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Dinh PC, Monahan PO, Fosså SD, Sesso HD, Feldman DR, Dolan ME, Nevel K, Kincaid J, Vaughn DJ, Martin NE, Sanchez VA, Einhorn LH, Frisina R, Fung C, Kroenke K, Travis LB. Impact of pain and adverse health outcomes on long-term US testicular cancer survivors. J Natl Cancer Inst 2024; 116:455-467. [PMID: 37966940 PMCID: PMC10919346 DOI: 10.1093/jnci/djad236] [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: 08/16/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND No study has quantified the impact of pain and other adverse health outcomes on global physical and mental health in long-term US testicular cancer survivors or evaluated patient-reported functional impairment due to pain. METHODS Testicular cancer survivors given cisplatin-based chemotherapy completed validated surveys, including Patient-Reported Outcomes Measurement Information System v1.2 global physical and mental health, Patient-Reported Outcomes Measurement Information System pain questionnaires, and others. Multivariable linear regression examined relationships between 25 adverse health outcomes with global physical and mental health and pain-interference scores. Adverse health outcomes with a β^ of more than 2 are clinically important and reported below. RESULTS Among 358 testicular cancer survivors (median age = 46 years, interquartile range [IQR] = 38-53 years; median time since chemotherapy = 10.7 years, IQR = 7.2-16.0 years), median adverse health outcomes number was 5 (IQR = 3-7). A total of 12% testicular cancer survivors had 10 or more adverse health outcomes, and 19% reported chemotherapy-induced neuropathic pain. Increasing adverse health outcome numbers were associated with decreases in physical and mental health (P < .0001 each). In multivariable analyses, chemotherapy-induced neuropathic pain (β^ = -3.72; P = .001), diabetes (β^ = -4.41; P = .037), obesity (β^ = -2.01; P = .036), and fatigue (β^ = -8.58; P < .0001) were associated with worse global mental health, while being married or living as married benefited global mental health (β^ = 3.63; P = .0006). Risk factors for pain-related functional impairment included lower extremity location (β^ = 2.15; P = .04) and concomitant peripheral artery disease (β^ = 4.68; P < .001). Global physical health score reductions were associated with diabetes (β^ = -3.81; P = .012), balance or equilibrium problems (β^ = -3.82; P = .003), cognitive dysfunction (β^ = -4.43; P < .0001), obesity (β^ = -3.09; P < .0001), peripheral neuropathy score (β^ = -2.12; P < .0001), and depression (β^ = -3.17; P < .0001). CONCLUSIONS Testicular cancer survivors suffer adverse health outcomes that negatively impact long-term global mental health, global physical health, and pain-related functional status. Clinically important factors associated with worse physical and mental health identify testicular cancer survivors requiring closer monitoring, counseling, and interventions. Chemotherapy-induced neuropathic pain must be addressed, given its detrimental impact on patient-reported functional status and mental health 10 or more years after treatment.
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Affiliation(s)
- Paul C Dinh
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Patrick O Monahan
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA
| | - Sophie D Fosså
- Department of Oncology, Oslo University Hospital, Radiumhospital, Oslo, Norway
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine Research, Brigham and Women’s Hospital, Boston, MA, USA
| | - Darren R Feldman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - M Eileen Dolan
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Kathryn Nevel
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - John Kincaid
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - David J Vaughn
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Neil E Martin
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Victoria A Sanchez
- Department of Medical Engineering, University of South Florida, Tampa, FL, USA
| | - Lawrence H Einhorn
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robert Frisina
- Department of Medical Engineering, University of South Florida, Tampa, FL, USA
| | - Chunkit Fung
- Department of Medicine, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Kurt Kroenke
- Regenstrief Institute, Inc, Indiana University, Indianapolis, IN, USA
| | - Lois B Travis
- Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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2
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Fosså SD, Haugnes HS, Dahl AA, Kiserud CE, Fosså A, Skalleberg J, Myklebust TÅ. Adverse health outcomes and global quality of life in long-term testicular cancer survivors: a longitudinal 30-year perspective. Ann Oncol 2023; 34:1165-1174. [PMID: 37739265 DOI: 10.1016/j.annonc.2023.09.3101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND The aim of this study was to characterize the prevalence of self-reported adverse health outcomes (AHOs), track changes in AHOs, and examine their impact on health-related quality of life (HrQoL) in testicular cancer survivors (TCSs) who were diagnosed between 1980 and 1994. These assessments were conducted during two survey waves (SWs), with the first occurring ∼12 years after surgery-only or platinum-based chemotherapy (PBCT), and the second ∼28 years after initial treatment. The study primarily focused on 'typical AHOs', which included Peripheral Sensory Neuropathy (PSN), Raynaud's phenomenon, Tinnitus, and Hearing loss. PATIENTS AND METHODS A total of 427 TCSs were included in the evaluation, distributed as follows: surgery-only group (n = 155), PBCT-standard group with ≤850 mg cisplatin (n = 222), and PBCT-high group with >850 mg cisplatin (n = 50). For comparison of HrQoL, men from the general population served as a control group (referred to as 'Norms'). The statistical significance level was set at P < 0.05, and clinical importance, in terms of testing HrQoL differences, was defined as Δ ≥2.5 points. RESULTS A higher number of TCSs who underwent PBCT reported experiencing typical AHOs compared with those who had surgery only. The highest prevalence rates were observed among TCSs who had undergone PBCT-high. Further, the number of TCSs describing typical AHOs, except Raynaud's phenomenon, increased during the observation period of 16 years. At the last SW, a median of 4 AHOs (any type) were reported after PBCT-high compared with a median of 2 AHOs after Surgery-only or after PBCT-standard. With Surgery-only as reference, PBCT-high, but not PBCT-standard, was associated with decreasing physical HrQoL in the last SW (A2 Regression coefficient: -4.3; P = 0.008). When comparing all TCSs with Norms no clinically important difference in physical and mental HrQoL was observed at either SW. However, at the last SW, TCSs after PBCT-high therapy represented a subgroup of TCSs with clinically important impairment of HRQoL. Of the typical AHOs, only PSN reduced HrQoL. Chronic fatigue, pain, anxiety/depression, sexual dysfunction, unemployment, being single, and low education were additional covariates. CONCLUSIONS After a median of 28 years since their treatment, HrQoL in TCSs was found to be comparable to that of Norms. This similarity held true even though AHOs, especially after PBCT-high, were becoming more prevalent among TCSs. The study revealed that individuals with a history of PBCT-high are at a high risk of experiencing a significantly increased prevalence of long-term AHOs, which subsequently leads to diminished HrQoL. It is crucial to recognize and provide specialized attention to these TCSs during lifelong follow-up care.
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Affiliation(s)
- S D Fosså
- Department of Oncology, Oslo University Hospital, Oslo; Institute of Clinical Medicine, University of Oslo, Oslo.
| | - H S Haugnes
- Department of Oncology, University Hospital of North Norway, Tromsø; Department of Clinical Medicine, UiT, The Arctic University, Tromsø
| | - A A Dahl
- Department of Oncology, Oslo University Hospital, Oslo
| | - C E Kiserud
- Department of Oncology, Oslo University Hospital, Oslo
| | - A Fosså
- Department of Oncology, Oslo University Hospital, Oslo
| | - J Skalleberg
- Department of Otolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo
| | - T Å Myklebust
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund; Department of Registration, Cancer Registry of Norway, Oslo, Norway
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Pathak N, Raj A, Santhosh AP, Kumar S, Haresh KP, Singh P, Nayak B, Shamim SA, Seth A, Ray M, Kaushal S, Sahoo RK, Batra A. Quality of life assessment in testicular non-seminomatous germ cell tumour survivors. J Cancer Surviv 2023:10.1007/s11764-023-01416-y. [PMID: 37395935 DOI: 10.1007/s11764-023-01416-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/13/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE Patients with Germ cell tumours (GCT) are at risk of long-term toxicities due to multimodality therapy. It is debatable whether there is an impact on the quality of life(QoL) of GCT survivors. METHODS A case-control study was conducted at a tertiary care centre in India, using the EORTC QLQ C30 questionnaire, to compare the QoL between GCT survivors(disease free > 2 years) and healthy matched controls. A multivariate regression model was used to identify factors affecting QoL. RESULTS A total of 55 cases and 100 controls were recruited. Cases had a median age of 32 years (interquartile range, IQR 28-40 years), ECOG PS of 0-1(75%), advanced stage III (58%), chemotherapy (94%) and 66% were > 5 years from diagnosis. The median age of controls: 35 years (IQR 28-43 years). A statistically significant difference was seen for emotional (85.8 ± 14.2 vs 91.7 ± 10.4, p 0.005), social(83.0 ± 22.0 vs 95.2 ± 9.6, p < 0.001) and global scales (80.4 ± 21.1 vs 91.3 ± 9.7, p < 0.001). Cases had more nausea and vomiting(3.3 ± 7.4 vs 1.0 ± 3.9, p 0.015), pain(13.9 ± 13.9 vs 4.8 ± 9.8, p < 0.001), dyspnea(7.9 + 14.3 vs 2.7 ± 9.1, p 0.007), and appetite loss(6.7 ± 14.9 vs 1.9 ± 7.9, p 0.016) and greater financial toxicity(31.5 ± 32.3 vs 9.0 ± 16.3, p < 0.001). Adjusting for age, performance status, BMI, stage, chemotherapy, RPLND, recurrent disease, and time since diagnosis, no predictive variables were significant. CONCLUSION There is a detrimental impact of history of GCT in long term survivors of GCT.
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Affiliation(s)
- Neha Pathak
- Department of Medical Oncology, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Abhishek Raj
- Department of Medical Oncology, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Akhil P Santhosh
- Department of Medical Oncology, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Sudhir Kumar
- Department of Medical Oncology, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - K P Haresh
- Department of Radiation Oncology, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhjot Singh
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Brusabhanu Nayak
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Shamim Ahmed Shamim
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Amlesh Seth
- Department of Urology, All India Institute of Medical Sciences, New Delhi, India
| | - Mukurdipi Ray
- Department of Surgical Oncology, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kaushal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Ranjit Kumar Sahoo
- Department of Medical Oncology, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India.
| | - Atul Batra
- Department of Medical Oncology, Dr B.R.A.I.R.C.H, All India Institute of Medical Sciences, New Delhi, India.
