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Kubuschok B, Otremba B, Welslau M, Topaly J, Wolff T, Lenz G, Grau M, Bittencourt da Silva L, Brückmann I, Foierl T. Quality of life assessment in diffuse large B-cell lymphoma (DLBCL) in REFLECT: a prospective, non-interventional, multicenter, German study, assessing Sandoz rituximab in combination with CHOP. Ann Hematol 2024:10.1007/s00277-024-05850-5. [PMID: 38900302 DOI: 10.1007/s00277-024-05850-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
Health-related quality of life (HRQoL) data are important indicators of health status in patients with lymphoma. The objective of this analysis was to assess the impact of treatment with Sandoz rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) on HRQoL in treatment-naïve adult patients with diffuse large B-cell lymphoma (DLBCL) included in the prospective, real-world REFLECT study. REFLECT is the first prospective study to assess HRQoL in patients with DLBCL treated with a rituximab biosimilar. HRQoL was assessed via the patient-reported European Organization for Research and Treatment of Cancer Core Quality of Life questionnaire at baseline, mid-treatment (month 3), end of treatment (month 6), and follow-up (months 9 and 12). Subgroup analyses were performed to evaluate the influence of baseline characteristics on HRQoL, and associations between baseline HRQoL and treatment response. HRQoL was assessed in 169 patients. Mean global health status score remained stable from baseline (54.8) to mid-treatment (month 3; 54.7), before steadily improving through to end of treatment (month 6; 61.4), and follow-up month 9 (64.9) and month 12 (68.8). Similar trends were observed across most functional and symptom subscales. Higher cognitive, physical, or role functioning, and less appetite loss, diarrhea, fatigue, or pain at baseline, were all associated with an improved likelihood of reaching a complete versus partial response at the end of treatment. Overall, these findings confirm the HRQoL benefits of R-CHOP therapy in treatment-naïve adult patients with DLBCL, and suggest that baseline HRQoL may be predictive of treatment response.
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Affiliation(s)
- Boris Kubuschok
- Department of Internal Medicine II (Hematology/Oncology) and Comprehensive Cancer Center Augsburg, CCC Alliance WERA and Bavarian Cancer Research Center (BZKF), Universitätsklinikum Augsburg, Augsburg, Germany.
| | | | - Manfred Welslau
- Comprehensive Cancer Center Mainfranken, Onkologie Aschaffenburg, Germany and Comprehensive Cancer Center Mainfranken, CCC Alliance WERA and BZKF, Würzburg, Germany
| | | | | | - Georg Lenz
- Department of Medicine A for Hematology, Oncology and Pneumology, Universitätsklinikum Münster, Münster, Germany
| | - Michael Grau
- Department of Medicine A for Hematology, Oncology and Pneumology, Universitätsklinikum Münster, Münster, Germany
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Spooner AJ, Turner J, Button E, Yates P, Kennedy G, Butler J, Bradford N, Chan A, Hart NH, Chan RJ. Supporting Cancer Survivors Following Treatment for Non-Hodgkin's and Hodgkin's Lymphoma: A Pilot Study Assessing the Feasibility and Process Outcomes of a Nurse-Led Intervention. Semin Oncol Nurs 2024; 40:151592. [PMID: 38368204 DOI: 10.1016/j.soncn.2024.151592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Lymphoma is the sixth most common cancer in Australia and comprises 2.8% of worldwide cancer diagnoses. Research targeting development and evaluation of post-treatment care for debilitating complications resulting from the disease and its treatment is limited. This study aimed to assess the feasibility and acceptability of a nurse-led survivorship intervention, post-treatment in Hodgkin's and non-Hodgkin's lymphoma survivors. METHODS A single-center, prospective, 3-arm, pilot, randomized controlled, parallel-group trial was used. People with lymphoma were recruited and randomized to the intervention (ENGAGE), education booklet only, or usual care arm. Participants receiving ENGAGE received an educational booklet and were offered 3 consultations (via various modes) with a cancer nurse to develop a survivorship care plan and healthcare goals. Participant distress and intervention acceptability was measured at baseline and 12-wk. Acceptability was measured via a satisfaction survey using a 11-point scale. Feasibility was measured using participation, retention rates, and process outcomes. Data were analyzed using descriptive statistics. RESULTS Thirty-four participants with HL and NHL were recruited to the study (11 = intervention, 11 = information only, 12 = usual care). Twenty-seven participants (79%) completed all time points from baseline to 12 wk. Seven (88%) of the 8 participants receiving ENGAGE completed all consultations using various modes to communicate with the nurse (videoconference 14/23, 61%; phone 5/23, 22%; face-to-face 4/23, 17%). Participants who completed the intervention were highly satisfied with ENGAGE. CONCLUSION The ENGAGE intervention is feasible and highly acceptable for lymphoma survivors. These findings will inform a larger trial assessing effectiveness and cost effectiveness of ENGAGE.
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Affiliation(s)
- Amy J Spooner
- School of Nursing, Queensland University of Technology, Brisbane Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane Australia
| | - Jane Turner
- Faculty of Medicine, University of Queensland, Brisbane Australia
| | - Elise Button
- School of Nursing, Queensland University of Technology, Brisbane Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane Australia; Cancer Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
| | - Patsy Yates
- School of Nursing, Queensland University of Technology, Brisbane Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane Australia; Cancer Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
| | - Glen Kennedy
- Cancer Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia; Mater Cancer Care Centre, Mater Health, Brisbane, Australia
| | - Jason Butler
- Cancer Care Services, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, Australia
| | - Natalie Bradford
- School of Nursing, Queensland University of Technology, Brisbane Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane Australia; Youth Cancer Services, Queensland Children's Hospital, Brisbane, Australia
| | - Alexandre Chan
- School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, United States of America
| | - Nicolas H Hart
- School of Nursing, Queensland University of Technology, Brisbane Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney, Sydney, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, Australia
| | - Raymond J Chan
- School of Nursing, Queensland University of Technology, Brisbane Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Division of Cancer Services, Princess Alexandra Hospital, Metro South Hospital and Health Service, Brisbane, Australia.
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Loh KP, McLaughlin EM, Krok-Schoen JL, Odejide OO, El-Jawahri A, Qi L, Shadyab AH, Johnson LG, Paskett ED. Correlates of common concerns in older cancer survivors of leukemia and lymphoma: results from the WHI LILAC study. J Cancer Surviv 2023; 17:769-780. [PMID: 35982359 PMCID: PMC9938088 DOI: 10.1007/s11764-022-01249-1] [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: 07/26/2022] [Accepted: 08/12/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Older survivors of leukemia and lymphoma often experience long-term effects of chemotherapy. We described common concerns related to their cancer and treatment in older survivors of leukemia and non-Hodgkin lymphoma (NHL) and assessed correlates of these concerns. METHODS We utilized data from the Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study that recruited post-menopausal women aged 50-79. Participants diagnosed with leukemia and NHL were included (n = 420). They were asked about 14 areas of current concerns related to their cancer and treatment and to rate each from 0 (no concern) to 2 (major concern), with total scores ranging from 0 to 28. Linear regression was used to assess factors correlated with the concern score, and logistic regression for factors correlated with the three most common concerns. RESULTS Mean age at assessment was 81 years (range 69-99); 72% reported at least one concern, and median concern score among these survivors was 3.5 (Q1-Q3 2-5). Factors significantly correlated with concern scores were sadness, pain, distress, higher prior symptom count, and loneliness (all p < 0.05). Significant factors correlated with common concerns were (1) fatigue/sleep: sadness/depression, distress, higher prior symptom count, greater loneliness, and worse physical functioning; (2) physical functioning/activity: older age, public insurance, higher body mass index, pain, worse QoL, and higher treatment-related comorbidities; (3) memory/concentration: prior chemotherapy or radiation, worse QoL, higher prior symptom count, and greater loneliness (all p < 0.05). CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS Almost three-quarters of older survivors of leukemia and lymphoma reported at least one concern; a multifaceted intervention may be needed to address these concerns.
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Affiliation(s)
- Kah Poh Loh
- Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14642, USA.
| | - Eric M McLaughlin
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Jessica L Krok-Schoen
- Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Oreofe O Odejide
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Center for Lymphoma, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Areej El-Jawahri
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Lisa G Johnson
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Electra D Paskett
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
- Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH, USA
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Tsai MH, Wu YH, Bevel MS. The relationship of chronic disease conditions to mental and physical health among cancer survivors. Support Care Cancer 2023; 31:364. [PMID: 37249650 DOI: 10.1007/s00520-023-07841-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/24/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE This study examined the relationship between the presence of chronic disease conditions and mental and physical health among cancer survivors in the United States. METHODS We conducted a cross-sectional analysis utilizing survey data from the 2016-2017 Behavioral Risk Factor Surveillance System (BRFSS) on 65,673 eligible cancer survivors. The primary outcomes of interest were self-rated metal/physical health in the past 30 days. Descriptive statistics and multivariate logistic regression were used to examine the mentioned association. RESULTS 15.3% and 24.8% of survivors reported having several days of poor mental and physical health (14-30 days compared to 0-13 days), and 42.4% of survivors reported having one to two chronic diseases. In multivariate analysis, survivors with one to two chronic diseases were more likely to report several days of poor mental (OR, 2.74; 95% CI, 2.22-3.38) and physical (OR, 1.95; 95% CI, 1.72-2.22) health. Survivors with 3+ chronic diseases had markedly higher odds of having several days of poor mental (OR, 6.41; 95% CI, 5.19-7.91) and physical health (OR, 4.71; 95% CI, 4.16-5.34). Among survivors with at least one chronic disease, older age, insured, and more perceived social/emotional support were negatively associated with mental health (p value <0.05). Similarly, older age was related to fewer days of poor physical health (p value <0.05) regardless of chronic disease conditions. CONCLUSION Having chronic diseases was associated with more days of poor mental and physical health among cancer survivors. Integrated, extensive care should include mental/physical health components and chronic disease management in cancer survivorship care.
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Affiliation(s)
- Meng-Han Tsai
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA.
