culturally relevant and region-specific environmental risk factors on the post-treatment neurocognitive development in cancer survivors, a holistic approach that addresses the complex interactions between biological, physical, and psychosocial factors is needed. This will aid the development of effective intervention strategies to improve the functional and psychosocial outcomes of cancer survivors in Asian societies.
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Affiliation(s)
- Liwen Peng
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, 8th Floor, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, Shatin, New Territories, Hong Kong
| | - Perri Pui-Yan Yam
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, 8th Floor, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, Shatin, New Territories, Hong Kong
| | - Lok Sum Yang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, 8th Floor, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, Shatin, New Territories, Hong Kong
| | - Satomi Sato
- Graduate School of Public Health, Faculty of Health and Behavioral Science, St. Luke's International University, Tokyo, Japan
| | - Chi Kong Li
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.,Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Kowloon Bay, Hong Kong
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, 8th Floor, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, Shatin, New Territories, Hong Kong.
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17
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Pinto S, Fresneau B, Hounsossou HC, Mayet A, Marchi J, Pein F, Journy N, Mansouri I, Drubay D, Letort V, Lemler S, Demoor-Goldschmidt C, Jackson A, Souchard V, Vu-Bezin G, Diallo I, Rubino C, Oberlin O, Haddy N, de Vathaire F, Dumas A, Allodji RS. Identifying clusters of health risk behaviors and their predictors in adult survivors of childhood cancer: A report from the French Childhood Cancer Survivor Study. Psychooncology 2020; 29:1595-1603. [PMID: 32658375 DOI: 10.1002/pon.5470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 06/20/2020] [Accepted: 07/01/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Health risk behaviors (HRB) of childhood cancer survivors (CCS) are generally studied separately, despite the evidence suggesting that HRB are not independent. To our knowledge, few studies have examined HRB profiles in the former pediatric cancer patients. In this study, we identified HRB profiles and examined predictors engaging in unhealthy behaviors in CCS. METHODS We used data from a French cohort of CCS that includes five-year survivors diagnosed between 1945 and 2000 and treated before reaching age 18, in five centers in France. A total of 2961 adult CCS answered a self-reported questionnaire pertaining to HRB. Latent class analysis was used to identify HRB profiles combining physical activity, smoking, cannabis use, and alcohol drinking. Multinomial logistic analyses examined predictors for engaging in unhealthy behaviors. RESULTS Three HRB patterns emerged: "Low-risk" (n = 1846, 62.3%) included CCS who exhibited the highest frequency for usual physical activity and the lowest probabilities for current smoking or cannabis use, but most drank at least moderately; "Moderate-risk behaviors" (n = 291, 9.8%), and "High-risk behaviors" (n = 824, 27.8%) for CCS who exhibited the highest frequencies for current smoking, cannabis use, and heavy drinking. The multivariable regression revealed that male CCS, less educated or not married were significantly more likely to be in the high-risk behaviors group than the low-risk group. CONCLUSIONS As CCS remain a vulnerable population, screening for HRB should be routinized in long-term follow-up care and interventions targeting multiple HRB simultaneously among survivors should be developed.