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4
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Deleemans JM, Samnani S, Lloyd C, Alimohamed N. Improving adherence and health outcomes in testicular cancer survivors using a mobile health-based intervention: A mixed-methods pilot study. Digit Health 2023; 9:20552076231167002. [PMID: 37113254 PMCID: PMC10126680 DOI: 10.1177/20552076231167002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/15/2023] [Indexed: 04/29/2023] Open
Abstract
Objective Testicular cancer (TC) is one of the most common cancers among young men, with survival rates exceeding 97% due to effective treatments. Post-treatment follow-up care is important for long-term survival and monitoring psychosocial symptoms, yet TC survivors (TCS) show poor adherence to post-treatment care. Mobile-health-based interventions show high acceptability in men with cancer. This study will examine the feasibility of using the Zamplo health app to improve adherence to post-treatment care and support psychosocial outcomes in TCS. Methods This mixed-methods, longitudinal, single-arm pilot study will recruit N = 30 patients with a diagnosis of TC who finished treatment within ≤ 6 months and are currently aged ≥18 years old. Adherence to follow-up appointments (e.g. blood work, scans) will be assessed (primary outcome), and measures for fatigue, depression, anxiety, sexual satisfaction and function, social roles satisfaction, general mental and physical health and body image (secondary outcomes) will be completed at four-time points: baseline, 3, 6 and 12 months. One-on-one semi-structured interviews will be conducted post-intervention (month 12). Results Improvements in post-treatment follow-up appointment adherence and psychosocial outcomes will be analyzed using descriptive statistics, paired samples t-tests to determine changes across time points 1 through 4, and correlation analysis. Qualitative data will be analyzed using thematic analysis. Conclusion Findings will inform future, larger trials that incorporate evaluation of sustainability and economic implications to improve adherence to TC follow-up guidelines. Findings will be disseminated via infographics, social media, publications and presentations conducted in partnership with TC support organizations and at conferences.
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Affiliation(s)
- Julie M Deleemans
- Department of Oncology, Cumming School
of Medicine, University of Calgary, Calgary, Canada
- Zamplo Research Inc., Calgary,
Canada
- Julie M Deleemans, Tom Baker Cancer Centre,
1331 29th Street NW, Calgary, AB, T2N 4N2, Canada.
| | - Sunil Samnani
- Department of Oncology, Cumming School
of Medicine, University of Calgary, Calgary, Canada
| | - Chris Lloyd
- OneBall Charitable Cancer Organization,
Calgary, Canada
| | - Nimira Alimohamed
- Department of Oncology, Cumming School
of Medicine, University of Calgary, Calgary, Canada
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5
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Shrem NS, Wood L, Hamilton RJ, Kuhathaas K, Czaykowski P, Roberts M, Matthew A, Izard JP, Chung P, Nappi L, Jones J, Soulières D, Aprikian A, Power N, Canil C. Testicular cancer survivorship: Long-term toxicity and management. Can Urol Assoc J 2022; 16:257-272. [PMID: 35905486 PMCID: PMC9343164 DOI: 10.5489/cuaj.8009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Affiliation(s)
- Noa Shani Shrem
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Lori Wood
- Division of Medical Oncology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS, Canada
| | - Robert J. Hamilton
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Kopika Kuhathaas
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Piotr Czaykowski
- Department of Medical Oncology and Hematology, CancerCare Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - Matthew Roberts
- Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
| | - Andrew Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jason P. Izard
- Departments of Urology and Oncology, Queen’s University, Kingston, ON, Canada
| | - Peter Chung
- Department of Radiation Oncology, Radiation Medicine Program, Princess Margaret Hospital, University of Health Network, University of Toronto, Toronto, ON, Canada
| | - Lucia Nappi
- Division of Medical Oncology, British Columbia Cancer - Vancouver Cancer Centre, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Denis Soulières
- Division of Medical Oncology/Hematology, Le Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Armen Aprikian
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Nicholas Power
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Christina Canil
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
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De Padova S, Urbini M, Schepisi G, Virga A, Meggiolaro E, Rossi L, Fabbri F, Bertelli T, Ulivi P, Ruffilli F, Casadei C, Gurioli G, Rosti G, Grassi L, De Giorgi U. Immunosenescence in Testicular Cancer Survivors: Potential Implications of Cancer Therapies and Psychological Distress. Front Oncol 2021; 10:564346. [PMID: 33520693 PMCID: PMC7844142 DOI: 10.3389/fonc.2020.564346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/23/2020] [Indexed: 01/13/2023] Open
Abstract
Testicular cancer (TC) is the most frequent solid tumor diagnosed in young adult males. Although it is a curable tumor, it is frequently associated with considerable short-term and long-term morbidity. Both biological and psychological stress experienced during cancer therapy may be responsible for stimulating molecular processes that induce premature aging and deterioration of immune system (immunosenescence) in TC survivors, leading to an increased susceptibility to infections, cancer, and autoimmune diseases. Immunosenescence is a remodeling of immune cell populations with inversion of the CD4:CD8 ratio, accumulation of highly differentiated memory cells, shrinkage of telomeres, shift of T-cell response to Th2 type, and release of pro-inflammatory signals. TC survivors exposed to chemotherapy show features of immunological aging, including an increase in memory T-cells (CD4+ and CD8+) and high expression of the senescence biomarker p16INK4a in CD3+ lymphocytes. However, the plethora of factors involved in the premature aging of TC survivors make the situation more complex if we also take into account the psychological stress and hormonal changes experienced by patients, as well as the high-dose chemotherapy and hematopoietic stem cell transplantation that some individuals may be required to undergo. The relatively young age and the long life expectancy of TC patients bear witness to the importance of improving quality of life and of alleviating long-term side-effects of cancer treatments. Within this context, the present review takes an in-depth look at the molecular mechanisms of immunosenescence, describing experimental evidence of cancer survivor aging and highlighting the interconnected relationship between the many factors modulating the aging of the immune system of TC survivors.
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Affiliation(s)
- Silvia De Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Milena Urbini
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Giuseppe Schepisi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alessandra Virga
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Elena Meggiolaro
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Lorena Rossi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Francesco Fabbri
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Tatiana Bertelli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Paola Ulivi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Federica Ruffilli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Chiara Casadei
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Giorgia Gurioli
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Giovanni Rosti
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Luigi Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara and University Hospital Psychiatry Unit, Integrated Department of Mental Health S. Anna University Hospital and Health Authorities, Ferrara, Italy
| | - Ugo De Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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7
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Okada K, Fujita K, Fukuhara S, Kiuchi H, Uemura M, Imamura R, Nonomura N. Erectile Dysfunction in Germ Cell Tumor Survivors. World J Mens Health 2020; 39:533-540. [PMID: 32777864 PMCID: PMC8255390 DOI: 10.5534/wjmh.200042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/30/2020] [Accepted: 06/16/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose Germ cell tumors (GCTs) are the most common malignant neoplasms in adolescents and young adults, and most patients with these tumors can be completely cured. Therefore, maintaining quality of life (QOL) is important. Erectile dysfunction (ED) is one factor that reduces the QOL of GCT survivors. We aimed to clarify the relationship between ED and age, follow-up period, serum levels of hormones, and treatment methods for GCT survivors. Materials and Methods We evaluated ED using the Sexual Health Inventory for Men questionnaire (SHIM) and measured serum levels of hormones in survivors after GCT treatment. The relationships between the SHIM score responses and age, serum levels of hormones, follow-up period, and treatment methods were assessed using a logistic analysis. Results Fifty-two GCT survivors were enrolled and 46 survivors completed the SHIM. The median age, follow-up period, and SHIM score were 38 years, 35 months, and 18, respectively. Regarding the SHIM scores, 85% had scores <22 and 46% had scores <17. The percentage of SHIM scores <17 was 69% in patients with under 2 years of follow-up. It significantly improved to 33% in patients with over 2 years of follow-up. The multivariate analysis identified the follow-up period as an independent factor for SHIM scores <17. Age, serum levels of hormone, and treatment method were not significant factors for SHIM scores <17. Conclusions Improvement of SHIM score can be expected after GCT treatment regardless of age, serum levels of hormone, and treatment method.
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Affiliation(s)
- Koichi Okada
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kazutoshi Fujita
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan.
| | - Shinichiro Fukuhara
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiroshi Kiuchi
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Motohide Uemura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ryoichi Imamura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Norio Nonomura
- Department of Urology, Osaka University Graduate School of Medicine, Suita, Japan
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8
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Yu YL, Yeo H, Kang S. The impact of depressive symptoms on health value in patients with gynecologic cancer: A comparison with physical symptoms and performance status. Gynecol Oncol 2020; 157:733-739. [PMID: 32307127 DOI: 10.1016/j.ygyno.2020.04.044] [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: 02/20/2020] [Accepted: 04/03/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The importance of managing depressive symptoms is frequently underestimated in the clinic. In this study, the effects of depressive symptoms on health utility value (HUV) in gynecologic cancer patients are evaluated. In addition, the effects were compared with those of performance status and physical symptoms. METHODS Patient-reported outcome data from 274 gynecologic cancer patients were prospectively collected. HUV was measured using the 3-level version of the EuroQoL 5-dimension descriptive system (EQ-5D-3L) and the EuroQoL visual analog scale (EQ-VAS). The Patient Health Questionnaire-9 (PHQ-9) was used to measure the severity of depressive symptoms. The impact of depressive symptoms on HUV was analyzed using the generalized linear model. RESULTS Moderate-severe depressive symptoms were significantly associated with a decrease in HUV in gynecologic cancer patients (p < 0.0001 for the EQ-5D-3L and EQ-VAS). Severe fatigue and severe pain were also associated with a decrease in HUV (p = 0.018 and p < 0.0001 for the EQ-5D-3L and EQ-VAS; p < 0.0001 for the EQ-5D-3L, respectively), and the effect sizes were comparable to that of moderate-severe depressive symptoms. In addition to the patients with moderate-severe depressive symptoms, the patients with mild depressive symptoms also experienced a significant decrease in HUV (p < 0.0001 for the EQ-5D-3L and EQ-VAS). The effect size for mild depressive symptoms was comparable to those for mild fatigue or mild pain. CONCLUSIONS Even mild depressive symptoms may significantly compromise HUV in gynecologic cancer patients, and the effect is comparable to that of performance status or physical symptoms. Gynecologic oncologists should put more effort into properly preventing, detecting, and managing depressive symptoms.
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Affiliation(s)
- Ye Lee Yu
- Division of Precision Medicine, National Cancer Center Korea, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Republic of Korea.
| | - Hyemin Yeo
- Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, Republic of Korea
| | - Sokbom Kang
- Division of Precision Medicine, National Cancer Center Korea, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Republic of Korea.
