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Curran L, Mahoney A, Hastings B. A Systematic Review of Trajectories of Clinically Relevant Distress Amongst Adults with Cancer: Course and Predictors. J Clin Psychol Med Settings 2024:10.1007/s10880-024-10011-x. [PMID: 38704756 DOI: 10.1007/s10880-024-10011-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2024] [Indexed: 05/07/2024]
Abstract
To improve interventions for people with cancer who experience clinically relevant distress, it is important to understand how distress evolves over time and why. This review synthesizes the literature on trajectories of distress in adult patients with cancer. Databases were searched for longitudinal studies using a validated clinical tool to group patients into distress trajectories. Twelve studies were identified reporting trajectories of depression, anxiety, adjustment disorder or post-traumatic stress disorder. Heterogeneity between studies was high, including the timing of baseline assessments and follow-up intervals. Up to 1 in 5 people experienced persistent depression or anxiety. Eight studies examined predictors of trajectories; the most consistent predictor was physical symptoms or functioning. Due to study methodology and heterogeneity, limited conclusions could be drawn about why distress is maintained or emerges for some patients. Future research should use valid clinical measures and assess theoretically driven predictors amendable to interventions.
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Affiliation(s)
- Leah Curran
- Health@Business Research Network, School of Management and Governance, University of New South Wales, High Street, Kensington, Australia.
- The Kinghorn Cancer Centre, St Vincent's Hospital Network, 370 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia.
| | - Alison Mahoney
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital Network, 390 Victoria Street, Darlinghurst, Australia
- School of Psychiatry, University of New South Wales, High Street, Kensington, Australia
| | - Bradley Hastings
- Health@Business Research Network, School of Management and Governance, University of New South Wales, High Street, Kensington, Australia
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2
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Wang S, Deng Y, Zhang Y, Guo VY, Zhang B, Cheng X, Xin M, Hao Y, Hou F, Li J. The role of illness-related cognition in the relationships between resilience and depression/anxiety in nasopharyngeal cancer patients. Cancer Med 2023; 12:21408-21418. [PMID: 37991167 PMCID: PMC10726906 DOI: 10.1002/cam4.6688] [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: 08/04/2023] [Revised: 10/05/2023] [Accepted: 10/26/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE Resilience has been reported as an important predictor of better mental health and prognoses in cancer patients, while its mechanisms were not clearly elucidated. In this study, we surveyed a large sample of nasopharyngeal carcinoma patients to investigate the mediating role of illness-related cognition (illness perception, stigma and meaning in life) on the associations between resilience and symptoms of anxiety and depression. METHODS This cross-sectional study involved 773 participants diagnosed with nasopharyngeal carcinoma. Participants completed a self-reported structured questionnaire to assess their illness perception, stigma and meaning in life, resilience and symptoms of anxiety and depression. Structural equation models (SEM) were employed to explore the relationship between resilience and symptoms of anxiety and depression in the entire sample, as well as in two subgroups: Subgroup I (0-1 year since diagnosis), and Subgroup II (over 1 year since diagnosis). RESULTS In the entire sample, after adjusting for potential confounders, illness perception, stigma and meaning in life were found to mediate the protective effect of resilience on symptoms of depression (mediating effect proportion: 65.25%) and anxiety (mediating effect proportion: 67.63%). In Subgroup I, direct effects were dominant in the associations between resilience and symptoms of anxiety (mediating effect proportion: 37.95%) and depression (mediating effect proportion: 29.13%). However, in Subgroup II, the associations between resilience and symptoms of anxiety (mediating effect proportion: 98.92%) and depression (mediating effect proportion: 81.04%) were completely mediated. CONCLUSIONS Our study suggests that direct and indirect effects of resilience on depression and anxiety dominate in early periods (0-1 year) and long-term periods (over 1 year) following the cancer diagnosis, respectively. The findings indicate that comprehensive intervention considering both the direct effect of resilience in early stages (e.g., health education prescription and social support groups) and the indirect effects of illness cognition in long-term periods (e.g., cognitive behavioral therapies) are likely to yield the most favorable outcomes for cancer patients.