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Affiliation(s)
- Sandrine Pinto
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Brice Fresneau
- Gustave Roussy, Department of Pediatric oncology, Université Paris-Saclay, Villejuif, France
| | - Hubert C Hounsossou
- Polytechnic School of Abomey-Calavi (EPAC), University of Abomey-Calavi, Cotonou, Benin
| | - Aurélie Mayet
- Center for Epidemiology and Public Health of the French Army (CESPA), Marseille, France
| | - Joeffrey Marchi
- Center for Epidemiology and Public Health of the French Army (CESPA), Marseille, France
| | - François Pein
- Département de Recherche, Institut de Cancérologie de l'Ouest, Site René Gauducheau CLCC Nantes-Atlantique, Saint-Herblain, France
| | - Neige Journy
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Imene Mansouri
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Damien Drubay
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Villejuif, France
| | - Véronique Letort
- Laboratory of Mathematics in Interaction with Computer Science (MICS), CentraleSupélec, Gif-sur-Yvette, France
| | - Sarah Lemler
- Laboratory of Mathematics in Interaction with Computer Science (MICS), CentraleSupélec, Gif-sur-Yvette, France
| | - Charlotte Demoor-Goldschmidt
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France.,Département de Recherche, Institut de Cancérologie de l'Ouest, Site René Gauducheau CLCC Nantes-Atlantique, Saint-Herblain, France.,Pediatric Oncology, Chu de Nantes, Nantes, France
| | - Angela Jackson
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Vincent Souchard
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Giao Vu-Bezin
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Ibrahima Diallo
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Carole Rubino
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Odile Oberlin
- Gustave Roussy, Department of Pediatric oncology, Université Paris-Saclay, Villejuif, France
| | - Nadia Haddy
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Florent de Vathaire
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France
| | - Agnès Dumas
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France.,ECEVE-INSERM UMR 1123, Paris, France
| | - Rodrigue S Allodji
- University of Paris-Saclay, University of Paris-Sud, UVSQ, CESP, Radiation Epidemiology Team, Villejuif, France.,INSERM, CESP, Radiation Epidemiology Team, Villejuif, France.,Gustave Roussy, Department of Clinical Research, Radiation Epidemiology Team, Villejuif, France.,Polytechnic School of Abomey-Calavi (EPAC), University of Abomey-Calavi, Cotonou, Benin
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18
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Asvat Y, King AC, Smith LJ, Lin X, Hedeker D, Henderson TO. Substance use behaviors in adolescent and young adult cancer patients: Associations with mental and physical health. Psychooncology 2020; 29:1068-1076. [PMID: 32154963 DOI: 10.1002/pon.5378] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/25/2020] [Accepted: 03/03/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Cancer diagnosis in adolescents and young adults (AYAs) coincides with the developmental initiation of substance use and emergence of affective disturbance. We examined substance use behaviors and risk-stratified associations with mental and physical health, as well as objective indicators of tobacco and cannabis use and concordance with self-report and medical records. METHODS AYAs were 15 to 39 years at cancer diagnosis and ≥18 years and ≥6 months postdiagnosis at study enrollment. Risk-stratified groups included nonsmoker/nondrinker, nonsmoker/drinker, smoker/drinker. Assessments included demographics, past year tobacco, alcohol, and cannabis use, depression, anxiety, sleep, and physical activity. Urine analysis provided biochemical verification of tobacco and cannabis use. RESULTS Participants included 100 AYAs (60% male) with primarily hematological cancers (88%). Past year alcohol, tobacco, and cannabis use prevalence rates were 80%, 15%, and 33%, respectively. A minority (non-users) refrained from both alcohol and tobacco (20%), while most were exclusively alcohol users (65%) or alcohol and tobacco co-users (15%). Relative to other sub-groups, co-users reported more depressive and anxious symptoms, while non-users reported more physical activity. More frequent tobacco and cannabis use were associated with more depressive and anxious symptoms, while more frequent alcohol use was associated with lower physical activity. There were no group differences or associations with sleep quality. There was considerable discordance between tobacco use self-report, biochemical verification, and medical record documentation. CONCLUSIONS Substance use among AYAs is common and detrimental to mental and physical health, especially among more frequent users and co-users, highlighting the need for early assessment and intervention.
