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Lampert-Okin SL. The Not-So-Good Cancer: Psychosocial Challenges for YA Thyroid Cancer Patients and Survivors and the Creation of a YA Thyroid Cancer Support Group. J Adolesc Young Adult Oncol 2024. [PMID: 38682360 DOI: 10.1089/jayao.2024.0033] [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: 05/01/2024] Open
Abstract
Thyroid cancer (TC) has been deemed "the good cancer" owing to its slow growth, availability of targeted treatment, and low mortality rates. Inconsistent with this name, survivors of TC have similar or poorer quality of life than individuals with other types of cancer. Furthermore, young adults (YAs; age 18-35) with TC are at risk for additional psychosocial challenges. Support groups have been identified as a mechanism for improving quality of life among other YAs with cancer. A YA TC group is warranted given the unique experiences of TC survivors. Discussion points from a newly developed YA TC support group are reviewed.
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Affiliation(s)
- Sara L Lampert-Okin
- Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
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2
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Camp L, Coffman E, Chinthapatla J, Boey KA, Lux L, Smitherman A, Manning ML, Vizer LM, Haines E, Valle CG. Active Treatment to Survivorship Care: A Mixed-Methods Study Exploring Resource Needs and Preferences of Young Adult Cancer Survivors in Transition. J Adolesc Young Adult Oncol 2023; 12:735-743. [PMID: 36706031 PMCID: PMC10618808 DOI: 10.1089/jayao.2022.0095] [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] [Indexed: 01/28/2023] Open
Abstract
Purpose: The purpose of this study was to identify resource needs and preferences of young adult cancer survivors (YAs) during the transition from active treatment to survivorship care to inform tailored care tools to support YAs during this period. Methods: A mixed methods study following a sequential explanatory approach was conducted among YAs between the ages of 15 and 39. Online surveys were distributed to assess participant information and resource needs, and responses were further explored during virtual focus group and interview discussions. Frequencies and proportions were calculated to identify quantitative resource needs, and a descriptive qualitative approach was used to gather and analyze qualitative data. Results: Thirty-one participants completed the online surveys, and 27 participated in qualitative data collection. The top resource needs identified in the surveys and discussed in focus groups and interviews were (1) fear of recurrence, (2) sleep and fatigue, (3) anxiety, (4) nutrition, (5) physical activity, and (6) finances. Emergent themes identified during transcript analyses included the need for (1) tailored, customizable resources, (2) connection with other survivors, (3) tools to guide conversations about cancer, (4) clarity in what to expect during treatment and survivorship, and (5) consistent and equitable care in YA oncology. Conclusions: Participants identified six important information needs in addition to an overarching need for tailored support and equitable distribution of resources while transitioning into early survivorship. Thus, tailored interventions are needed to enhance the distribution of YA-centered resources, improve equity in YA cancer care, and connect YAs with peer survivors.
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Affiliation(s)
- Lindsey Camp
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Erin Coffman
- Department of Nutrition, Gillings School of Global Public Health, 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
| | - Juhitha Chinthapatla
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kelly Ann Boey
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Lauren Lux
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Andrew Smitherman
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Pediatrics, Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michelle L Manning
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lisa M Vizer
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily Haines
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Carmina G Valle
- Department of Nutrition, Gillings School of Global Public Health, 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
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3
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Karcioglu AS, Dhillon VK, Davies L, Stack BC, Bloom G, Randolph G, Lango MN. Analysis of Unmet Information Needs Among Patients With Thyroid Cancer. JAMA Otolaryngol Head Neck Surg 2023; 149:110-119. [PMID: 36580287 PMCID: PMC9857628 DOI: 10.1001/jamaoto.2022.4108] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/23/2022] [Indexed: 12/30/2022]
Abstract
Importance Counseling prior to thyroid cancer (TC) treatment is an essential component of informed consent. An informed patient affects treatment-related expectations and patient engagement, factors that contribute significantly to patient-reported quality-of-life outcomes. Objective To describe experiences with pretreatment counseling among survivors of TC and to test factors associated with self-reported treatment meeting expectations. Design, Setting, and Participants A cross-sectional survey was administered between October 18, 2019, and February 8, 2020, to members of ThyCa: Thyroid Cancer Survivors' Association Inc, and to individuals accessing the public-facing ThyCa website. Survey respondents were asked 55 questions, including 4 free-text questions and 2 multiple-choice questions about pretreatment counseling. Main Outcomes and Measures Respondents self-reported (1) their unmet information needs, (2) rates of treatment meeting expectations, and (3) rates of treatment understanding. A mixed-methods analysis was performed, including qualitative content analysis of free-text responses and multivariable logistic regression of factors associated with self-reported levels of treatment meeting