- Georgia Prevention Institute, Augusta University, 1457 Walton Way, Augusta, GA, 30901, USA.
| | - Yun-Hsuan Wu
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Malcolm S Bevel
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
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Strouse CS, Larson MC, Ehlers SL, Yost KJ, Maurer MJ, Ansell SM, Inwards DJ, Johnston PB, Micallef IN, Link BK, Farooq U, Cerhan JR, Thompson CA. Long-Term Health-Related Quality of Life of Autologous Hematopoietic Cell Transplantation Patients and Nontransplant Patients With Aggressive Lymphoma: A Prospective Cohort Analysis. JCO Oncol Pract 2022; 18:e1069-e1080. [PMID: 35594505 PMCID: PMC9287288 DOI: 10.1200/op.21.00694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/11/2022] [Accepted: 04/08/2022] [Indexed: 01/22/2023] Open
Abstract
PURPOSE This study assessed the long-term quality of life (QOL) of patients with aggressive lymphoma subtypes treated with autologous hematopoietic cell transplant (autoHCT) compared with those without history of transplant. METHODS Patient-reported QOL measures were prospectively gathered from patients enrolled in the Iowa/Mayo Specialized Program of Research Excellence Molecular Epidemiology Resource cohort with aggressive lymphoma subtypes. QOL was measured using the Functional Assessment of Cancer Therapy-General (FACT-G), Functional Assessment of Chronic Illness Therapy-Fatigue Scale, State-Trait Anxiety Inventory (STAI), and Profile of Mood States instruments and with a numeric rating scale for overall QOL and spiritual QOL. The autoHCT group and no HCT groups were compared at 3 years (FU3) and 6 years (FU6) after lymphoma diagnosis. RESULTS In total, 980 patients with lymphoma (106 autoHCT and 874 no HCT) diagnosed between 2002 and 2013 were included for analysis. The mean FACT-G total score was similar in the autoHCT and no HCT groups at FU3 (89.9 v 90.1, P = .64) and also at FU6 (91.5 v 89.6, P = .44). No differences between the autoHCT and no HCT groups were identified in the FACT subscales. The STAI identified lower anxiety in the autoHCT group by mean STAI1 (state) at FU3 (30.1 v 33.4, P < .01) and by mean STAI2 (trait) at FU6 (30.1 v 33.5, P = .02). No other clinically meaningful differences were identified between the two groups using the other QOL instruments. CONCLUSION Patients remaining in remission at 3 and 6 years after diagnosis had a high level of QOL with no significant differences associated with history of treatment with autoHCT.
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Affiliation(s)
- Christopher S. Strouse
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, University of Iowa, Iowa City, IA
| | | | - Shawna L. Ehlers
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Kathleen J. Yost
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | - Stephen M. Ansell
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN
| | - David J. Inwards
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN
| | - Patrick B. Johnston
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN
| | - Ivana N. Micallef
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN
| | - Brian K. Link
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, University of Iowa, Iowa City, IA
| | - Umar Farooq
- Division of Hematology, Oncology, and Blood and Marrow Transplantation, University of Iowa, Iowa City, IA
| | - James R. Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Carrie A. Thompson
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN
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Marte C, George LS, Rutherford SC, Ouyang DJ, Martin P, Leonard JP, Trevino KM. Unmet mental health needs in patients with advanced B-cell lymphomas. Palliat Support Care 2022; 20:328-333. [PMID: 35713350 PMCID: PMC9843817 DOI: 10.1017/s1478951521001164] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT Existing research on psychological distress and mental health service utilization has focused on common types of solid tumor cancers, leaving significant gaps in our understanding of patients experiencing rare forms of hematologic cancers. OBJECTIVE To examine distress, quality of life, and mental health service utilization among patients with aggressive, refractory B-cell lymphomas. METHOD Patients (n = 26) with B-cell lymphomas that relapsed after first- or second-line treatment completed self-report measures of distress (Hospital Anxiety and Depression Scale) and quality of life (Short-Form Health Survey, SF-12). Patients also reported whether they had utilized mental health treatment since their cancer diagnosis. RESULTS Approximately 42% (n = 11) of patients reported elevated levels of psychological distress. Of patients with elevated distress, only one quarter (27.2%; n = 3) received mental health treatment, while more than half did not receive mental health treatment (54.5%; n = 6), and 18.1% (n = 2) did not want treatment. Patients with elevated distress reported lower mental quality of life than patients without elevated distress [F (1, 25) = 15.32, p = 0.001]. SIGNIFICANCE OF THE RESULTS A significant proportion of patients with advanced, progressive, B-cell lymphomas may experience elevated levels of distress. Yet, few of these distressed patients receive mental health treatment. Findings highlight the need to better identify and address barriers to mental health service utilization among patients with B-cell lymphoma, including among distressed patients who decline treatment.
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Affiliation(s)
| | | | | | | | - Peter Martin
- Weill Cornell Medicine, New York, NY
- New York Presbyterian, New York, NY
| | - John P Leonard
- Weill Cornell Medicine, New York, NY
- New York Presbyterian, New York, NY
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Ouchveridze E, Banerjee R, Desai A, Aziz M, Lee-Smith W, Mian H, Berger K, McClune B, Sborov D, Qazilbash M, Kumar S, Mohyuddin GR. Financial toxicity in hematological malignancies: a systematic review. Blood Cancer J 2022; 12:74. [PMID: 35459862 PMCID: PMC9033803 DOI: 10.1038/s41408-022-00671-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 02/06/2023] Open
Abstract
Hematologic malignancy outcomes have remarkably improved in the past decade with further advancement expected in future years. However, the detrimental effects of financial toxicity (FT) on patients with hematologic malignancies, because of both diagnoses and subsequent treatments, have not been studied comprehensively. We performed a systematic review of all studies reporting FT as a primary or secondary outcome among adult or pediatric patients with hematological malignancies. A total of 55 studies met the inclusion criteria for analysis. Across studies, 20-50% of patients reported some form of FT, including loss of work productivity, food and transportation costs, and depletion of savings. Younger age, lower-income level, unemployment, and rural residence were the most commonly identified risk factors for FT. Two studies looked at survival outcomes, with one reporting improvement in survival with a decrease in financial toxicity. However, significant heterogeneity in FT definitions was found between countries and payor systems. Only half of the studies (51%, n = 28) used validated survey instruments such as the COST assessment. The present systematic review identified that FT is common in patients with hematological malignancies and may be associated with poorer outcomes. However, studies of FT generally use non-standardized methods with cross-sectional analyses rather than longitudinal, prospective assessments. Further work is needed to standardize FT reporting and investigate measures to alleviate FT among patients with hematologic malignancies.
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Affiliation(s)
- Evguenia Ouchveridze
- Department of Hematological Malignancies and Cellular Therapeutics, Kansas University Medical Center, Kansas, KS, USA
| | - Rahul Banerjee
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Aakash Desai
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Muhammad Aziz
- Mulford Health Science Library, University of Toledo, Toledo, OH, USA
| | - Wade Lee-Smith
- Mulford Health Science Library, University of Toledo, Toledo, OH, USA
| | - Hira Mian
- Department of Oncology, McMaster University, Hamilton, ON, Canada
| | - Katherine Berger
- Patient Advocate, University of Hartford, West Hartford, CT, USA
| | - Brian McClune
- Division of Hematology and Hematological Malignancies, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Douglas Sborov
- Division of Hematology and Hematological Malignancies, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Muzaffar Qazilbash
- Division of Transplant, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shaji Kumar
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Ghulam Rehman Mohyuddin
- Division of Hematology and Hematological Malignancies, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
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Ekels A, van de Poll-Franse LV, Posthuma EFM, Kieffer J, Issa DE, Koster A, Nijziel MR, Pruijt JHFM, Stevens WBC, Tick LW, Oerlemans S. Persistent symptoms of fatigue, neuropathy and role-functioning impairment among indolent non-Hodgkin lymphoma survivors: A longitudinal PROFILES registry study. Br J Haematol 2022; 197:590-601. [PMID: 35365860 DOI: 10.1111/bjh.18139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 11/27/2022]
Abstract
Little is known about the long-term health-related quality of life (HRQoL) and persistence of symptoms among patients with indolent non-Hodgkin lymphoma (iNHL). This large population-based longitudinal study therefore investigated the long-term HRQoL and persistence of symptoms and identified associated sociodemographic, clinical and psychological factors. Patients diagnosed between 1999 and 2014 and four or more months after diagnosis were invited to participate in a longitudinal survey. Sociodemographic and clinical data were obtained from the Netherlands Cancer Registry. The EORTC QLQ-C30 and CLL-16 were completed by 669 patients (74% response rate). Patients completed on average four questionnaires. Primary treatment was active surveillance (52%), systemic therapy (31%) or radiotherapy (13%). Respectively, 36% reported persistent fatigue, 33% persistent neuropathy and 25% persistent role-functioning impairment. This was 2-3 times higher than in the age- and sex-matched normative population. Up to 10 years after diagnosis, scores remained relatively stable without clinically relevant changes. Comorbidities, psychological distress, shorter time since diagnosis, systemic therapy, younger age, education level and having no partner were associated with worse outcomes (all ps < 0.05). Up to a third of patients with iNHL experience long-term persistent symptoms which do not improve over time. Early recognition of symptoms will help in providing tailored supportive care for those in need.