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Affiliation(s)
- Yasmin Asvat
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Andrea C King
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Lia J Smith
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Xiaolei Lin
- School of Data Science, Fudan University, Shanghai, China, USA
| | - Donald Hedeker
- Department of Public Health Sciences and College, University of Chicago, Chicago, Illinois, USA
| | - Tara O Henderson
- Department of Pediatrics, University of Chicago, Chicago, Illinois, USA
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19
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Salchow J, Mann J, Koch B, von Grundherr J, Jensen W, Elmers S, Straub LA, Vettorazzi E, Escherich G, Rutkowski S, Dwinger S, Bergelt C, Sokalska-Duhme M, Bielack S, Calaminus G, Baust K, Classen CF, Rössig C, Faber J, Faller H, Hilgendorf I, Gebauer J, Langer T, Metzler M, Schuster S, Niemeyer C, Puzik A, Reinhardt D, Dirksen U, Sander A, Köhler M, Habermann JK, Bokemeyer C, Stein A. Comprehensive assessments and related interventions to enhance the long-term outcomes of child, adolescent and young adult cancer survivors - presentation of the CARE for CAYA-Program study protocol and associated literature review. BMC Cancer 2020; 20:16. [PMID: 31906955 PMCID: PMC6945396 DOI: 10.1186/s12885-019-6492-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 12/23/2019] [Indexed: 12/21/2022] Open
Abstract
Background Improved, multimodal treatment strategies have been shown to increase cure rates in cancer patients. Those who survive cancer as a child, adolescent or young adult (CAYA), are at a higher risk for therapy-, or disease-related, late or long-term effects. The CARE for CAYA-Program has been developed to comprehensively assess any potential future problems, to offer need-based preventative interventions and thus to improve long-term outcomes in this particularly vulnerable population. Methods The trial is designed as an adaptive trial with an annual comprehensive assessment followed by needs stratified, modular interventions, currently including physical activity, nutrition and psycho-oncology, all aimed at improving the lifestyle and/or the psychosocial situation of the patients. Patients, aged 15–39 years old, with a prior cancer diagnosis, who have completed tumour therapy and are in follow-up care, and who are tumour free, will be included. At baseline (and subsequently on an annual basis) the current medical and psychosocial situation and lifestyle of the participants will be assessed using a survey compiled of various validated questionnaires (e.g. EORTC QLQ C30, NCCN distress thermometer, PHQ-4, BSA, nutrition protocol) and objective parameters (e.g. BMI, WHR, co-morbidities like hyperlipidaemia, hypertension, diabetes), followed by basic care (psychological and lifestyle consultation). Depending on their needs, CAYAs will be allocated to preventative interventions in the above-mentioned modules over a 12-month period. After 1 year, the assessment will be repeated, and further interventions may be applied as needed. During the initial trial phase, the efficacy of this approach will be compared to standard care (waiting list with intervention in the following year) in a randomized study. During this phase, 530 CAYAs will be included and 320 eligible CAYAs who are willing to participate in the interventions will be randomly allocated to an intervention. Overall, 1500 CAYAs will be included and assessed. The programme is financed by the innovation fund of the German Federal Joint Committee and will be conducted at 14 German sites. Recruitment began in January 2018. Discussion CAYAs are at high risk for long-term sequelae. Providing structured interventions to improve lifestyle and psychological situation may counteract against these risk factors. The programme serves to establish uniform regular comprehensive assessments and need-based interventions to improve long-term outcome in CAYA survivors. Trial registration Registered at the German Clinical Trial Register (ID: DRKS00012504, registration date: 19th January 2018).