expectations. Results Of the 1412 survey respondents, 1249 were women (88.4%). The median age at diagnosis was 48 years (range, 18-85 years), and the median age at the time of survey completion was 60 years (range, 18-87 years). A total of 1259 respondents (89.2%) provided free-text responses to the question, "What would you tell someone newly diagnosed with your same condition?" Of these individuals, 526 (37.2%) reported inadequate pretreatment plan understanding and 578 (40.9%) reported that their treatment experience did not meet their expectations. Treatment met expectations for only 95 respondents (18.1%) reporting an inadequate pretreatment plan understanding. Of the 526 survivors of TC reporting a lack of understanding, 473 (90.0%) provided additional textual comments, most commonly in the categories of postoperative treatment, surveillance, and treatment effects. On multivariable logistic regression, self-reported failure to have an understanding of TC treatment was independently associated with failure of treatment to meet expectations (odds ratio, 5.1 [95% CI, 3.7-6.9]). Patients reporting a full understanding of their treatment plan were 5-fold more likely to indicate that their initial treatment experience was on par with expectations, independent of reported postoperative complications, age, sex, and other potential confounders. Conclusions and Relevance In this survey study, a substantial proportion of survivors of TC reported inadequate pretreatment understanding. This gap in understanding was associated with high levels of self-reported failure of treatment to meet expectations, which in turn is associated in other studies with poorer patient-reported quality-of-life outcomes. These outcomes may be improved by addressing gaps in patient understanding so expectations more closely match TC diagnosis and treatment pathways.
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Affiliation(s)
- Amanda Silver Karcioglu
- Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston
- Division of Otolaryngology–Head and Neck Surgery, NorthShore University HealthSystem, Evanston, Illinois
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Vaninder K. Dhillon
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Bethesda, Maryland
| | - Louise Davies
- Veterans Affairs Outcomes Group, Department of Veterans Affairs Hospital, White River Junction, Vermont
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
- Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire
| | - Brendan C. Stack
- Department of Otolaryngology–Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield
| | - Gary Bloom
- ThyCa: Thyroid Cancer Survivors’ Association Inc, Olney, Maryland
| | - Gregory Randolph
- Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Miriam N. Lango
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston
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Pitt SC, Zanocco K, Sturgeon C. The Patient Experience of Thyroid Cancer. Endocrinol Metab Clin North Am 2022; 51:761-780. [PMID: 36244692 DOI: 10.1016/j.ecl.2022.04.002] [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] [Indexed: 11/26/2022]
Abstract
The 3 phases of thyroid cancer care are discussed: diagnosis, management, and survivorship. Drivers of quality of life (QOL) in each phase are described, and suggestions are made for mitigating the risk of poor QOL. Active surveillance is another emerging management strategy that has the potential to improve QOL by eliminating upfront surgical morbidity but will need to be studied prospectively.
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Affiliation(s)
- Susan C Pitt
- Department of Surgery, University of Michigan Taubman 2920F, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Kyle Zanocco
- Department of Surgery, University of California Los Angeles, CHS 72-222, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
| | - Cord Sturgeon
- Department of Surgery, Northwestern University, 676 North Saint Claire Street, Suite 650, Chicago, IL 60611, USA.
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Alyousef MY, Ghandour MK, Al-Mohawes M, Alnwaisir M, Islam T, Al Qahtani K. Long-Term Quality of Life (5-15 Years Post-Thyroidectomy) of Thyroid Carcinoma Patients in Two Tertiary Care Hospitals. Cureus 2022; 14:e22005. [PMID: 35282529 PMCID: PMC8908066 DOI: 10.7759/cureus.22005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 11/27/2022] Open
Abstract
Purpose Early detection of thyroid cancer has reduced mortality and improved survival of patients. Increased detection has raised the incidence of early stage disease. Some physicians underestimate the suffering of these patients due to the concept of "good cancer.” The unmet needs of the survivors still need to be addressed. The objective of this paper was to evaluate the long-term quality of life (QOL) of thyroid cancer survivors. Methods A cross-sectional telephone survey of 211 thyroid cancer survivors who underwent thyroidectomy performed between 2006 and 2016 in two academic tertiary care hospitals was conducted using a validated Arabic version of the European Organization for Research and Treatment of Cancer head and neck cancer specific quality of life questionnaire (EROTC QLQ) - H&N43 questionnaire using a scale of 1-4, with 4 being most severe. Results On almost half (48.5%) of patients, thyroidectomy was performed in 2013 or earlier. Patients’ perceptions of problems were very low, with a mean score of 1.56 ± 0.7). Worry about the test results (2.37 ± 1.19), future health (2.36 ± 1.22), tingling or numbness in hands or feet (2.32 ± 1.22), pain in the shoulder (2.04 ± 1.18), and dry, itchy skin (2.04 ± 1.18) were the only items that received a mean score of more than 2. No statistically significant differences in patients’ problems were observed according to either tumor histopathology or type of thyroidectomy. Conclusion The overall QOL score for the patients was very good. The persistent problems identified need to be addressed in the long-term follow-up. Survivorship care plans need to be developed incorporating proper interventions.