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Affiliation(s)
- Shenghao Wang
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Yang Deng
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Yuan Zhang
- Sun Yat‐sen Global Health InstituteSun Yat‐sen UniversityGuangzhouChina
- Department of Radiation OncologySun Yat‐sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouChina
| | - Vivian Yawei Guo
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Bo Zhang
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Xi Cheng
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Meiqi Xin
- Department of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityHong KongChina
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response Peking UniversityBeijingChina
- Key Laboratory of Epidemiology of Major Diseases (Peking University)Ministry of EducationBeijingChina
| | - Fengsu Hou
- Sun Yat‐sen Global Health InstituteSun Yat‐sen UniversityGuangzhouChina
- Department of Public HealthShenzhen Kangning HospitalShenzhenChina
| | - Jinghua Li
- Department of Medical Statistics, School of Public HealthSun Yat‐sen UniversityGuangzhouChina
- Sun Yat‐sen Global Health InstituteSun Yat‐sen UniversityGuangzhouChina
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Cherba M, Brummans BHJM, Hier MP, Giguère L, Chartier G, Jacobs H, Forest VI, Mlynarek A, Sultanem K, Henry M. Framing Concerns about Body Image during Pre- and Post-Surgical Consultations for Head and Neck Cancer: A Qualitative Study of Patient–Physician Interactions. Curr Oncol 2022; 29:3341-3363. [PMID: 35621662 PMCID: PMC9139818 DOI: 10.3390/curroncol29050272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/25/2022] [Accepted: 05/02/2022] [Indexed: 12/04/2022] Open
Abstract
Patients with head and neck cancer report high unmet psychosocial needs as they undergo lifesaving treatments that can significantly alter their appearance and cause functional impairments. This qualitative analysis of recordings of 88 pre- and post-surgical consultations involving 20 patients respond to the need for empirical studies of patient–provider conversations about body image concerns. It indicates that the emphasis on concerns about survival, cure, and physical recovery during clinical consultations may leave concerns about the impacts of surgery on appearance and function unexplored and even silenced. The interviews with patients and medical team members that complement the analysis of the recordings suggest that an emphasis on survival, cure, and physical recovery can respond to the need for reassurance in the context of serious illness. However, it can also be problematic as it contributes to the silencing of patients’ concerns and to a potential lack of preparedness for the consequences of surgery. The results of this study can contribute to raising surgeons’ awareness of the interactional dynamics during clinical consultations. Moreover, the results highlight the unique role that surgeons can play in validating patients’ psychosocial concerns to support patients’ rehabilitation in both physical and psychosocial domains.
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Affiliation(s)
- Maria Cherba
- Department of Communication, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Correspondence:
| | | | - Michael P. Hier
- Department of Otolaryngology—Head and Neck Surgery, McGill University, Montreal, QC H3A 0G4, Canada; (M.P.H.); (V.-I.F.); (A.M.)
- Department of Otolaryngology—Head and Neck Surgery, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Lauriane Giguère
- School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Gabrielle Chartier
- Department of Nursing, Oncology Division, Jewish General Hospital, Montreal, QC H3T 1E2, Canada;
| | - Hannah Jacobs
- Department of Audiology and Speech-Language Pathology, Jewish General Hospital, Montreal, QC H3T 1E2, Canada;
| | - Véronique-Isabelle Forest
- Department of Otolaryngology—Head and Neck Surgery, McGill University, Montreal, QC H3A 0G4, Canada; (M.P.H.); (V.-I.F.); (A.M.)
- Department of Otolaryngology—Head and Neck Surgery, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Alex Mlynarek
- Department of Otolaryngology—Head and Neck Surgery, McGill University, Montreal, QC H3A 0G4, Canada; (M.P.H.); (V.-I.F.); (A.M.)
- Department of Otolaryngology—Head and Neck Surgery, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Khalil Sultanem
- Division of Radiation Oncology, Jewish General Hospital, Montreal, QC H3T 1E2, Canada;
- Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H3A 0G4, Canada;
| | - Melissa Henry
- Gerald Bronfman Department of Oncology, McGill University, Montreal, QC H3A 0G4, Canada;
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Segal Cancer Centre, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
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McDowell L, Rischin D, Gough K, Henson C. Health-Related Quality of Life, Psychosocial Distress and Unmet Needs in Older Patients With Head and Neck Cancer. Front Oncol 2022; 12:834068. [PMID: 35242716 PMCID: PMC8885992 DOI: 10.3389/fonc.2022.834068] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/24/2022] [Indexed: 01/22/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the most common cancer involving the mucosal surfaces of the head and neck and is associated with a number of etiological factors, including cigarette smoking, alcohol and betel nut consumption and exposure to high-risk human papillomavirus. The risk of HNSCC increases with age, peaking in the seventh and eighth decade, but this varies by anatomical and histological subtype. While several advancements have been made in the treatment of head and neck cancer (HNC) in recent decades, undertaking curative treatment still subjects the majority of HNSCC patients to substantial treatment-related toxicity requiring patients to tolerate a gamut of physical, psychological, and emotional demands on their reserves. In conjunction with other patient-related factors, clinicians involved in treating patients with HNSCC may incorporate advancing chronological age into their decision-making process when determining treatment recommendations. While advancing chronological age may be associated with increased concerns regarding physical treatment tolerability, clinicians may also be concerned about heightened vulnerability in various health and wellbeing outcomes. The available literature, however, does not provide evidence of this vulnerability in patients with advancing age, and, in many instances, older patients self-report greater resilience compared to their younger counterparts. While this data is reassuring it is limited by selection bias and heterogeneity in trial and study design and the absence of a consistent definition of the elderly patient with HNSCC. This narrative review article also includes a review of the measures used to assess HRQL, psychosocial outcomes and unmet needs in elderly or older patients with HNSCC.
