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Roed ML, Severinsen MT, Maksten EF, Jørgensen L, Enggaard H. Cured but not well - haematological cancer survivors' experiences of chemotherapy-induced peripheral neuropathy in everyday life: a phenomenological-hermeneutic study. J Cancer Surviv 2024:10.1007/s11764-024-01612-4. [PMID: 38743186 DOI: 10.1007/s11764-024-01612-4] [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: 03/01/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE To explore haematological cancer survivors' experience of chemotherapy-induced peripheral neuropathy (CIPN) in everyday life. METHODS Data were generated by means of individual semi-structured interviews with 12 haematological cancer survivors who experience CIPN after completion of treatment. Data were analysed using thematic analysis. RESULTS The thematic analysis yielded an in-depth description of the experience of CIPN symptoms and the influence of the symptoms on everyday life as being unwell despite being cured. Four main themes emerged from the analysis: (1) A diffuse and contradictory sensation which is impossible to ignore in everyday life, (2) Not feeling well, even though I'm cured, (3) Living with CIPN, despite limitations, and (4) An invisible companion, that everybody knows about. CONCLUSION The findings shows that survival from haematological cancer does not always equal well-being, as experiencing CIPN has extensive consequences on everyday life. CIPN affects haematological cancer survivors' transition to an ordinary everyday life, with disturbances in the physical function, daily activities, social relationships, psychological aspects, and work ability. As a diffuse and contradictory symptom, CIPN appears as an invisible companion that leads to a feeling of being alone. IMPLICATIONS FOR CANCER SURVIVORS A better and deeper understanding of haematological cancer survivors' experience of CIPN in everyday life may improve communication, guidance, and treatment of CIPN symptoms. The results suggest a need for interventions and strategies to accommodate the gap in practice and to address the impact of CIPN in everyday life.
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Affiliation(s)
- Mette Louise Roed
- Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.
| | - Marianne Tang Severinsen
- Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Eva Futtrup Maksten
- Department of Haematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lone Jørgensen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Clinic Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Helle Enggaard
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
- Clinic Cancer Research Unit, Aalborg University Hospital, Aalborg, Denmark
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Kim EY, Hong SJ. Real-Life Experiences of Chemotherapy-Induced Peripheral Neuropathy in Patients with Cancer: A Qualitative Meta-Synthesis Study. Semin Oncol Nurs 2023; 39:151499. [PMID: 37586913 DOI: 10.1016/j.soncn.2023.151499] [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: 03/20/2023] [Revised: 06/08/2023] [Accepted: 07/28/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE Chemotherapy-induced peripheral neuropathy is an unpleasant symptom experienced by most cancer survivors who receive neurotoxic chemotherapy. It is not life threatening; however, it impairs sensorimotor skills, thereby interfering with daily activities and reducing the quality of life. Healthcare providers are becoming increasingly aware of the significance of its management. Nonetheless, a lack of understanding remains. This study aimed to understand the experience of cancer survivors with chemotherapy-induced peripheral neuropathy. DATA SOURCES The selection and search for relevant literature conformed to the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols guidelines. Four databases were searched for literature exploring the experiences of cancer survivors with chemotherapy-induced peripheral neuropathy. Moreover, articles from reference lists were retrieved. Of 969 collected articles, 13 qualitative studies were included. The seven-step meta-ethnography developed by Noblits and Hare was used to analyze and synthesize selected studies. This study complied with the enhancing transparency in reporting the synthesis of qualitative research guidelines. CONCLUSION Three themes ("Tough and challenging life with chemotherapy-induced peripheral neuropathy," "Being patient in a chaotic life," and "Transition to a new way of life") and six subthemes were derived after reviewing, analyzing, and synthesizing selected study findings. They faced difficult daily challenges and endured psychologically chaotic moments; however, they gradually learned to live with the symptoms and adapted their way of life. IMPLICATIONS FOR NURSING PRACTICE This review emphasizes the importance of the need for personalized nursing interventions promoting self-management and new adaptation strategies for gaining better understanding of chemotherapy-induced peripheral neuropathy.
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Affiliation(s)
- Eun Young Kim
- Assistant Professor, Department of Nursing, Soonchunhyang University, Cheonan, Republic of Korea
| | - Se Jin Hong
- Assistant Professor, College of Nursing, Gachon University, Incheon, Republic of Korea.