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Dionisi-Vici M, Fantoni M, Botto R, Nervo A, Felicetti F, Rossetto R, Gallo M, Arvat E, Torta R, Leombruni P. Distress, anxiety, depression and unmet needs in thyroid cancer survivors: a longitudinal study. Endocrine 2021; 74:603-610. [PMID: 34143334 PMCID: PMC8571224 DOI: 10.1007/s12020-021-02786-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/03/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Despite a good prognosis, thyroid cancer (TC) survivors often report psychological distress and decreased quality of life. This longitudinal study aims to evaluate TC survivors' levels of distress, anxiety, depression and unmet needs, checking potential life events. METHODS Distress Thermometer, Hospital Anxiety Depression Scale, Supportive Care Need Survey (short form) and Interview for Recent Life Events were administered to 73 TC survivors (T0) and 44 of them were re-tested one year later (T1). Participants were at 0-5, 5-10 or >10 years from the end of their cancer-related treatments. RESULTS At T0, distress, anxiety and depression mean scores were 6.4, 6.8 and 5.3, while at T1 they were 5.5, 4.8 and 5.1. Only anxiety scores decreased significantly between T0 and T1. 50.7% of patients had unmet psychological needs at T0 and 50.0% at T1. Most participants were satisfied in the communicative/ informative (T0:79.5%; T1: 77.3%) and social/health care areas (T0:74.0%; T1:75.0%). The most experienced stressful events detected concerned their working areas. CONCLUSIONS Results confirmed that patients reported distress, anxiety and depression concerns even many years after the end of treatments. Both medical and psychological surveillance are relevant to improving TC survivors' wellbeing.
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Affiliation(s)
- Margherita Dionisi-Vici
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | | | - Rossana Botto
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy.
| | - Alice Nervo
- Oncological Endocrinology Unit, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Francesco Felicetti
- Transition Unit for Childhood Cancer Survivors, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Ruth Rossetto
- Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Marco Gallo
- Oncological Endocrinology Unit, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Emanuela Arvat
- Oncological Endocrinology Unit, Department of Oncology, AOU Città della Salute e della Scienza Hospital, Turin, Italy
| | - Riccardo Torta
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
| | - Paolo Leombruni
- Clinical Psychology Unit, Department of Neuroscience, University of Turin, "Città della Salute e della Scienza" Hospital of Turin, Turin, Italy
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Jackson Levin N, Zhang A, Reyes-Gastelum D, Chen DW, Hamilton AS, Zebrack B, Haymart MR. Change in worry over time among Hispanic women with thyroid cancer. J Cancer Surviv 2021; 16:844-852. [PMID: 34633638 DOI: 10.1007/s11764-021-01078-8] [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: 03/10/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study is to assess change in worry over time in Hispanic women with thyroid cancer. METHODS Worry about recurrence, quality of life, family at risk, death, and harm from treatments was assessed in 273 Hispanic women with thyroid cancer diagnosed in 2014-2015. Subjects were recruited from Surveillance, Epidemiology, and End Results (SEER) Los Angeles. Participants were surveyed at two points in time (time 1: 2017-2018 and time 2: 2019). Multivariable logistic regression was used to determine correlates with high worry (somewhat, quite a bit, very much) versus low worry (not at all, a little) at time 2. RESULTS For the five worry items, 20.1-39.6% had high worry at both time 1 and time 2. An additional 7.6-13.4% had low worry at time 1 that became high worry at time 2. In multivariable logistic regression controlling for age, recurrence status, education level, and number of complications or side effects symptoms, younger age (20-39) as compared to older (40-79) was associated with high worry about thyroid cancer recurrence (OR 2.16, 95% CI 1.12-4.17). History of recurrent or persistent disease was associated with high worry about harms from treatment (OR 2.94, 95% CI 1.29-6.67). Greater number of complications or side effects of symptoms was associated with more worry across all five items. CONCLUSIONS Some Hispanic women with thyroid cancer have persistently high worry, with young adult Hispanic women vulnerable to worry about recurrence. IMPLICATIONS FOR CANCER SURVIVORS Hispanic women with thyroid cancer may benefit from targeted psychosocial support during survivorship, with interventions informed by patient and cancer characteristics.
