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Mao X, Wu S, Huang D, Li C. Complications and comorbidities associated with antineoplastic chemotherapy: Rethinking drug design and delivery for anticancer therapy. Acta Pharm Sin B 2024; 14:2901-2926. [PMID: 39027258 PMCID: PMC11252465 DOI: 10.1016/j.apsb.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/29/2024] [Accepted: 02/10/2024] [Indexed: 07/20/2024] Open
Abstract
Despite the considerable advancements in chemotherapy as a cornerstone modality in cancer treatment, the prevalence of complications and pre-existing diseases is on the rise among cancer patients along with prolonged survival and aging population. The relationships between these disorders and cancer are intricate, bearing significant influence on the survival and quality of life of individuals with cancer and presenting challenges for the prognosis and outcomes of malignancies. Herein, we review the prevailing complications and comorbidities that often accompany chemotherapy and summarize the lessons to learn from inadequate research and management of this scenario, with an emphasis on possible strategies for reducing potential complications and alleviating comorbidities, as well as an overview of current preclinical cancer models and practical advice for establishing bio-faithful preclinical models in such complex context.
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Affiliation(s)
- Xiaoman Mao
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - Shuang Wu
- Medical Research Institute, Southwest University, Chongqing 400715, China
| | - Dandan Huang
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - Chong Li
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
- Medical Research Institute, Southwest University, Chongqing 400715, China
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
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Coupe K, Block A, Mark S, Cooper BA, Paul SM, Dunn LB, Hammer MJ, Conley YP, Levine JD, Miaskowski C. Increases in stress and adverse childhood experiences are associated with the co-occurrence of anxiety and depression in oncology patients. J Psychosoc Oncol 2024:1-24. [PMID: 38528755 PMCID: PMC11422520 DOI: 10.1080/07347332.2024.2326146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
PURPOSE Identify subgroups of patients with distinct joint anxiety AND depression profiles and evaluate for differences in demographic and clinical characteristics, as well as stress, resilience, and coping. DESIGN Longitudinal study. PARTICIPANTS Patients (n = 1328) receiving chemotherapy. METHODS Measures of state anxiety and depression were done six times over two cycles of chemotherapy. All of the other measures were completed prior to second or third cycle of chemotherapy. Latent profile analysis was used to identify the distinct joint anxiety and depression profiles. FINDINGS Three classes were identified (i.e. Low Anxiety and Low Depression (57.5%); Moderate Anxiety and Moderate Depression (33.7%), High Anxiety and High Depression (8.8%)). For all of the stress measures, a dose response effect was seen among the profiles. Two worst profiles reported higher occurrence rates for a number of adverse childhood experiences. IMPLICATIONS FOR PROVIDERS Patients need referrals for stress reduction techniques and mental health and social services.
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Affiliation(s)
- Katie Coupe
- School of Nursing, University of California, San Francisco, CA
| | - Astrid Block
- School of Nursing, University of California, San Francisco, CA
| | - Sueann Mark
- School of Nursing, University of California, San Francisco, CA
| | - Bruce A. Cooper
- School of Nursing, University of California, San Francisco, CA
| | - Steven M. Paul
- School of Nursing, University of California, San Francisco, CA
| | - Laura B. Dunn
- School of Medicine, University of Arkansas, Little Rock, AK
| | | | | | - Jon D. Levine
- School of Medicine, University of California, San Francisco, CA
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, CA
- School of Medicine, University of California, San Francisco, CA
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van Doeveren T, Remmers S, Atema V, van den Bergh RC, Boevé ER, Cornel EB, van der Heijden AG, Hendricksen K, Cauberg EC, Jacobs RA, Kroon BK, Leliveld AM, Meijer RP, Merks B, Oddens JR, Roelofs L, Somford DM, de Vries P, Wijsman B, Windt WA, Zwaan PJ, van Leeuwen PJ, Boormans JL, Aben KK. Short-term Changes in Health-related Quality of Life of Patients Undergoing Radical Surgery for Upper Urinary Tract Urothelial Carcinoma: Results from a Prospective Phase 2 Clinical Trial. EUR UROL SUPPL 2024; 60:15-23. [PMID: 38375344 PMCID: PMC10874848 DOI: 10.1016/j.euros.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 02/21/2024] Open
Abstract
Background and objective The possible negative impact of radical surgery on patients' health-related quality of life (HRQoL) plays an important role in preoperative counseling. Here, we analyzed the HRQoL of patients treated for upper urinary tract urothelial carcinoma (UTUC) in the context of a single-arm phase 2 multicenter study, in which the safety and efficacy of a single preoperative intravesical instillation with mitomycin C were investigated. Our objective was to investigate early changes in HRQoL in patients undergoing radical surgery for UTUC and identify factors associated with these outcomes. Methods Patients with pTanyN0-1M0 UTUC were prospectively included. HRQoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) questionnaire at baseline, and at 1 and 3 mo after surgery. A linear mixed model was used to evaluate the changes in HRQoL over time and identify the variables associated with these outcomes. The clinical effect size was used to assess the clinical impact and level of perceptibility of HRQoL changes for clinicians and/or patients based on given thresholds. Key findings and limitations Between 2017 and 2020, 186 patients were included. At baseline, 1 mo after surgery, and 3 mo after surgery, response rates were 91%, 84%, and 78%, respectively. One month after surgery, a statistically significant and clinically relevant deterioration was observed in physical, role, and social functioning, and for the included symptom scales: constipation, fatigue, and pain. An improvement in emotional functioning was observed. At 3 mo, HRQoL returned to baseline levels, except emotional functioning, which improved at 1 mo and persisted to be better than that before surgery. Age >70 yr was associated with worse physical functioning, but better social and emotional functioning. Male patients reported better emotional functioning than females. Postoperative complications were negatively associated with social functioning. Conclusions and clinical implications UTUC patients treated with radical surgery experienced a significant, albeit temporary, decline in HRQoL. Three months following surgery, HRQoL outcomes returned to baseline levels. This information can be used to counsel UTUC patients before undergoing radical surgery and contextualize recovery after surgery. Patient summary We investigated the changes in quality of life as reported by patients who underwent surgery for upper tract urothelial carcinoma (UTUC). We found that patients experienced a decline in quality of life 1 mo after surgery, but this was temporary, with full recovery of quality of life 3 mo after surgery. These findings can help doctors and other medical staff in counseling UTUC patients before undergoing radical surgery.