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Jensen MAE, Mørch CD, Yilmaz MN, Feilberg C, Pedersen B. A new self-understanding as chemo sufferer - a phenomenological study of everyday life with chemotherapy induced neuropathy among survivors after colorectal cancer. Int J Qual Stud Health Well-being 2022; 17:2049437. [PMID: 35315728 PMCID: PMC8942531 DOI: 10.1080/17482631.2022.2049437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To explore the essential meaning of how sensory disturbances caused by Oxaliplatin influence self-understanding and freedom to live an everyday life among survivors after colorectal cancer. METHODS Data was generated by means of a semi-structured individual interview with eight survivors after colorectal cancer who continued to experience chemotherapy-induced peripheral neuropathy at least one year after completing chemotherapy with Oxaliplatin. Data analysis was guided by existential phenomenology and descriptive life-world research. RESULTS The essential meaning was structured by four constituents. 1) An unpleasant fluctuating sensation which is impossible to ignore, 2) Breaking through of noise and pain despite struggling to keep them at bay, 3) Continuously feeling ill despite being cured, and 4) Bodily constraints that impact self-understanding and limit enjoyment of life. CONCLUSION The survivors used distraction to keep the sensory disturbances at bay but were forced to adapt to a new self-understanding as sufferers after chemotherapy despite being cured of their cancer disease. This way of being-in-the-world was understood by survivors, their families and healthcare professionals as a necessary price to pay to be alive. However, marked as sufferer after chemotherapy, the participants' everyday style of experience and life revealed as an ill health condition, which limited their ability to accomplish everyday activities as before and their freedom to realize their potential-the "I can".
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Affiliation(s)
- Marlene AE. Jensen
- Department of Oncology, Clinic for Surgery and Cancer treatment, Aalborg University Hospital, Denmark
| | - Carsten D. Mørch
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Mette N. Yilmaz
- Department of Oncology, Clinic for Surgery and Cancer treatment, Aalborg University Hospital, Denmark; Clinical Cancer Research Centre, Aalborg University Hospital, Denmark
| | - Casper Feilberg
- Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Birgith Pedersen
- Department of Oncology, Clinic for Surgery and Cancer treatment, Aalborg University Hospital, Denmark; Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
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Pedersen B, Jensen MÆ, Yilmaz MN, Mørch CD, Feilberg C. A peculiar experience- everyday life with chronic sensory disturbances after oxaliplatin treatment for colorectal cancer - a phenomenological study. Int J Qual Stud Health Well-being 2021; 16:1950889. [PMID: 34296981 PMCID: PMC8317951 DOI: 10.1080/17482631.2021.1950889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose: To deepen the understanding of how survivors' experience and give meaning to the embodied phenomenon of chronic sensory disturbances in everyday life after oxaliplatin treatment for colorectal cancer.Methods: Data was generated by means of a semi-structured interview guide and drawings with the aim to explore eight survivors' lifeworld experiences. Data was analyzed through a phenomenological approach.Results: The essential meaning of sensory disturbances emerged in two main themes and four sub-themes. Theme A: 'A peculiar experience that is difficult to logically understand' with the subthemes; 'An ambiguous perception in hands and feet' and 'Being alienated from one's own body'. Theme B: Losing touch with the world' with the subthemes: 'A lack of sensory contact with physical surfaces' and 'Breakdown of sensitivity in hands hampers fine motor skills and social contact'.Conclusion: Sensory disturbances contributed to an ambiguous and discordant perception of an alienated body that was difficult to describe and affected the ability to act and connect to things and other people. Metaphors and drawings were valuable as means to verbalize and illustrate the changed body perception where the 'I can' changed into 'I cannot'. To support the embodied connection to the world new usage patterns were required.