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Affiliation(s)
- Nina Jackson Levin
- School of Social Work and Department of Anthropology, University of Michigan, 1080 S. University Ave, Room B660, Ann Arbor, MI, 48109, USA
| | - Anao Zhang
- School of Social Work, University of Michigan, 1080 S. University, Room 3704, Ann Arbor, MI, 48109, USA
| | - David Reyes-Gastelum
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, North Campus Research Complex, 2800 Plymouth Rd. Bldg. 16, 400S-20, MI, 48109, Ann Arbor, USA
| | - Debbie W Chen
- Department of Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Domino's Farms (Lobby C, Suite 1300), 24 Frank Lloyd Wright Drive, PO Box 451, Ann Arbor, MI, 48106, USA
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St., SSB318E, MC9239, Los Angeles, CA, 90089-9239, USA
| | - Bradley Zebrack
- School of Social Work, University of Michigan, 1080 S. University, Room 2778, Ann Arbor, MI, 48109, USA
| | - Megan R Haymart
- Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, North Campus Research Complex, 2800 Plymouth Road, Bldg 16, Rm 408E, Ann Arbor, MI, 48109, USA.
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8
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Evans Webb M, Murray E, Younger ZW, Goodfellow H, Ross J. The Supportive Care Needs of Cancer Patients: a Systematic Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:899-908. [PMID: 33492650 PMCID: PMC8523012 DOI: 10.1007/s13187-020-01941-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/06/2020] [Indexed: 06/12/2023]
Abstract
Cancer, and the complex nature of treatment, has a profound impact on lives of patients and their families. Subsequently, cancer patients have a wide range of needs. This study aims to identify and synthesise cancer patients' views about areas where they need support throughout their care. A systematic search of the literature from PsycInfo, Embase and Medline databases was conducted, and a narrative. Synthesis of results was carried out using the Corbin & Strauss "3 lines of work" framework. For each line of work, a group of key common needs were identified. For illness-work, the key needs idenitified were; understanding their illness and treatment options, knowing what to expect, communication with healthcare professionals, and staying well. In regards to everyday work, patients wanted to maintain a sense of normalcy and look after their loved ones. For biographical work, patients commonly struggled with the emotion impact of illness and a lack of control over their lives. Spiritual, sexual and financial problems were less universal. For some types of support, demographic factors influenced the level of need reported. While all patients are unique, there are a clear set of issues that are common to a majority of cancer journeys. To improve care, these needs should be prioritised by healthcare practitioners.
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Affiliation(s)
- Madeleine Evans Webb
- UCL Research Department of Epidemiology & Public Health, 1-19 Torrington Place, London, WC1E 6BT UK
| | - Elizabeth Murray
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
| | - Zane William Younger
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
| | - Henry Goodfellow
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
| | - Jamie Ross
- Department of Primary Care and Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF UK
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Lazard AJ, Collins MKR, Hedrick A, Varma T, Love B, Valle CG, Brooks E, Benedict C. Using Social Media for Peer-to-Peer Cancer Support: Interviews With Young Adults With Cancer. JMIR Cancer 2021; 7:e28234. [PMID: 34473063 PMCID: PMC8446843 DOI: 10.2196/28234] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/16/2021] [Accepted: 07/11/2021] [Indexed: 01/19/2023] Open
Abstract
Background Web-based social support can address social isolation and unmet support needs among young adults with cancer (aged 18-39 years). Given that 94% of young adults own and use smartphones, social media can offer personalized, accessible social support among peers with cancer. Objective This study aims to examine the specific benefits, downsides, and topics of social support via social media among young adults with cancer. Methods We conducted semistructured interviews with young adults with cancer, aged between 18 and 39 years, who were receiving treatment or had completed treatment for cancer. Results Most participants (N=45) used general audience platforms (eg, Facebook groups), and some cancer-specific social media (eg, Caring Bridge), to discuss relevant lived experiences for medical information (managing side effects and treatment uncertainty) and navigating life with cancer (parenting and financial issues). Participants valued socializing with other young adults with cancer, making connections outside their personal networks, and being able to validate their emotional and mental health experiences without time and physical constraints. However, using social media for peer support can be an emotional burden, especially when others post disheartening or harassing content, and can heighten privacy concerns, especially when navigating cancer-related stigma. Conclusions Social media allows young adults to connect with peers to share and feel validated about their treatment and life concerns. However, barriers exist for receiving support from social media; these could be reduced through content moderation and developing more customizable, potentially cancer-specific social media apps and platforms to enhance one’s ability to find peers and manage groups.