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Affiliation(s)
- Lachlan McDowell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Danny Rischin
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Karla Gough
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Christina Henson
- Department of Radiation Oncology, Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, United States
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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.
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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
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de Oliveira Faria S, Hurwitz G, Kim J, Liberty J, Orchard K, Liu G, Barbera L, Howell D. Identifying Patient-Reported Outcome Measures (PROMs) for Routine Surveillance of Physical and Emotional Symptoms in Head and Neck Cancer Populations: A Systematic Review. J Clin Med 2021; 10:jcm10184162. [PMID: 34575271 PMCID: PMC8470145 DOI: 10.3390/jcm10184162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
The aims of this review were to identify symptoms experienced by head and neck cancer (HNC) patients and their prevalence, as well as to compare symptom coverage identified in HNC specific patient-reported outcome measures (PROMs). Searches of Ovid Medline, Embase, PsychInfo, and CINAHL were conducted to identify studies. The search revealed 4569 unique articles and identified 115 eligible studies. The prevalence of reported symptoms was highly variable among included studies. Variability in sample size, timing of the assessments, and the use of different measures was noted across studies. Content mapping of commonly used PROMs showed variability and poor capture of prevalent symptoms, even though validation studies confirmed satisfactory reliability and validity. This suggests limitations of some of the tools in providing an accurate and comprehensive picture of the patient's symptoms and problems.
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Affiliation(s)
- Sheilla de Oliveira Faria
- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada;
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
- Correspondence: ; Tel.: +55-11-3061-8278
| | - Gillian Hurwitz
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Jaemin Kim
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Jacqueline Liberty
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Kimberly Orchard
- Cancer Care Ontario, Toronto, ON M5G 2L7, Canada; (G.H.); (J.K.); (J.L.); (K.O.)
| | - Geoffrey Liu
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada;
- Dalla Lana School of Public Health, Toronto, ON M5T 3M7, Canada
- Temerty Faculty of Medicine, Toronto, ON M5S 1A8, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Lisa Barbera
- Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada;
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
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Henry M, Sargi E, Frenkiel S, Hier M, Zeitouni A, Kost K, Mlynarek A, Black M, MacDonald C, Richardson K, Chartier G, Sadeghi N, Rosberger Z. Longitudinal study indicating antecedent psychosocial vulnerability as predictor of anxiety disorders post-treatment in people with head and neck cancer. Psychooncology 2021; 30:1910-1919. [PMID: 34190381 DOI: 10.1002/pon.5760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/11/2021] [Accepted: 06/23/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aimed to: (1) determine the contribution of pre-cancer psychosocial vulnerability as an independent predictor of anxiety disorder (AD) onset immediately post-treatment in patients diagnosed with a first occurrence of head and neck cancer (HNC), controlling for sociodemographics and medical variables; and (2) estimate prevalence of AD and identify trajectories from the moment of diagnosis to the immediate post-treatment (i.e., over a period of 3 months) in this population. METHODS Two-hundred twenty-four consecutive patients (participation rate = 72%) newly diagnosed with a primary HNC were assessed with a structured clinical interview for a mental disorder, validated psychometric measures, and medical chart reviews. RESULTS Twenty-five percent of patients presented a lifetime AD, 19.4% within 2 weeks of HNC diagnosis, and 16.6% immediately post-treatment; representing 26.7% of patients with AD at any timepoint from the moment of diagnosis to immediately post-treatment. Patients were more likely to present an AD immediately post-treatment when they: were diagnosed with advanced-stage cancer (OR = 3.40, p = 0.006), presented a upon cancer diagnosis AD (OR = 2.45, p = 0.008) and/or experienced childhood abuse (OR = 1.96, p = 0.03). CONCLUSIONS Several AD trajectories may arise when patients are diagnosed with primary HNC. Health professionals should address AD and screen for risk factors (i.e., advanced stage cancer, AD upon cancer diagnosis, history of childhood abuse) as early as possible to assure optimal mental health care in this vulnerable population.