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Affiliation(s)
- J Salchow
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - J Mann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Koch
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J von Grundherr
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - W Jensen
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Elmers
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L A Straub
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E Vettorazzi
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Escherich
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Rutkowski
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Dwinger
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Bergelt
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - S Bielack
- Klinikum Stuttgart, Olgahospital, Stuttgart, Germany
| | | | - K Baust
- University Hospital Bonn, Bonn, Germany
| | - C F Classen
- University Hospital Rostock, Rostock, Germany
| | - C Rössig
- University Children's Hospital Münster, Münster, Germany
| | - J Faber
- Mainz University Medical Center, Mainz, Germany
| | - H Faller
- University Hospital Würzburg, Würzburg, Germany
| | | | - J Gebauer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - T Langer
- University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - M Metzler
- University Hospital Erlangen, Erlangen, Germany
| | - S Schuster
- University Hospital Erlangen, Erlangen, Germany
| | - C Niemeyer
- Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - A Puzik
- Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - D Reinhardt
- University Hospital Essen, Essen, Germany.,German Cancer Consortium, Essen, Germany
| | - U Dirksen
- University Hospital Essen, Essen, Germany.,German Cancer Consortium, Essen, Germany
| | - A Sander
- Hannover Medical School, Hannover, Germany
| | - M Köhler
- Medical Faculty University Hospital Magdeburg, Magdeburg, Germany
| | | | - C Bokemeyer
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Stein
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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20
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Jong MC, Lown A, Schats W, Otto HR, Jong M. Mapping the concept, content and outcome of wilderness therapy for childhood cancer survivors: protocol for a scoping review. BMJ Open 2019; 9:e030544. [PMID: 31481374 PMCID: PMC6731868 DOI: 10.1136/bmjopen-2019-030544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Long-term childhood cancer survivors are at risk for frailty and have significant health-related issues in adulthood. Various health promotion interventions have been proposed to enhance quality of life including wilderness therapy, which applies the impact of nature on health in a therapeutic context. Previous studies have described positive outcomes linked with various wilderness-related therapies for cancer survivors. However, there is no clarity on the role these therapies play in childhood cancer. The current scoping review aims to systematically map the concept, content and outcome of wilderness therapy for childhood cancer survivors. METHODS AND ANALYSIS This review will be guided by the Joanna Briggs Institute Reviewers' manual for scoping reviews. A systematic literature search using medical subject headings (MeSH) and text words related to wilderness therapy and childhood cancer survivors will be performed in EMBASE, ERIC, Medline, Psycinfo, CINAHL, Scopus, Web of Science, SPORTDiscus and Svemed+, Sociological Abstracts, supplemented by grey literature searches. Eligible quantitative and qualitative studies will be screened, included, assessed for quality and extracted for data by two reviewers independently. Results will be described in a narrative style, reported in extraction tables and diagrams, and where appropriate in themes and text. ETHICS AND DISSEMINATION This study describes a protocol for a scoping review that will undertake secondary analysis of data already published in literature and is therefore exempt from medical ethical review. The scoping review will inform understanding of the benefits and risks of wilderness therapy for childhood cancer survivors, their families, practitioners, clinicians and researchers, and will help elucidate the steps necessary for building its evidence base going forward. Results will be published in a peer-reviewed scientific journal.
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Affiliation(s)
- Miek C Jong
- Department of Health Sciences, Mid Sweden University, Campus Sundsvall, Sundsvall, Sweden
- The Arctic University of Norway, National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT, Tromsø, Norway
| | - Anne Lown
- Department of Social Behavioral Sciences, University of California San Francisco, San Francisco, California, USA
| | - Winnie Schats
- Scientific Information Service, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Mats Jong
- Department of Health Sciences, Mid Sweden University, Campus Sundsvall, Sundsvall, Sweden
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21
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Fisher RS, Rausch JR, Ferrante AC, Prussien KV, Olshefski RS, Vannatta KA, Compas BE, Gerhardt CA. Trajectories of health behaviors across early childhood cancer survivorship. Psychooncology 2018; 28:68-75. [PMID: 30402997 DOI: 10.1002/pon.4911] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/27/2018] [Accepted: 10/02/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The majority of childhood cancer survivors develop at least one late effect subsequent to treatment (eg, cardiovascular disease and obesity). Consistent engagement in recommended health behaviors may mitigate some of these conditions. Researchers have identified early survivorship as a teachable moment, yet few studies have examined positive health behaviors during this period. METHODS Families of children with cancer (ages 5-17) were initially recruited following a diagnosis or relapse of cancer. Three years post diagnosis, survivors (n = 82, Mage = 13.3, SD = 3.7) and their mothers (n = 103, Mage = 41.1, SD = 7.6) completed a questionnaire assessing exercise, dietary, and sleep patterns among survivors. A follow-up assessment was conducted 2 years later. Mixed models tested change in health behavior over time. RESULTS At 3- and 5-year post diagnosis, mother and self-report indicated that few survivors engaged in appropriate levels of low-intensity exercise, fruit/vegetable intake, and dairy consumption. However, most survivors engaged in recommended levels of high intensity exercise, fast food restriction, and sleep. Health behaviors remained stable over time, except for mother report of sleep duration, which decreased (b = -0.6, P < 0.001). Brain tumor diagnosis predicted a larger decrease in self-report of sleep duration compared with other diagnoses (P = 0.04). Income predicted fast food intake such that higher income was associated with decreased intake over time, whereas lower income was associated with increased intake (P = 0.04). CONCLUSIONS During early survivorship, several health behaviors fell short of expectations for exercise and diet and did not improve upon reaching 5-year post diagnosis. Providers should evaluate survivors' health behaviors, including sleep, early and often, intervening when necessary.