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9
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Vyas A, Alghaith G, Hufstader-Gabriel M. Psychotropic polypharmacy and its association with health-related quality of life among cancer survivors in the USA: a population-level analysis. Qual Life Res 2020; 29:2029-2037. [PMID: 32207028 DOI: 10.1007/s11136-020-02478-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE Cancer survivors that use multiple psychotropic medications are at an increased risk of psychotropic polypharmacy. We examined the association between psychotropic polypharmacy and health-related quality of life (HRQoL) among cancer survivors living in the USA. METHODS We used the Medical Expenditure Panel Survey (MEPS) data for 2010, 2012, and 2014 to identify adult cancer survivors. Psychotropic polypharmacy was defined as use of at least two classes of psychotropic prescription medications. The physical component summary (PCS) and the mental component summary (MCS) were obtained from the 12-item Short Form Health Survey version 2 to measure HRQoL. Adjusted ordinary least square regressions were performed to evaluate the association between psychotropic polypharmacy and HRQoL. RESULTS Among 31 million US cancer survivors (weighted from a sample of 2609), 16.3% reported psychotropic polypharmacy. Lung cancer survivors had the highest prevalence of psychotropic polypharmacy (22.5%), followed by survivors of breast cancer (17.8%), colorectal, and other gastrointestinal cancers (16.0%). The unadjusted PCS and MCS scores for those with psychotropic polypharmacy were significantly lower than those without psychotropic polypharmacy, overall, and for each cancer type. In multivariable regressions, cancer survivors with psychotropic polypharmacy had significantly lower PCS scores (β = - 3.63, p < 0.0001) and MCS scores (β = - 2.28, p = 0.0138) compared to those without psychotropic polypharmacy. CONCLUSION Cancer survivors requiring multiple psychotropic medications have poorer quality of life.
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Affiliation(s)
- Ami Vyas
- Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Kingston, RI, 02881, USA.
| | - Ghadah Alghaith
- Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Kingston, RI, 02881, USA.,Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
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10
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Alexis O, Adeleye AO, Worsley AJ. Men's experiences of surviving testicular cancer: an integrated literature review. J Cancer Surviv 2019; 14:284-293. [PMID: 31823122 DOI: 10.1007/s11764-019-00841-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/25/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To synthesise literature in order to elucidate the experiences of men who have survived testicular cancer and determine their quality of life following treatment. METHODS An integrated review sought appropriate literature by utilising a keyword search across seven databases. Retrieved studies were appraised for quality, with 2 qualitative, 12 quantitative and 2 mixed method studies deemed appropriate for this review. The data were extracted and aggregated into categories by way of a thematic analysis. The themes were personal challenges and impact on health, psychological and emotive challenges, perception of reproduction and sexual changes and outlook and support. RESULTS Men experienced physical, emotional and sexual difficulties. Some men believed they were infertile, despite evidence that fertility is not compromised in the long term. Psychological conditions can be exacerbated by cultural pressures to conceive and cultural expressions about male identity. Men who had undergone orchidectomy reported minimal impact on their mental health than the men who had chemotherapy or radiotherapy as part of their treatment modality. Sexual dysfunction caused by chemotherapy-associated side effects was detrimental to men's quality of life. In addition, men who had a partner, who were employed, and who had children were able to adjust better after treatment than those who did not. Provision of clear and honest information post-treatment helped testicular cancer survivors return to their normal lives. CONCLUSIONS The evidence from the review suggests that the burden of disease for testicular cancer survivors is overall low. Men who had surgical intervention and were treated for testicular cancer experienced minimal impact on their mental health status than the men who had chemotherapy or radiotherapy as part of their treatment modality. IMPLICATIONS FOR CANCER SURVIVORS There is a need to provide appropriate referrals to the relevant services, including psychosocial support, and the development of more adequate communication resources for men following treatment for testicular cancer.
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Affiliation(s)
- Obrey Alexis
- Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Adeniyi O Adeleye
- School of Nursing, Midwifery and Social Sciences, CQUniversity, Rockhampton, Australia
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11
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De Padova S, Casadei C, Berardi A, Bertelli T, Filograna A, Cursano MC, Menna C, Burgio SL, Altavilla A, Schepisi G, Prati S, Montalti S, Chovanec M, Banna GL, Grassi L, Mego M, De Giorgi U. Caregiver Emotional Burden in Testicular Cancer Patients: From Patient to Caregiver Support. Front Endocrinol (Lausanne) 2019; 10:318. [PMID: 31191451 PMCID: PMC6546807 DOI: 10.3389/fendo.2019.00318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/01/2019] [Indexed: 12/15/2022] Open
Abstract
Testicular cancer is the most common tumor in young males aged 15-40 years. The overall cure rate for men with testicular cancer is >90%, so a huge number of these patients will become testicular cancer survivors. These people may feel some stress in the experience of diagnosis, treatment, and consequences that affects the quality of life, and during follow-up, especially when new issues and emotional distresses appear over time, such as late side-effects of treatments and emotional challenges including fear of tumor relapse, fertility and sexuality concerns, and social and workplace issues. The cancer experience has an impact not only on patients, but also on their relatives (e.g., spouses, parents, or siblings), who often have to assume a caregiving role for the duration of and following treatment for cancer. Moreover, the caregiver plays an important role in supporting a man with a testicular cancer, providing physical and emotional care. This review presents a summary of existing knowledge regarding the impact and the burden of testicular cancer on caregivers.
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Affiliation(s)
- Silvia De Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Chiara Casadei
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Alejandra Berardi
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Tatiana Bertelli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Alessia Filograna
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | | | - Cecilia Menna
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Salvatore Luca Burgio
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Amelia Altavilla
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Giuseppe Schepisi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Sabrina Prati
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Sandra Montalti
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
| | - Michal Chovanec
- Medical Oncology Department, Campus Bio-Medico University, Rome, Italy
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | | | - Luigi Grassi
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, St. Anna University Hospital and NHS Community Health Trusts, Ferrara, Italy
| | - Michal Mego
- Medical Oncology Department, Campus Bio-Medico University, Rome, Italy
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Ugo De Giorgi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), IRCCS, Meldola, Italy
- *Correspondence: Ugo De Giorgi
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12
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Schepisi G, De Padova S, De Lisi D, Casadei C, Meggiolaro E, Ruffilli F, Rosti G, Lolli C, Ravaglia G, Conteduca V, Farolfi A, Grassi L, De Giorgi U. Psychosocial Issues in Long-Term Survivors of Testicular Cancer. Front Endocrinol (Lausanne) 2019; 10:113. [PMID: 30858829 PMCID: PMC6397854 DOI: 10.3389/fendo.2019.00113] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/07/2019] [Indexed: 01/20/2023] Open
Abstract
Testicular cancer is the most frequent tumor in young males aged 15-39 years. As cure rates are currently around 90%, the prevalence of survivors is increasing. However, a disease-free condition does not necessarily correspond to a life free of physical and psychosocial health problems. The aim of this review was to explore psychosocial morbidity among testicular cancer survivors. A literature search was conducted in three electronic databases (PubMed, Medline, and Embase). The results of the search on cancer survivors were then combined with those of the search on psychosocial concerns and work performance. Eighty-four publications met the inclusion criteria. Physical, psychological, work-related problems and changing perspectives about work and life in general influenced life and career decisions among testicular cancer survivors. Individual health, sexual relationships and work problems, affect several important aspects of survival and significantly influence the QoL of long-term survivors.
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Affiliation(s)
- Giuseppe Schepisi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
- *Correspondence: Giuseppe Schepisi
| | - Silvia De Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Delia De Lisi
- Medical Oncology Department, Santa Chiara Hospital, Trento, Italy
| | - Chiara Casadei
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Elena Meggiolaro
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Federica Ruffilli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Giovanni Rosti
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Cristian Lolli
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Giorgia Ravaglia
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Vincenza Conteduca
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Alberto Farolfi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Luigi Grassi
- Hospital Psychiatry Unit, Department of Biomedical and Specialty Surgical Sciences, Integrated Department of Mental Health and Addictive Behavior, Institute of Psychiatry, St. Anna University Hospital and NHS Community Health Trusts, University of Ferrara, Ferrara, Italy
| | - Ugo De Giorgi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
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Sztankay M, Aaronson NK, Arraras JI, Basso U, Bumbasirevic U, Efficace F, Giesinger JM, Johnson CD, van Leeuwen M, Oberguggenberger AS, Sosnowski R, Young T, Holzner B. International phase IV validation study of an EORTC quality of life questionnaire for testicular cancer patients: the EORTC QLQ-TC26. BMC Cancer 2018; 18:1104. [PMID: 30419889 PMCID: PMC6233273 DOI: 10.1186/s12885-018-5036-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 09/04/2018] [Indexed: 12/30/2022] Open
Abstract
Background Given the high cure-rate for testicular cancer (TC) and the patients’ young age, comprehensive evaluation of health-related quality of life (HRQOL) is an important consideration in this patient population. The EORTC QLQ-TC26 questionnaire module has been developed to supplement the EORTC QLQ-C30 in assessing TC-specific HRQOL in clinical trials and routine clinical practice. This international, multicentre phase IV validation study evaluated the psychometric properties of the new module. Methods This international, multicentre phase IV validation study enrolled testicular cancer patients from seven European countries. Patients completed the EORTC quality of life core questionnaire EORTC QLQ-C30 and the QLQ-TC26 at two consecutive time points and a debriefing questionnaire regarding the QLQ-TC26 after baseline assessment. Psychometric evaluation included examination of the hypothesized module scale structure, internal consistency and test-retest reliability, known-groups validity, responsiveness to change over time and cross-cultural acceptability. Results Data from 313 patients (mean age 38.6, SD 9.5) were analysed. All items exhibited a high completion rate with less than 2.4% missing values except for the sexuality items (up to 8.8%). The confirmatory factor analysis supported the hypothesised scale structure of the QLQ-TC26. Test-retest reliability was good for 8 of 12 scales (intraclass correlation: R t1|t2 ranged from 0.71–0.91) and four scales did not meet the acceptable criteria. Internal consistency was good for all twelve scales (Cronbach alpha = 0.79–0.90), except Communication (alpha = 0.67) and Sexual Functioning (alpha = 0.62). The module was able to distinguish clearly between patients with differing clinical status. Responsiveness to change over time was acceptable. Conclusion The EORTC QLQ-TC26 is a valid, reliable and well-accepted condition-specific questionnaire, supplementing the EORTC QLQ-C30, for the assessment of testicular cancer patients’ HRQOL in clinical trials. Electronic supplementary material The online version of this article (10.1186/s12885-018-5036-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Monika Sztankay
- Medical University of Innsbruck, University Hospital Innsbruck, Psychiatry II, Innsbruck, Austria. .,Department of Psychiatry, Psychotherapy & Psychosomatics, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria.