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Affiliation(s)
- Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Meredith K Reffner Collins
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Ashley Hedrick
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Tushar Varma
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Brad Love
- School of Advertising and Public Relations, The University of Texas at Austin, Austin, TX, United States.,Gryt Health, New York, NY, United States
| | - Carmina G Valle
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Erik Brooks
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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10
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de Heus E, van der Zwan JM, Husson O, Frissen AR, van Herpen CML, Merkx MAW, Duijts SFA. Unmet supportive care needs of patients with rare cancer: A systematic review. Eur J Cancer Care (Engl) 2021; 30:e13502. [PMID: 34409667 DOI: 10.1111/ecc.13502] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/04/2021] [Accepted: 07/27/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Patients with rare cancers may experience different unmet needs than those with common cancer. The objective of this systematic review was to (1) investigate unmet supportive care needs of rare cancer patients throughout the disease trajectory and (2) identify predictive factors for these unmet needs. METHODS PubMed, PsycINFO and CINAHL were searched for publications (January 2011 to March 2021) focusing on unmet needs of patients with rare cancer. Two reviewers independently selected studies, extracted data and performed quality assessment. Findings were synthesised. RESULTS The search yielded 4,598 articles, of which 59 articles met eligibility criteria and 57 were of medium or high quality. Rare cancer patients most frequently reported unmet needs in the healthcare system and information domain (up to 95%), followed by the psychological domain (up to 93%) and the physical and daily living domain (up to 80%). Unmet needs were mainly reported in the posttreatment phase. The most frequently identified predictors were higher anxiety, younger age and higher neuroticism. CONCLUSION Patients with rare cancer have unmet needs throughout their disease trajectory. Supportive care needs of rare cancer patients should be addressed individually, depending on the rare cancer subdomain and phase of disease and from diagnosis onwards.
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Affiliation(s)
- Eline de Heus
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan Maarten van der Zwan
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Olga Husson
- Division of Psychosocial Research and Epidemiology and Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Anne-Roos Frissen
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Carla M L van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Matthias A W Merkx
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Saskia F A Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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11
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Koot A, Netea-Maier R, Ottevanger P, Hermens R, Stalmeier P. Needs, Preferences, and Values during Different Treatment Decisions of Patients with Differentiated Thyroid Cancer. J Pers Med 2021; 11:jpm11070682. [PMID: 34357149 PMCID: PMC8304194 DOI: 10.3390/jpm11070682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 12/23/2022] Open
Abstract
Background: The purpose of this study was to identify the needs, preferences, and values of patients with differentiated thyroid cancer (DTC) and the physicians treating patients with DTC regarding two different treatment decisions, namely: the extent of primary surgery (low-risk patients) and the tyrosine kinase inhibitor (TKI) treatment (high-risk patients). Methods: A qualitative study was conducted. There were two physician focus groups discussing the extent of primary surgery. One included endocrinologists (n = 4) and surgeons (n = 5), and the other included nuclear medicine physicians (n = 3) treating patients with low-risk DTC. The physicians focus group discussing waiting or starting TKIs included endocrinologists (n = 2) and oncologists (n = 5) treating patients with advanced radioactive iodide (RAI) refractory DTC. Moreover, one patient focus group per treatment decision took place. In total 13 patients and 19 physicians participated. Interviews were audio-taped, fully transcribed verbatim, and analyzed. Results: Several themes were identified. Patients, but not physicians, mentioned the importance of a strong doctor–patient relationship. Patients in both treatment decision groups wanted to receive more detailed information, whereas physicians preferred providing more general information. Patients in the TKI decision group focused on palliative care, whereas physicians focused more on the effect and benefit of TKIs. Conclusions: Considering the identified themes in DTC, based on the patients’ needs, preferences, and values, enables us to improve doctor–patient communication and to develop decision support tools.