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Affiliation(s)
- Rachel S Fisher
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Joseph R Rausch
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, The Ohio State University, Columbus, Ohio
| | - Amanda C Ferrante
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Kemar V Prussien
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee
| | - Randal S Olshefski
- Department of Pediatrics, The Ohio State University, Columbus, Ohio.,Division of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, Ohio
| | - Kathryn A Vannatta
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, The Ohio State University, Columbus, Ohio.,Department of Psychology, The Ohio State University, Columbus, Ohio
| | - Bruce E Compas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,Department of Pediatrics, The Ohio State University, Columbus, Ohio.,Department of Psychology, The Ohio State University, Columbus, Ohio
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22
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Diorio C, Lin M, Ginn E, Ladas EJ. Psychosocial determinants of physical activity and dietary behaviors in adolescents and young adults with cancer and survivors. Pediatr Blood Cancer 2018; 65:e27243. [PMID: 29797639 DOI: 10.1002/pbc.27243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Survivors of childhood cancer are at increased risk of lifestyle influenced health issues. We sought to understand the association between stages of change (SOC) and psychosocial variables related to modifiable health behaviors: physical activity (PA), dietary fat intake, and intake of fruits and vegetables among adolescents and young adults at different phases of cancer therapy. METHODS We conducted an exploratory cross-sectional survey of adolescents and young adults currently being treated for cancer or who are survivors of childhood cancer. We evaluated SOC and several psychosocial variables using the previously validated Patient-Centered Assessment and Counseling for Exercise (PACE+): Physical Activity and Diet Surveys for Adolescents tool. Current dietary behaviors were evaluated with 24 hr diet recall. RESULTS One hundred and eighteen patients participated in the survey. SOC did not vary by phase of treatment. Ethnicity and body mass index were strongly associated with SOC for PA, but not for dietary behaviors. There was a significant association between SOC and self-efficacy, knowledge of strategies, and family or friend support for PA, dietary fat, and fruits and vegetables. Higher self-efficacy and family support were significant variables impacting SOC and participants' reported intake of fruits and vegetables servings. CONCLUSION We demonstrate that SOC for the investigated behaviors did not change based on phase of treatment, supporting the initiation of lifestyle interventions early on in treatment. We identify several psychosocial variables that may act as important targets for future lifestyle interventions aimed to improve dietary and exercise behaviors in adolescents and young adults with cancer and survivors.