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Juan I Arraras
- Medical Oncology Department, Hospital of Navarre, Navarre, Spain
| | - Umberto Basso
- Medical Oncology 1, Istituto Oncologico Veneto (IOV) IRCCS, Padova, Italy
| | - Uros Bumbasirevic
- Clinic of Urology, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Fabio Efficace
- Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy
| | - Johannes M Giesinger
- Medical University of Innsbruck, University Hospital Innsbruck, Psychiatry II, Innsbruck, Austria
| | - Colin D Johnson
- University Surgical Unit, University of Southampton, Southampton University Hospitals, Southampton, UK
| | - Marieke van Leeuwen
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Anne S Oberguggenberger
- Medical University of Innsbruck, University Hospital Innsbruck, Psychiatry II, Innsbruck, Austria
| | - Roman Sosnowski
- Urooncology Department, Maria Sklodowska Curie Memorial Cancer Hospital, Warsaw, Poland
| | - Teresa Young
- Jackson Macmillan Centre, East & North Hertfordshire NHS Trust including Mount Vernon Cancer Center, Northwood Middlesex, UK
| | - Bernhard Holzner
- Medical University of Innsbruck, University Hospital Innsbruck, Psychiatry II, Innsbruck, Austria
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Soon JA, Anton A, Torres J, Lawrence R, Parente P, McKendrick J, Davis ID, Pezaro C. Exploring the spectrum of late effects following radical orchidectomy for stage I testicular seminoma: a systematic review of the literature. Support Care Cancer 2018; 27:373-382. [DOI: 10.1007/s00520-018-4492-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 10/02/2018] [Indexed: 12/16/2022]
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Qualidade de vida e capacidade funcional de pacientes com capsulite adesiva: identificação de fatores de risco associados a melhores desfechos após tratamento com bloqueio de nervo. REVISTA BRASILEIRA DE REUMATOLOGIA 2017. [DOI: 10.1016/j.rbr.2017.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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16
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Fernandes MR, Barbosa MA, Faria RM. Quality of life and functional capacity of patients with adhesive capsulitis: identifying risk factors associated to better outcomes after treatment with nerve blocking. REVISTA BRASILEIRA DE REUMATOLOGIA 2017; 57:445-451. [PMID: 28619680 DOI: 10.1016/j.rbre.2017.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 04/11/2017] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The objectives of this study were to assess the quality of life and functional capacity of adhesive capsulitis patients at the beginning and end of procedure and to identify risk factors associated to better outcomes after treatment with nerve blocking. METHODS A prospective cohort study was performed. Inclusion criteria were clinical signs of adhesive capsulitis and disease changes on shoulder imaging exams. The short form of World Health Organization Quality of life and Disabilities of the Arm, Shoulder and Hand questionnaires were administered at the beginning and end of treatment. A score of 55 points or more on the Constant index was used for discontinuation of treatment. We used the Wilcoxon test for paired samples. Multiple regression analysis of Poisson was carried out using exposure variables with p<0.20 in the univariate analysis and the satisfactory quality of life and better functional capability as outcomes. The significance level was 5%. RESULTS 43 patients were evaluated. For the comparison between medians values at the beginning and end of treatment (physical domain: 46.43-67.86; psychologic domain: 66.67-79.17; social domain: 66.67-75; environment domain: 62.5-68.75; DASH: 64.16-38.33), p was <0.05. Aging (physical/psychologic/DASH), higher educational level (physical/environment/DASH), less severity (only physical) and fewer nerve blocking (only psychologic) were these independent risk factors. CONCLUSIONS Quality of life and functional capacity of the patients improve at the end of procedure. Older patients and higher education levels are the risk factors most associated to satisfactory quality of life and better functional capacity after treatment with nerve blocking.
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Affiliation(s)
- Marcos Rassi Fernandes
- Universidade Federal de Goiás (UFG), Pós-Graduação em Ciências da Saúde, Goiânia, GO, Brazil.
| | - Maria Alves Barbosa
- Universidade Federal de Goiás (UFG), Pós-Graduação em Ciências da Saúde, Goiânia, GO, Brazil
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Fung C, Sesso HD, Williams AM, Kerns SL, Monahan P, Abu Zaid M, Feldman DR, Hamilton RJ, Vaughn DJ, Beard CJ, Kollmannsberger CK, Cook R, Althouse S, Ardeshir-Rouhani-Fard S, Lipshultz SE, Einhorn LH, Fossa SD, Travis LB. Multi-Institutional Assessment of Adverse Health Outcomes Among North American Testicular Cancer Survivors After Modern Cisplatin-Based Chemotherapy. J Clin Oncol 2017; 35:1211-1222. [PMID: 28240972 PMCID: PMC5455601 DOI: 10.1200/jco.2016.70.3108] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Purpose To provide new information on adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) after four cycles of etoposide and cisplatin (EPX4) or three or four cycles of bleomycin, etoposide, cisplatin (BEPX3/BEPX4). Methods Nine hundred fifty-two TCSs > 1 year postchemotherapy underwent physical examination and completed a questionnaire. Multinomial logistic regression estimated AHOs odds ratios (ORs) in relation to age, cumulative cisplatin and/or bleomycin dose, time since chemotherapy, sociodemographic factors, and health behaviors. Results Median age at evaluation was 37 years; median time since chemotherapy was 4.3 years. Chemotherapy consisted largely of BEPX3 (38.2%), EPX4 (30.9%), and BEPX4 (17.9%). None, one to two, three to four, or five or more AHOs were reported by 20.4%, 42.0%, 25.1%, and 12.5% of TCSs, respectively. Median number after EPX4 or BEPX3 was two (range, zero to nine and zero to 11, respectively; P > .05) and two (range, zero to 10) after BEPX4. When comparing individual AHOs for EPX4 versus BEPX3, Raynaud phenomenon (11.6% v 21.4%; P < .01), peripheral neuropathy (29.2% v 21.4%; P = .02), and obesity (25.5% v 33.0%; P = .04) differed. Larger cumulative bleomycin doses (OR, 1.44 per 90,000 IU) were significantly associated with five or more AHOs. Increasing age was a significant risk factor for one to two, three to four, or five or more AHOs versus zero AHOs (OR, 1.22, 1.50, and 1.87 per 5 years, respectively; P < .01); vigorous physical activity was protective (OR, 0.62, 0.51, and 0.41, respectively; P < .05). Significant risk factors for three to four and five or more AHOs included current (OR, 3.05 and 3.73) or former (OR, 1.61 and 1.76) smoking ( P < .05). Self-reported health was excellent/very good in 59.9% of TCSs but decreased as AHOs increased ( P < .001). Conclusion Numbers of AHOs after EPX4 or BEPX3 appear similar, with median follow-up of 4.3 years. A healthy lifestyle was associated with reduced number of AHOs.
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Affiliation(s)
- Chunkit Fung
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Howard D. Sesso
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Annalynn M. Williams
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Sarah L. Kerns
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Patrick Monahan
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Mohammad Abu Zaid
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Darren R. Feldman
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Robert J. Hamilton
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - David J. Vaughn
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Clair J. Beard
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Christian K. Kollmannsberger
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Ryan Cook
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Sandra Althouse
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Shirin Ardeshir-Rouhani-Fard
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Steve E. Lipshultz
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Lawrence H. Einhorn
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Sophie D. Fossa
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Lois B. Travis
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - for the Platinum Study Group
- Chunkit Fung, Annalynn M. Williams, and Sarah L. Kerns, University of Rochester Medical Center, James P. Wilmot Cancer Institute, Rochester; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Howard D. Sesso, Brigham and Women’s Hospital; Clair J. Beard, Dana-Farber Cancer Institute, Boston, MA; Patrick Monahan, Mohammad Abu Zaid, Ryan Cook, Sandra Althouse, Shirin Ardeshir-Rouhani-Fard, Lawrence H. Einhorn, and Lois B. Travis, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN; Robert J. Hamilton, Princess Margaret Cancer Center, Toronto, Ontario; Christian K. Kollmannsberger, University of British Columbia, Vancouver, British Columbia, Canada; David J. Vaughn, University of Pennsylvania, Philadelphia, PA; Steve E. Lipshultz, Wayne State University School of Medicine; Steve E. Lipshultz, Children’s Hospital of Michigan; Steve E. Lipshultz, Karmanos Cancer Institute, Detroit, MI; and Sophie D. Fossa, Oslo University Hospital, Radium Hospital, Oslo, Norway
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18
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Matheson L, Watson EK, Nayoan J, Wagland R, Glaser A, Gavin A, Wright P, Rivas C. A qualitative metasynthesis exploring the impact of prostate cancer and its management on younger, unpartnered and gay men. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28382745 DOI: 10.1111/ecc.12676] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2017] [Indexed: 11/29/2022]
Abstract
Prostate cancer (PCa) can negatively impact on men's sexual, urinary and emotional functioning, affecting quality of life. Most men with PCa are older (≥65 years), married and heterosexual and little is known about the impact on men who are younger, unpartnered or gay. We aimed to synthesise existing qualitative research on these three groups of men. A systematic metasynthesis was undertaken that included data on the unique impacts of PCa on younger (<65 years) (n = 7 papers), unpartnered (n = 17 papers) or gay or bisexual men (n = 11 papers) using a modified meta-ethnographic approach. The three overarching constructs illustrated the magnified disruption to men's biographies, that included: marginalisation, isolation and stigma-relating to men's sense of being "out of sync"; the burden of emotional and embodied vulnerabilities and the assault on identity-illustrating the multiple threats to men's work, sexual and social identities; shifting into different communities of practice-such as the shift from being part of a sexually active community to celibacy. These findings suggest that PCa can have a particular impact on the quality of life of younger, unpartnered and gay men. This has implications for the provision of tailored support and information to these potentially marginalised groups.
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Affiliation(s)
- L Matheson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - E K Watson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - J Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - R Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - A Glaser
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - A Gavin
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - P Wright
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - C Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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19
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Oldenburg J, Gietema JA. The Sound of Silence: A Proxy for Platinum Toxicity. J Clin Oncol 2016; 34:2687-9. [PMID: 27382103 DOI: 10.1200/jco.2016.68.2476] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Jan Oldenburg
- Akershus University Hospital, Lørenskog, Norway; and University of Oslo, Oslo, Norway
| | - Jourik A Gietema
- University of Groningen, University Medical Center Groningen, The Netherlands
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20
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Abstract
Testicular germ cell tumours are at the crossroads of developmental and neoplastic processes. Their cause has not been fully elucidated but differences in incidences suggest that a combination of genetic and environment factors are involved, with environmental factors predominating early in life. Substantial progress has been made in understanding genetic susceptibility in the past 5 years on the basis of the results of large genome-wide association studies. Testicular germ cell tumours are highly sensitive to radiotherapy and chemotherapy and hence have among the best outcomes of all tumours. Because the tumours occur mainly in young men, preservation of reproductive function, quality of life after treatment, and late effects are crucial concerns. In this Seminar, we provide an overview of advances in the understanding of the epidemiology, genetics, and biology of testicular germ cell tumours. We also summarise the consensus on how to treat testicular germ cell tumours and focus on a few controversies and improvements in the understanding of late effects of treatment and quality of life for survivors.