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Affiliation(s)
- Birgith Pedersen
- Department of Oncology, Clinic for Surgery and Cancer Treatment, Aalborg University Hospital, Denmark; Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Marlene Æ. Jensen
- Department of Oncology, Clinic for Surgery and Cancer Treatment, Aalborg University Hospital, Aalborg, Denmark
| | - Mette N. Yilmaz
- Department of Oncology, Clinic for Surgery and Cancer Treatment, Aalborg University Hospital, Denmark; Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Carsten Dahl Mørch
- Department of Health Science and Technology, Center for Neuroplasticity and Pain (CNAP), Integrative Neuroscience Research Group, Aalborg University, Aalborg, Denmark
| | - Casper Feilberg
- Department of Communication and Psychology, Center for Qualitative Studies, Aalborg University, Aalborg, Denmark
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Battaglini E, Goldstein D, Grimison P, McCullough S, Mendoza-Jones P, Park SB. Chemotherapy-Induced Peripheral Neurotoxicity in Cancer Survivors: Predictors of Long-Term Patient Outcomes. J Natl Compr Canc Netw 2021; 19:821-828. [PMID: 34340206 DOI: 10.6004/jnccn.2021.7026] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/12/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Chemotherapy-induced peripheral neurotoxicity (CIPN) is a major adverse effect of cancer treatment. However, its impact remains poorly understood. This study aimed to investigate the impact associated with CIPN on the lives of cancer survivors. PATIENTS AND METHODS A volunteer sample of 986 individuals who had received neurotoxic chemotherapy completed an anonymous, cross-sectional survey. Outcomes assessed included CIPN symptoms, pain, neuropathic pain, quality of life (QoL), physical activity, and comorbid health conditions via the Self-Administered Comorbidity Questionnaire. RESULTS Respondents had a mean age of 58 years (SD, 10.7), and 83.2% were female. Most were treated for breast (58.9%) or colorectal cancer (13.5%); had received docetaxel (32.7%), paclitaxel (31.6%), or oxaliplatin (12.5%); and had completed treatment 3.6 ± 3.5 years previously. We found that 76.5% of respondents reported current CIPN. Respondents reporting severe CIPN had poorer QoL, more comorbidities, and higher body mass index, and more often received multiple neurotoxic chemotherapies than those with mild CIPN. Respondents who completed the survey ≤1 year after completing chemotherapy did not differ in reported CIPN or pain compared with respondents who completed chemotherapy ≥6 years earlier. However, respondents who completed chemotherapy ≥6 years earlier reported better QoL. Multivariable linear regression analyses revealed predictors of CIPN severity as follows: F(7, 874) = 64.67; P<.001; R2 = 0.34, including pain (β = -0.36; P<.001), burning pain (β = 0.25; P<.001), sex (male sex associated with greater CIPN: β = 0.14; P<.001), years since completing chemotherapy (shorter time associated with greater CIPN; β = -0.10; P<.001), age (β = 0.80; P=.006), number of comorbid conditions (β = 0.07; P=.02), and body mass index (β = 0.07; P=.02). CONCLUSIONS Respondents with a high CIPN symptom burden experienced poorer general health and QoL. Improvements in CIPN may be more likely soon after treatment. However, improvements in QoL may occur over time in those with chronic symptoms. CIPN seems to have lasting impacts on cancer survivors, and understanding risk factors is important to enable the design of further preventive and therapeutic management strategies.
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Affiliation(s)
- Eva Battaglini
- Prince of Wales Clinical School, University of New South Wales Medicine, University of New South Wales, Kensington
| | - David Goldstein
- Prince of Wales Clinical School, University of New South Wales Medicine, University of New South Wales, Kensington
| | - Peter Grimison
- The Chris O'Brien Lifehouse, Camperdown.,Sydney Medical School, Faculty of Medicine, University of Sydney, Sydney
| | - Susan McCullough
- Translational Cancer Research Network Consumer Advisory Panel, Sydney; and
| | - Phil Mendoza-Jones
- Translational Cancer Research Network Consumer Advisory Panel, Sydney; and
| | - Susanna B Park
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
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Girisa S, Saikia Q, Bordoloi D, Banik K, Monisha J, Daimary UD, Verma E, Ahn KS, Kunnumakkara AB. Xanthohumol from Hop: Hope for cancer prevention and treatment. IUBMB Life 2021; 73:1016-1044. [PMID: 34170599 DOI: 10.1002/iub.2522] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 12/16/2022]
Abstract
Cancer is a major public health concern due to high mortality and poor quality of life of patients. Despite the availability of advanced therapeutic interventions, most treatment modalities are not efficacious, very expensive, and cause several adverse side effects. The factors such as drug resistance, lack of specificity, and low efficacy of the cancer drugs necessitate developing alternative strategies for the prevention and treatment of this disease. Xanthohumol (XN), a prenylated chalcone present in Hop (Humulus lupulus), has been found to possess prominent activities against aging, diabetes, inflammation, microbial infection, and cancer. Thus, this manuscript thoroughly reviews the literature on the anti-cancer properties of XN and its various molecular targets. XN was found to exert its inhibitory effect on the growth and proliferation of cancer cells via modulation of multiple signaling pathways such as Akt, AMPK, ERK, IGFBP2, NF-κB, and STAT3, and also modulates various proteins such as Notch1, caspases, MMPs, Bcl-2, cyclin D1, oxidative stress markers, tumor-suppressor proteins, and miRNAs. Thus, these reports suggest that XN possesses enormous therapeutic potential against various cancers and could be potentially used as a multi-targeted anti-cancer agent with minimal adverse effects.