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Affiliation(s)
- Anna Koot
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
- Correspondence: ; Tel.: +31-651637081
| | - Romana Netea-Maier
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Petronella Ottevanger
- Department of Internal Medicine, Division of Oncology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Rosella Hermens
- Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
| | - Peep Stalmeier
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
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12
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Lazard AJ, Collins MKR, Hedrick A, Horrell LN, Varma T, Love B, Valle CG, Benedict C. Initiation and changes in use of social media for peer support among young adult cancer patients and survivors. Psychooncology 2021; 30:1859-1865. [PMID: 34165848 DOI: 10.1002/pon.5758] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE Social isolation is a prominent challenge for many young adults with cancer. Despite desires for peer-to-peer connections through technology, little is known about how young adults initiate or use social media for support over time. METHODS We interviewed young adults with cancer (n = 45; age 18-39, in or post cancer treatment) to explore their initiation of social media for support, changes in use over time, and types of connections sought. RESULTS Young adults with cancer learn about online support through individual personal recommendations, advocacy organizations, or searching on Google or social media. Most were reluctant to use social media support initially because of feeling overwhelmed-from diagnoses, abundance of online information, or demands of participation-and joined when informational and emotional needs arose. Many wished they had joined earlier. Some participants use social media to make close connections while others simply want to "see" others' shared experiences or crowdsource information. CONCLUSION Young adults with cancer often haphazardly find online support from personal recommendations or Internet searches. Desires for social media connections are not one-size-fits-all; there are important audience segmentations for the degree and type of peer support. IMPLICATIONS FOR CANCER SURVIVORS Better promotion of online social support options and benefits-early in one's cancer timeline and systematically through healthcare providers, cancer organizations, or family and friends-could improve access to helpful peer-to-peer support.
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Affiliation(s)
- Allison J Lazard
- Hussman School of Journalism and Media, 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
| | - Meredith K Reffner Collins
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ashley Hedrick
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lindsey N Horrell
- Connell School of Nursing, Boston College, Newton, Massachusetts, USA
| | - Tushar Varma
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brad Love
- School of Advertising and Public Relations, The University of Texas at Austin, Austin, Texas, USA.,Gryt Health, Rochester, New York, USA
| | - Carmina G Valle
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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13
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Chen DW, Reyes-Gastelum D, Hawley ST, Wallner LP, Hamilton AS, Haymart MR. Unmet Information Needs Among Hispanic Women with Thyroid Cancer. J Clin Endocrinol Metab 2021; 106:e2680-e2687. [PMID: 33660770 PMCID: PMC8208677 DOI: 10.1210/clinem/dgab128] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/16/2021] [Indexed: 01/07/2023]
Abstract
CONTEXT Thyroid cancer is the second most common cancer in Hispanic women. OBJECTIVE To determine the relationship between acculturation level and unmet information needs among Hispanic women with thyroid cancer. DESIGN Population-based survey study. PARTICIPANTS Hispanic women from Los Angeles Surveillance Epidemiology and End Results registry with thyroid cancer diagnosed in 2014-2015 who had previously completed our thyroid cancer survey in 2017-2018 (N = 273; 80% response rate). MAIN OUTCOME MEASURES Patients were asked about 3 outcome measures of unmet information needs: (1) internet access, (2) thyroid cancer information resources used, and (3) ability to access information. Acculturation was assessed with the Short Acculturation Scale for Hispanics (SASH). Health literacy was measured with a validated single-item question. RESULTS Participants' median age at diagnosis was 47 years (range 20-79) and 48.7% were low-acculturated. Hispanic women were more likely to report the ability to access information "all of the time" if they preferred thyroid cancer information in mostly English compared to mostly Spanish (88.5% vs 37.0%, P < 0.001). Low-acculturated (vs high-acculturated) Hispanic women were more likely to have low health literacy (47.2% vs 5.0%, P < 0.001) and report use of in-person support groups (42.0% vs 23.1%, P = 0.006). Depending on their level of acculturation, Hispanic women accessed the internet differently (P < 0.001) such that low-acculturated women were more likely to report use of only a smartphone (34.0% vs 14.3%) or no internet access (26.2% vs 1.4%). CONCLUSIONS Low-acculturated (vs high-acculturated) Hispanic women with thyroid cancer have greater unmet information needs, emphasizing the importance of patient-focused approaches to providing medical information.