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Affiliation(s)
- Thomas van Doeveren
- Department of Urology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Sebastiaan Remmers
- Department of Urology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Vera Atema
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | | | - Egbert R. Boevé
- Department of Urology, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands
| | - Erik B. Cornel
- Department of Urology, Ziekenhuis Groep Twente, Hengelo, The Netherlands
| | | | - Kees Hendricksen
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Rens A.L. Jacobs
- Department of Urology, Zuyderland Medical Center, Heerlen and Sittard, The Netherlands
| | - Bin K. Kroon
- Department of Urology, Rijnstate Medical Center, Arnhem, The Netherlands
| | - Annemarie M. Leliveld
- Department of Urology, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard P. Meijer
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bob Merks
- Department of Urology, Haaglanden Medical Center, Leidschendam, The Netherlands
| | - Jorg R. Oddens
- Department of Urology, AmsterdamUMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Luc Roelofs
- Department of Urology, Treant Zorggroep, Emmen, The Netherlands
| | - Diederik M. Somford
- Department of Urology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - Peter de Vries
- Department of Urology, Treant Zorggroep, Emmen, The Netherlands
| | - Bart Wijsman
- Department of Urology, Elisabeth-Tweesteden Medical Center, Tilburg, The Netherlands
| | | | - Peter J. Zwaan
- Department of Urology, Gelre Ziekenhuis, Apeldoorn, The Netherlands
| | - Pim J. van Leeuwen
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Joost L. Boormans
- Department of Urology, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Katja K.H. Aben
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
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Garcia P, Block A, Mark S, Mackin L, Paul SM, Cooper BA, Conley YP, Hammer MJ, Levine JD, Miaskowski C. Higher Levels of Multiple Types of Stress Are Associated With Worse State Anxiety and Morning Fatigue Profiles in Patients Receiving Chemotherapy. Cancer Nurs 2024:00002820-990000000-00209. [PMID: 38259094 PMCID: PMC11263502 DOI: 10.1097/ncc.0000000000001304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Anxiety and fatigue are common problems in patients receiving chemotherapy. Unrelieved stress is a potential cause for the co-occurrence of these symptoms. OBJECTIVES The aims of this study were to identify subgroups of patients with distinct state anxiety and morning fatigue profiles and evaluate for differences among these subgroups in demographic and clinical characteristics, as well as measures of global, cancer-specific, and cumulative life stress and resilience and coping. METHODS Patients (n = 1335) completed measures of state anxiety and morning fatigue 6 times over 2 cycles of chemotherapy. All of the other measures were completed prior to the second or third cycle of chemotherapy. Latent profile analysis was used to identify the state anxiety and morning fatigue profiles. RESULTS Three distinct joint profiles were identified: Low Anxiety and Low Morning Fatigue (59%), Moderate Anxiety and Moderate Morning Fatigue (33.4%), and High Anxiety and High Morning Fatigue (7.6%). Patients in the 2 highest classes were younger, were less likely to be married/partnered, and had a higher comorbidity burden. All of the stress scores demonstrated a dose-response effect (ie, as anxiety and morning fatigue profiles worsened, stress increased). Patients in the 2 highest classes reported higher rates of emotional abuse, physical neglect, physical abuse, and sexual harassment. CONCLUSIONS More than 40% of these patients experienced moderate to high levels of both anxiety and morning fatigue. Higher levels of all 3 types of stress were associated with the 2 highest profiles. IMPLICATIONS FOR PRACTICE Clinicians need to perform comprehensive evaluations of patients' levels of stress and recommend referrals to psychosocial services.
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Affiliation(s)
- Philip Garcia
- Author Affiliations: School of Nursing, University of California, San Francisco (Mr Garcia, Ms Block, and Drs Mark, Mackin, Paul, Cooper, and Miaskowski); School of Nursing, University of Pittsburgh, Pennsylvania (Dr Conley); Dana Farber Cancer Institute, Boston, Massachusetts (Dr Hammer); School of Medicine, University of California, San Francisco (Drs Miaskowski and Levine)
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Bergerot CD, Philip EJ, Bergerot PG, Razavi M, Lee D, Clark KL, Loscalzo M, Pal SK, Dale W. Anxiety, Depression, and Coping Strategies during Chemotherapy Treatment: A Comparison of Older and Younger Adults with Advanced Cancer in Brazil. Cancer Invest 2023; 41:781-788. [PMID: 37882784 DOI: 10.1080/07357907.2023.2274033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
We sought to examine differences in anxiety, depression and coping strategies among younger (<64-year old) and older (≥65-year old) patients. Patients were assessed at baseline (T1), mid-point (T2) and on the last day of treatment (T3) using the Hospital Anxiety and Depression Scale and the Ways of Coping. A linear mixed modeling approach was used. The study included 200 patients (gender: 70% women; diagnosis: 30% breast, 22% hematological, 18% gastrointestinal; disease stage: 60% advanced). Older patients who used an emotion-focused coping strategy had a greater decrease in anxiety at T3 compared to those that used problem-focused coping (p = .002).
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Affiliation(s)
| | - Errol J Philip
- Medical School, University of California San Francisco, San Francisco, California, USA
| | | | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - David Lee
- University of New Mexico, Albuquerque, New Mexico, USA
| | - Karen Lynn Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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Bergerot CD, Wang AWT, Serpentini S, Borgese C, Kim Y. Healthcare providers' perceptions about the unmet needs of their patients with cancer across healthcare systems: results of the International Psycho-Oncology Society survivorship survey. Support Care Cancer 2023; 31:538. [PMID: 37632538 DOI: 10.1007/s00520-023-07998-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/15/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE Systematic understanding of patients' unmet needs is essential for providing effective supportive care. This study sought to compare the unmet needs of patients with cancer identified by health care providers (HCPs) among four major healthcare systems. METHODS HCPs (n = 247) participated in the International Psycho-Oncology Society (IPOS) Survivorship Online Survey, evaluating their patients' unmet needs. The country of HCPs was grouped into four major healthcare systems: Beveridge model, Bismarck model, National Health Insurance model, and out-of-pocket model. RESULTS Most HCPs were from countries with the Bismarck model. Substantial levels (> 50%) of unmet needs in all domains are reported across the four healthcare systems. Pediatric patients/survivors living in countries under out-of-pocket healthcare model were evaluated to have less unmet needs for managing decline in physical or cognitive functioning and insomnia/sleep difficulty/fatigue, than those in countries under Beveridge, Bismarck, and National Health Insurance models. Moreover, middle-aged patients/survivors under Beveridge and National Health Insurance models were likely to have greater unmet needs for dealing with cancer-related financial concerns than those under Bismarck model. CONCLUSION This study provides valuable insights into the unmet needs of patients with cancer in different healthcare systems, highlighting the significance of targeted interventions to address the unique needs of patients across diverse healthcare systems. Further investigation is warranted to identify the system factors associated with patients' unmet needs, enabling the development of effective healthcare policies and interventions to comprehensively address the multifaceted needs of patients with cancer.
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Affiliation(s)
- Cristiane Decat Bergerot
- Department of Supportive Care, Oncoclinicas, SMH/N Quadra 02, Ed de Clínicas, 12º Andar, Brasilia, DF, Brazil.
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Topcu A, Yurtsever I, Isleyen ZS, Besiroglu M, Yasin AI, Topcu ZA, Shbair AT, Toluk O, Simsek M, Seker M, Turk HM. The correlation between skeletal muscle index and anxiety in patients with lung cancer on the first day of chemotherapy. Future Oncol 2023. [PMID: 37367530 DOI: 10.2217/fon-2022-1200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
Aim: To evaluate the relationship between anxiety and skeletal muscle index (SMI) levels in lung cancer patients on the first day of chemotherapy. Materials & methods: This cross-sectional study included 108 patients. We analyzed patient characteristics, SMI levels, pain status and predicted anxiety factors. Results: Anxiety was detected in 61% of patients. SMI levels were significantly lower in the high anxiety group than the low anxiety group (p < 0.001). A significant correlation was observed between anxiety and SMI levels (r = -0.292; p = 0.002). Anxiety levels were significantly correlated with trait anxiety (r = 0.618; p < 0.001) and visual analog scale-pain (r = 0.364; p < 0.001). SMI (odds ratio: 0.94), trait anxiety (odds ratio: 1.12) and visual analog scale pain (odds ratio: 1.28) were independent risk factors for anxiety after adjusting for sex, stage and Eastern Cooperative Oncology Group performance status. Conclusion: Our study highlighted that higher anxiety scores were significantly correlated with lower SMI levels. We found that SMI, pain and trait anxiety were independent risk factors for anxiety.
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Affiliation(s)
- Atakan Topcu
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Ismail Yurtsever
- Department of Radiology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | | | - Mehmet Besiroglu
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Ayse Irem Yasin
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Zeynep Alaca Topcu
- Department of Medical Oncology, Istanbul Medeniyet University, Istanbul, 34722, Turkey
| | - Abdallah Tm Shbair
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Ozlem Toluk
- Department of Biostatistics, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Melih Simsek
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Mesut Seker
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
| | - Haci Mehmet Turk
- Department of Medical Oncology, Bezmialem Vakif University, Istanbul, 34093, Turkey
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Podina IR, Bucur AM, Todea D, Fodor L, Luca A, Dinu LP, Boian RF. Mental health at different stages of cancer survival: a natural language processing study of Reddit posts. Front Psychol 2023; 14:1150227. [PMID: 37425170 PMCID: PMC10326387 DOI: 10.3389/fpsyg.2023.1150227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/07/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction The purpose of this study was to use text-based social media content analysis from cancer-specific subreddits to evaluate depression and anxiety-loaded content. Natural language processing, automatic, and lexicon-based methods were employed to perform sentiment analysis and identify depression and anxiety-loaded content. Methods Data was collected from 187 Reddit users who had received a cancer diagnosis, were currently undergoing treatment, or had completed treatment. Participants were split according to survivorship status into short-term, transition, and long-term cancer survivors. A total of 72524 posts were analyzed across the three cancer survivor groups. Results The results showed that short-term cancer survivors had significantly more depression-loaded posts and more anxiety-loaded words than long-term survivors, with no significant differences relative to the transition period. The topic analysis showed that long-term survivors, more than other stages of survivorship, have resources to share their experiences with suicidal ideation and mental health issues while providing support to their survivor community. Discussion The results indicate that Reddit texts seem to be an indicator of when the stressor is active and mental health issues are triggered. This sets the stage for Reddit to become a platform for screening and first-hand intervention delivery. Special attention should be dedicated to short-term survivors.