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Affiliation(s)
- Ewa Rajpert-De Meyts
- Department of Growth and Reproduction, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disrupting Effects on Male Reproduction and Child Health, Copenhagen, Denmark
| | - Katherine A McGlynn
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Keisei Okamoto
- Department of Urology, Shiga University of Medical Science, Tsukinowa, Seta, Shiga, Japan.
| | - Michael A S Jewett
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON, Canada
| | - Carsten Bokemeyer
- Department of Oncology, Haematology, Bone Marrow Transplantation with section Pneumology, Department of Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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21
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Age-related variation and predictors of long-term quality of life in germ cell tumor survivors. Urol Oncol 2016; 34:60.e1-6. [DOI: 10.1016/j.urolonc.2015.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 08/30/2015] [Accepted: 09/14/2015] [Indexed: 11/18/2022]
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22
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Fujisawa D, Inoguchi H, Shimoda H, Yoshiuchi K, Inoue S, Ogawa A, Okuyama T, Akechi T, Mimura M, Shimizu K, Uchitomi Y. Impact of depression on health utility value in cancer patients. Psychooncology 2015; 25:491-5. [PMID: 26283141 DOI: 10.1002/pon.3945] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 07/28/2015] [Accepted: 07/28/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The quality-adjusted life year, which is usually calculated from the health utility value, is now a standard measurement used in political decision-making in health. Although depression is the leading cause of decrement in health utility in general population, impact of comorbid depression among cancer patients has not been studied sufficiently. Therefore, this study aimed to measure the impact of depression on cancer patients' health utility score, according to the severity of depression. METHODS Impact of depression severity (measured by the Patient Health Questionnaire) on health utility score (measured by the EuroQoL-5 scale) was evaluated in a sample of 328 Japanese cancer patients, controlling for performance status, symptom burden, and demographic variables. RESULTS The patients with depression had significantly lower health utility value than those without depression (mean decrement = 0.14). Decrements in health utility of 0.13, 0.18, and 0.19 were observed for mild, moderate, and moderately severe to severe level of depression, respectively. The difference was significant between groups. Depression severity was a significant predictor for health utility (standardized coefficient beta = -0.25), which was comparable with physical symptom burden and performance status. Participants' age, gender, cancer stage, and comorbid illness were not significant. The model explained 37.9% of the variance. CONCLUSIONS Even mild level of depression caused clinically meaningful decrement in health utility value in cancer patients, which was comparable with decrements due to major physical complications of cancer. Influence of depression should be carefully investigated when interpreting the quality-adjusted life year among cancer patients. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Daisuke Fujisawa
- Department of Neuropsychiatry and Palliative Care Center, Keio University School of Medicine, Japan.,Department of Psycho-Oncology, National Cancer Center, Japan
| | | | - Haruki Shimoda
- Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan.,Department of Mental Health, University of Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Science and Psychosomatic Medicine, University of Tokyo, Japan
| | | | - Asao Ogawa
- Department of Psycho-Oncology, National Cancer Center, Japan
| | - Toru Okuyama
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry and Palliative Care Center, Keio University School of Medicine, Japan
| | - Ken Shimizu
- Department of Psycho-Oncology, National Cancer Center, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center, Japan
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23
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Teques AP, Carrera GB, Ribeiro JP, Teques P, Ramón GL. The importance of emotional intelligence and meaning in life in psycho-oncology. Psychooncology 2015; 25:324-31. [PMID: 26257313 DOI: 10.1002/pon.3921] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 04/21/2015] [Accepted: 07/06/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Cancer was considered the disease of the 20th century, and the management, treatment, and adaptation of patients to general wellbeing were worldwide concerns. Emotional intelligence has frequently been associated with wellbeing and considered one important factor to optimal human functioning. The purpose of the present study was to test the differences regarding the relationship between emotional intelligence, purpose in life, and satisfaction with life between cancer and healthy people. METHODS This model was tested using structural path analysis in two independent samples. First, in a general Portuguese population without chronic disease, 214 participants (nmale = 41, nfemale = 173; Mage = 53). Second, in 202 patients with cancer (nmale = 40, nfemale = 162; Mage = 58.65). A two-step methodology was used to test the research hypothesis. RESULTS First, a confirmatory factor analysis supported the measurement model. All factors also show reliability, convergent, and discriminate validity. Second, the path coefficients for each model indicate that the proposed relationships differ significantly according to the groups. The perception capacities of emotional intelligence were more related to satisfaction with life and purpose in life in oncologic patients than in the general population without chronic disease, specifically emotional understanding and regulation. Likewise, the relationship between purpose in life and satisfaction with life in oncologic patients was significantly higher than for the general population. CONCLUSION The current findings thus suggest that emotional intelligence and purpose in life are potential components to promoting satisfaction in life in healthy people and more so in oncologic patients.
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Affiliation(s)
- Andreia Pereira Teques
- Faculty of Medicine, University of Salamanca, Department of Psychiatry and Medical Psychology, Salamanca, 4445-577, Spain
| | - Glória Bueno Carrera
- Faculty of Medicine, University of Salamanca, Department of Psychiatry and Medical Psychology, Salamanca, 4445-577, Spain
| | - José Pais Ribeiro
- Faculty of Psychology and Educational Sciences, University of Porto, Department of Psychology, Porto, Portugal
| | - Pedro Teques
- Sport Sciences School of Rio Maior, Polytechnic Institute of Santarem, Department of Sport Psychology, Santarém, Portugal
| | - Ginés Llorca Ramón
- Faculty of Medicine, University of Salamanca, Department of Psychiatry and Medical Psychology, Salamanca, 4445-577, Spain
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24
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Smith AB, Butow P, Olver I, Luckett T, Grimison P, Toner GC, Stockler MR, Hovey E, Stubbs J, Turner S, Hruby G, Gurney H, Alam M, Cox K, King MT. The prevalence, severity, and correlates of psychological distress and impaired health-related quality of life following treatment for testicular cancer: a survivorship study. J Cancer Surviv 2015; 10:223-33. [PMID: 26178326 DOI: 10.1007/s11764-015-0468-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 06/30/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aimed to establish the prevalence, severity, and correlates of psychological distress and impaired generic health-related quality of life (HRQOL) in testicular cancer (TC) survivors. METHODS Men who had completed active anti-cancer treatment for TC between 6 months and 5 years previously showing no evidence of recurrence were recruited from 14 Australian cancer centers from September 2009 to February 2011. Participants completed a self-report questionnaire measuring demographic, disease, and treatment information, psychological distress (i.e., depression, anxiety, and stress; DASS21), generic health-related quality of life (HRQOL; SF-36v2), TC-specific HRQOL (EORTC QLQ-TC26), coping (MAC), social support (DUFSS), and unmet needs (CaSUN). RESULTS Of 486 eligible TC survivors, 244 (50.2%) completed the questionnaire. Compared with normative data, TC survivors reported: small but statistically significant increases in mean levels of anxiety and depression; a greater prevalence of moderate to extremely severe anxiety (19%) and depression (20%); and significant deficits to mostly mental aspects of generic HRQOL. The most problematic TC-specific HRQOL issues (e.g., fear of recurrence) were also more mental than physical. In multiple regression analyses, the strongest correlates of psychological distress and impaired generic HRQOL were psychosocial (e.g., helpless/hopeless coping and lower social support) rather than disease or treatment factors. CONCLUSIONS Generally, TC survivors appear to experience mild psychological distress and HRQOL impairments, while a vulnerable subgroup experience more severe morbidity. IMPLICATIONS FOR CANCER SURVIVORS There is a need to identify TC survivors at risk of poorer outcomes and for interventions to target the areas of greatest impairment (i.e., psychological distress and mental HRQOL).
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Affiliation(s)
- Allan Ben Smith
- Psycho-Oncology Co-operative Research Group (PoCoG), Chris O'Brien Lifehouse (C39Z), University of Sydney, Sydney, NSW, 2006, Australia. .,Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.
| | - Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), Chris O'Brien Lifehouse (C39Z), University of Sydney, Sydney, NSW, 2006, Australia
| | - Ian Olver
- Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Tim Luckett
- Improving Palliative Care through Clinical Trials (ImPaCCT), South Western Sydney Clinical School, The University of New South Wales, and Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Peter Grimison
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.,Chris O'Brien Lifehouse and University of Sydney, Sydney, NSW, Australia
| | - Guy C Toner
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.,Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC, Australia
| | - Martin R Stockler
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.,Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Elizabeth Hovey
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.,Prince of Wales Hospital, Sydney, NSW, Australia
| | - John Stubbs
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.,CanSpeak, Sydney, NSW, Australia
| | - Sandra Turner
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia
| | - George Hruby
- Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Howard Gurney
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, NSW, Australia
| | | | - Keith Cox
- Chris O'Brien Lifehouse, Sydney, NSW, Australia
| | - Madeleine T King
- Psycho-Oncology Co-operative Research Group (PoCoG), Chris O'Brien Lifehouse (C39Z), University of Sydney, Sydney, NSW, 2006, Australia.,Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia.,Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
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Matheson L, Boulton M, Lavender V, Protheroe A, Brand S, Wanat M, Watson E. Dismantling the present and future threats of testicular cancer: a grounded theory of positive and negative adjustment trajectories. J Cancer Surviv 2015; 10:194-205. [PMID: 26159160 DOI: 10.1007/s11764-015-0466-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 06/15/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE Testicular cancer commonly affects men in the prime of their lives. While survival rates are excellent, little previous research has examined men's experiences of adjustment to survivorship. We aimed to explore this issue in younger testicular cancer survivors. METHODS In-depth qualitative interviews were conducted with testicular cancer survivors over two time points approximately 6 months apart in the year following treatment completion. Interviews were analysed using a grounded theory approach. RESULTS The sample included 18 testicular cancer survivors between 22 and 44 years (mean age 34). A grounded theory was developed, which explained the process of positive adjustment over the first year following the treatment completion in terms of men's ability to dismantle the present and future threats of cancer, involving the key transitions of gaining a sense of perspective and striving to get on with life and restore normality. These were facilitated by six key processes. The processes that explained a negative adjustment trajectory are also presented. CONCLUSIONS These findings contribute to the understanding of the psychosocial impact of testicular cancer on younger men's lives and have implications for the provision of support to testicular cancer survivors. Further investigation into the feasibility of one-on-one peer support interventions is warranted, as well as informal support that respects men's desire for independence. IMPLICATIONS FOR CANCER SURVIVORS Understanding the processes involved in adjustment highlights ways in which health professionals can offer support to those struggling to adjust through challenging illness beliefs, encouraging emotional disclosure and facilitating peer mentoring.