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Affiliation(s)
- Debbie W Chen
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - David Reyes-Gastelum
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Sarah T Hawley
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Lauren P Wallner
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ann S Hamilton
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Megan R Haymart
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
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14
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Zhang J, Li L, Liu D, Zhu T, Gao Q, Chen H, Ma L, Li J, Wang Z. Development and validation of the information needs questionnaire for differentiated thyroid cancer patient with radioactive iodine therapy (INQ-DTC). Nurs Open 2021; 9:1794-1804. [PMID: 34003590 PMCID: PMC8994968 DOI: 10.1002/nop2.925] [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: 11/15/2020] [Revised: 03/29/2021] [Accepted: 04/20/2021] [Indexed: 12/24/2022] Open
Abstract
AIMS This study aimed to develop and validate the psychometric properties of Information Needs Questionnaire for Differentiated Thyroid Cancer (INQ-DTC) in DTC patients with radioactive iodine (RAI) therapy. DESIGN Mixed methods. METHODS Using qualitative methods, we developed the initial questionnaire from a personal perspective of information needs of 15 patients with DTC. We used a formal Delphi consensus process to help assess the initial questionnaire and provide recommendations for its application. Totally, 230 DTC patients with RAI therapy were selected for the process of validation. RESULTS The final version of INQ-DTC contains 33 items. The total Cronbach's alpha coefficient was 0.945, the total split-half reliability was 0.822, and the test-retest value was 0.984 for the overall score. Exploratory factor analysis extracted 5 factors, which could explain 61.86% of the total variance. The Scale-level content validity index (S-CVI) was 0.928, and 0.929 for the item-level content validity index (I-CVI).
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Affiliation(s)
- Jing Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Limei Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dongling Liu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Tingting Zhu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Qiaoqiao Gao
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Hui Chen
- The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Ling Ma
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Jiayin Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Zichen Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
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15
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Lubitz CC, Kiernan CM, Toumi A, Zhan T, Roth MY, Sosa JA, Tuttle RM, Grubbs EG. Patient Perspectives on the Extent of Surgery and Radioactive Iodine Treatment for Low-Risk Differentiated Thyroid Cancer. Endocr Pract 2021; 27:383-389. [PMID: 33840638 PMCID: PMC10028733 DOI: 10.1016/j.eprac.2021.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 01/07/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To understand patient perspective regarding recommended changes in the 2015 American Thyroid Association (ATA) guidelines. Specifically, in regard to active surveillance (AS) of some small differentiated thyroid cancer (DTC), performance of less extensive surgery for low-risk DTC, and more selective administration of radioactive iodine (RAI). METHODS An online survey was disseminated to thyroid cancer patient advocacy organizations and members of the ATA to distribute to the patients. Data were collected on demographic and treatment information, and patient experience with DTC. Patients were asked "what if" scenarios on core topics, including AS, extent of surgery, and indications for RAI. RESULTS Survey responses were analyzed from 1546 patients with DTC: 1478 (96%) had a total thyroidectomy, and 1167 (76%) underwent RAI. If there was no change in the overall cancer outcome, 606 (39%) of respondents would have considered lobectomy over total thyroidectomy, 536 (35%) would have opted for AS, and 638 (41%) would have chosen to forego RAI. Moreover, (774/1217) 64% of respondents wanted more time with their clinicians when making decisions about the extent of surgery. A total of 621/1167 of patients experienced significant side effects with RAI, and 351/1167 of patients felt that the risks of treatment were not well explained. 1237/1546 (80%) of patients felt that AS would not be overly burdensome, and quality of life was the main reason cited for choosing AS. CONCLUSION Patient perspective regarding choice in the management of low-risk DTC varies widely, and a large proportion of DTC patients would change aspects of their care if oncologic outcomes were equivalent.