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Affiliation(s)
- Ioana R. Podina
- Laboratory of Cognitive Clinical Sciences, University of Bucharest, Bucharest, Romania
- Department of Applied Psychology, University of Bucharest, Bucharest, Romania
| | - Ana-Maria Bucur
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, Romania
| | - Diana Todea
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, Romania
| | - Liviu Fodor
- International Institute for The Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
- Evidence Based Psychological Assessment and Interventions Doctoral School, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Andreea Luca
- Interdisciplinary School of Doctoral Studies, University of Bucharest, Bucharest, Romania
| | - Liviu P. Dinu
- Human Language Technology Research Center, University of Bucharest, Bucharest, Romania
- Faculty of Mathematics and Computer Science, University of Bucharest, Bucharest, Romania
| | - Rareș F. Boian
- Department of Computer Science, Babeş-Bolyai University, Cluj-Napoca, Romania
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Rodriguez-Gonzalez A, Hernández R, Cruz-Castellanos P, Fernández-Montes A, Castillo-Trujillo O, Muñoz MM, Cano-Cano JM, Corral MJ, Esteban E, Jiménez-Fonseca P, Calderon C. Using the emotional functioning in clinical practice to detect psychological distress in patients with advanced thoracic and colorectal cancer. Health Qual Life Outcomes 2023; 21:15. [PMID: 36800957 PMCID: PMC9936733 DOI: 10.1186/s12955-023-02099-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
PURPOSE Patients with advanced cancer suffer significant decline of their psychological state. A rapid and reliable evaluation of this state is essential to detect and treat it and improve quality of life. The aim was to probe the usefulness of the emotional function (EF) subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EF-EORTC-QLQ-C30) to assess psychological distress in cancer patients. METHODS This is a multicenter, prospective, observational study involving 15 Spanish hospitals. Patients diagnosed with unresectable advanced thoracic or colorectal cancer were included. Participants completed the Brief Symptom Inventory 18 (BSI-18), the current the gold standard, and the EF-EORTC-QLQ-C30 to assess their psychological distress prior to initiating systemic antineoplastic treatment. Accuracy, sensitivity, positive predictive value (PPV), specificity, and negative predictive value (NPV) were calculated. RESULTS The sample comprised 639 patients: 283 with advanced thoracic cancer and 356 with advanced colorectal cancer. According to the BSI scale, 74% and 66% displayed psychological distress with an EF-EORTC-QLQ-C30 accuracy of 79% and 76% in detecting psychological distress in individuals with advanced thoracic and colorectal cancer, respectively. Sensitivity was 79 and 75% and specificity was 79 and 77% with a PPV of 92 and 86% and a NPV of 56 and 61% (scale cut-off point, 75) for patients with advanced thoracic and colorectal cancer, respectively. The mean AUC for thoracic cancer was 0.84 and, for colorectal cancer, it was 0.85. CONCLUSION This study reveals that the EF-EORTC-QLQ-C30 subscale is a simple and effective tool for detecting psychological distress in people with advanced cancer.
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Affiliation(s)
- Adán Rodriguez-Gonzalez
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Raquel Hernández
- grid.411220.40000 0000 9826 9219Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Patricia Cruz-Castellanos
- grid.81821.320000 0000 8970 9163Department of Oncology Medical. Hospital, Universitario La Paz, Madrid, Spain
| | - Ana Fernández-Montes
- grid.418883.e0000 0000 9242 242XDepartment of Medical Oncology, Complejo Hospitalario Universitario de Ourense – CHUO, Orense, Spain
| | - Oscar Castillo-Trujillo
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - María M. Muñoz
- Department of Medical Oncology, Hospital General Virgen de La Luz, Cuenca, Spain
| | - Juana M. Cano-Cano
- grid.411096.bDepartment of Medical Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - María J. Corral
- grid.5841.80000 0004 1937 0247Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Emilio Esteban
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Paula Jiménez-Fonseca
- grid.411052.30000 0001 2176 9028Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.
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Bergerot CD, Wang AWT, Csaba DL, Bahcivan O, Kim Y. Cancer Patients' Unmet Needs in Three Low- to Middle- Income Countries: Perspectives from Health Care Providers. Cancer Invest 2023; 41:1-8. [PMID: 36621937 PMCID: PMC10349901 DOI: 10.1080/07357907.2023.2167210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/14/2022] [Accepted: 01/08/2023] [Indexed: 01/10/2023]
Abstract
We sought to determine differences by low- and middle- income countries (Brazil, Romania, and Turkiye) on the degree to which health care providers (HCPs) note unmet needs among patients with cancer (N = 741). HCPs endorsed sexuality/intimacy and financial concerns as the most common. Investigating age differences in unmet needs between Brazil and Turkiye, were that should be targeted by. Results revealed that unmet needs to manage emotional distress were higher among older patients in Turkiye, whereas unmet needs to manage insomnia/fatigue were higher among pediatric patients in Brazil. Findings may guide the development of programs to address unmet needs among patients.
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Affiliation(s)
| | | | - Dégi L. Csaba
- Faculty of Sociology and Social Work, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Ozan Bahcivan
- Psiko-Onkologlar Dernegi (Turkish Psycho-Oncological Association), Izmir, Turkiye
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Quality of Life in Women With Breast Cancer Receiving Chemotherapy and the Moderating Role of Cortisol. Cancer Nurs 2022; 45:E856-E864. [PMID: 35324503 DOI: 10.1097/ncc.0000000000001081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Quality of life (QoL) is severely affected by breast cancer (BC) and its treatment, particularly chemotherapy treatment. Psychological morbidity, illness perceptions, and self-efficacy for coping are important variables that impact QoL during the treatment of BC. The impact of cortisol on QoL has been poorly studied. OBJECTIVE The aim of this study was to identify the contributing variables to QoL in women with BC receiving adjuvant chemotherapy, as well as the moderating role of cortisol in the relationship between treatment adverse effects and QoL. METHODS This cross-sectional study included 112 women with BC undergoing chemotherapy who answered the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire, the Supplementary Questionnaire Breast Cancer Module, the Illness Perception Questionnaire, the Cancer Behavior Inventory-Brief Version, and the Hospital Anxiety and Depression Scale. In addition, salivary cortisol concentrations were also assessed. RESULTS The strongest contributor to lower QoL was treatment adverse effects. The illness perception and the cancer stage also contributed to a lower QoL. Nadir cortisol moderated the relationship between adverse effects and QoL. CONCLUSION Breast cancer chemotherapy and illness perceptions, even at the beginning of treatment, showed a great impact on QoL. IMPLICATIONS FOR PRACTICE It is important during chemotherapy to assess women's illness perceptions, as well as their stress levels to help women cope with the stress associated with treatment adverse effects. Monitoring cortisol is important as cortisol moderated the relationship between adverse effects and QoL. For those women struggling with stress, a reference to a mental health provider is warranted.