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Affiliation(s)
- Melissa Henry
- Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada
| | - Elyonora Sargi
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Saul Frenkiel
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Michael Hier
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Anthony Zeitouni
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Karen Kost
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Alex Mlynarek
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Martin Black
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada
| | - Christina MacDonald
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Nursing, Jewish General Hospital, Montreal, Quebec, Canada
| | - Keith Richardson
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Gabrielle Chartier
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Nursing, Jewish General Hospital, Montreal, Quebec, Canada
| | - Nader Sadeghi
- Department of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology-Head and Neck Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Zeev Rosberger
- Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada.,Lady-Davis Institute for Medical Research, Montreal, Quebec, Canada.,Department of Psychology, McGill University, Montreal, Quebec, Canada
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Impact of depressive disorders on quality of life after middle ear surgery in patients with chronic otitis media. Eur Arch Otorhinolaryngol 2020; 278:3217-3225. [PMID: 33011956 PMCID: PMC8328900 DOI: 10.1007/s00405-020-06397-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/23/2020] [Indexed: 01/31/2023]
Abstract
Purpose The aim of this study was to determine whether preoperative depressive symptoms influence health-related quality of life (HRQOL) after middle ear surgery in patients with chronic otitis media (COM). Methods This prospective clinical case study was conducted at a tertiary referral center. All 102 patients who had undergone middle ear surgery for COM were assessed clinically and by audiometric testing (pure tone audiometry) in pre- and postoperative settings. Disease-specific HRQOL was assessed by the validated chronic otitis media outcome test 15 (COMOT-15) and the Zurich chronic middle ear inventory (ZCMEI-21). General HRQOL was measured using the short form 36 (SF-36). Depressive symptoms were assessed using the patient health questionnaire (PHQ-D). The Charlson comorbidity index (CCI) was used to classify comorbidities. The middle ear status was determined using the ossiculoplasty outcome parameter staging (OOPS) index. Results After middle ear surgery, the total COMOT-15 and ZCMEI-21 scores improved significantly (p < 0.001). General HRQOL (total SF-36 score) was unaffected by surgery (p < 0.05). Patients without elevated depressive symptoms had significantly better total scores for the COMOT-15 (p < 0.01), ZCMEI-21 (p < 0.001), and for SF-36 (p < 0.001) postoperatively. The results of the multiple regression analyses show that, after adjusting for the OOPS, CCI, and hearing improvement, preoperative depressiveness was significantly associated with worse postoperative COMOT-15 and ZCMEI-21 outcome scores (β = 0.425 and β = 0.362, p < 0.001). Conclusion Preoperative depressiveness was an essential predictive factor for HRQOL in patients with COM. This should be considered during patient selection to provide more suitable preoperative counseling.
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Psychological distress and nutritional status in head and neck cancer patients: a pilot study. Eur Arch Otorhinolaryngol 2020; 277:1211-1217. [PMID: 32025788 PMCID: PMC7072056 DOI: 10.1007/s00405-020-05798-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 01/18/2020] [Indexed: 12/24/2022]
Abstract
Purpose To determine whether the psychological state of patients with head and neck cancer (HCN) is associated with their nutritional status. Methods In 40 patients with locally advanced HNC treated with definitive or adjuvant (chemo)radiotherapy, psychological and nutritional status were assessed before treatment, at its completion and 3 months’ post-therapy. Psychosocial distress was measured using the Hospital Anxiety and Depression Scale questionnaire (HADS-A, HADS-D), whereas the nutritional status was evaluated using standard methods (Nutritional Risk Screening Tool 2002, anthropometric data, dynamometry and laboratory tests) and with a bioelectrical impedance analysis parameter phase angle (PA). Results Before treatment, more patients were screened positive for anxiety than at treatment completion (p = 0.037) or 3 months’ post-therapy (p = 0.083). Depression prevalence was non-significantly higher at the end and after therapy. Compared to the baseline, more cachectic patients and a reduction of PA values were found at successive assessments. Anxiety was more often recorded among malnourished/cachectic patients (assessment 1, p = 0.017; assessment 2, p = 0.020) who were also found more frequently depressed (assessment 2, p = 0.045; assessment 3, p = 0.023). Significantly higher PA values were measured in patients without distress determined at 3 months’ post-therapy by the HADS-A (p = 0.027). Conclusion The association between the psychological and nutritional status found in this pilot study and the options for intervention warrants further clarification in a larger prospective trial.