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Affiliation(s)
- Sosmitha Girisa
- Cancer Biology Laboratory and DBT-AIST International Center for Translational and Environmental Research (DAICENTER), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, India
| | - Queen Saikia
- Cancer Biology Laboratory and DBT-AIST International Center for Translational and Environmental Research (DAICENTER), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, India
| | - Devivasha Bordoloi
- Cancer Biology Laboratory and DBT-AIST International Center for Translational and Environmental Research (DAICENTER), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, India
| | - Kishore Banik
- Cancer Biology Laboratory and DBT-AIST International Center for Translational and Environmental Research (DAICENTER), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, India
| | - Javadi Monisha
- Cancer Biology Laboratory and DBT-AIST International Center for Translational and Environmental Research (DAICENTER), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, India
| | - Uzini Devi Daimary
- Cancer Biology Laboratory and DBT-AIST International Center for Translational and Environmental Research (DAICENTER), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, India
| | - Elika Verma
- Cancer Biology Laboratory and DBT-AIST International Center for Translational and Environmental Research (DAICENTER), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, India
| | - Kwang Seok Ahn
- Department of Science in Korean Medicine, College of Korean Medicine, Kyung Hee University, 24 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea
| | - Ajaikumar B Kunnumakkara
- Cancer Biology Laboratory and DBT-AIST International Center for Translational and Environmental Research (DAICENTER), Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, Assam, India
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Lim CYS, Laidsaar-Powell RC, Young JM, Kao SCH, Zhang Y, Butow P. Colorectal cancer survivorship: A systematic review and thematic synthesis of qualitative research. Eur J Cancer Care (Engl) 2021; 30:e13421. [PMID: 33733545 DOI: 10.1111/ecc.13421] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 12/06/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION With rapid changes in treatments for colorectal cancer (CRC), qualitative research into CRC survivorship requires greater synthesis. This paper aims to fill this gap through a systematic review (PROSPERO CRD42019131576) and thematic synthesis of the qualitative literature on survivorship experiences across early-stage and advanced CRC survivors. METHODS CINAHL, Embase, MEDLINE, PsycINFO and PubMed were searched for qualitative CRC survivorship papers. Titles, abstracts and full texts were screened. Included articles (n = 81) underwent data extraction, CASP qualitative bias ratings and thematic synthesis. RESULTS Bowel dysfunction caused functional limitations and negative quality of life (QoL), while stomas posed threats to body image and confidence. Physical symptoms hindered return to work, increasing financial burdens. Survivors' unmet needs included information regarding symptom expectations and management, and ongoing support throughout recovery. Advanced and early-stage survivors shared similar experiences. Advanced survivors struggled with fear of cancer recurrence/progression and feelings of powerlessness. Functional limitations, financial impacts and sexuality in advanced survivors were underexplored areas. CONCLUSION CRC and its treatments impact survivors' QoL in all areas. A coordinated supportive care response is required to address survivors' unmet needs. Future qualitative studies should explore advanced CRC subpopulations, treatment-specific impacts on QoL and long-term (>5 years) impacts on CRC survivors.