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Responsiveness and Minimally Important Differences of the Traditional Chinese Version of PROMIS Paediatric-25 Profile in Chinese Children With Cancer. REHABILITATION ONCOLOGY 2022. [DOI: 10.1097/01.reo.0000000000000307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Oppegaard K, Shin J, Harris CS, Schimmel A, Paul SM, Cooper BA, Levine JD, Conley YP, Hammer M, Dunn L, Kober KM, Miaskowski C. Higher stress and symptom severity are associated with worse depressive symptom profiles in patients receiving chemotherapy. Eur J Oncol Nurs 2022; 58:102031. [PMID: 35397404 PMCID: PMC10788966 DOI: 10.1016/j.ejon.2021.102031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/02/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE In a sample of oncology patients, identify subgroups of patients with distinct depressive symptom profiles and evaluate for differences in demographic and clinical characteristics, levels of stress and resilience, and the severity of common co-occurring symptoms. METHODS Patients (n = 1327) had a diagnosis of breast, gastrointestinal, gynecological, or lung cancer; had received chemotherapy within the preceding four weeks; and were scheduled to receive at least two additional cycles of chemotherapy. Demographic and clinical characteristics, stress, resilience, and co-occurring symptoms were evaluated at enrollment. Depressive symptoms were evaluated using the Center for Epidemiological Studies-Depression (CES-D) scale a total of six times over two cycles of chemotherapy. Latent profile analysis (LPA) was used to identify subgroups of patients (i.e., latent classes) with distinct depressive symptom profiles using the six CES-D scores. RESULTS Based on the findings from the LPA, 47.3% of the patients were classified as "None"; 33.6% as "Subsyndromal"; 13.8% as "Moderate"; and 5.3% as "High". Compared to None class, patients in the Subsyndromal, Moderate, and High classes had a lower functional status, a higher comorbidity burden, and a self-reported diagnosis of depression or back pain. Those patients with higher levels of depressive symptoms reported higher levels of stress, lower levels of resilience, and increased severity of co-occurring symptoms. CONCLUSIONS Inter-individual variability in depressive symptoms was associated with demographic and clinical characteristics, multiple types of stress and levels of resilience, as well as with the increased severity of multiple co-occurring symptoms. The risk factors associated with worse depressive symptom profiles can assist clinicians to identify high risk patients and initiate more timely supportive care interventions.
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Affiliation(s)
- Kate Oppegaard
- School of Nursing, University of California, San Francisco, CA, USA
| | - Joosun Shin
- School of Nursing, University of California, San Francisco, CA, USA
| | - Carolyn S Harris
- School of Nursing, University of California, San Francisco, CA, USA
| | | | - Steven M Paul
- School of Nursing, University of California, San Francisco, CA, USA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, CA, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, CA, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Laura Dunn
- School of Medicine, Stanford University, Stanford, CA, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, CA, USA
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, CA, USA; School of Medicine, University of California, San Francisco, CA, USA.
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Baudry AS, Yakimova S, Congard A, Untas A, Guiu S, Lefeuvre-Plesse C, Loustalot C, Guillemet C, Segura-Djezzar C, Savoye AM, Coussy F, Frenel JS, Vanlemmens L, Christophe V. Adjustment of young women with breast cancer after chemotherapy: A mediation model of emotional competence via emotional distress. Psychooncology 2022; 31:848-855. [PMID: 34989072 DOI: 10.1002/pon.5876] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/15/2021] [Accepted: 12/27/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Emotional competence (EC) is considered a substantial resource in the adjustment of cancer patients, especially via its effect on anxiety and depression symptoms. This research aimed at assessing the impact of intrapersonal EC in young women (≤45 years) with breast cancer (YWBC) on their specific quality of life (i.e. subjective experience related to daily difficulties and perceived repercussions of the disease and treatments) related to chemotherapy, via anxiety and depression symptoms. METHODS Two hundred fifty YWBC from 24 French centers completed a self-reported questionnaire after diagnosis (T1) and after the chemotherapy phase (T2), comprising the Young Women Breast Cancer Inventory, the Profile of EC and the Hospital Anxiety and Depression Scale. The indirect effect of EC (T1) on subjective experience (T2) via anxiety and depression symptoms (T2) was tested using regressions and the Macro PROCESS. RESULTS Emotional competence predicted fewer anxiety and depression symptoms at T1 and T2, and a better subjective experience at T2 via fewer anxiety and depression symptoms. Depression symptoms appeared to be a stronger mediator than anxiety symptoms on four dimensions (Support from close relatives, feeling of couple cohesion, body image and sexuality, management of children and everyday life), whereas anxiety symptoms appeared to be a stronger mediator on two dimensions (negative affectivity and apprehension about the future, deterioration of relationships). CONCLUSIONS These results support the importance of developing psycho-affective interventions to reinforce the EC of YWBC during chemotherapy in order to facilitate the cognitive and emotional processes necessary for a better adjustment and subjective experience.
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Affiliation(s)
- Anne-Sophie Baudry
- Pôle Cancérologie et Spécialités Médicales - Centre Hospitalier de Valenciennes, Valenciennes, France.,Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France.,Human and Social Sciences Department - Centre Léon Bérard, Lyon, France
| | - Sonya Yakimova
- Aix-Marseille Université, Centre de Recherche PsyCLÉ, EA 3273, Marseille, France
| | - Anne Congard
- Nantes Université, Laboratoire de Psychologie des Pays de la Loire, LPPL, EA 4638, Nantes, France
| | - Aurélie Untas
- Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, Boulogne-Billancourt, France
| | - Séverine Guiu
- Department of Medical Oncology, ICM, Montpellier, France.,IRCM, INSERM, Université Montpellier, ICM, Montpellier, France
| | | | | | | | | | | | - Florence Coussy
- Département d'oncologie Médicale, Institut Curie Hôpital René Huguenin, Saint-Cloud, France
| | | | | | - Véronique Christophe
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France.,Human and Social Sciences Department - Centre Léon Bérard, Lyon, France
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15
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Mendonça AB, Pereira ER, Magnago C, da Silva PG, Morett Leão DC, Costa Rosa Andrade Silva RM, Meira KC. Distress and Spiritual Well-Being in Brazilian Patients Initiating Chemotherapy during the COVID-19 Pandemic-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13200. [PMID: 34948809 PMCID: PMC8702099 DOI: 10.3390/ijerph182413200] [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] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/29/2021] [Accepted: 12/06/2021] [Indexed: 12/27/2022]
Abstract
Social distancing and the priority given to COVID-19 patients in health services, which caused postponement of appointments and cancer treatment, may have triggered unprecedented levels of distress in cancer patients. The aim of this study was to analyze the prevalence of distress and the levels of spiritual well-being of people initiating chemotherapy during the COVID-19 pandemic, identifying the factors associated with distress, and determining if there is a relationship between distress and spiritual well-being. A cross-sectional study was conducted with 91 Brazilians. Data were collected by applying the Spiritual Well-Being Scale (SWBS) and the Distress Thermometer and Problem List for Patients. The prevalence of distress was 59.5%, and the average score of spiritual well-being was 106.54 (±9.06). Emotional issues were the most reported by patients with distress. The Poisson regression showed that male sex (PR = 0.588; 95% CI 0.392-0.881), age (PR = 0.985; 95% CI 0.973-0.996), and spiritual well-being score were predictors of distress (PR = 0.971; 95% CI 0.946-0.996). These findings indicate that distress relief involves implementation of public health programs capable of integrating spiritual interventions into cancer care.
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Affiliation(s)
- Angelo Braga Mendonça
- Nursing School, Fluminense Federal University, Niterói 24020-091, Brazil; (E.R.P.); (D.C.M.L.); (R.M.C.R.A.S.)
| | - Eliane Ramos Pereira
- Nursing School, Fluminense Federal University, Niterói 24020-091, Brazil; (E.R.P.); (D.C.M.L.); (R.M.C.R.A.S.)
| | - Carinne Magnago
- School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil;
| | - Pedro Gilson da Silva
- School of Health, Federal University of Rio Grande do Norte, Natal 59075-000, Brazil; (P.G.d.S.); (K.C.M.)
| | - Diva Cristina Morett Leão
- Nursing School, Fluminense Federal University, Niterói 24020-091, Brazil; (E.R.P.); (D.C.M.L.); (R.M.C.R.A.S.)
| | | | - Karina Cardoso Meira
- School of Health, Federal University of Rio Grande do Norte, Natal 59075-000, Brazil; (P.G.d.S.); (K.C.M.)