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Affiliation(s)
- Lauren Matheson
- Cancer Care Research Group, Department of Applied Health and Professional Development, Faculty of Health and Life Sciences, Oxford Brookes University, Marston, Oxford, OX3 0FL, UK.
| | - Mary Boulton
- Cancer Care Research Group, Department of Applied Health and Professional Development, Faculty of Health and Life Sciences, Oxford Brookes University, Marston, Oxford, OX3 0FL, UK
| | - Verna Lavender
- Cancer Care Research Group, Department of Applied Health and Professional Development, Faculty of Health and Life Sciences, Oxford Brookes University, Marston, Oxford, OX3 0FL, UK
| | - Andrew Protheroe
- University of Oxford Department of Oncology, Oxford Cancer and Haematology Centre, Oxford University Hospitals Trust, Headington, Oxford, OX3 7LJ, UK
| | - Sue Brand
- Bristol Testicular Cancer Service, Bristol Haematology and Oncology Centre, University Hospitals Bristol, Horfield Road, Bristol, BS2 8ED, UK
| | - Marta Wanat
- Cancer Care Research Group, Department of Applied Health and Professional Development, Faculty of Health and Life Sciences, Oxford Brookes University, Marston, Oxford, OX3 0FL, UK
| | - Eila Watson
- Cancer Care Research Group, Department of Applied Health and Professional Development, Faculty of Health and Life Sciences, Oxford Brookes University, Marston, Oxford, OX3 0FL, UK
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Quality of life among testis cancer survivors. Urol Oncol 2015; 33:413-9. [PMID: 26087970 DOI: 10.1016/j.urolonc.2015.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 05/10/2015] [Accepted: 05/13/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND As the most common cancer among males in late adolescence and early adulthood and as a disease with a 5-year relative survival rate of 96%, testis cancer has many survivors who live many years during which chronic toxicities may impair their quality of life. METHODS In this review, I aimed to summarize the most relevant literature on quality of life among testis cancer survivors identified via PubMed literature search between 1990 and 2015. RESULTS Survivors of testis cancer experience an overall quality of life (QOL) that is not measurably different from that of men of the same age in the general population. Nonetheless, testis cancer and its treatments can result in a variety of long-term conditions that affect QOL. These include peripheral neuropathy, hearing loss, tinnitus, fatigue, and Raynaud-like phenomenon. Exercise interventions have been shown to improve fatigue and overall QOL in cancer survivors, and there is evidence that psychosocial and mind-body interventions may also be beneficial. Pharmacological interventions have not been shown to be helpful for cancer-related fatigue, hearing loss, or neuropathy. CONCLUSIONS Testis cancer survivors should be asked about symptoms related to the conditions above and referred to specialists as indicated. Survivors complaining of fatigue should be encouraged to adopt a regular program of aerobic exercise.
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Tamminga SJ, Verbeek JHAM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Frings-Dresen MHW, de Boer AGEM. Effectiveness of a hospital-based work support intervention for female cancer patients - a multi-centre randomised controlled trial. PLoS One 2013; 8:e63271. [PMID: 23717406 PMCID: PMC3661555 DOI: 10.1371/journal.pone.0063271] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 04/02/2013] [Indexed: 12/24/2022] Open
Abstract
Objective One key aspect of cancer survivorship is return-to-work. Unfortunately, many cancer survivors face problems upon their return-to-work. For that reason, we developed a hospital-based work support intervention aimed at enhancing return-to-work. We studied effectiveness of the intervention compared to usual care for female cancer patients in a multi-centre randomised controlled trial. Methods Breast and gynaecological cancer patients who were treated with curative intent and had paid work were randomised to the intervention group (n = 65) or control group (n = 68). The intervention involved patient education and support at the hospital and improvement of communication between treating and occupational physicians. In addition, we asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. Outcomes at 12 months of follow-up included rate and time until return-to-work (full or partial), quality of life, work ability, work functioning, and lost productivity costs. Time until return-to-work was analyzed with Kaplan-Meier survival analysis. Results Return-to-work rates were 86% and 83% (p = 0.6) for the intervention group and control group when excluding 8 patients who died or with a life expectancy of months at follow-up. Median time from initial sick leave to partial return-to-work was 194 days (range 14–435) versus 192 days (range 82–465) (p = 0.90) with a hazard ratio of 1.03 (95% CI 0.64–1.6). Quality of life and work ability improved statistically over time but did not differ statistically between groups. Work functioning and costs did not differ statistically between groups. Conclusion The intervention was easily implemented into usual psycho-oncological care and showed high return-to-work rates. We failed to show any differences between groups on return-to-work outcomes and quality of life scores. Further research is needed to study which aspects of the intervention are useful and which elements need improvement. Trial Registration Nederlands Trial Register (NTR) 1658
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Affiliation(s)
- Sietske J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
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Punekar RS, Short PF, Moran JR. Use of psychotropic medications by US cancer survivors. Psychooncology 2012; 21:1237-43. [PMID: 21905155 PMCID: PMC4079257 DOI: 10.1002/pon.2039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 06/15/2011] [Accepted: 06/18/2011] [Indexed: 11/10/2022]
Abstract
OBJECTIVES This study aimed to describe national utilization of psychotropic medications by adult cancer survivors in the USA and to estimate the extra use of psychotropic medications that is attributable to cancer survivorship. METHODS Prescription data for 2001-2006 from the Medical Expenditure Panel Survey (MEPS) were linked to the data identifying cancer survivors from the National Health Interview Survey, the MEPS sampling frame. The sample was limited to adults 25 years of age and older. Propensity score matching was used to estimate the effects of cancer survivorship on utilization of psychotropic medications by comparing cancer survivors and other adults in MEPS. Utilization was measured as any use during a calendar year and the number of prescriptions purchased (including refills). Analyses were stratified by gender and age, distinguishing adults younger than 65 years from those 65 years and older. RESULTS Nineteen percent of cancer survivors under age 65 years and 16% of survivors age 65 years and older used psychotropic medications. Sixteen percent of younger survivors used antidepressants, 7% used antianxiety medications. For older survivors, utilization rates for these two drug types were 11% and 7%, respectively. The increase in any use attributable to cancer amounted to 4-5 percentage points for younger survivors (p < 0.05) and 2-3 percentage points for older survivors (p < 0.05), depending on gender. CONCLUSION Increased use of psychotropic medications by cancer survivors, compared with other adults, suggests that survivorship presents ongoing psychological challenges.
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Pal SK, Yamzon J, Sun V, Carmichael C, Saikia J, Ferrell B, Frankel P, Hsu J, Twardowski P, Stein CA, Margolin K. Paclitaxel-based high-dose chemotherapy with autologous stem cell rescue for relapsed germ cell tumor: clinical outcome and quality of life in long-term survivors. Clin Genitourin Cancer 2012; 11:121-7. [PMID: 23062817 DOI: 10.1016/j.clgc.2012.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 08/30/2012] [Accepted: 09/13/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND High-dose chemotherapy (HDCT) is a viable and potentially curative approach for patients with relapsed or refractory germ cell tumors (GCTs). However, no comparative data exist to define the optimal chemotherapeutic strategy, and little is known about the quality of life (QOL) of long-term survivors. Herein we attempt to characterize the QOL in long-term survivors who received high-dose paclitaxel, etoposide, carboplatin, and ifosfamide (TECTIC). PATIENTS AND METHODS Details of the TECTIC regimen and clinical outcomes for the initial 33 patients have been reported. In the present study, we report the clinical data for 15 additional patients. Using the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and the Functional Assessment of Cancer Therapy-Taxane (FACT-T) questionnaires, we surveyed all patients who survived at least 4 years after HDCT. RESULTS Forty-eight patients were enrolled and 46 patients received protocol therapy. For all 48 patients, the median progression-free survival (PFS) and overall survival (OS) were 11.8 months (range, 5.8-not reached) and 21.7 months (range, 12.7-not reached), respectively. Seventeen patients were progression free at a median of 123.2 months (51.6-170.2 months), and 6 patients remain alive after progression with a median OS of 68.8 months (47.6-147.1 months). Of the 23 surviving patients, 18 were accessible and consented to telephone interviews. Compared with historical cohorts, survivors had a higher global health scale score (87.04 vs. 75.62; P = .02) but a lower physical functioning score (68.89 vs. 92.66; P = .0001) by the QLQ-C30 scale. CONCLUSIONS HDCT with the TECTIC regimen produces durable remissions in patients with relapsed or refractory GCTs with acceptable QOL in long-term survivors.
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Affiliation(s)
- Sumanta K Pal
- Department of Medical Oncology and Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
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Haugnes HS, Bosl GJ, Boer H, Gietema JA, Brydøy M, Oldenburg J, Dahl AA, Bremnes RM, Fosså SD. Long-term and late effects of germ cell testicular cancer treatment and implications for follow-up. J Clin Oncol 2012; 30:3752-63. [PMID: 23008318 DOI: 10.1200/jco.2012.43.4431] [Citation(s) in RCA: 186] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Germ cell testicular cancer (TC) represents a malignancy with high cure rates. Since the introduction of cisplatin-based chemotherapy in the late 1970s, the 5-year survival rate has increased considerably, and it is currently above 95%. Because TC is usually diagnosed before the age of 40 years, these men can expect to live for another 40 to 50 years after being successfully treated. This success, however, is hampered by an increased risk of long-term and late effects of treatment. Secondary malignant neoplasms and cardiovascular disease represent the most common potentially life-threatening late effects, typically occurring more than 10 years after treatment. Other long-term effects include pulmonary toxicity, nephrotoxicity, neurotoxicity, decreased fertility, hypogonadism, and psychosocial problems. The incidence and time to onset of these various adverse effects vary according to treatment type and intensity. There is still little knowledge about underlying mechanisms and genetic susceptibility of the various adverse effects. Apart from treatment burden, it is not yet possible to identify patients who are at high risk for certain late effects after TC treatment. In this clinical review, we present the current status regarding different somatic and psychosocial long-term late effects after treatment for TC, based on Medline searches and our own research. Moreover, we postulate recommendations for general medical evaluations that should begin after treatment is completed and continue during follow-up.
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Affiliation(s)
- Hege S Haugnes
- Oncology Department, University Hospital of North Norway, Tromsø, Norway.