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Affiliation(s)
- Afke Ekels
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.,Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.,Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
| | | | - Jacobien Kieffer
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Djamila E Issa
- Department of Internal Medicine, Jeroen Bosch Hospital, s-Hertogenbosch, The Netherlands
| | - Adrianus Koster
- Department of Internal Medicine, VieCuri Medical Centre, Venlo and Venray, The Netherlands
| | - Marten R Nijziel
- Department of Hemato-Oncology, Catharina Cancer Institute, Catharina Hospital, Eindhoven, The Netherlands
| | - Johannes H F M Pruijt
- Department of Internal Medicine, Jeroen Bosch Hospital, s-Hertogenbosch, The Netherlands
| | - Wendy B C Stevens
- Department of Haematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lidwine W Tick
- Department of Internal Medicine, Máxima Medical Centre, Eindhoven, The Netherlands
| | - Simone Oerlemans
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
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Paunescu AC, Copie CB, Malak S, Gouill SL, Ribrag V, Bouabdallah K, Sibon D, Rumpold G, Preau M, Mounier N, Haioun C, Jardin F, Besson C. Quality of life of survivors 1 year after the diagnosis of diffuse large B-cell lymphoma: a LYSA study. Ann Hematol 2022; 101:317-332. [PMID: 34617134 PMCID: PMC8494456 DOI: 10.1007/s00277-021-04689-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/28/2021] [Indexed: 12/20/2022]
Abstract
Health-related quality of life (HRQoL) is a multidimensional concept including physical, emotional, social, and cognitive functions, disease symptoms, and side effects of treatment. Differences in HRQoL due to gender, existence of comorbidities, and number of chemotherapy cycles are little explored in diffuse large B-cell lymphoma (DLBCL) survivors. Our objective was to investigate whether differences in HRQoL in function of these factors exist 1 year after the diagnosis of DLBCL. One hundred and one patients, enrolled in the RT3 (Real-Time Tailored Therapy) Study, answered self-administrated European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), EORTC High-Grade Non-Hodgkin Lymphoma (NHL-HG29), Hospital Anxiety and Depression Scale (HADS), Post Traumatic Growth Inventory (PTGI), and Multidimensional Fatigue Inventory (MFI) questionnaires. Adjusted means of scores were calculated in multivariate linear regression models. Fifty-seven survivors (mean age of 58.5 years) answered all questionnaires. Women have significantly higher scores of posttraumatic growth and lower physical functioning than men (P < 0.04). Survivors with comorbidities have increased physical fatigue and symptom burden, increased emotional impact, mental fatigue and depression, and reduced physical functioning and global health status (all P < 0.05). A greater number of cycles of chemotherapy increase the level of symptoms (pain, neuropathy, and dyspnoea; P < 0.05). The various aspects related to HRQoL should be discussed with DLBCL patients and investigated, with the aim of developing strategies to ensure appropriate psychosocial and supportive care and to improve the HRQoL in these patients.
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Affiliation(s)
| | | | | | - Steven Le Gouill
- Service d’hématologie clinique du CHU de Nantes, INSERM CRCINA Nantes-Angers, NeXT Université de Nantes, Nantes, France
| | - Vincent Ribrag
- DITEP and Hematology department, Gustave Roussy, Villejuif, France
| | - Krimo Bouabdallah
- Department Hematology, University Hospital of Bordeaux, Pessac, France
- Hôpitaux de Bordeaux CHU, Bordeaux, France
| | - David Sibon
- INSERM UMR 1163 & CNRS URL 8254, Hematology Department, Necker University Hospital, APHP, Paris, France
| | - Gerhard Rumpold
- Department of Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Marie Preau
- UR GRePS, Université Lumière Lyon 2, Institut de Psychologie, Bron, France
| | - Nicolas Mounier
- Department of Onco-Hematology, Archet Hospital, Nice, France
| | - Corinne Haioun
- Lymphoid Malignancies Unit, Henri Mondor University Hospital, AP-HP, UPEC, Creteil, France
| | - Fabrice Jardin
- Department of Hematology, Centre Henri Becquerel, Rouen, France
| | - Caroline Besson
- Inserm CESP U1018, Gustave Roussy, 114 Rue Édouard Vaillant, 94805 Villejuif, France
- Centre Hospitalier de Versailles, Hôpital André Mignot, Le Chesnay, 177 Rue de Versailles, 78157 Versailles, France
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10
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Patient Perspectives on Health-Related Quality of Life in Diffuse Large B-Cell Lymphoma Treated with Car T-Cell Therapy: A Qualitative Study. Oncol Ther 2021; 10:123-141. [PMID: 34778941 PMCID: PMC8590924 DOI: 10.1007/s40487-021-00174-0] [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: 07/06/2021] [Accepted: 10/05/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction Chimeric antigen receptor T-cell (CAR T) therapy offers a potentially curative option for patients with relapsed and refractory hematologic malignancies, including diffuse large B-cell lymphoma (DLBCL). Patient-reported experiences with CAR T therapy are limited and have not been well characterized. The purpose of this qualitative study was to explore patient descriptions of key domains of health-related quality of life (HRQoL) in DLBCL patients treated with CAR T therapy. Methods A targeted literature review was initially conducted to inform the development of the interview guide comprising predetermined open-ended questions. Two focus groups were conducted with a total of 18 patients with DLBCL identified from patient advisory boards. Focus group sessions were recorded and transcribed verbatim. MAXQDA 18.2.0 qualitative data analysis software was utilized to facilitate a constant-comparative coding process to identify key concepts. Results Eight domain impairments (social functioning, emotional functioning, fatigue, physical functioning, cognitive functioning, role functioning, sleep, and pain/discomfort) were identified from the qualitative analysis and endorsed by DLBCL patients treated with CAR T. Compared with before CAR T therapy, patients reported increased impairment in every domain during or immediately after CAR T therapy. This impairment improved for each domain 6 months after CAR T therapy except for pain/discomfort. Compared with before CAR T therapy, improvement in impairment for each domain was observed 6 months after CAR T therapy except for fatigue, sleep, and pain/discomfort. Conclusion This study provides meaningful information regarding the impact of CAR T therapy on HRQoL in patients with DLBCL throughout their treatment journey. Health care professionals and investigators can utilize these data in examining existing patient-reported outcome (PRO) measures that are used in DLBCL clinical trials and to better understand the needs of DLBCL survivors.
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11
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Evaluation of two strategies to implement physical cancer rehabilitation guidelines for survivors of abdominopelvic cavity tumors: a controlled before-and-after study. J Cancer Surviv 2021; 16:497-513. [PMID: 34519980 PMCID: PMC9142440 DOI: 10.1007/s11764-021-01045-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 04/16/2021] [Indexed: 11/05/2022]
Abstract
Purpose This study evaluates the effectiveness and feasibility of two strategies to implement physical cancer rehabilitation (PCR) guidelines for patients who have survived abdominopelvic cavity malignancies. Methods We tested and compared two tailored strategies to implement PCR guidelines for survivors of gastrointestinal, female organ and urogenital organ malignancies, in a clustered controlled before-and-after study. A patient-directed (PD) strategy was tested in five cancer centers, aiming to empower survivors. A multifaceted (MF) strategy was tested in four cancer centers, aiming additionally to influence healthcare professionals and the healthcare organization. Data were collected from existing registration systems, patient questionnaires and professional questionnaires. We measured both implementation- and client outcomes. For insight into the effectiveness we measured indicators related to PCR guidelines: (1) screening with the Distress Thermometer (DT) (=primary outcome measure), (2) information provision concerning physical activity (PA) and physical cancer rehabilitation programs (PCRPs), (3) advice to take part in PA and PCRPs, (4) referral to PCRPs, (5) participation in PCRPs, (6) PA uptake (PAU); and patient reported outcomes (PROs) such as (7) quality of life, (8) fatigue, and (9) empowerment. Furthermore, survivor and center determinants were assessed as possible confounders. Multilevel analyses were performed to compare the scores of the indicators of the PD and MF strategies, as well as the differences between the characteristics of these groups. The use of and experiences with both strategies were measured using questionnaires and Google Analytics to assess feasibility. Results In total, 1326 survivors participated in the study, 673 in the before- and 653 in the after-measurement. Regarding our primary outcome measure, we found a significant improvement of screening with the DT between the before- and after-measurement for both strategies, respectively from 34.2 to 43.1% (delta=8.9%; odds ratio (OR)=1.6706; p=0.0072) for the PD strategy and from 41.5 to 56.1% (delta=14.6%; OR=1.7098; p=0.0028) for the MF strategy. For both the primary and secondary outcomes, no statistically significant effect of the MF strategy compared to the PD strategy was observed. We found good use of and positive experiences with both strategies. Conclusion Implementation strategies containing tools enhancing patient empowerment seem to be effective in increasing the systematic screening with the DT for survivors of abdominopelvic cavity malignancies. Further research is needed to assess the additional effectiveness of strategies that stimulate compliance among healthcare professionals and healthcare organizations. Implications for Cancer Survivors Using implementation strategies containing tools enhancing patient empowerment seem to be effective in increasing the systematic screening with the DT and might improve the quality of care of patients who have survived abdominopelvic cavity malignancies. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01045-3.
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12
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Effect of lisocabtagene maraleucel on HRQoL and symptom severity in relapsed/refractory large B-cell lymphoma. Blood Adv 2021; 5:2245-2255. [PMID: 33904895 DOI: 10.1182/bloodadvances.2020003503] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/02/2021] [Indexed: 11/20/2022] Open
Abstract
CD19-directed chimeric antigen receptor (CAR) T-cell therapy has shown efficacy as a third-line or later treatment in patients with relapsed/refractory large B-cell lymphoma (LBCL). Using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire, we evaluated the impact of CAR T-cell treatment with lisocabtagene maraleucel (liso-cel) on health-related quality of life (HRQoL) and symptoms in patients with relapsed/refractory LBCL in the ongoing, open-label, nonrandomized TRANSCEND NHL 001 trial. Clinically meaningful improvement was observed in EORTC QLQ-C30 scores for global health status/QoL, based on a minimally important difference of 10 points at 2 to 18 months after liso-cel infusion. There were no clinically meaningful changes in physical functioning and pain, whereas clinically meaningful improvements were observed in fatigue at 2, 12, and 18 months. The proportion of patients with clinically meaningful improvement in global health status/QoL was generally higher for treatment responders than for nonresponders. A trend toward decreased mean EQ-5D-5L index scores was observed at 1 month after liso-cel infusion, followed by subsequent increases through 18 months. Mean EQ-5D-5L visual analog scale scores increased from 2 through 18 months. In summary, patients with relapsed/refractory LBCL treated with liso-cel had early, sustained, and clinically meaningful improvements in HRQoL and symptoms that correlated with antitumor activity. This study was registered at www.clinicaltrials.gov as #NCT02631044.