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Oppegaard K, Harris CS, Shin J, Paul SM, Cooper BA, Levine JD, Conley YP, Hammer M, Cartwright F, Wright F, Dunn L, Kober KM, Miaskowski C. Anxiety profiles are associated with stress, resilience and symptom severity in outpatients receiving chemotherapy. Support Care Cancer 2021; 29:7825-7836. [PMID: 34176016 PMCID: PMC10788963 DOI: 10.1007/s00520-021-06372-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/17/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The purposes of this study, in a sample of oncology patients (n = 1326) receiving chemotherapy, were to identify subgroups of patients with distinct anxiety profiles and evaluate for differences in demographic and clinical characteristics, stress and resilience measures, and severity of co-occurring symptoms (i.e., depression, sleep disturbance, attentional function, fatigue, pain). METHODS Patients completed self-report questionnaires a total of six times over two cycles of chemotherapy. Severity of state anxiety was evaluated using the Spielberger State Anxiety Inventory and resilience was assessed using the Connor-Davidson Resilience Scale. Symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, General Sleep Disturbance Scale, Lee Fatigue Scale, Attentional Function Index and Brief Pain Inventory. RESULTS Based on the findings from the latent profile analysis that utilized the six assessments of state anxiety, 47.7% of the patients were classified as "Low," 28.3% as "Moderate," 19.5% as "High," and 4.5.% as "Very High." Anxiety levels remained relatively stable across the six timepoints. Compared to the Low class, membership in the Moderate, High, and Very High classes was associated with a number of characteristics (e.g., younger age, female gender, lower functional status, more comorbidities). Those patients with higher levels of anxiety reported higher levels of stress, lower levels of resilience, and increased severity of co-occurring symptoms. CONCLUSION Our findings suggest that a substantial number of oncology patients may warrant referral to psychological services. Clinicians need to perform systematic assessments of anxiety, stress, and common symptoms and initiate appropriate interventions to enhance resilience and coping.
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Affiliation(s)
- Kate Oppegaard
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Carolyn S Harris
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Joosun Shin
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Steven M Paul
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Bruce A Cooper
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Jon D Levine
- School of Medicine, University of California, 675 Nelson Rising Lane, San Francisco, CA, 94158, USA
- School of Dentistry, University of California, 513 Parnassus Ave, MSB, San Francisco, CA, 94117, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, 440 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA
| | - Marilyn Hammer
- Dana-Farber Cancer Institute, 450 Brookline Avenue, LW523, Boston, MA, 02215, USA
| | - Frances Cartwright
- Department of Nursing, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1068, New York, NY, 10029, USA
| | - Fay Wright
- Rory Meyers College of Nursing, New York University, 433 1st Avenue, Room 740, New York, NY, 10010, USA
| | - Laura Dunn
- School of Medicine, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA
| | - Kord M Kober
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Christine Miaskowski
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA.
- School of Medicine, University of California, 675 Nelson Rising Lane, San Francisco, CA, 94158, USA.
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Effects of a WeChat-based multimodal psychoeducational intervention on psychological well-being and quality of life in acute leukaemia patients in China: a randomised controlled trial. J Cancer Surviv 2021; 16:1461-1477. [PMID: 34705196 DOI: 10.1007/s11764-021-01124-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The treatment and side effects of chemotherapy for acute leukaemia (AL) may cause both physical and psychological symptoms in patients. This study evaluated the effects of a WeChat-based multimodal psychoeducational intervention (ICARE programme) on fatigue, distress, anxiety, depression, and quality of life (QoL) among adult AL patients. METHODS In total, 72 participants were randomly assigned either to an intervention or control group (n = 36), respectively, from two large tertiary hospitals in Fuzhou, China (from April to December 2019). Data were collected at baseline, post-intervention, and after a 4-week follow-up using the Brief Fatigue Inventory, Distress Thermometer, Hospital Anxiety and Depression Scale, and Functional Assessment of Cancer Therapy-leukaemia. Descriptive statistics was used to summarise the sociodemographic and clinical characteristics of the participants and a linear mixed model was used to analyse the score changes. RESULTS Between the two groups, there were statistically significant improvements in fatigue, distress, anxiety, depression, physical well-being, social/family well-being, emotional well-being, functional well-being (all p < 0.001), and leukaemia-specific subscale (p = 0.001). The difference over time was significant for leukaemia-specific subscale and fatigue, both (p < 0.001), anxiety (p = 0.001), and social/family well-being (p = 0.005). The interaction effects were significant for fatigue, distress, anxiety, physical well-being, social/family well-being, and emotional well-being, all (p < 0.001), depression (p = 0.019), leukaemia-specific subscale (p = 0.008), and total QoL score (p = 0.004). CONCLUSION WeChat-based multimodal psychoeducational intervention demonstrated a significant effect in reducing fatigue, distress, anxiety, depression, and QoL in AL patients. This ICARE programme contributed to continuing care to support AL patients. IMPLICATIONS FOR CANCER SURVIVORS The ICARE programme can improve the mental health and QoL of AL patients. The application of WeChat-based psychoeducational interventions have significant potential to benefit cancer patients due to their reach and can be an added value to routine care.
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18
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Symptom status, body perception, and risk of anxiety and depression in breast cancer patients receiving paclitaxel: a prospective longitudinal study. Support Care Cancer 2021; 30:2069-2079. [PMID: 34657181 PMCID: PMC8520499 DOI: 10.1007/s00520-021-06619-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/08/2021] [Indexed: 11/04/2022]
Abstract
Background Paclitaxel regimen which is widely used in clinical treatment causes many negative physical and psychological consequences on women with breast cancer (BC). This longitudinal study firstly aimed to investigate symptom status, body perception changes, and the risk of anxiety and depression in BC patients receiving during paclitaxel regimen. Materials and methods This descriptive and prospective study was conducted with 84 BC patients receiving paclitaxel regimen. “Chemotherapy Symptom Assessment Scale (C-SAS),” “Body Perception Scale (BPS),” and “Hospital Anxiety and Depression Scale (HADS)” were applied at five time points (T1, before the first Paclitaxel infusion; T2, at the end of first cycle; T3, at the end of fourth cycle; T4, at the end of eighth cycle; T5, at the end of twelfth cycle). Data was analyzed using descriptive statistics, Cochrane Q, and linear mix model regression analysis. Results The frequency of needling and numbness in hands and feet, pain, and skin or nail changes significantly increased in the subsequent assessment points (T2, T3, T4, and T5) compared to the initial assessment (T1) (p < 0.05). The mean scores of BPS significantly decreased at T2, T4, and T5 compared to T1 (F = 8.152, p < 0.001). The mean scores of the anxiety subscale of the HADS scale decreased at the T3, T4, and T5 compared to T1 (F = 6.865, p < 0.001), and the mean scores of the depression subscale significantly increased at the T5 compared to T1 (F = 3.708, p = 0.006). Conclusions The oncology nurse should comprehensively evaluate the patients who scheduled to receive paclitaxel treatment, and provide counseling to the patients during these specific weeks. Better management of the symptoms that increase with the paclitaxel regimen with repeated interviews under the supervision of the nurse will also prevent the deterioration of body perception. In addition, since the risk of depression increases over time in patients receiving paclitaxel, nurses should periodically screen the risk of depression, and timely consult the patients for the appropriate support.