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Affiliation(s)
- Caroline Diorio
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Meiko Lin
- Teachers College, Columbia University
| | - Elizabeth Ginn
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York
| | - Elena J Ladas
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York.,Institute of Human Nutrition, Columbia University Medical Center, New York
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23
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van der Kooi ALLF, Brewster DH, Wood R, Nowell S, Fischbacher C, van den Heuvel-Eibrink MM, Laven JSE, Wallace WHB, Anderson RA. Perinatal risks in female cancer survivors: A population-based analysis. PLoS One 2018; 13:e0202805. [PMID: 30138451 PMCID: PMC6107257 DOI: 10.1371/journal.pone.0202805] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 08/09/2018] [Indexed: 12/16/2022] Open
Abstract
Background/objectives Advances in cancer management have resulted in improved survival rates, particularly in children and young adults. However, treatment may adversely affect reproductive outcomes among female cancer survivors. The objective of this study was to investigate their risk of adverse perinatal outcomes compared to the general population. Design/methods We performed a population-based analysis, including all female cancer survivors diagnosed before the age of 40 years between 1981 and 2012. Pregnancy and perinatal complications were identified through linkage of the Scottish Cancer Registry with hospital discharge records based on the Community Health Index (CHI) database. We compared 1,629 female cancer survivors with a first ever singleton pregnancy after diagnosis, with controls matched on age, deprivation quintile, and year of cancer diagnosis selected from the general population (n = 8,899). Relative risks and 95%-confidence intervals of perinatal risks were calculated using log-binomial regression. Results Survivors were more likely to give birth before 37 weeks of gestation (relative risk (RR]) 1.32, 95%-CI 1.10–1.59), but did not show an increased risk of low birth weight (<2.5kg: RR 1.15, 95%-CI 0.94–1.39), and were less likely to give birth to offspring small for gestational age (RR 0.81, 95%-CI 0.68–0.98). Operative delivery and postpartum haemorrhage were more common but approached rates in controls with more recent diagnosis. The risk of congenital abnormalities was not increased (RR 1.01, 95%-CI 0.85–1.20). Conclusion Cancer survivors have an increased risk of premature delivery and postpartum haemorrhage, but their offspring are not at increased risk for low birth weight or congenital abnormalities. In recent decades there has been a normalisation of delivery method in cancer survivors, nevertheless careful management remains appropriate particularly for those diagnosed in childhood.
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Affiliation(s)
- Anne-Lotte L. F. van der Kooi
- Department of Obstetrics and Gynecology, Erasmus MC–Sophia Children’s Hospital, Rotterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - David H. Brewster
- Scottish Cancer Registry, Information Services Division, NHS National Services Scotland, Edinburgh, Scotland
| | - Rachael Wood
- Information Services Division, NHS National Services Scotland, Edinburgh, Scotland
| | - Sian Nowell
- eData Research & Innovation Service (eDRIS), Information Services Division, NHS National Services Scotland and Farr Institute Scotland, Edinburgh, Scotland
| | - Colin Fischbacher
- Scottish Cancer Registry, Information Services Division, NHS National Services Scotland, Edinburgh, Scotland
| | | | - Joop S. E. Laven
- Department of Obstetrics and Gynecology, Erasmus MC–Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - W. Hamish B. Wallace
- Department of Oncology and Haematology, Royal Hospital for Sick Children, Sciennes Road, Edinburgh, Scotland
| | - Richard A. Anderson
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
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24
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Long KA, Lehmann V, Gerhardt CA, Carpenter AL, Marsland AL, Alderfer MA. Psychosocial functioning and risk factors among siblings of children with cancer: An updated systematic review. Psychooncology 2018; 27:1467-1479. [DOI: 10.1002/pon.4669] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 01/18/2018] [Accepted: 01/29/2018] [Indexed: 12/23/2022]
Affiliation(s)
| | - Vicky Lehmann
- Department of Pediatrics and Psychology; Ohio State University; Columbus OH USA
- Center for Biobehavioral Health Research Institute at Nationwide Children's Hospital; Columbus OH USA
| | - Cynthia A. Gerhardt