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13
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Patient-reported long-term quality of life after tisagenlecleucel in relapsed/refractory diffuse large B-cell lymphoma. Blood Adv 2021; 4:629-637. [PMID: 32074277 DOI: 10.1182/bloodadvances.2019001026] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/30/2019] [Indexed: 01/28/2023] Open
Abstract
The JULIET phase 2 trial evaluated a single infusion of tisagenlecleucel in adult patients with relapsed/refractory (r/r) diffuse large B-cell lymphoma (DLBCL). The objective of the current analysis was to evaluate patient-reported health-related quality of life (HRQoL) with a median follow-up of 19.3 months among patients infused with a single dose of tisagenlecleucel. Patients enrolled were ≥18 years of age with r/r DLBCL after ≥2 lines of therapy and had either undergone a failed autologous stem cell transplant or were ineligible for the procedure. Two validated HRQoL instruments, Functional Assessment of Cancer Therapy-Lymphoma (FACT-Lym) and Short Form-36 (SF-36) Health Survey, were used to measure HRQoL at baseline and months 3, 6, 12, and 18. At data cutoff (21 May 2018), 115 patients had received tisagenlecleucel infusion. Among the 99 patients evaluated, overall response rate was 54%, and 40% of patients achieved complete response (CR). Initially, 108 patients completed the HRQoL assessments at baseline, including 57 patients who eventually achieved CR or partial response (PR). Further, 30 and 21 patients in clinical response who completed assessments at baseline also completed assessments at months 12 and 18, respectively. Patients who achieved CR or PR sustained HRQoL improvement in all FACT scores at all time points. SF-36 instruments showed improvement above the minimal clinically important differences on 5 of 8 subscales. Long-term follow-up in the phase 2 JULIET study demonstrated that patients with r/r DLBCL who respond to tisagenlecleucel therapy had sustained, clinically meaningful improvements in HRQoL. This trial was registered at www.clinicaltrials.gov as #NCT02445248.
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14
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Bernard S, Hachon L, Diasonama JF, Madaoui C, Aguinaga L, Miekoutima E, Moatti H, Perrial E, Madelaine I, Brice P, Thieblemont C. Ambulatory high-dose methotrexate administration as central nervous system prophylaxis in patients with aggressive lymphoma. Ann Hematol 2021; 100:979-986. [PMID: 33608849 PMCID: PMC7960588 DOI: 10.1007/s00277-020-04341-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/04/2020] [Indexed: 12/20/2022]
Abstract
High-dose methotrexate (HD-MTX) at 3 g/m2 is one of the strategies for central nervous system (CNS) prophylaxis in the first-line treatment of aggressive lymphomas, especially in diffuse large B cell lymphoma patients with high-risk CNS-International Prognostic Index. The objective of our study was to retrospectively analyze the safety of 2 cycles of systemic HD-MTX administered as an ambulatory regimen. Between January 2013 and December 2016, 103 patients were carefully selected on 6 criteria, including age < 60, albumin > 34, performance status 0 or 1, normal renal and hepatic functions, good understanding of practical medical guidance, and no loss of weight. Strict procedures of HD-MTX infusion were observed including alkalinization, urine pH monitoring, and leucovorin rescue. Renal and hepatic functions were monitored at days 2 and 7. MTX clearance was not monitored. Toxicities and grades of toxicity were collected according to the NCI-CTCAE (version 4.0). Among the 103 selected patients, 92 (89%) patients successfully completed the planned 2 cycles of HD-MTX on an outpatient basis. Eleven patients completed only 1 cycle, 3 because of lymphoma progression and 8 because of toxicity including 3 grade II hepatotoxicity, 2 grade I/II renal toxicity, 1 grade III neutropenia, 1 active herpetic infection, and 1 grade III ileus reflex. Reported adverse events (AE) included 92 (84%) grade I/II and 18 (16%) grade III/IV. Grade III hepatotoxicity, mostly cytolysis, was the most frequent AE observed with 8 (8%) events. Grade III/IV hematologic toxicities concerned 9 patients with 8 grade III/IV neutropenia and 1 thrombocytopenia. Renal toxicity was rare, mild, and transient, observed with 4 (4%) grade I/II events. Ambulatory administration of HD-MTX at 3 g/m2 without MTX clearance monitoring is safe with strict medical guidance. It requires careful selection of patients before administration, and a renal and hepatic monitoring after the administration.
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Affiliation(s)
- S Bernard
- Service d'hémato-Oncologie, Assistance publique - Hôpitaux de Paris (AP-HP)- Hôpital Saint-Louis (SLS), 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - L Hachon
- Service de Pharmacie, Assistance publique - Hôpitaux de Paris (AP-HP)- Hôpital Saint-Louis (SLS), F-75010, Paris, France
| | - J F Diasonama
- Service d'hémato-Oncologie, Assistance publique - Hôpitaux de Paris (AP-HP)- Hôpital Saint-Louis (SLS), 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - C Madaoui
- Service de Pharmacie, Assistance publique - Hôpitaux de Paris (AP-HP)- Hôpital Saint-Louis (SLS), F-75010, Paris, France
| | - L Aguinaga
- Service d'hémato-Oncologie, Assistance publique - Hôpitaux de Paris (AP-HP)- Hôpital Saint-Louis (SLS), 1, Avenue Claude Vellefaux, 75010, Paris, France.,Université de Paris, Paris Diderot, F-75010, Paris, France
| | - E Miekoutima
- Service d'hémato-Oncologie, Assistance publique - Hôpitaux de Paris (AP-HP)- Hôpital Saint-Louis (SLS), 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - H Moatti
- Service d'hémato-Oncologie, Assistance publique - Hôpitaux de Paris (AP-HP)- Hôpital Saint-Louis (SLS), 1, Avenue Claude Vellefaux, 75010, Paris, France.,Université de Paris, Paris Diderot, F-75010, Paris, France
| | | | - I Madelaine
- Service de Pharmacie, Assistance publique - Hôpitaux de Paris (AP-HP)- Hôpital Saint-Louis (SLS), F-75010, Paris, France
| | - P Brice
- Service d'hémato-Oncologie, Assistance publique - Hôpitaux de Paris (AP-HP)- Hôpital Saint-Louis (SLS), 1, Avenue Claude Vellefaux, 75010, Paris, France
| | - Catherine Thieblemont
- Service d'hémato-Oncologie, Assistance publique - Hôpitaux de Paris (AP-HP)- Hôpital Saint-Louis (SLS), 1, Avenue Claude Vellefaux, 75010, Paris, France. .,Université de Paris, Paris Diderot, F-75010, Paris, France.
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15
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Drabbe C, Van der Graaf WTA, De Rooij BH, Grünhagen DJ, Soomers VLMN, Van de Sande MAJ, Been LB, Keymeulen KBMI, van der Geest ICM, Van Houdt WJ, Husson O. The age-related impact of surviving sarcoma on health-related quality of life: data from the SURVSARC study. ESMO Open 2021; 6:100047. [PMID: 33516150 PMCID: PMC7844567 DOI: 10.1016/j.esmoop.2021.100047] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/28/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) data of sarcoma survivors are scarce and the impact of age remains unclear. The aims of this population-based study were to (i) compare HRQoL scores amongst three age-groups [adolescents and young adults (AYA, aged 18-39 years), older adults (OA, aged 40-69 years) and elderly (aged ≥70 years)]; (ii) compare HRQoL of each sarcoma survivor age group with an age- and sex-matched normative population sample; (iii) determine factors associated with low HRQoL per age group. METHODS Dutch sarcoma survivors, who were 2-10 years after diagnosis, were invited to complete the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions questionnaire on HRQoL. RESULTS In total, 1099 survivors (58% response rate) completed the questionnaire: 186 AYAs, 748 OAs and 165 elderly. The median time since diagnosis for all patients was 5.2 years. Bone sarcomas were seen in 41% of AYAs, 22% of OAs and in 16% of elderly survivors (P < 0.01). AYA and OA survivors reported statistically significant and clinically meaningful worse physical, role, cognitive, emotional and social functioning compared with a matched norm population, which was not the case for elderly survivors. AYAs reported significantly worse scores on emotional and cognitive functioning compared with OA and elderly survivors. Malignant peripheral nerve sheath tumour, osteosarcoma and chordoma were the subtypes of which survivors reported the lowest HRQoL scores in comparison with the norm. For all age groups, chemotherapy, having a bone sarcoma and having comorbidities were most frequently associated with low scores on HRQoL subscales, whereas a shorter time since diagnosis was not. CONCLUSION In this nationwide sarcoma survivorship study, the disease and its treatment had relatively more impact on the HRQoL of AYA and OA survivors than on elderly survivors. These results emphasise the need for personalised follow-up care that not only includes risk-adjusted care related to disease relapse, but also age-adjusted care.
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Affiliation(s)
- C Drabbe
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - W T A Van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - B H De Rooij
- Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands; Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - D J Grünhagen
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - V L M N Soomers
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M A J Van de Sande
- Department of Orthopaedic Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - L B Been
- Department of Surgical Oncology, University Medical Centre Groningen, Groningen, The Netherlands
| | - K B M I Keymeulen
- Department of Surgical Oncology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - I C M van der Geest
- Department of Orthopaedics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - W J Van Houdt
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - O Husson
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Institute of Cancer Research, Sutton, London, UK.
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16
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Mariegaard J, Wenstrup J, Lim KZM, Bidstrup PE, von Heymann A, Johansen C, Knudsen GM, Law I, Specht L, Stenbæk DS. Prevalence of cognitive impairment and its relation to mental health in Danish lymphoma survivors. Support Care Cancer 2020; 29:3319-3328. [PMID: 33118105 DOI: 10.1007/s00520-020-05857-4] [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: 08/04/2020] [Accepted: 10/23/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE This study sought to investigate the prevalence of self-reported cognitive impairment and its relation to illness and treatment characteristics and mental health in Hodgkin lymphoma (HL) and diffuse large B cell lymphoma (DLBCL) survivors as cancer-related cognitive impairment has not been extensively studied in lymphoma survivors. METHODS One hundred fifteen HL and DLBCL survivors (mean age = 40.3 years, mean months since completed treatment = 29.6) completed questionnaires on executive function and mental health. We examined the prevalence of executive impairment and compared illness and treatment characteristics and mental health across survivors reporting impaired and non-impaired executive functioning using chi-square, Cochran-Armitage, and Mann-Whitney U tests. RESULTS We found that 39% reported executive impairment. Survivors reporting impaired executive functioning reported worse mental health (ps < .001) than survivors reporting non-impaired executive functioning. A larger proportion of the impaired group had received a high chemo dose compared to the non-impaired group although this result fell short of significance after adjustment for multiple comparisons (p = .017). CONCLUSIONS Self-reported cognitive impairment is prevalent in HL and DLBCL survivors and is associated with worse mental health and possibly high chemo dose. Future studies should investigate objective impairment and the possible dose-response relationship between chemo dose and cognitive impairment in lymphoma survivors.