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19
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Constructing a Predictive Model of Depression in Chemotherapy Patients with Non-Hodgkin's Lymphoma to Improve Medical Staffs' Psychiatric Care. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9201235. [PMID: 34337060 PMCID: PMC8313321 DOI: 10.1155/2021/9201235] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/10/2021] [Accepted: 06/29/2021] [Indexed: 12/23/2022]
Abstract
Objectives Depression is highly prevalent in non-Hodgkin's lymphoma (NHL) patients undergoing chemotherapy. The social stress associated with malignancy induces neurovascular pathology promoting clinical levels of depressive symptomatology. The purpose of this study was to establish an effective depressive symptomatology risk prediction model to those patients. Methods This study included 238 NHL patients receiving chemotherapy, 80 of whom developed depressive symptomatology. Different types of variables (sociodemographic, medical, and psychosocial) were entered in the models. Three prediction models (support vector machine-recursive feature elimination model, random forest model, and nomogram prediction model based on logistic regression analysis) were compared in order to select the one with the best predictive power. The selected model was then evaluated using calibration plots, ROC curves, and C-index. The clinical utility of the nomogram was assessed by the decision curve analysis (DCA). Results The nomogram prediction has the most efficient predictive ability when 10 predictors are included (AUC = 0.938). A nomogram prediction model was constructed based on the logistic regression analysis with the best predictive accuracy. Sex, age, medical insurance, marital status, education level, per capita monthly household income, pathological stage, SSRS, PSQI, and QLQ-C30 were included in the nomogram. The C-index was 0.944, the AUC value was 0.972, and the calibration curve also showed the good predictive ability of the nomogram. The DCA curve suggested that the nomogram had a strong clinical utility. Conclusions We constructed a depressive symptomatology risk prediction model for NHL chemotherapy patients with good predictive power and clinical utility.
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Nakamura ZM, Deal AM, Nyrop KA, Chen YT, Quillen LJ, Brenizer T, Muss HB. Serial Assessment of Depression and Anxiety by Patients and Providers in Women Receiving Chemotherapy for Early Breast Cancer. Oncologist 2020; 26:147-156. [PMID: 32946156 DOI: 10.1002/onco.13528] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 09/04/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Depression and anxiety are common in patients with breast cancer and associated with worse quality of life and treatment outcomes. Yet, these symptoms are often underrecognized and undermanaged in oncology practice. The objective of this study was to describe depression and anxiety severity and associated patient factors during adjuvant or neoadjuvant chemotherapy in women with early breast cancer using repeated single-item reports. MATERIALS AND METHODS Depression and anxiety were measured from consecutive patients and their clinicians during chemotherapy infusion visits. Associations between psychiatric symptoms and patient characteristics were assessed using Fisher's exact tests for categorical variables and t tests for continuous variables. The joint relationship of covariates significant in unadjusted analyses was evaluated using log-binomial regression. Cohen's kappa was used to assess agreement between patient- and clinician-reported symptoms. RESULTS In a sample of 256 patients, 26% reported at least moderately severe depression, and 41% reported at least moderately severe anxiety during chemotherapy, representing a near doubling in the prevalence of these symptoms compared with before chemotherapy. Patient-provider agreement was fair (depression: κ = 0.31; anxiety: κ = 0.28). More severe psychiatric symptoms were associated with being unmarried, having worse function, endorsing social activity limitations, using psychotropic medications, and having a mental health provider. In multivariable analysis, social activity limitations were associated with more severe depression (relative risk [RR], 2.17; 95% confidence interval [CI], 1.36-3.45) and anxiety (RR, 1.48; 95% CI, 1.05-2.09). CONCLUSION Oncologists frequently underestimate patients' depression and anxiety and should consider incorporating patient-reported outcomes to enhance monitoring of mental health symptoms. IMPLICATIONS FOR PRACTICE In this sample of 256 patients with breast cancer, depression and anxiety, measured using single-item toxicity reports completed by patients and providers, were very common during adjuvant or neoadjuvant chemotherapy. Patient-reported depression and anxiety of at least moderate severity were associated with multiple objective indicators of psychiatric need. Unfortunately, providers underrecognized the severity of their patients' mental health symptoms. The use of patient-reported, single-item toxicity reports can be incorporated into routine oncology practice and provide clinically meaningful information regarding patients' psychological health.
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Affiliation(s)
- Zev M Nakamura
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kirsten A Nyrop
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yi Tang Chen
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Laura J Quillen
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Tucker Brenizer
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hyman B Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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van den Brekel L, van der Baan FH, Zweers D, Koldenhof JJ, Vos JBH, de Graeff A, Witteveen PO, Teunissen SCCM. Predicting Anxiety in Hospitalized Cancer Patients. J Pain Symptom Manage 2020; 60:522-530.e1. [PMID: 32305577 DOI: 10.1016/j.jpainsymman.2020.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/04/2020] [Accepted: 04/07/2020] [Indexed: 12/23/2022]
Abstract
CONTEXT Anxiety in patients with cancer is highly prevalent; yet it remains underestimated and inadequately assessed. Little is known about predictors for anxiety in hospitalized patients with cancer. Insight in predictors should improve recognition and enable a targeted approach. OBJECTIVES To determine the prevalence of anxiety and predictors for anxiety in hospitalized patients with cancer at different stages of disease. METHODS A cross-sectional analysis of patients with cancer admitted to the Utrecht University Medical Center in 2015-2018 was conducted. The Utrecht Symptom Diary, an adapted Dutch version of the Edmonton Symptom Assessment System, was used to assess symptom burden on a numeric rating scale (0 = no symptom and 10 = worst possible symptom). Scores ≥4 were considered clinically relevant. All patients completed the Utrecht Symptom Diary as part of routine care. The first questionnaire after admission was selected. Using multivariable linear regression, the predictive value of potential predictors on anxiety was analyzed. RESULTS In total, 2144 patients were included, of which 22% reported clinically relevant anxiety. The prevalence of anxiety was highest (36%) in patients receiving symptom-directed palliation only. In the total group, female gender, younger age, depressed mood, sleeping problems, dyspnea, and cancer of the head and neck were predictive of anxiety. Throughout all stages of disease, depressed mood was consistently the strongest predictor. CONCLUSION We found a high prevalence of anxiety in hospitalized patients with cancer. It is recommended to explore anxiety in hospitalized patients with cancer, in particular when they experience depressed mood. Structural use of a symptom diary during hospitalization facilitates the recognition of anxiety and concurrent symptoms.
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Affiliation(s)
- Lieke van den Brekel
- Department of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands.
| | - Frederieke H van der Baan
- Department of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands
| | - Danielle Zweers
- Department of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands; Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - José J Koldenhof
- Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - J Bernard H Vos
- Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Alexander de Graeff
- Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Petronella O Witteveen
- Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Saskia C C M Teunissen
- Department of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands; Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
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22
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Jewett PI, Teoh D, Petzel S, Lee H, Messelt A, Kendall J, Hatsukami D, Everson-Rose SA, Blaes AH, Vogel RI. Cancer-Related Distress: Revisiting the Utility of the National Comprehensive Cancer Network Distress Thermometer Problem List in Women With Gynecologic Cancers. JCO Oncol Pract 2020; 16:e649-e659. [PMID: 32091952 DOI: 10.1200/jop.19.00471] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
PURPOSE The Distress Thermometer (DT) includes a measure of cancer-related distress and a list of self-reported problems. This study evaluated the utility of the DT problem list in identifying concerns most associated with distress and poorer quality of life (QOL) in survivors of gynecologic cancer. METHODS Demographic, clinical, psychosocial functioning, and DT data were described among 355 women participating in a gynecologic cancer cohort. Problems from the DT list were ranked by prevalence, distress, and QOL. Logistic regression models explored factors associated with problems that were common (≥ 25% prevalence) and associated with distress and QOL. RESULTS The average age of participants was 59.9 years (standard deviation [SD], 10.8 years). Most participants were non-Hispanic white (97%) and had ovarian (44%) or uterine (42%) cancer. The mean DT score was 2.7 (SD, 2.7); participants reported a mean of 7.3 problems (SD, 5.9 problems). The most common problems were fatigue (53.6%), worry (49.9%), and tingling (46.3%); least common problems were childcare (2.1%), fevers (2.1%), and substance abuse (1.1%). Report of some common problems, including tingling, sleep, memory, skin issues, and appearance, was not associated with large differences in distress or QOL. In contrast, some rarer problems such as childcare, treatment decisions, eating, housing, nausea, and bathing/dressing were associated with worse distress or QOL. Younger age, lower income, and chemotherapy were risk factors across common problems that were associated with worse distress or QOL (fatigue, nervousness, sadness, fears, and pain). CONCLUSION The DT problem list did not easily identify concerns most associated with distress and low QOL in patients with gynecologic cancer. Adaptations that enable patients to report their most distressing concerns would enhance clinical utility of this commonly used tool.