- Department of Pediatrics and Psychology; Ohio State University; Columbus OH USA
- Center for Biobehavioral Health Research Institute at Nationwide Children's Hospital; Columbus OH USA
| | | | | | - Melissa A. Alderfer
- Nemours Children's Health System/A.I. duPont Hospital for Children; Wilmington DE USA
- Sidney Kimmel Medical College; Thomas Jefferson University; Philadelphia PA USA
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25
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Distance-delivered physical activity interventions for childhood cancer survivors: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2017; 118:27-41. [DOI: 10.1016/j.critrevonc.2017.08.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 07/05/2017] [Accepted: 08/21/2017] [Indexed: 11/21/2022] Open
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26
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Buchbinder D, Lown EA. Response to: "Tobacco use among siblings of childhood cancer survivors: A report from the childhood cancer survivor study". Pediatr Blood Cancer 2017; 64. [PMID: 28052553 DOI: 10.1002/pbc.26417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 11/08/2022]
Affiliation(s)
- David Buchbinder
- Department of Pediatrics and Division of Hematology at Children's Hospital of Orange County, Orange, California
| | - E Anne Lown
- Department of Social and Behavioral Sciences, University of California at San Francisco, San Francisco, California
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27
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Berkman AM, Brewster AM, Jones LW, Yu J, Lee JJ, Peng SA, Crocker A, Ater JL, Gilchrist SC. Racial Differences in 20-Year Cardiovascular Mortality Risk Among Childhood and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2017; 6:414-421. [PMID: 28530506 DOI: 10.1089/jayao.2017.0024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Whether cardiovascular disease (CVD) risk differs according to race and cancer type among survivors of childhood or young adulthood cancers is unknown. METHODS Data from the years 1973-2011 were analyzed using the Surveillance, Epidemiology, and End Results (SEER) registries. Cases were categorized by ICD-0-3/WHO 2008 Adolescent and Young Adult classification. CVD death was determined by ICD-10 codes for diseases of the heart, atherosclerosis, cerebrovascular diseases, or other diseases of the arteries. Cox proportional hazards models were fitted to evaluate the hazard ratio (HR) and 95% confidence intervals (CIs) for the effects of race on time-to-event outcomes. RESULTS A total of 164,316 cases of childhood and young adult primary cancers were identified. There were 43,335 total and 1466 CVD deaths among Black and White survivors. Black survivors had higher risks of all-cause mortality (HR: 1.75, 95% CI: 1.70-1.7) and CVD mortality (HR: 2.13, 95% CI: 1.85-2.46) compared to White survivors. The increased risk of CVD for Black survivors compared to White survivors persisted at 5-years (HR: 2.38, 95% CI: 1.83-3.10), 10-years (HR: 2.59, 95% CI: 2.09-3.21), and 20-years (HR: 2.31, 95% CI: 1.95-2.74) postdiagnosis, and varied by cancer type, with the highest HRs for melanoma (HR: 8.16, 95% CI: 1.99-33.45) and thyroid cancer (HR: 3.43, 95% CI: 1.75-6.73). CONCLUSIONS Black survivors of childhood or young adulthood cancers have a higher risk of CVD mortality compared to Whites that varies by cancer type. Knowledge of at-risk populations is important to guide surveillance recommendations and behavioral interventions. Further study is needed to understand the etiology of racial differences in CVD mortality in this population.
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Affiliation(s)
- Amy M Berkman
- 1 Larner College of Medicine, University of Vermont , Burlington, Vermont
| | - Abenaa M Brewster
- 2 Department of Clinical Cancer Prevention, The University of Texas M.D. Anderson Cancer Center , Houston, Texas
| | - Lee W Jones
- 3 Department of Medicine, Memorial Sloan Kettering Cancer Center , New York, New York
| | - Jun Yu
- 4 Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center , Houston, Texas
| | - J Jack Lee
- 4 Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center , Houston, Texas
| | - S Andrew Peng
- 4 Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center , Houston, Texas
| | - Abigail Crocker
- 5 Department of Mathematics and Statistics, University of Vermont , Burlington, Vermont
| | - Joann L Ater
- 6 Division of Pediatrics, The University of Texas M.D. Anderson Cancer Center , Houston, Texas
| | - Susan C Gilchrist
- 2 Department of Clinical Cancer Prevention, The University of Texas M.D. Anderson Cancer Center , Houston, Texas
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