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Affiliation(s)
- Johanna Mariegaard
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, DK-2100, Copenhagen, Denmark
| | - Jonathan Wenstrup
- Department of Oncology, Copenhagen University Hospital Rigshospitalet, DK-2100, Copenhagen, Denmark.,Psychological Aspects of Cancer, Survivorship Unit, Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark.,Department of Neurology, Bispebjerg-Frederiksberg Hospital, DK-2400, Copenhagen, Denmark
| | - Kevin Zi Ming Lim
- Psychological Aspects of Cancer, Survivorship Unit, Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100, Copenhagen, Denmark
| | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer, Survivorship Unit, Danish Cancer Society Research Center, DK-2100, Copenhagen, Denmark
| | - Annika von Heymann
- CASTLE Cancer Late Effects Research Unit, Department of Oncology, Copenhagen University Hospital Rigshospitalet, DK-2100, Copenhagen, Denmark
| | - Christoffer Johansen
- CASTLE Cancer Late Effects Research Unit, Department of Oncology, Copenhagen University Hospital Rigshospitalet, DK-2100, Copenhagen, Denmark
| | - Gitte Moos Knudsen
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, DK-2100, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100, Copenhagen, Denmark
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine & PET, Copenhagen University Hospital Rigshospitalet, DK-2100, Copenhagen, Denmark
| | - Lena Specht
- Department of Oncology, Copenhagen University Hospital Rigshospitalet, DK-2100, Copenhagen, Denmark
| | - Dea Siggaard Stenbæk
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, DK-2100, Copenhagen, Denmark.
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Abstract
BACKGROUND Survivors of lymphoma experience multiple challenges after treatment. However, a lack of knowledge of in-depth experiences of lymphoma survivors in early aftercare persists. OBJECTIVE To gain an in-depth understanding of the experiences of lymphoma survivors in early aftercare who have received an aftercare consultation based on evidence-based guideline recommendations, with an advanced practice nurse. METHODS This study used a narrative design. We recruited lymphoma survivors after a best-practice aftercare consultation with an advanced practice nurse. A total of 22 lymphoma survivors and 9 partners participated. Data were collected through narrative interviews and analyzed according to thematic narrative analysis. RESULTS Six themes emerged: living and dealing with health consequences, coping with work and financial challenges, having a positive outlook and dealing with uncertainty, deriving strength from and experiencing tensions in relationships, getting through tough times in life, and receiving support from healthcare professionals. CONCLUSIONS The stories of lymphoma survivors in early aftercare revealed their experiences of how they coped with a range of challenges in their personal lives. Choosing an aftercare trajectory based on an aftercare consultation that encourages patients to think about their issues, goals, and possible aftercare options may be useful for their transition from treatment to survivorship. IMPLICATIONS FOR PRACTICE Survivors' social support and self-management capabilities are important aspects to be addressed in cancer care. An aftercare consultation involving shared goal setting and care planning may help nurses provide personalized aftercare.
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18
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Muzzatti B, Cattaruzza N, Piccinin M, Flaiban C, Agostinelli G, Berretta M, Annunziata MA. Cognitive function in long-term lymphoma survivors: relationship between subjective reports and objective assessments and with quality of life. PSYCHOL HEALTH MED 2020; 26:968-979. [PMID: 32459120 DOI: 10.1080/13548506.2020.1770815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Cognitive functioning plays a fundamental role in people's life and quality of life (QoL), and anti-cancer chemotherapy may provoke long-lasting cognitive problems. This study investigated the subjective perception of cognitive functioning in long-term lynfoma survivors and its associations with objectively assessed cognitive functioning and QoL. 198 long-term lynfoma survivors were administered the Cognitive Functioning Self-Assessment Scale (CFSS), the Esame Neuropsicologico Breve 2 (ENB2) and the Short Form 36 Health Survey Questionnaire (SF-36). Subjectively reported cognitive functioning was worse than the norm for the general population (p<0.001). Difficulty in recalling recent information (22%), using of periphrases or generic terms (16.7%) and tip-of-the-tongue phenomena (14.7%) were the cognitive difficulties most frequently reported. CFSS overall score correlated positively with the number of impaired performances (p<0.001) and borderline performances (p=0.014) on the ENB2. Both subjectively and objectively assessed cognitive measures correlated negatively with most assessed QoL domains, indicating that QoL is worse when cognitive functioning is poor. Subjective concerns about one's own cognitive functioning are a reality for long-term lynphoma survivors, who experience these worries more than the general population does. Since improving QoL is a priority in oncology, this study supports the use of interventions to improve cognitive functioning in cancer survivors.
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Affiliation(s)
- Barbara Muzzatti
- Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | | | - Marika Piccinin
- Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Cristiana Flaiban
- Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
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19
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La Carpia D, Liperoti R, Guglielmo M, Di Capua B, Devizzi LF, Matteucci P, Farina L, Fusco D, Colloca G, Di Pede P, Ferrara ML, Hohaus S, Bernabei R, Ripamonti CI. Cognitive decline in older long-term survivors from Non-Hodgkin Lymphoma: a multicenter cross-sectional study. J Geriatr Oncol 2020; 11:790-795. [PMID: 32008957 DOI: 10.1016/j.jgo.2020.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 06/12/2019] [Accepted: 01/08/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare cognition in a group of older long-term survivors from Non-Hodgkin Lymphoma (NHL) and in a corresponding group of non-cancer controls of the same age. Functional status, polypharmacy and multimorbidity were also evaluated. METHODS A cross-sectional study was performed in a population of 63 outpatient long-term survivors from NHL, aged 65 or more and 61 non-cancer controls. Socio-demographic, clinical and functional data were collected. Cognitive function was assessed through neuropsychological tests. RESULTS NHL survivors showed a slightly worse functional status than controls, they were affected by more chronic conditions (3.4 vs 2.3; p = .003) and were taking a higher number of medications (3.4 vs 2.3; p = .03). The Mini Mental State Examination (MMSE) was not significantly different between the groups. NHL survivors performed worse than controls in executive functioning (Trail Making Test B-A 47.9 vs 32.1 p = .04, OR for Stroop test time over 75th percentile in survivors: 2.66; CI 95% 1.04-6.61; OR for Multiple Features Target Cancellation time over 75th percentile in survivors: 2.84; CI 95% 1.10-7.31). A small, statistically significant difference was also observed in verbal memory scores between the two groups. . CONCLUSIONS The findings of this study suggest that, compared with non-cancer controls, older survivors from NHL may have a lower cognitive performance, especially in the executive functioning and attention domains, regardless of multimorbidity and polypharmacy. Further evidence from larger samples is needed to confirm such findings and better characterize cognitive decline in NHL survivors.
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Affiliation(s)
| | - Rosa Liperoti
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mauro Guglielmo
- Oncology-Supportive Care Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Beatrice Di Capua
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Paola Matteucci
- Haematology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Lucia Farina
- Haematology Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Domenico Fusco
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuseppe Colloca
- Radiation Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Patricia Di Pede
- Oncology-Supportive Care Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Stephan Hohaus
- Haematology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Roberto Bernabei
- Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carla Ida Ripamonti
- Oncology-Supportive Care Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
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Sustained degradation of quality of life in a subgroup of lymphoma survivors: a two-year prospective survey. BMC Cancer 2019; 19:1178. [PMID: 31795958 PMCID: PMC6892152 DOI: 10.1186/s12885-019-6337-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 11/06/2019] [Indexed: 12/24/2022] Open
Abstract
Background Previous studies have suggested that lymphoma survivors commonly display altered Health-Related Quality of Life (HRQoL). Because these were predominantly cross-sectional studies, the dynamic of events as well as the factors which influence HRQoL remain to be determined. Methods We conducted a prospective study on a cohort of 204 Hodgkin and non-Hodgkin lymphoma survivors who remained disease-free 2 years after undergoing chemotherapy (referred to the M0-M12-M24 periods). Results We found that although Physical and Mental Component Scores (PCS and MCS) of HRQoL significantly improved from M0 to M24 in the vast majority of patients (favorable group), approximately 20% of patients displayed severe alterations in HRQoL (global SF-36 scores < 50) extending over the 2-year period (unfavorable group). Low M24 PCSs were associated with Post-Traumatic Stress Disorder (PTSD), depression, cardiovascular events and neuropathy. In contrast social determinants, comorbidity and infections, as well as several other parameters related to the disease or to the treatment itself were not associated with low M24 PCSs. Low M24 MCSs were associated with a low educational level, aggressive histology, infections, cardiovascular events and PTSS. However, the most predictive risk factor for low SF-36 scores at M24 was a low SF-36 score at M12. The unfavorable group also displayed a low incidence of return to work. Conclusions Although the HRQoL of lymphoma survivors generally improved over time, persistent and severe HRQoL alterations still affected approximately one fifth of patients, resulting in important social consequences. This specific group, which presents with identifiable risk factors, may benefit from early, targeted psycho-social support.
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21
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van Walree IC, Hamaker ME, van de Poll-Franse LV, Vos MC, Boll D, van Huis-Tanja LH, Ezendam NPM. Older ovarian cancer survivors report lower long-term health-related quality of life than younger survivors: A study from the population-based profiles registry. Gynecol Oncol 2019; 153:391-398. [PMID: 30772033 DOI: 10.1016/j.ygyno.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/24/2019] [Accepted: 02/03/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess long-term differences in health-related quality of life (HRQoL) of older ovarian cancer survivors compared to both an age-matched normative population and to younger survivors. In addition, the differential effect of chemotherapy on HRQoL between older and younger survivors was compared. METHODS Ovarian cancer survivors (n = 348) diagnosed between 2000 and 2010, as registered by the Dutch population-based Eindhoven Cancer Registry, were invited to complete the EORTC QLQ-C30 HRQoL questionnaire in 2012. HRQoL outcomes of survivors were compared with an age-matched normative population and older survivors (≥70 years) were compared with younger survivors. RESULTS The questionnaire was returned by 191 ovarian cancer survivors (55%), 31% were aged ≥70 years (n = 59). Compared to the normative population, survivors ≥70 years scored lower on global health status and all functioning subscales except emotional functioning, and they reported more symptoms. Survivors aged <70 years only reported worse physical and cognitive functioning in comparison with the normative population. Most differences were of medium to small clinical relevance. Age appeared to moderate the effect of chemotherapy on HRQoL. Older survivors who had received chemotherapy experienced better physical functioning and less pain and insomnia while the opposite was found in younger survivors. CONCLUSION In comparison with an age-matched normative population, older ovarian cancer survivors report lower HRQoL scores than younger survivors. As this represents a selection of long-term survivors, future research should focus on the trajectory of HRQoL from diagnosis throughout treatment and follow-up to identify which factors are related to worse HRQoL in the entire older ovarian cancer population and whether timely interventions are able to improve HRQoL.