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Bumbasirevic U, Bojanic N, Pekmezovic T, Janjic A, Janicic A, Milojevic B, Tulic C. Health-related quality of life, depression, and sexual function in testicular cancer survivors in a developing country: a Serbian experience. Support Care Cancer 2012; 21:757-63. [PMID: 22933132 DOI: 10.1007/s00520-012-1577-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 08/13/2012] [Indexed: 01/07/2023]
Abstract
PURPOSE The aims of this study were to assess health-related quality of life (HRQoL), depression, adverse physical symptoms, and sexual function within Serbian long-term testicular cancer survivors (TCS) and to address cultural specificity. METHODS This is a cross-sectional study involving 202 TCS, followed up after platinum-based chemotherapy. The HRQoL was measured using the Short Form 36 and the European Organization for Research and Treatment of Cancer Quality of Life questionnaire. The Beck Depression Inventory (BDI) was used to explore general depressive status while sexual function was assessed using a nine-item questionnaire. RESULTS The mean follow-up time since treatment was 47.3 ± 26.8 months. The highest values of the SF-36 scales were obtained for physical functioning, and the lowest SF-36 values were obtained for vitality. Age of patients and BDI scores statistically significantly influenced total quality of life. The mean score of the whole sample on the BDI-II was 4.0. Age is the only statistically significant risk factor for the development of depression. A total of 27.3% TCS reported decreased sexual function compared to the period before treatment. Any level of impairment of erectile function was reported by 20.8% patients and problems with ejaculation by 25.7% patients. Loss of desire was reported by 17.3% TCS. The presence of sexual problems statistically significantly lowered scores of SF-36 domains. CONCLUSION Sexual problems seriously impaired HRQoL in TCS. Additionally, HRQoL was also affected by age, depression, and fatigue. Serbian TCS achieved high levels of SF-36 scores, and these results are comparable to studies conducted in developed countries.
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Abouassaly R, Fossa SD, Giwercman A, Kollmannsberger C, Motzer RJ, Schmoll HJ, Sternberg CN. Sequelae of treatment in long-term survivors of testis cancer. Eur Urol 2011; 60:516-26. [PMID: 21684072 DOI: 10.1016/j.eururo.2011.05.055] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 05/30/2011] [Indexed: 11/25/2022]
Abstract
CONTEXT Testicular cancer patients are often diagnosed at a young age, and because of the advances in the treatment of this disease, the vast majority have a normal life expectancy after therapy. Thus, recognition of the long-term sequelae of treatment (ie, surgery, radiation therapy, and chemotherapy) is particularly important in these patients. OBJECTIVE To review the adverse effects and the risk of secondary malignancy in long-term survivors of testicular cancer. EVIDENCE ACQUISITION We conducted a Medline search to identify original articles and reviews on the long-term effects of testicular cancer treatment. Although the search included articles from January 1948 to February 2011, the majority of the included articles were published in the last two decades. EVIDENCE SYNTHESIS All studies examining the long-term sequelae of treatment in testicular cancer are retrospective in nature, with most classified as cohort, case-control, and/or epidemiologic studies. Given that no standardized method of reporting long-term complications exists, evidence synthesis is limited. CONCLUSIONS Recent evidence suggests an increased risk of cardiovascular disease, neurotoxicity, and mild reductions in renal function in survivors of testicular cancer. Treatment of testicular malignancy can also negatively affect gonadal function and fertility and has been shown to result in an increased risk of solid malignancy and leukemia.
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Affiliation(s)
- Robert Abouassaly
- Urological Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA.
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de Boer AGEM, Bruinvels DJ, Tytgat KMAJ, Schoorlemmer A, Klinkenbijl JHG, Frings-Dresen MHW. Employment status and work-related problems of gastrointestinal cancer patients at diagnosis: a cross-sectional study. BMJ Open 2011; 1:e000190. [PMID: 22138895 PMCID: PMC3236817 DOI: 10.1136/bmjopen-2011-000190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objective To assess the employment status of patients with gastrointestinal cancer at diagnosis and to examine work-related problems of employed patients. Design New, consecutive patients were included at the Gastrointestinal Oncology Center Amsterdam, a one-stop, rapid access diagnostic assessment centre. Patients were interviewed on their employment status by a nurse. If (self-) employed, patients were asked to self-report on work-related problems, perceived distress (0-10), cancer-related problems, fatigue (MFI-20, range 4-20) and work ability (three WAI questions, range 0-10). Results Of all 333 included new consecutive patients (age range 32-89 years), 95 patients (28%) were (self-) employed at time of diagnosis, 179 (54%) were pensioners, and 59 were not working (18%). For the assessment of work-related problems, 45 (47%) of these 95 employed patients with cancer participated. Their mean age was 56 years, and patients had oesophageal/stomach (49%), colorectal (18%) or hepatic/pancreatic/biliary cancer (33%). Half of the employed patients (49%) were still at work, while 51% were on sick leave. The main reasons for sick leave were stress (35%), (scheduled) operation (26%), fatigue (17%) and pain (13%). Most patients on sick leave (70%) had no contact with their own occupational physician, although the majority (67%) would like to continue to work. Work-related problems were experienced by 73% of working patients. The mean work ability was 5.4, the mean general fatigue score was 11.5, and the mean distress score was 4.7. Employed patients on sick leave reported a lower work ability, more fatigue and higher distress but no more cancer-related problems compared with those still working. Conclusion A quarter of all patients with gastrointestinal cancer seen at an oncological centre are employed at time of diagnosis, and of these employed patients, 73% experience work-related problems. During diagnosis and treatment, information and support on work-related issues should be offered to patients with cancer as an essential part of high-quality oncological care.
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Affiliation(s)
- A G E M de Boer
- Coronel Institute of Occupational Health (Outpatient Clinic People and Work), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - D J Bruinvels
- Coronel Institute of Occupational Health (Outpatient Clinic People and Work), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - K M A J Tytgat
- Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Gastrointestinal Oncology Center Amsterdam (GIOCA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A Schoorlemmer
- Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Gastrointestinal Oncology Center Amsterdam (GIOCA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J H G Klinkenbijl
- Gastrointestinal Oncology Center Amsterdam (GIOCA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health (Outpatient Clinic People and Work), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Feuerstein M, Todd BL, Moskowitz MC, Bruns GL, Stoler MR, Nassif T, Yu X. Work in cancer survivors: a model for practice and research. J Cancer Surviv 2010; 4:415-37. [DOI: 10.1007/s11764-010-0154-6] [Citation(s) in RCA: 183] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Accepted: 09/30/2010] [Indexed: 11/12/2022]
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Travis LB, Beard C, Allan JM, Dahl AA, Feldman DR, Oldenburg J, Daugaard G, Kelly JL, Dolan ME, Hannigan R, Constine LS, Oeffinger KC, Okunieff P, Armstrong G, Wiljer D, Miller RC, Gietema JA, van Leeuwen FE, Williams JP, Nichols CR, Einhorn LH, Fossa SD. Testicular cancer survivorship: research strategies and recommendations. J Natl Cancer Inst 2010; 102:1114-30. [PMID: 20585105 DOI: 10.1093/jnci/djq216] [Citation(s) in RCA: 206] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Testicular cancer represents the most curable solid tumor, with a 10-year survival rate of more than 95%. Given the young average age at diagnosis, it is estimated that effective treatment approaches, in particular, platinum-based chemotherapy, have resulted in an average gain of several decades of life. This success, however, is offset by the emergence of considerable long-term morbidity, including second malignant neoplasms, cardiovascular disease, neurotoxicity, nephrotoxicity, pulmonary toxicity, hypogonadism, decreased fertility, and psychosocial problems. Data on underlying genetic or molecular factors that might identify those patients at highest risk for late sequelae are sparse. Genome-wide association studies and other translational molecular approaches now provide opportunities to identify testicular cancer survivors at greatest risk for therapy-related complications to develop evidence-based long-term follow-up guidelines and interventional strategies. We review research priorities identified during an international workshop devoted to testicular cancer survivors. Recommendations include 1) institution of lifelong follow-up of testicular cancer survivors within a large cohort setting to ascertain risks of emerging toxicities and the evolution of known late sequelae, 2) development of comprehensive risk prediction models that include treatment factors and genetic modifiers of late sequelae, 3) elucidation of the effect(s) of decades-long exposure to low serum levels of platinum, 4) assessment of the overall burden of medical and psychosocial morbidity, and 5) the eventual formulation of evidence-based long-term follow-up guidelines and interventions. Just as testicular cancer once served as the paradigm of a curable malignancy, comprehensive follow-up studies of testicular cancer survivors can pioneer new methodologies in survivorship research for all adult-onset cancer.
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Affiliation(s)
- Lois B Travis
- Department of Radiation Oncology, James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY 14642, USA.
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Tuinman MA, Hoekstra HJ, Vidrine DJ, Gritz ER, Sleijfer DT, Fleer J, Hoekstra-Weebers JEHM. Sexual function, depressive symptoms and marital status in nonseminoma testicular cancer patients: a longitudinal study. Psychooncology 2010; 19:238-47. [PMID: 19319832 DOI: 10.1002/pon.1560] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
GOAL To longitudinally investigate sexual functioning in testicular cancer patients during the first year, and examine the effect of relationship status (with a partner or single) and depressive symptoms on sexual functioning. PATIENTS AND METHODS 93 testicular cancer patients (39% single) treated in two large referral centers for testicular cancer filled in the International Index of Erectile Function (IIEF) and CES-D after orchiectomy (T1) and 3 (T2) and 12 (T3) months later. RESULTS Orgasmic functioning, overall satisfaction and total sexual functioning decreased between T1 and T2 and increased to an above T1 level at T3. Levels of erectile functioning and intercourse satisfaction were higher at T3 than at T1 and T2. Desire remained stable. Type of treatment did not affect sexual functioning. Singles reported worse sexual functioning at all measurement times than committed patients, and comparable desire. One year after surgery, singles also reported worse sexual functioning on three domains when compared with norms. Depressive symptoms were highest and significantly but weakly related to one domain of sexual functioning at T1, to three domains at T2, and to none at T3. Early depressive symptoms had small to moderate predictive power on sexual functioning at T2, but not at T3. CONCLUSION Sexual functioning, but not desire, fluctuates during the first year after testicular cancer. Type of treatment and depressive symptoms were no risk factors for sexual dysfunction in the longer term. Singles reported more sexual problems than patients in a relationship and norms, they may need more information and guidance concerning their sexuality.
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Affiliation(s)
- Marrit A Tuinman
- Department of Surgical Oncology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
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The Effects of Testicular Cancer Treatment on Health-related Quality of Life. Urology 2010; 75:636-41. [DOI: 10.1016/j.urology.2009.09.053] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Revised: 09/24/2009] [Accepted: 09/25/2009] [Indexed: 11/20/2022]
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Rossen PB, Pedersen AF, Zachariae R, von der Maase H. Health-Related Quality of Life in Long-Term Survivors of Testicular Cancer. J Clin Oncol 2009; 27:5993-9. [DOI: 10.1200/jco.2008.19.6931] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose A growing number of patients with testicular cancer (TC) become long-term survivors. As a consequence, quality-of-life (QOL) issues become increasingly important. The objective of this study was to investigate QOL among Danish TC survivors. Methods A long-term follow-up assessment of all patients with TC treated at Aarhus University Hospital in Denmark between 1990 and 2000 was conducted. A total of 401 survivors (response rate, 66%) completed questionnaires concerning QOL (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30), depression (Beck Depression Inventory-II), fatigue (Multidimensional Fatigue Inventory-20), and health-related issues such as neurotoxic symptoms and Raynaud-like phenomena. On the basis of their treatment, participants were categorized as having received surveillance, radiotherapy, or chemotherapy. Results QOL among patients with TC was equal to that of men from the general population. Although patients who received chemotherapy reported higher levels of peripheral sensory neuropathy, ototoxicity, and Raynaud-like phenomena, treatment strategies were generally unrelated to QOL and depressive symptoms. Conclusion Overall, the patients in this study reported high levels of QOL. The results suggest that patients treated for TC should be informed about the anticipated good post-therapeutic QOL and the low risk of psychosocial and physical long-term effects.