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Affiliation(s)
- Chloe Yi Shing Lim
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah Clare Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Jane M Young
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,RPA Institute of Academic Surgery (IAS) and Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Sydney, NSW, Australia
| | - Steven Chuan-Hao Kao
- Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Yuehan Zhang
- National Centre for Epidemiology and Population Health, Australian National University Research School of Population Health, Canberra, ACT, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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Rutherford C, Müller F, Faiz N, King MT, White K. Patient-reported outcomes and experiences from the perspective of colorectal cancer survivors: meta-synthesis of qualitative studies. J Patient Rep Outcomes 2020; 4:27. [PMID: 32335745 PMCID: PMC7183519 DOI: 10.1186/s41687-020-00195-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 04/08/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is prevalent in the developed world. Favourable survival rates highlight the need to better understand CRC survivors' experiences of long-term impacts of treatment, which can in turn inform decision making. This systematic review aimed to identify and synthesise CRC survivors' experiences of long-term impacts on health-related quality of life. METHODS We searched Medline, Embase and PsychINFO from inception to January 2019. Qualitative studies describing CRC survivors' experiences at least 1-year post-treatment were included. Study eligibility, quality assessment (COREQ guidelines), and data synthesis was performed independently by two reviewers and discussed with the study team. RESULTS Of 1363 papers retrieved, 20 reporting 15 studies met eligibility. Thematic synthesis produced 12 themes: symptoms, physical, social, psychological and sexual functioning, impact on relationships, informal care needs provided by family/friend, supportive care needs provided by healthcare professional, health care experiences, health behaviour, financial toxicity and occupational experiences. Stoma problems (e.g. leakage, skin irritation) were common in ostomates. Survivors with no/reversed stoma experienced unexpected, long-term altered and unpredictable bowel functioning. Survivors often regulated timing, amount and foods consumed to manage bowel functioning. Less common symptoms included fatigue, impaired sleep and anal pain. Stoma problems and altered bowel functioning impaired survivors' physical, social, sexual and psychological functioning. Cognitive functioning and heredity issues were not reported in any paper. CONCLUSION CRC survivors experience ongoing symptoms and functioning impairments more than 1-year post-treatment completion. Many survivors find their own ways to manage symptoms rather than seek professional help. Follow-up care for CRC survivors should integrate screening for long-term effects and provide targeted supportive care.
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Affiliation(s)
- Claudia Rutherford
- The University of Sydney, School of Psychology, Quality of Life Office, Faculty of Science, Sydney, Australia.
- The University of Sydney, Susan Wakil School of Nursing and Midwifery, Cancer Nursing Research Unit (CNRU), Faculty of Medicine and Health, Sydney, Australia.
| | - Fabiola Müller
- The University of Sydney, School of Psychology, Quality of Life Office, Faculty of Science, Sydney, Australia
| | - Nasiba Faiz
- The University of Sydney, Susan Wakil School of Nursing and Midwifery, Cancer Nursing Research Unit (CNRU), Faculty of Medicine and Health, Sydney, Australia
| | - Madeleine T King
- The University of Sydney, School of Psychology, Quality of Life Office, Faculty of Science, Sydney, Australia
| | - Kate White
- The University of Sydney, Susan Wakil School of Nursing and Midwifery, Cancer Nursing Research Unit (CNRU), Faculty of Medicine and Health, Sydney, Australia
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Reporting of paclitaxel-induced peripheral neuropathy symptoms to clinicians among women with breast cancer: a qualitative study. Support Care Cancer 2020; 28:4163-4172. [PMID: 31897779 DOI: 10.1007/s00520-019-05254-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 12/16/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Cases of chemotherapy-induced peripheral neuropathy (CIPN) under-reporting have been sporadically described in the literature, but no studies have focused on actively examining this behavior. Our primary aim was to identify women who purposefully under-reported CIPN, along with reasons for doing so. A secondary aim was to explore factors enabling or hindering communication of CIPN to clinicians. METHODS Semi-structured interviews were conducted with women with breast cancer who had received paclitaxel in a prospective observational study. The interview guide was developed based on factors hypothesized to influence side effect disclosure to clinicians. Interviews were recorded, transcribed verbatim, and thematically content analyzed. RESULTS Thirty-four women were interviewed. Three main themes emerged from the analysis: (1) enablers of CIPN reporting (e.g., positive relationship with the oncology team, sufficient appointment time, existence of alternative communication channels to office visits, expectation of CIPN as a side effect); (2) deterrents to CIPN reporting (e.g., perception of need to complete the full course of therapy, fear of treatment discontinuation, lack of knowledge of long-term consequences of CIPN); and (3) balancing survival versus functional impairment due to CIPN. Women prioritized efficacy over CIPN until physical functioning was meaningfully affected. No patients reported purposeful CIPN under-reporting, but three women admitted having considered doing so. CONCLUSIONS Despite the lack of evidence of CIPN withholding, women considered both the effectiveness and the toxicity of paclitaxel treatment, as well as beliefs about treatment and long-term consequences of CIPN and relationship with the oncology team, when deciding whether to report CIPN symptoms.