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Affiliation(s)
- I C van Walree
- Department of Internal Medicine, Diakonessenhuis Utrecht, the Netherlands.
| | - M E Hamaker
- Department of Geriatric Medicine, Diakonessenhuis Utrecht, the Netherlands
| | - L V van de Poll-Franse
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, the Netherlands; Eindhoven Cancer Registry, Comprehensive Cancer Center the Netherlands, the Netherlands; Netherlands Cancer Institute (NKI), Amsterdam, the Netherlands
| | - M C Vos
- Department of Obstetrics and Gynecology, Elisabeth TweeSteden Ziekenhuis Tilburg, the Netherlands
| | - D Boll
- Department of Obstetrics and Gynecology, Catharina Hospital Eindhoven, the Netherlands
| | - L H van Huis-Tanja
- Department of Internal Medicine, Diakonessenhuis Utrecht, the Netherlands
| | - N P M Ezendam
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, the Netherlands; Netherlands Comprehensive Cancer Organisation, the Netherlands
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22
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Younger E, Husson O, Bennister L, Whelan J, Wilson R, Roast A, Jones RL, van der Graaf WT. Age-related sarcoma patient experience: results from a national survey in England. BMC Cancer 2018; 18:991. [PMID: 30333006 PMCID: PMC6192120 DOI: 10.1186/s12885-018-4866-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 09/26/2018] [Indexed: 01/04/2023] Open
Abstract
Background Sarcomas are rare, heterogeneous tumours affecting patients of any age. Previous surveys describe that sarcoma patients report a significantly worse experience than those with common cancers. Consequently, Sarcoma UK conducted a national survey and these data were examined for age- and tumour-related differences in patients’ experiences. Methods Patients were randomly selected from respondents to National Cancer Patient Experience Surveys (n = 900). Differences between patient groups according to age (Adolescents and Young Adults [AYA] 18–39 years, middle-aged 40–64 years, elderly 65 + years) and tumour type (soft-tissue [STS] vs. bone]) were analysed with t-tests or chi-square tests. Results Survey response rate was 62% (n = 558; STS 75%, bone sarcoma 25%). Delay in diagnosis was reported; 27% patients (n = 150) waited > 3 months and initial symptoms were incorrectly interpreted; AYA STS patients were significantly more likely to be treated for another condition, or advised that their symptoms were not serious, than older STS patients. Clinical trial participation was low (6%, n = 35). Symptom burden was high, most commonly daytime fatigue (48%, n = 277) and pain (44%, n = 248). AYAs were significantly more likely to report most side-effects and post-treatment concerns than older patients. Elderly patients were more satisfied with the information and emotional support provided than younger patients, however were significantly less likely to be referred to rehabilitation services. Conclusions This study identifies significant age-related differences in the sarcoma patient journey, which are not only related to variation in tumour-types. These results provide rationale for adopting an age-specific approach to the management of sarcoma patients in order to improve overall patient experience. Electronic supplementary material The online version of this article (10.1186/s12885-018-4866-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Olga Husson
- Sarcoma Unit, Royal Marsden Hospital, London, SW3 6JJ, UK.,Division of Clinical Studies, Institute of Cancer Research, London, SW7 3RP, UK
| | | | - Jeremy Whelan
- University College London Hospital (UCLH), London, NW1 2BU, UK
| | - Roger Wilson
- Sarcoma UK Registered Cancer Charity, London, N1 6AH, UK
| | - Andy Roast
- Sarcoma UK Registered Cancer Charity, London, N1 6AH, UK
| | - Robin L Jones
- Sarcoma Unit, Royal Marsden Hospital, London, SW3 6JJ, UK.,Division of Clinical Studies, Institute of Cancer Research, London, SW7 3RP, UK
| | - Winette Ta van der Graaf
- Sarcoma Unit, Royal Marsden Hospital, London, SW3 6JJ, UK. .,Division of Clinical Studies, Institute of Cancer Research, London, SW7 3RP, UK.
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23
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Taylor K, Monterosso L, Bulsara C. Qualitative results from a phase II pilot randomised controlled trial of a lymphoma nurse-led model of survivorship care. Eur J Oncol Nurs 2018; 35:9-14. [DOI: 10.1016/j.ejon.2018.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 01/28/2018] [Accepted: 01/29/2018] [Indexed: 11/30/2022]
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24
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van Leeuwen M, Husson O, Alberti P, Arraras JI, Chinot OL, Costantini A, Darlington AS, Dirven L, Eichler M, Hammerlid EB, Holzner B, Johnson CD, Kontogianni M, Kjær TK, Morag O, Nolte S, Nordin A, Pace A, Pinto M, Polz K, Ramage J, Reijneveld JC, Serpentini S, Tomaszewski KA, Vassiliou V, Verdonck-de Leeuw IM, Vistad I, Young TE, Aaronson NK, van de Poll-Franse LV. Understanding the quality of life (QOL) issues in survivors of cancer: towards the development of an EORTC QOL cancer survivorship questionnaire. Health Qual Life Outcomes 2018; 16:114. [PMID: 29866185 PMCID: PMC5987570 DOI: 10.1186/s12955-018-0920-0] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/30/2018] [Indexed: 11/12/2022] Open
Abstract
BACKROUND The number of cancer survivors is growing steadily and increasingly, clinical trials are being designed to include long-term follow-up to assess not only survival, but also late effects and health-related quality of life (HRQOL). Therefore it is is essential to develop patient-reported outcome measures (PROMs) that capture the full range of issues relevant to disease-free cancer survivors. The objectives of this project are: 1) to develop a European Organisation for Research and Treatment of Cancer (EORTC) questionnaire that captures the full range of physical, mental and social HRQOL issues relevant to disease-free cancer survivors; and 2) to determine at which minimal time since completion of treatment the questionnaire should be used. METHODS We reviewed 134 publications on cancer survivorship and interviewed 117 disease-free cancer survivors with 11 different types of cancer across 14 countries in Europe to generate an exhaustive, provisional list of HRQOL issues relevant to cancer survivors. The resulting issue list, the EORTC core questionnaire (QLQ-C30), and site-specific questionnaire modules were completed by a second group of 458 survivors. RESULTS We identified 116 generic survivorship issues. These issues covered body image, cognitive functioning, health behaviors, negative and positive outlook, health distress, mental health, fatigue, sleep problems, physical functioning, pain, several physical symptoms, social functioning, and sexual problems. Patients rated most of the acute symptoms of cancer and its treatment (e.g. nausea) as no longer relevant approximately one year after completion of treatment. CONCLUSIONS Compared to existing cancer survivorship questionnaires, our findings underscore the relevance of assessing issues related to chronic physical side effects of treatment such as neuropathy and joint pain. We will further develop a core survivorship questionnaire and three site-specific modules for disease-free adult cancer survivors who are at least one year post-treatment.