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Affiliation(s)
- Philip Blach Rossen
- From the Department of Oncology, Aarhus University Hospital; Psychooncology Research Unit, University of Aarhus, Aarhus; and Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anette Fischer Pedersen
- From the Department of Oncology, Aarhus University Hospital; Psychooncology Research Unit, University of Aarhus, Aarhus; and Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Robert Zachariae
- From the Department of Oncology, Aarhus University Hospital; Psychooncology Research Unit, University of Aarhus, Aarhus; and Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hans von der Maase
- From the Department of Oncology, Aarhus University Hospital; Psychooncology Research Unit, University of Aarhus, Aarhus; and Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Fosså SD, Oldenburg J, Dahl AA. Short- and long-term morbidity after treatment for testicular cancer. BJU Int 2009; 104:1418-22. [PMID: 19840023 DOI: 10.1111/j.1464-410x.2009.08869.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Patients with testicular cancer are at risk of having severe short-term and life-threatening long-term effects; we reviewed previous reports of these sequelae. After orchidectomy and before further treatment patients have major mental distress which gradually decreases during the treatment phase. Gastrointestinal side-effects dominate during both chemo- and radiotherapy, with the risk of severe haematological, infectious and thromboembolic complications during chemotherapy. Long-term sequelae comprise second cancers, cardiovascular morbidity/mortality and gonadal dysfunction. Nevertheless, 70% of patients who attempt paternity after treatment are successful. About 20% of patients develop long-term neuro- and/or ototoxicity. The long-term quality of life of survivors of testicular cancer is comparable to that of controls. Risk-adapted treatment of patients with testicular cancer and adequate follow-up of those at risk of life-threatening toxicity are ways to reduce the short- and long-term morbidity in survivors. Patients should be informed about these potential complications and the importance of adjusting their lifestyle (e.g. smoking habits, physical activity and weight control).
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Affiliation(s)
- Sophie D Fosså
- The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
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Schagen SB, Boogerd W, Muller MJ, Ten Bokkel Huinink W, Moonen L, Meinhardt W, Van Dam FS. Cognitive complaints and cognitive impairment following BEP chemotherapy in patients with testicular cancer. Acta Oncol 2009; 47:63-70. [PMID: 17934892 DOI: 10.1080/02841860701518058] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION There is growing concern that some cytotoxic regimens for cancer affect cognitive functioning. This study examined the prevalence of cognitive complaints and deficits in testicular cancer (TC) patients treated with the worldwide standard BEP (bleomycin, etoposide and cisplatin) chemotherapy. MATERIALS AND METHODS Seventy TC patients treated with BEP chemotherapy after surgery (S + CT) were examined with interviews and neuropsychological tests. These patients were compared with 57 TC patients treated with radiotherapy after surgery (S + RT) and with 55 TC patients that received surgery only (S). Patients were examined a median of 3 years after completion of treatment. RESULTS Thirty two percent of the S + CT patients reported cognitive complaints compared with 32% of the S + RT patients and 27% of the S patients (p = 0.85). No differences in mean cognitive test performance were observed between the groups. On individual impairment scores, more S + CT patients showed cognitive dysfunction compared with S patients, but not compared with S + RT patients (S + CT versus S [p = 0.038, OR = 4.6, CI = 1.1-19.7], S + CT versus S + RT [p = 0.70, OR = 0.8, CI = 0.3-2.4] and S + RT versus S [p = 0.070, OR = 3.7, CI = 0.8-15.7). Cognitive complaints were not related to cognitive test performance, but to emotional distress and fatigue. DISCUSSION Cognitive complaints are common among TC patients, independent of treatment modality. These complaints are related to emotional distress and fatigue and not to formal cognitive deficits. The finding of a small group of TC patients treated with chemotherapy exhibiting cognitive deficits should be confirmed in a prospective study before we can decide on its cause and relevance.
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LUCKETT T, BUTOW PN, KING MT, OLVER IN. Psycho-social issues in long-term survivors of testicular cancer: Directions for future research. Asia Pac J Clin Oncol 2008. [DOI: 10.1111/j.1743-7563.2008.00181.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Evidence-based pragmatic guidelines for the follow-up of testicular cancer: optimising the detection of relapse. Br J Cancer 2008; 98:1894-902. [PMID: 18542063 PMCID: PMC2441965 DOI: 10.1038/sj.bjc.6604280] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Testicular germ cell tumours (TGCTs) are the most common cause of cancer in men between the ages of 15 and 40 years, and, overall, the majority of patients should expect to be cured. The European Germ Cell Cancer Consensus Group has provided clear guidelines for the primary treatment of both seminoma and nonseminomatous germ cell tumours. There is, however, no international consensus on how best to follow patients after their initial management. This must promptly and reliably identify relapses without causing further harm. The standardising of follow-up would result in optimising risk-benefit ratios for individual patients, while ensuring economic use of resources. We have identified the seven common scenarios in managing seminomas and nonseminomas of the various stages and discuss the pertinent issues around relapse and follow-up. We review the available literature and present our comprehensive TGCT follow-up guidelines. Our protocols provide a pragmatic, easily accessible user-friendly basis for other centres to use or to adapt to suit their needs. Furthermore, this should enable future trials to address specific issues around follow-up giving meaningful and useful results.
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Fosså S, Loge J, Dahl A. Long-term survivorship after cancer: how far have we come? Ann Oncol 2008; 19 Suppl 5:v25-9. [DOI: 10.1093/annonc/mdn305] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Tuinman MA, Hoekstra HJ, Sleijfer DT, Fleer J, Vidrine DJ, Gritz ER, Hoekstra-Weebers JEHM. Testicular cancer: a longitudinal pilot study on stress response symptoms and quality of life in couples before and after chemotherapy. Support Care Cancer 2006; 15:279-86. [PMID: 16944218 PMCID: PMC2092408 DOI: 10.1007/s00520-006-0119-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Accepted: 06/22/2006] [Indexed: 12/22/2022]
Abstract
Goals of work The current study was designed to longitudinally examine stress response symptoms (SRS) and quality of life (QoL) in couples confronted with disseminated testicular cancer. The objectives were to examine couples’ patterns of adjustment over time and possible differences in adjustment between the patient and his partner. Materials and methods Couples completed the Impact of Event Scale and the QoL subscales physical functioning, social functioning, and mental health of the RAND-36 before chemotherapy (T1), after completion of chemotherapy (T2), and 1 year later (T3). Results Before chemotherapy 26% of the patients and 50% of partners reported clinically elevated levels of SRS. Patients reported lower physical and social functioning at T2 compared to T1 and T3. Partners reported an improvement in social functioning over the year and no changes in physical functioning or mental health. No relationships between patients and partners’ functioning were found. One year after diagnosis, QoL of patients and partners was similar to that of reference groups, and patients even reported better physical functioning than the reference group. SRS of patients and partners were negatively related at T1, and patients and partners’ social functioning were positively related at T2. Conclusions According to stress response levels, the period before the start of chemotherapy was most stressful for couples. Adjustment patterns differ between testicular cancer patients and their partners with patients reporting lowered QoL after completion of chemotherapy. QoL of couples returned to normal levels 1 year after diagnosis. The effect of disseminated testicular cancer on the QoL of patients and their partners seems to be temporary. A minority may need clinical attention for severe SRS.
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Affiliation(s)
- Marrit A. Tuinman
- Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, P.O. Box 30001, Groningen, 9700 RB The Netherlands
| | - Harald J. Hoekstra
- Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, P.O. Box 30001, Groningen, 9700 RB The Netherlands
| | - Dirk Th. Sleijfer
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joke Fleer
- Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, P.O. Box 30001, Groningen, 9700 RB The Netherlands
| | - Damon J. Vidrine
- Department of Behavioral Science, University of Texas M. D. Anderson Cancer Center, Houston, USA
| | - Ellen R. Gritz
- Department of Behavioral Science, University of Texas M. D. Anderson Cancer Center, Houston, USA
| | - Josette E. H. M. Hoekstra-Weebers
- Department of Psychosocial Services, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, Groningen, 9700 RB The Netherlands
- Comprehensive Cancer Center North-Netherlands, P.O. Box 330, Groningen, 9700 AH The Netherlands
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Archea C, Yen IH, Chen H, Eisner MD, Katz PP, Masharani U, Yelin EH, Earnest G, Blanc PD. Negative life events and quality of life in adults with asthma. Thorax 2006; 62:139-46. [PMID: 16928721 PMCID: PMC2111249 DOI: 10.1136/thx.2006.065730] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The relationship between stress and quality of life in adults with asthma has not been well studied. Stress, quantified by negative life events, may be linked to quality of life in asthma through multiple pathways, including increase in disease severity and adverse effects on socioeconomic status (SES). METHODS The responses to a self-completed questionnaire assessing negative life events (NLEs) in the previous 12 months (from a 24-item checklist) among 189 adults with asthma from a well-characterised cohort were analysed. The relationship between the number of NLEs reported and asthma-specific quality of life (AQOL) was measured with the Marks instrument. General linear modelling was used to test the conjoint effects of NLEs, SES and disease severity based on the Severity of Asthma Score, a validated acute and chronic disease measure. RESULTS Those with annual family incomes < 60,000 dollars reported significantly more NLEs than those with higher incomes (p = 0.03). The number of NLEs did not differ significantly between those with forced expiratory volume in 1 s <80% predicted and those with >80% predicted, nor among those with lower compared with higher Severity of Asthma Score. The frequency of NLEs was associated with poorer (higher numerical score) AQOL (p = 0.002). When studied together in the same model, combinations of income level and asthma severity (greater or lesser Severity of Asthma Score; p < 0.001) and number of NLEs (p = 0.03) were both significantly associated with AQOL. CONCLUSION NLEs are associated with quality of life among adults with asthma, especially among those of lower SES. Clinicians should be aware of this relationship, especially in vulnerable patient subsets.
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Affiliation(s)
- C Archea
- Department of Medicine, University of California San Francisco, 350 Parnassus Avenue, Suite 609, San Francisco, CA 94117, USA
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