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Drott J, Fomichov V, Börjeson S, Berterö C. Sense of coherence and health‐related quality of life in patients with neurotoxicity after cancer chemotherapy: Assessment from a real‐time mobile phone–based system. Psychooncology 2019; 29:107-113. [DOI: 10.1002/pon.5243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Jenny Drott
- Department of SurgeryLinköping University Linköping Sweden
- Division of Nursing Science, Department of Medical and Health SciencesLinköping University Linköping Sweden
| | - Victoria Fomichov
- Centre for Organisational Support and Development County Council of ÖstergötlandLinköping University Linköping Sweden
| | - Sussanne Börjeson
- Department of OncologyLinköping University Linköping Sweden
- Division of Nursing Science, Department of Medical and Health SciencesLinköping University Linköping Sweden
| | - Carina Berterö
- Division of Nursing Science, Department of Medical and Health SciencesLinköping University Linköping Sweden
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Oxaliplatin-Induced Neurotoxic Side Effects and Their Impact on Daily Activities: A Longitudinal Study Among Patients With Colorectal Cancer. Cancer Nurs 2019; 42:E40-E48. [PMID: 31658096 DOI: 10.1097/ncc.0000000000000674] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Oxaliplatin (OXA) is frequently used in the treatment of patients with colorectal cancer, and OXA-induced neurotoxic side effects are common. Reports on real-time patient-reported neurotoxic side effects and impact on the patient's daily activities are sparse in existing studies. OBJECTIVE The aim of this study was to identify and assess patient-reported OXA-induced neurotoxic side effects and their impact on the patient's daily activities, during and after chemotherapy. METHODS In a multicenter prospective longitudinal study, 46 chemo-naïve patients with colorectal cancer treated with postoperative adjuvant OXA-based chemotherapy were monitored during treatment and at 3-, 6-, 9-, and 12-month follow-ups. Patients were recruited from September 2013 to June 2016. In total, 370 Oxaliplatin-Associated Neurotoxicity Questionnaire responses were available for analysis. A mobile phone-based system was used to receive real-time assessments. RESULTS All patients reported neurotoxic side effects and impact on daily activities during treatment. The side effects changed in character and body location over time and had an impact on the daily activities. CONCLUSIONS The high prevalence of OXA-induced neurotoxic side effects significantly interfered with the patients' daily activities. We found significant differences between baseline data and follow-up time points for neurotoxicity, and the patients had not returned to baseline after 1 year. IMPLICATIONS FOR PRACTICE The real-time assessment using mobile phone technology seems to be a valuable tool for monitoring patient-reported neurotoxicity and interventions for tailored care. Effectively identifying neurotoxicity and its impact on the patient's daily activities is important in supportive cancer care.
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Hildebrandt C, Mayer H, Koller A. Experiences of patients with colorectal cancer from diagnosis until completion of treatment: A meta-ethnography approach. Psychooncology 2018; 28:219-227. [PMID: 30447170 DOI: 10.1002/pon.4946] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 11/09/2018] [Accepted: 11/13/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The purpose of this meta-synthesis was to explore the experience of living with symptoms caused by colorectal cancer (CRC) and its treatment from the perspectives of those affected. METHODS In a systematic search of qualitative studies published up to September 2017, 21 relevant papers were identified. The meta-ethnography followed the approach developed by Noblit and Hare. To relate key themes from one paper to similar themes of different papers, a "reciprocal translation" was carried out. RESULTS Through synthesis, a new model was developed during treatment ("lines-of-argument synthesis"). Two constructs of experiences took place before the illness. Six third-order constructs were developed to capture patients' experiences during treatment, including "disruption in life through CRC" as well as the complex and circular experiences summarized as "experiences of symptoms and challenges by CRC". In contrast, experiences in dealing with changes that CRC and the treatment imply were "making sense of the experience", "sharing the experience", "experiences with controlling ones' body", and "experiences with reforming life". CONCLUSIONS This meta-ethnography clarifies fundamental aspects of patients' experience in very different settings or starting points by specifying a more complete and holistic spectrum of experiences with CRC and its treatment.