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Affiliation(s)
- Marieke van Leeuwen
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
| | - Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paola Alberti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Milan Center for Neuroscience, Milan, Italy
| | | | - Olivier L Chinot
- Pôle Neurosciences Cliniques, Service de Neuro-Oncologie, Aix-Marseille Université, Marseille, France
| | - Anna Costantini
- Departmental Psychoncology Unit, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
| | - Martin Eichler
- Division of Epidemiology and Health Services Research at Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), Mainz, Germany
| | - Eva B Hammerlid
- Department of Otolaryngology Head and Neck Surgery, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Bernhard Holzner
- Department of Psychiatry and Psychotheraphy, Division of Psychooncology, Innsbruck Medical University, Innsbruck, Austria
| | - Colin D Johnson
- University Surgical Unit, University Hospitals Southampton, Southampton, UK
| | - Meropi Kontogianni
- Department of Nutrition & Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Trille Kristina Kjær
- Unit of Survivorship Research, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ofir Morag
- Oncology Institute, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Sandra Nolte
- Department of Psychosomatic Medicine Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andrew Nordin
- East Kent Gynaecological Oncology Centre, Margate, UK
| | - Andrea Pace
- Neuroncology Unit, National Cancer Institute Regina Elena, Rome, Italy
| | - Monica Pinto
- Rehabilitation Unit, Department of Supportive Care, Istituto Nazionale Tumori - IRCCS- Fondazione G. Pascale, Naples, Italy
| | - Katja Polz
- Evangelische Kliniken Gelsenkirchen, Gelsenkirchen, Germany
| | - John Ramage
- Department of Gastroenterology and Hepatology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK
| | - Jaap C Reijneveld
- Department of Neurology and Brain Tumor Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Samantha Serpentini
- Unit of Psychoncology - Breast Unit, Istituto Oncologico Veneto (IOV)-IRCCS, Padua, Italy
| | - Krzysztof A Tomaszewski
- Health Outcomes Research Unit, Department of Geriatrics, Gerontology, and Social Work, Faculty of Education, Ignatianum Academy, Krakow, Poland
| | - Vassilios Vassiliou
- Department of Radiation Oncology, Bank of Cyprus Oncology Centre, Nicosia, Cyprus
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology / Head & Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Ingvild Vistad
- Department of Gynecology and Obstetrics, Sorlandet Hospital Kristiansand, Kristiansand, Norway
| | - Teresa E Young
- Lynda Jackson Macmillan Centre, East & North Hertfordshire NHS Trust including Mount Vernon Cancer Centre, Northwood, UK
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Lonneke V van de Poll-Franse
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Comprehensive Cancer Centre South (CCCS), Eindhoven Cancer Registry, Eindhoven, The Netherlands
- Tilburg University, Tilburg, The Netherlands
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25
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Mols F, Schoormans D, Smit JWA, Netea-Maier RT, Links TP, van der Graaf WTA, Husson O. Age-related differences in health-related quality of life among thyroid cancer survivors compared with a normative sample: Results from the PROFILES Registry. Head Neck 2018; 40:2235-2245. [DOI: 10.1002/hed.25325] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 01/09/2018] [Accepted: 04/09/2018] [Indexed: 01/23/2023] Open
Affiliation(s)
- Floortje Mols
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology; Tilburg University; Tilburg The Netherlands
- Department of Research; Netherlands Comprehensive Cancer Organisation; Utrecht The Netherlands
| | - Dounya Schoormans
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology; Tilburg University; Tilburg The Netherlands
| | - Jan W. A. Smit
- Radboud University Medical Center, Department of Internal Medicine; Nijmegen The Netherlands
| | - Romana T. Netea-Maier
- Radboud University Medical Center, Department of Internal Medicine, Division of Endocrinology; Nijmegen The Netherlands
| | - Thera P. Links
- University of Groningen, University Medical Center Groningen, Department of Endocrinology; Groningen The Netherlands
| | - Winette T. A. van der Graaf
- Radboud University Medical Center, Department of Medical Oncology; Nijmegen The Netherlands
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust; London UK
| | - Olga Husson
- Department of Medical Psychology; Radboud University Medical Centre; Nijmegen The Netherlands
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26
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Thong MS, Mols F, Doege D, van de Poll-Franse L, Arndt V. Population-based cancer survivorship research: Experiences from Germany and the Netherlands. J Cancer Policy 2018. [DOI: 10.1016/j.jcpo.2018.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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27
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Verweij NM, Bonhof CS, Schiphorst AHW, Maas HA, Mols F, Pronk A, Hamaker ME. Quality of life in elderly patients with an ostomy - a study from the population-based PROFILES registry. Colorectal Dis 2018; 20:O92-O102. [PMID: 29243393 DOI: 10.1111/codi.13989] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 08/21/2017] [Indexed: 02/08/2023]
Abstract
AIM Ostomies are being placed frequently in surgically treated elderly patients with colorectal cancer (CRC). An insight into the (potential) impact of ostomies on quality of life (QoL) could be useful in patient counselling as well as in the challenging shared treatment decision-making. METHOD Patients with CRC diagnosed between 2000 and 2009 and registered in the population-based Eindhoven Cancer Registry received a QoL questionnaire (EORTC QLQ-C30) in 2010. In addition, QoL was compared with an age- and sex-matched normative population. RESULTS The study included 2299 CRC patients, of whom 494 had an ostomy. No differences were found in reported ostomy-related problems between patients aged ≤65, 66-75 and ≥76 years. Ostomy patients aged 66-75 and ≥76 years reported significantly lower physical functioning compared with those without an ostomy. In the elderly (those aged ≥76 years) ostomates reported a worse physical and social functioning compared with the normative population. All these differences were of small clinical relevance. The impact of an ostomy seems to be more prominent in younger (≤75 years old) ostomates, as they experience more functional limitations and a decrease in global health status compared with younger nonostomy patients and the normative population. CONCLUSION Although elderly (≥76 years old) patients with an ostomy report significantly more limitations in functioning compared with a normative population and elderly CRC patients without an ostomy, the clinical relevance of this finding is limited. In contrast, the impact of an ostomy is more prominent in younger patients. Thus, age itself is not a reason for withholding an ostomy.
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Affiliation(s)
- N M Verweij
- Department of Geriatric Medicine, Diakonessenhuis, Utrecht, The Netherlands.,Department of Surgery, Diakonessenhuis, Utrecht, The Netherlands
| | - C S Bonhof
- Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - A H W Schiphorst
- Department of Surgery, Diakonessenhuis, Utrecht, The Netherlands
| | - H A Maas
- Department of Geriatric Medicine, Elisabeth - Tweesteden Ziekenhuis, Tilburg, The Netherlands
| | - F Mols
- Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands.,Netherlands Comprehensive Cancer Organisation (IKNL), Netherlands Cancer Registry, Eindhoven, The Netherlands
| | - A Pronk
- Department of Surgery, Diakonessenhuis, Utrecht, The Netherlands
| | - M E Hamaker
- Department of Geriatric Medicine, Diakonessenhuis, Utrecht, The Netherlands
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28
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van de Poll-Franse L, Oerlemans S, Bredart A, Kyriakou C, Sztankay M, Pallua S, Daniëls L, Creutzberg CL, Cocks K, Malak S, Caocci G, Molica S, Chie W, Efficace F. International development of four EORTC disease-specific quality of life questionnaires for patients with Hodgkin lymphoma, high- and low-grade non-Hodgkin lymphoma and chronic lymphocytic leukaemia. Qual Life Res 2017; 27:333-345. [PMID: 29127596 PMCID: PMC5846994 DOI: 10.1007/s11136-017-1718-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE This paper describes the international, cross-cultural development of four disease-specific EORTC QoL questionnaires, to supplement the EORTC QLQ-C30, for patients with Hodgkin lymphoma (HL), high- or low-grade non-Hodgkin lymphoma (HG/LG-NHL), and CLL. METHODS Questionnaire development was conducted according to guidelines from the EORTC Quality of Life Group. Phase I comprised generation of QoL issues relevant to patients. Phase II included operationalization and assessment of item relevance. In phase III, items were pretested in a cross-cultural sample. RESULTS In Phase I, 75 issues were identified through focus groups and systematic literature searches. Interviews with 80 health-care professionals and 245 patients resulted in a provisional module of 38 items (phase II) representing items relevant for all or at least one of the four malignancies. In Phase III, this was tested in 337 patients from five European countries and resulted in a questionnaire with 27 items for HL (EORTC QLQ-HL27), 29 items for HG-NHL (EORTC QLQ-NHL-HG29), 20 items for LG-NHL (EORTC QLQ-NHL-LG20) and 17 items for CLL (EORTC QLQ-CLL17). CONCLUSIONS This study provides four new EORTC modules for use in clinical research and routine practice in conjunction with the EORTC QLQ-C30 for assessing QoL in patients with lymphoma and CLL.
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Affiliation(s)
- Lonneke van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Department of Psychosocial Research, Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Simone Oerlemans
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Anne Bredart
- Psycho-Oncology Unit, Institut Curie, Paris, France
- Psycho-pathology and Health Process Laboratory Psychology Institute, University Paris Descartes, Paris, France
| | - Charalampia Kyriakou
- Royal Free and North West London Hospitals, National Health Service Trust, London, UK
| | - Monika Sztankay
- Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria
| | - Stephan Pallua
- Department of Psychiatry, Psychotherapy and Psychosomatics, Innsbruck Medical University, Innsbruck, Austria
| | - Laurien Daniëls
- Department of Radiation Oncology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Carien L. Creutzberg
- Department of Radiation Oncology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Kim Cocks
- KCStats Consultancy, York, UK
- University of York, York, UK
| | - Sandra Malak
- Hôpital René Huguenin-Institut Curie- Hématologie, Saint-Cloud, France
| | - Giovanni Caocci
- Hematology, Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | | | | | - Fabio Efficace
- Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA) Data Centre, Rome, Italy
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Cancer-specific geriatric assessment and quality of life: important factors in caring for older patients with aggressive B-cell lymphoma. Support Care Cancer 2017; 25:2833-2842. [DOI: 10.1007/s00520-017-3698-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 03/31/2017] [Indexed: 12/20/2022]
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30
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Monterosso L, Taylor K, Platt V, Lobb E, Krishnasamy M, Musiello T, Bulsara C, Stratton K, Joske D. A qualitative study of the post-treatment experiences and support needs of survivors of lymphoma. Eur J Oncol Nurs 2017; 28:62-68. [PMID: 28478857 DOI: 10.1016/j.ejon.2017.03.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 02/10/2017] [Accepted: 03/05/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE To explore the post-treatment experiences and preferences for follow-up support of lymphoma survivors. METHODS Two focus groups were conducted with 17 participants to explore informational, psychological, emotional, social, practical and physical needs, 6-30 months post-treatment for lymphoma. Perceptions regarding a potential model of survivorship care were also elicited. RESULTS Thematic content analysis revealed five key themes: Information; Loss and uncertainty; Family, support and post-treatment experience; Transition, connectivity and normalcy, and Person-centred post-treatment care. Participants described a sense of loss as they transitioned away from regular interaction with the hospital at the end of treatment, but also talked about the need to find a "new normal". Establishing post-treatment support structures that can provide individualised information, support, reassurance and referrals to community and peer support were identified as a helpful way to navigate the transition from patient to post-treatment survivor. CONCLUSIONS Participants in our study articulated a need for a flexible approach to survivorship care, providing opportunities for individuals to access different types of support at different times post-treatment. Specialist post-treatment nurse care coordinators working across acute and community settings may offer one effective model of post-treatment support for survivors of haematological malignancies.