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Affiliation(s)
- Patricia I Jewett
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN.,Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, MN
| | - Deanna Teoh
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Sue Petzel
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Heewon Lee
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | - Audrey Messelt
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | | | | | - Susan A Everson-Rose
- Department of Medicine, Division of General Internal Medicine, and Program in Health Disparities Research, University of Minnesota, Minneapolis, MN
| | - Anne H Blaes
- Department of Medicine, Division of Hematology and Oncology, University of Minnesota, Minneapolis, MN
| | - Rachel I Vogel
- Department of Obstetrics, Gynecology, and Women's Health, Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
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23
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Ajaj R, Cáceres JOH, Berlin A, Wallis CJD, Chandrasekar T, Klaassen Z, Ahmad AE, Leao R, Finelli A, Fleshner N, Goldberg H. Gender-based psychological and physical distress differences in patients diagnosed with non-metastatic renal cell carcinoma. World J Urol 2020; 38:2547-2554. [PMID: 31893313 DOI: 10.1007/s00345-019-03057-2] [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] [Received: 09/07/2019] [Accepted: 12/12/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To analyze gender-based differences in distress symptoms in patients with non-metastatic renal cell carcinoma (RCC) at different stages of disease. METHODS The Edmonton Symptom Assessment System-revised (ESAS-r) questionnaire includes a physical (PHSDSS) and a psychological distress sub-score (PDSS). The ESAS-r was used to measure psychological and physical distress symptoms in localized RCC patients in a major cancer referral center between 2014 and 2017 at four predefined time points: (a) diagnosis, (b) biopsy, (c) surgery, and (d) last follow-up. Results were gender stratified, and multivariable linear regression models were used to determine associations with increased sub-scores. RESULTS Overall, 495 patients were included with 37.2% females. No significant gender differences were seen in mean age, relevant clinical parameters, and treatment. PDSS was significantly higher in females after diagnosis (8.5 vs. 5.1, p = 0.018), biopsy (8.9 vs. 4.1, p = 0.003), and surgery (6.5 vs. 4.4, p = 0.007), while being similar at the last follow-up. The multivariable model demonstrated a statistically significant association of female gender with higher PDSS after diagnosis (B = 3.755, 95% CI 0.761-6.750), biopsy (B = 6.076, 95% CI 2.701-9.451), and surgery (B = 1.974, 95% CI 0.406-3.542). PHSDSS was significantly higher in females after biopsy (10.0 vs. 5.7, p = 0.028) and surgery (8.6 vs. 6.1, p = 0.022). In the multivariable model, female gender conferred a higher PHSDSS only after surgery (B = 2.384, 95% CI 0.208-4.560). CONCLUSIONS Gender-associated psychological distress differences exist in non-metastatic RCC patients throughout treatment, while dissipating at last follow-up. Emphasis should be placed on screening for distress symptoms and providing psychological support continuously, particularly for female patients.
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Affiliation(s)
- Rami Ajaj
- Urology Division, Surgical Oncology Department, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Jaime Omar Herrera Cáceres
- Urology Division, Surgical Oncology Department, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Alejandro Berlin
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network; Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.,Techna Institute, University Health Network, Toronto, ON, Canada
| | - Christopher J D Wallis
- Urology Division, Surgical Oncology Department, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada.,Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Thenappan Chandrasekar
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Zachary Klaassen
- Division of Urology, Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA.,Georgia Cancer Center, Augusta, GA, USA
| | - Ardalan E Ahmad
- Urology Division, Surgical Oncology Department, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Ricardo Leao
- Urology Division, Surgical Oncology Department, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Antonio Finelli
- Urology Division, Surgical Oncology Department, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Neil Fleshner
- Urology Division, Surgical Oncology Department, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Hanan Goldberg
- Urology Division, Surgical Oncology Department, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada. .,Department of Urology, SUNY Upstate Medical University, Syracuse, NY, USA.
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24
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Epidemiological assessment of distress during chemotherapy: who is affected? J Taibah Univ Med Sci 2019; 14:448-453. [PMID: 31728143 PMCID: PMC6838912 DOI: 10.1016/j.jtumed.2019.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 08/02/2019] [Accepted: 08/07/2019] [Indexed: 01/10/2023] Open
Abstract
Objectives Following the rise in the incidence of cancer, the need for chemotherapy has escalated, as have its side effects. Psychological distress is one of the known side effects of chemotherapy; however, it has not received adequate attention. The purpose of this study was to measure psychological distress in patients receiving chemotherapy, making comparisons on the basis of age, gender, marital status, and chemotherapy dose, and to assess the patients' willingness to continue with treatment. Methodology A descriptive cross-sectional study was performed on outpatients receiving chemotherapy beyond the first dose at the Radiation & Isotopes Centre Khartoum (Rick). Data were collected via a face-to-face interview with the patients using the Hospital Anxiety and Depression Scale. Results Among patients undergoing chemotherapy, 55 (25.5%) experienced anxiety and depression. Of the 216 patients recruited, the majority were middle-aged (30–50 years old) married women. Development of psychological distress followed a U-shaped curve in relation to the number of chemotherapy doses received. Patients who received 1–5 and >10 doses experienced more psychological distress than those who received 6–10 chemotherapy doses. As many as 212 (98%) patients were willing to continue with chemotherapy. Conclusion In our study, psychological distress burdened a quarter of the patients receiving chemotherapy. Psychological distress plays a role in cancer recurrence and recovery; thus, there is a need for a holistic approach to the management of patients with cancer, including psychological evaluation to identify those at risk.
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25
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Bergerot CD, Razavi M, Philip EJ, Bergerot PG, Soto-Perez-de-Celis E, De Domenico EBL, Clark KL, Loscalzo M, Pal SK, Dale W. Association between chemotherapy toxicity risk scores and physical symptoms among older Brazilian adults with cancer. J Geriatr Oncol 2019; 11:280-283. [PMID: 31401205 DOI: 10.1016/j.jgo.2019.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Utilizing the Cancer and Aging Research Group (CARG) chemotherapy toxicity risk score before starting treatment in older adults with cancer is guideline-recommended. However, this has not been tested in most developing countries. We investigated the use of a Portuguese version of the CARG score, including the association between this score and physical symptoms, among older Brazilian adults with cancer. PATIENTS AND METHODS We enrolled patients aged ≥65 starting chemotherapy at a public Brazilian hospital. A Portuguese version of the CARG tool was created and linguistically validated. Patients were assessed for chemotherapy toxicity risk using the CARG score, and physical symptoms were evaluated using the Functional Assessment of Cancer Treatment-General (FACT-G) scale. Multivariable logistic regression was used to identify physical symptoms associated with high CARG scores, including pain, nausea, and fatigue. RESULTS Older patients (65+) with cancer were enrolled (n = 117). Patients were mostly female (57.3%), white (52.1%), married (52.1%), and had less than high school education (75.2%). Breast, gastrointestinal and lung cancers were the most common diagnosis, and 66.7% had metastatic disease. Elevated pain scores (P < .01) were associated with higher chemotherapy toxicity risk scores, even after adjusting for potential confounders. CONCLUSION We created and implemented a Portuguese language version of the CARG tool. We found that, although physical symptoms are not included in the CARG model, elevated pain was strongly associated with having a high CARG score. As a modifiable risk factor, pain should be addressed among older patients with cancer considering chemotherapy, to help mitigate their risks for toxicity.
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Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America; Universidade Federal de Sao Paulo (2014-2017), Sao Paulo, SP, Brazil
| | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Errol J Philip
- University of California San Francisco, San Francisco, CA, United States of America
| | - Paulo Gustavo Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | | | | | - Karen Lynn Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, United States of America.