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Affiliation(s)
| | - Hanna Mayer
- Department of Nursing ScienceUniversity of Vienna Vienna Austria
| | - Antje Koller
- Department of Nursing ScienceUniversity of Vienna Vienna Austria
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Williams LA, Garcia-Gonzalez A, Mendoza TR, Haq S, Cleeland CS. Concept domain validation and item generation for the Treatment-Induced Neuropathy Assessment Scale (TNAS). Support Care Cancer 2018; 27:1021-1028. [PMID: 30094731 DOI: 10.1007/s00520-018-4391-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/31/2018] [Indexed: 01/20/2023]
Abstract
PURPOSE Treatment-induced peripheral neuropathy (TIPN) is a difficult problem experienced by patients with cancer that can interfere with their ability to receive optimal therapy. The Treatment-Induced Peripheral Neuropathy Scale (TNAS) is a patient-reported outcome (PRO) measure developed to assess TIPN symptom burden. However, PRO validation is an ongoing process. The aim of this qualitative study was to define the conceptual model, establish content domain validity, and refine items for the TNAS based on patient input. METHODS Patients who received bortezomib, oxaliplatin, or platinum-taxane combination therapy reported their experience of TIPN in single qualitative audiotaped interviews. Themes of the TIPN experience were identified by descriptive analysis of the transcribed interviews. RESULTS Three groups of 10 patients each who had received bortezomib, oxaliplatin, or platinum-taxane combination therapy, for a total of 30 patients, reported their experiences. Two themes reported by patients were TIPN sensations and functional interference. Five sensations (numbness, tingling, pain, heat or burning, and coldness) and five functional impacts (using hands, walking, maintaining balance or falling, wearing shoes, and sleeping) were reported by at least 20% of patients and were selected for inclusion in the TNAS v3.0 for additional psychometric testing. CONCLUSIONS The assessment of TIPN must be convenient, reliable, and practical for patients, who are the most reliable source of information about symptoms. The TNAS, developed with direct patient input, provides an easily administered and conceptually valid method of patient report of TIPN burden for use in research and practice.
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Affiliation(s)
- Loretta A Williams
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler Drive, Unit 1450, Houston, TX, 77030, USA.
| | - Araceli Garcia-Gonzalez
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler Drive, Unit 1450, Houston, TX, 77030, USA
| | - Tito R Mendoza
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler Drive, Unit 1450, Houston, TX, 77030, USA
| | - Shireen Haq
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler Drive, Unit 1450, Houston, TX, 77030, USA
| | - Charles S Cleeland
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler Drive, Unit 1450, Houston, TX, 77030, USA
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Drott J, Vilhelmsson M, Kjellgren K, Berterö C. Experiences With a Self-Reported Mobile Phone-Based System Among Patients With Colorectal Cancer: A Qualitative Study. JMIR Mhealth Uhealth 2016; 4:e66. [PMID: 27282257 PMCID: PMC4919552 DOI: 10.2196/mhealth.5426] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/17/2016] [Accepted: 04/22/2016] [Indexed: 11/16/2022] Open
Abstract
Background In cancer care, mobile phone-based systems are becoming more widely used in the assessment, monitoring, and management of side effects. Objective To explore the experiences of patients with colorectal cancer on using a mobile phone-based system for reporting neurotoxic side effects. Methods Eleven patients were interviewed (ages 44-68 years). A semistructured interview guide was used to perform telephone interviews. The interviews were transcribed verbatim and analyzed with qualitative content analysis. Results The patients' experiences of using a mobile phone-based system were identified and constructed as: “being involved,” “pacing oneself,” and “managing the questions.” “Being involved” refers to their individual feelings. Patients were participating in their own care by being observant of the side effects they were experiencing. They were aware that the answers they gave were monitored in real time and taken into account by health care professionals when planning further treatment. “Pacing oneself” describes how the patients can have an impact on the time and place they choose to answer the questions. Answering the questionnaire was easy, and despite the substantial number of questions, it was quickly completed. “Managing the questions” pointed out that the patients needed to be observant because of the construction of the questions. They could not routinely answer all the questions. Patients understood that side effects can vary during the cycles of treatment and need to be assessed repeatedly during treatment. Conclusions This mobile phone-based system reinforced the patients’ feeling of involvement in their own care. The patients were comfortable with the technology and appreciated that the system was not time consuming.
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Affiliation(s)
- Jenny Drott
- Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
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