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Affiliation(s)
- Leanne Monterosso
- School of Nursing and Midwifery, University of Notre Dame Australia, Fremantle, Western Australia, Australia; St John of God Murdoch Hospital, Western Australia, Australia; School of Nursing, Edith Cowan University Joondalup, Western Australia, Australia.
| | - Karen Taylor
- School of Nursing and Midwifery, University of Notre Dame Australia, Fremantle, Western Australia, Australia; Western Australia Cancer and Palliative Care Network, Perth, Australia
| | - Violet Platt
- School of Nursing and Midwifery, University of Notre Dame Australia, Fremantle, Western Australia, Australia; Western Australia Cancer and Palliative Care Network, Perth, Australia
| | - Elizabeth Lobb
- Calvary Health Care, Kogarah, New South Wales, Australia; Cunningham Centre for Palliative Care, Darlinghurst, New South Wales, Australia; The University of Notre Dame, Darlinghurst, New South Wales, Australia
| | - Meinir Krishnasamy
- Department of Nursing, University of Melbourne, Victoria, Australia; Research and Education Lead-Nursing, The Victorian Comprehensive Cancer Centre, Victoria, Australia
| | - Toni Musiello
- University of Western Australia, Crawley, Western Australia, Australia
| | - Caroline Bulsara
- School of Nursing and Midwifery, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Kendall Stratton
- Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; School of Nursing and Midwifery, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - David Joske
- University of Western Australia, Crawley, Western Australia, Australia; Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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31
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Cognitive function and its relationship to other psychosocial factors in lymphoma survivors. Support Care Cancer 2016; 25:905-913. [PMID: 27837322 DOI: 10.1007/s00520-016-3480-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 11/01/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study was to estimate the prevalence of cognitive disturbance in lymphoma survivors and to explore relationships between cognitive function and other psychosocial factors. METHODS A package of standardized questionnaires was sent to 622 lymphoma patients treated at the Ottawa Hospital in the preceding 5 years. Patients with central nervous system involvement were excluded. The questionnaires addressed cognitive function, pain, insomnia, fatigue, and mood. Of the patients in the sampling frame, 54 % responded to the survey and 42 % met inclusion/exclusion criteria. Sixteen percent (99/622) agreed to undergo computerized neuropsychological testing with CNS vital signs (CNSVS). Scores on the objective and subjective cognitive measures were compared to those of a healthy female control group from a previous study. RESULTS The lymphoma group scored significantly lower than the controls on a cognitive rating scale (p = .018) and on CNSVS (p = .035). The difference on the CNSVS was primarily due to poorer attention and executive function scores in the lymphoma patients. The patients also had a higher frequency of impairment on both the objective (p = .009) and subjective (p < .001) cognitive measures. Among the lymphoma survivors, fatigue and anxiety were related to subjective cognitive disturbance (p < .001 for both), whereas pain was the only psychosocial measure associated with objective cognitive performance (p < .001). CONCLUSIONS These results suggest that cognitive disturbance may be a significant survivorship issue for lymphoma patients and should be more thoroughly investigated in this population.
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Drost FM, Mols F, Kaal SEJ, Stevens WBC, van der Graaf WTA, Prins JB, Husson O. Psychological impact of lymphoma on adolescents and young adults: not a matter of black or white. J Cancer Surviv 2016; 10:726-35. [PMID: 26856728 PMCID: PMC4920833 DOI: 10.1007/s11764-016-0518-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/20/2016] [Indexed: 01/11/2023]
Abstract
PURPOSE The purpose of the study is to examine differences in perceived impact of cancer (IOC) between adolescents and young adults (AYAs; 18-35 years at cancer diagnosis), adults (36-64 years) and elderly (65-84 years) with a history of (non-)Hodgkin lymphoma. Furthermore, to investigate the association of socio-demographic, clinical and psychological characteristics with IOC; and the association between IOC and health-related quality of life (HRQoL) among AYAs only. METHODS This study is part of a population-based PROFILES registry survey among lymphoma patients diagnosed between 1999 and 2009. Patients (n = 1.281) were invited to complete the IOCv1 and EORTC-QLQ-C30 questionnaires. Response rate was 67 % (n = 861). RESULTS AYA lymphoma survivors scored higher on the positive IOC summary scale, compared to adult and elderly patients (p < 0.001), while no significant differences were observed for negative IOC. Among AYAs, females, survivors with a partner, and survivors with elevated psychological distress levels scored significantly higher on the negative IOC summary scale. The negative IOC summary scale was negatively associated with all EORTC QLQ-C30 functioning scales (β ranging from -0.39 to -0.063; p < 0.05). The positive IOC summary scale was negatively associated with the EORTC QLQ-C30 subscale 'Emotional functioning' (β = -0.24; p < 0.05). CONCLUSION AYA, adult and elderly with a history of (non-)Hodgkin lymphoma experienced different types of IOC in terms of positive and negative aspects. IMPLICATIONS FOR CANCER SURVIVORS Although AYAs experience a more positive IOC compared to older survivors, some AYAs experience more negative IOC and may require developmentally appropriate interventions to address their specific concerns.
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Affiliation(s)
- F M Drost
- CoRPS - Centre of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - F Mols
- CoRPS - Centre of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands (CCCN), Netherlands Cancer Registry, Eindhoven, The Netherlands
| | - S E J Kaal
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - W B C Stevens
- Department of Haematology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - W T A van der Graaf
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - J B Prins
- Department of Medical Psychology, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - O Husson
- Department of Medical Psychology, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Williams AM, Zent CS, Janelsins MC. What is known and unknown about chemotherapy-related cognitive impairment in patients with haematological malignancies and areas of needed research. Br J Haematol 2016; 174:835-46. [PMID: 27391367 DOI: 10.1111/bjh.14211] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Cancer-related cognitive impairment (CRCI) is an important clinical problem for cancer patients and survivors. In this review, we summarize studies investigating the occurrence of impaired cognition in patients with haematological malignancies. Most published studies focus on survivors of childhood acute lymphoblastic leukaemia and primary central nervous system lymphoma. We also discuss studies conducted in acute myeloid leukaemia, myelodysplastic syndromes, chronic myeloid leukaemia, Hodgkin lymphoma (HL), non-HL and chronic lymphocytic leukaemia. Although research in this area is still emerging, it appears that a subset of chemotherapy-treated haematological malignancy survivors experience CRCI. Future research should focus on expanding the literature reviewed here with larger studies appropriately powered to assess cognition via objective and subjective measures in a longitudinal fashion to tease apart the impact of disease and the various forms of cancer treatment.
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Affiliation(s)
- Annalynn M Williams
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Clive S Zent
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle C Janelsins
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.,Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
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Sherman AC, Merluzzi TV, Pustejovsky JE, Park CL, George L, Fitchett G, Jim HSL, Munoz AR, Danhauer SC, Snyder MA, Salsman JM. A meta-analytic review of religious or spiritual involvement and social health among cancer patients. Cancer 2015; 121:3779-88. [PMID: 26258730 DOI: 10.1002/cncr.29352] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 10/29/2014] [Accepted: 11/10/2014] [Indexed: 12/25/2022]
Abstract
Religion and spirituality (R/S) play an important role in the daily lives of many cancer patients. There has been great interest in determining whether R/S factors are related to clinically relevant health outcomes. In this meta-analytic review, the authors examined associations between dimensions of R/S and social health (eg, social roles and relationships). A systematic search of the PubMed, PsycINFO, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature databases was conducted, and data were extracted by 4 pairs of investigators. Bivariate associations between specific R/S dimensions and social health outcomes were examined in a meta-analysis using a generalized estimating equation approach. In total, 78 independent samples encompassing 14,277 patients were included in the meta-analysis. Social health was significantly associated with overall R/S (Fisher z effect size = .20; P < .001) and with each of the R/S dimensions (affective R/S effect size = 0.31 [P < .001]; cognitive R/S effect size = .10 [P < .01]; behavioral R/S effect size = .08 [P < .05]; and 'other' R/S effect size = .13 [P < .001]). Within these dimensions, specific variables tied to social health included spiritual well being, spiritual struggle, images of God, R/S beliefs, and composite R/S measures (all P values < .05). None of the demographic or clinical moderating variables examined were significant. Results suggest that several R/S dimensions are modestly associated with patients' capacity to maintain satisfying social roles and relationships in the context of cancer. Further research is needed to examine the temporal nature of these associations and the mechanisms that underlie them.
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Affiliation(s)
- Allen C Sherman
- Behavioral Medicine, Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Thomas V Merluzzi
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana
| | - James E Pustejovsky
- Department of Educational Psychology, University of Texas at Austin, Austin, Texas
| | - Crystal L Park
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - Login George
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - George Fitchett
- Department of Religion, Health, and Human Values, Rush University Medical Center, Chicago, Illinois
| | - Heather S L Jim
- Health Outcomes and Behavior Department, Moffitt Cancer Center, Tampa, Florida
| | - Alexis R Munoz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Suzanne C Danhauer
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston Salem, North Carolina.,Comprehensive Cancer Center of Wake Forest University, Winston-Salem, North Carolina
| | - Mallory A Snyder
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - John M Salsman
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.,The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois
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Jaime-Pérez JC, Gamboa-Alonso CM, Vázquez-Mellado de Larracoechea A, Rodríguez-Martínez M, Gutiérrez-Aguirre CH, Marfil-Rivera LJ, Gómez-Almaguer D. Non-Hodgkin Lymphomas: Impact of Rituximab on Overall Survival of Patients with Diffuse Large B-Cell and Follicular Lymphoma. Arch Med Res 2015; 46:454-61. [DOI: 10.1016/j.arcmed.2015.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 07/13/2015] [Indexed: 01/13/2023]
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36
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Williams JN, Rai A, Flowers CR. Reply to age-related differences in quality of life among patients with diffuse large B-cell lymphoma. Cancer 2015; 121:2858-9. [PMID: 25925878 DOI: 10.1002/cncr.29425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 03/30/2015] [Indexed: 11/12/2022]
Affiliation(s)
| | - Ashish Rai
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Christopher R Flowers
- Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia
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Oerlemans S, Nijziel MR, van de Poll-Franse LV. Age-related differences in quality of life among patients with diffuse large B-cell lymphoma. Cancer 2015; 121:2857-8. [PMID: 25926003 DOI: 10.1002/cncr.29427] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 03/30/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Simone Oerlemans
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Eindhoven, The Netherlands.,Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Marten R Nijziel
- Department of Internal Medicine/Hemato-Oncology, Maxima Medical Center, Eindhoven/Veldhoven, The Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Eindhoven, The Netherlands.,Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
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van der Poel MWM, Oerlemans S, Schouten HC, van de Poll-Franse LV. Elderly multiple myeloma patients experience less deterioration in health-related quality of life than younger patients compared to a normative population: a study from the population-based PROFILES registry. Ann Hematol 2014; 94:651-61. [DOI: 10.1007/s00277-014-2264-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 11/22/2014] [Indexed: 01/25/2023]
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39
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The course of anxiety and depression for patients with Hodgkin’s lymphoma or diffuse large B cell lymphoma: a longitudinal study of the PROFILES registry. J Cancer Surviv 2014; 8:555-64. [DOI: 10.1007/s11764-014-0367-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 04/28/2014] [Indexed: 12/22/2022]
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