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26
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Zeng J, Wu J, Tang C, Xu N, Lu L. Effects of Exercise During or Postchemotherapy in Cancer Patients: A Systematic Review and Meta‐Analysis. Worldviews Evid Based Nurs 2019; 16:92-101. [PMID: 30854763 DOI: 10.1111/wvn.12341] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Jingchun Zeng
- Department of AcupunctureFirst Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou China
| | - Jiaming Wu
- Zhongshan Affiliated Hospital Guangzhou University of Chinese Medicine Zhongshan China
| | - Chunzhi Tang
- Clinical Research Center South China Research Center for Acupuncture and Moxibustion Medical College of Acu‐Moxi and Rehabilitation Guangzhou University of Chinese Medicine Guangzhou China
| | - Nenggui Xu
- Clinical Research Center South China Research Center for Acupuncture and Moxibustion Medical College of Acu‐Moxi and Rehabilitation Guangzhou University of Chinese Medicine Guangzhou China
| | - Liming Lu
- Clinical Research Center South China Research Center for Acupuncture and Moxibustion Medical College of Acu‐Moxi and Rehabilitation Guangzhou University of Chinese Medicine Guangzhou China
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27
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Calderon C, Carmona-Bayonas A, Jara C, Beato C, Mediano M, Ramón Y Cajal T, Carmen Soriano M, Jiménez-Fonseca P. Emotional functioning to screen for psychological distress in breast and colorectal cancer patients prior to adjuvant treatment initiation. Eur J Cancer Care (Engl) 2019; 28:e13005. [PMID: 30761638 DOI: 10.1111/ecc.13005] [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: 09/24/2017] [Revised: 09/04/2018] [Accepted: 01/17/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The objective was to analyze the usefulness of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) EF subscale to detect emotional problems in patients with breast (BC) and colorectal cancer (CRC). METHODS A prospective, observational, cross-sectional study was conducted. Participants completed the Brief Symptom Inventory (BSI) and EORTC-QLQ-C30. The following psychometric properties were calculated: accuracy, sensitivity, positive predictive value, specificity and negative predictive value. RESULTS The sample analyzed included 445 patients: 202 with BC and 243 with CRC. In total, 129 BC patients (64%) and 104 CRC patients (43%) suffered psychological distress according to the BSI. The accuracy of EORTC-QLQ-C30 EF in detecting psychological distress was 77% and 82% in BC and CRC respectively. Specificity rates for BC and CRC were 81% and 82%, and sensitivity was 75% and 82% respectively. Positive predictive value was 87% and 77%, and negative predictive value was 65% and 86% in BC and CRC respectively. The mean AUC for BC was 0.83 and 0.88 for CRC. CONCLUSIONS The EORTC-QLQ-C30 EF is useful for rapid screening. The systematic application of this scale would allow patients with cancer and emotional problems to be easily identified in clinical practice.
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Affiliation(s)
- Caterina Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Spain
| | | | - Carlos Jara
- Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain
| | - Carmen Beato
- Department of Medical Oncology, Grupo Hospitalario Quirón, Sevilla, Spain
| | - Marilo Mediano
- Department of Medical Oncology, Grupo Hospitalario Quirón, Sevilla, Spain
| | - Teresa Ramón Y Cajal
- Department of Medical Oncology, Hospital Universitario Santa Creu y San Pau, Barcelona, Spain
| | - Mª Carmen Soriano
- Department of Medical Oncology, Hospital Virgen de La Luz, Cuenca, Spain
| | - Paula Jiménez-Fonseca
- Department of Medical Oncology. Hospital, Universitario Central de Asturias, Oviedo, Spain
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28
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Bergerot CD, Battle D, Staehler MD, Pal SK. Distress in patients with renal cell carcinoma: a curious gap in knowledge. BJU Int 2018; 123:208-209. [DOI: 10.1111/bju.14564] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology and Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - Dena Battle
- Kidney Cancer Research Alliance (KCCure); Alexandria VA USA
| | | | - Sumanta Kumar Pal
- Department of Medical Oncology and Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
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29
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Bergerot CD, Bergerot PG, Philip EJ, De Domenico EBL, Manhaes MFM, Pedras RN, Salgia MM, Dizman N, Ashing KT, Li M, Dale W, Pal SK. Assessment of distress and quality of life in rare cancers. Psychooncology 2018; 27:2740-2746. [DOI: 10.1002/pon.4873] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/23/2018] [Accepted: 08/27/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology & Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
- Federal University of Sao Paulo; Sao Paulo Brazil
| | - Paulo Gustavo Bergerot
- Department of Medical Oncology & Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
- Federal University of Sao Paulo; Sao Paulo Brazil
| | - Errol J. Philip
- The Notre Dame Laboratory for Psycho-Oncology Research; University of Notre Dame; Notre Dame IL USA
| | | | | | | | - Meghan M. Salgia
- Department of Medical Oncology & Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - Nazli Dizman
- Department of Medical Oncology & Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - Kimlin Tam Ashing
- Department of Population Sciences; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - Min Li
- Department of Biostatistics; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - William Dale
- Department of Supportive Care Medicine; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - Sumanta K. Pal
- Department of Medical Oncology & Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
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30
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The risk factors for depression in cancer patients undergoing chemotherapy: a systematic review. Support Care Cancer 2018; 27:57-67. [PMID: 30225571 DOI: 10.1007/s00520-018-4466-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 09/10/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE This systematic review aims to identify the risk factors for depression in cancer patients undergoing chemotherapy. METHODS Eight electronic databases were searched from inception of the databases established until August 2017. References for the included studies were retrieved by manual searching. The quality of the eligible studies was appraised by two persons using the 11-item checklist of the Agency for Healthcare Research and Quality (AHRQ). RESULTS Among 5988 potentially relevant articles, 43 studies were eligible, with 17 studies of high quality and 25 studies of moderate quality. A total of 65 factors were extracted, including sociodemographic characteristics (n = 20), physiological condition (n = 20), disease and treatment (n = 12), and psychosocial factors (n = 13). Only social support, anxiety, perceived stress, and self-efficacy were found to be consistently associated with depression in cancer patients. There is not enough evidence to support the link between the other 61 factors and depression in cancer patients undergoing chemotherapy. CONCLUSIONS This review suggests that the development of depression programs should take social support, anxiety, perceived stress, and self-efficacy into account. More original studies with rigorous design are necessary to further confirm those 61 inconclusive risk factors for depression in cancer patients receiving chemotherapy.
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31
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Richardson EM, Scott JL, Schüz N, Sanderson K, Schüz B. 'It was all intertwined': Illness representations and self-management in patients with cancer and anxiety/depression. Psychol Health 2017; 32:1082-1108. [PMID: 28511605 DOI: 10.1080/08870446.2017.1324970] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Cancer and anxiety/depression frequently co-occur, leading to poorer outcomes for these illnesses. However, the majority of existing research investigates how participants view single illnesses alone. This study aimed to explore the content of individuals' multimorbid representations and how these relate to their coping behaviours and self-management strategies for cancer and anxiety/depression. DESIGN A semi-structured qualitative research design with theoretical thematic analysis. MAIN OUTCOME MEASURES Multimorbid illness representations, coping behaviours, and self-management strategies. RESULTS In interviews with 21 participants multimorbid representations varied, three participants viewed cancer and anxiety/depression as unrelated, five participants were uncertain about the relationship between cancer and anxiety/depression, and the majority of participants perceived cancer and anxiety/depression as related. This third group of participants often described relationships as causal, with representations having both positive and negative influences on coping behaviours and self-management strategies. Representations were shown to change over the course of the cancer experience, with fear of cancer recurrence and the influence of participants' most challenging illness also discussed. CONCLUSIONS People hold multimorbid illness representations that can influence self-management. An awareness of these representations by researchers, health professionals, and patients is important for the creation of future interventions that aim to improve and maintain patient wellbeing.
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Affiliation(s)
- Emma M Richardson
- a Division of Psychology, School of Medicine , University of Tasmania , Hobart , Australia
| | - Jennifer L Scott
- a Division of Psychology, School of Medicine , University of Tasmania , Hobart , Australia
| | - Natalie Schüz
- b School of Medicine , University of Tasmania , Hobart , Australia
| | - Kristy Sanderson
- c School of Health Sciences , University of East Anglia , Norwich , England
| | - Benjamin Schüz
- a Division of Psychology, School of Medicine , University of Tasmania , Hobart , Australia
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