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Sandulache VC, Lei YL, Heasley LE, Chang M, Amos CI, Sturgis EM, Graboyes E, Chiao EY, Rogus-Pulia N, Lewis J, Madabhushi A, Frederick MJ, Sabichi A, Ittmann M, Yarbrough WG, Chung CH, Ferrarotto R, Mai W, Skinner HD, Duvvuri U, Gerngross P, Sikora AG. Innovations in risk-stratification and treatment of Veterans with oropharynx cancer; roadmap of the 2019 Field Based Meeting. Oral Oncol 2019; 102:104440. [PMID: 31648864 DOI: 10.1016/j.oraloncology.2019.104440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 10/01/2019] [Indexed: 01/17/2023]
Affiliation(s)
- V C Sandulache
- Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, TX, United States; ENT Section, Operative Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States.
| | - Y L Lei
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - L E Heasley
- Department of Craniofacial Biology, School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Veterans Affairs Eastern Colorado Health Care System, Aurora, CO, United States
| | - M Chang
- Department of Radiation Oncology, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, United States
| | - C I Amos
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, United States
| | - E M Sturgis
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - E Graboyes
- Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, United States; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States
| | - E Y Chiao
- Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, United States; Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States
| | - N Rogus-Pulia
- Speech Pathology, University of Wisconsin School of Medicine, Madison, WI, United States; William S. Middleton Memorial Veterans Hospital, Madison, WI, United States
| | - J Lewis
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - A Madabhushi
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, United States; Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH, United States
| | - M J Frederick
- Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, TX, United States
| | - A Sabichi
- Department of Medicine, Section of Hematology Oncology, Baylor College of Medicine, Houston, TX, United States; Medical Care Line, Department of Medicine, Section of Hematology/Oncology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States
| | - M Ittmann
- Department of Pathology, Baylor College of Medicine, Houston, TX, United States; Department of Pathology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States
| | - W G Yarbrough
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - C H Chung
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, FL, United States
| | - R Ferrarotto
- Department of Thoracic Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Weiyuan Mai
- Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, United States; Department of Radiation Oncology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, United States
| | - H D Skinner
- Department of Radiation Oncology, UPMC, Pittsburgh, PA, United States
| | - U Duvvuri
- Department of Otolaryngology Head and Neck Surgery, UPMC, Pittsburgh, PA, United States; ENT Section, Operative Care Line, Pittsburgh Veterans Affairs Medical Center, Pittsburgh, PA, United States
| | - P Gerngross
- Dental Service Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States
| | - A G Sikora
- Bobby R. Alford Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, TX, United States; ENT Section, Operative Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, United States.
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11
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Robbertz AS, Weiss DM, Awan FT, Byrd JC, Rogers KA, Woyach JA. Identifying risk factors for depression and anxiety symptoms in patients with chronic lymphocytic leukemia. Support Care Cancer 2019; 28:1799-1807. [PMID: 31332513 DOI: 10.1007/s00520-019-04991-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 07/11/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE This study assessed whether empirically supported risk factors can identify future depression and anxiety symptoms in a specific cancer type, chronic lymphocytic leukemia (CLL). METHODS Patients enrolled in a CLL treatment clinical trial (N = 106) participated at baseline following informed consent and prior to treatment initiation. Risk factors with empirical support (personal or family psychiatric history, recurrent, advanced or progressive disease, low socioeconomic status, gender, medical comorbidities, and single marital status) and additional risk factors (cancer-specific stress, social contacts, negative life events, absolute lymphocyte counts, treatment group, and fatigue) were measured at baseline to predict depression and anxiety symptoms at 12 months. RESULTS Data show 14% (n = 15) and 12% (n = 13) of patients experienced moderate-severe depression and anxiety symptoms, respectively. Multiple linear regression analyses found medical comorbidities predicted 12-month anxiety symptoms (p < 0.05). Also, negative life events predicted depression and anxiety symptoms and fatigue predicted depression symptoms (p < 0.05). CONCLUSION Empirically supported risk factors associated with depression and anxiety symptoms are limited in predicting future depression and anxiety symptoms beyond initial screening in patients with CLL. In addition to levels of depression and anxiety symptoms at baseline, negative life events, higher levels of fatigue, and greater medical comorbidities were associated with future depression or anxiety symptoms in patients with CLL.
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Affiliation(s)
- Abigail S Robbertz
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA.
| | - David M Weiss
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Farrukh T Awan
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - John C Byrd
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Kerry A Rogers
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Jennifer A Woyach
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
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