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Affiliation(s)
- Carrie C Lubitz
- Massachusetts General Hospital Institute for Technology Assessment, Boston, Massachusetts; Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
| | - Colleen M Kiernan
- Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University, Nashville, Tennessee
| | - Asmae Toumi
- Massachusetts General Hospital Institute for Technology Assessment, Boston, Massachusetts
| | - Tiannan Zhan
- Massachusetts General Hospital Institute for Technology Assessment, Boston, Massachusetts
| | - Mara Y Roth
- Department of Medicine, Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle Cancer Care Alliance, Seattle, Washington
| | - Julie A Sosa
- Department of Surgery, University of California San Francisco, San Francisco, California
| | - R Michael Tuttle
- Endocrinology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elizabeth G Grubbs
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
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16
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Pitt SC, Saucke MC, Wendt EM, Schneider DF, Orne J, Macdonald CL, Connor NP, Sippel RS. Patients' Reaction to Diagnosis with Thyroid Cancer or an Indeterminate Thyroid Nodule. Thyroid 2021; 31:580-588. [PMID: 33012267 PMCID: PMC8195875 DOI: 10.1089/thy.2020.0233] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction: Little is known about the experiences and concerns of patients recently diagnosed with thyroid cancer or an indeterminate thyroid nodule. This study sought to explore patients' reactions to diagnosis with papillary thyroid cancer (PTC) or indeterminate cytology on fine needle aspiration. Methods: We conducted semistructured interviews with 85 patients with recently diagnosed PTC or an indeterminate thyroid nodule before undergoing thyroidectomy. We included adults with nodules ≥1 cm and Bethesda III, IV, V, and VI cytology. The analysis utilized grounded theory methodology to create a conceptual model of patient reactions. Results: After diagnosis, participants experienced shock, anxiety, fear, and a strong need to "get it out" because "it's cancer!" This response was frequently followed by a sense of urgency to "get it done," which made waiting for surgery difficult. These reactions occurred regardless of whether participants had confirmed PTC or indeterminate cytology. Participants described the wait between diagnosis and surgery as difficult, because the cancer or nodule was "still sitting there" and "could be spreading." Participants often viewed surgery and getting the cancer out as a "fix" that would resolve their fears and worries, returning them to normalcy. The need to "get it out" also led some participants to minimize the risk of complications or adverse outcomes. Education about the slow-growing nature of PTC reassured some, but not all patients. Conclusions: After diagnosis with PTC or an indeterminate thyroid nodule, many patients have strong emotional reactions and an impulse to "get it out" elicited by the word "cancer." This reaction can persist even after receiving education about the excellent prognosis. Understanding patients' response to diagnosis is critical, because their emotional reactions likely pose a barrier to implementing guidelines recommending less extensive management for PTC.
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Affiliation(s)
- Susan C. Pitt
- Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Address correspondence to: Susan C. Pitt, MD, MPHS, Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, CSC K4/738, Madison, WI 53792-7375, USA
| | - Megan C. Saucke
- Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | | | - David F. Schneider
- Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Jason Orne
- Department of Sociology, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Nadine P. Connor
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Rebecca S. Sippel
- Division of Endocrine Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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17
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David CL, Lowrey L. A qualitative investigation assessing whether implementing a Teenage Young Adult information evening, within a radiotherapy department, would improve the information support and treatment pathway for 18-24-year-old cancer patients. Radiography (Lond) 2021; 27:847-853. [PMID: 33589304 DOI: 10.1016/j.radi.2021.01.005] [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: 09/01/2020] [Revised: 01/11/2021] [Accepted: 01/17/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION This study evaluated the current information services provided to 10 Teenage Young Adult (TYA) oncology patients within a single radiotherapy department through retrospective patient views. Additionally, the participants provided valuable perspectives on the aptness and merit of implementing a dedicated information evening within the radiotherapy department. METHODS Focus group sessions and open-ended questionnaires were used as the primary data collection tools for this study, producing rich and informative data. The transcriptions from the focus groups, along with the questionnaire responses were then analysed using coding techniques, resulting in 6 distinct themes. RESULTS The participants felt they received adequate information about their radiotherapy treatment and its side effects. However, participants did report some gaps within the service provision that need to be addressed to improve treatment pathways in future. Furthermore, the information was always supplied in paper format which was often undesirable to the cohort with a more interactive format preferred. The participants disclosed very strong feelings of being different to "usual cancer patients" and displayed a desire for more opportunities to meet other TYA patients to be provided within their pathway. CONCLUSION AND IMPLICATIONS FOR PRACTICE The findings of this study suggest that the implementation of a dedicated TYA open evening would improve the information support and treatment pathway for 18-24-year-old cancer patients. The evening could offer a wanted opportunity where TYA patients could meet each other and additionally, treatment information and age appropriate support information could be provided in a different and more suitable format than current paper-based literature.
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Affiliation(s)
- C L David
- Radiotherapy Department, Basement P-2, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
| | - L Lowrey
- Kingston and St George's Joint Faculty, Health, Social Care and Education, Bay 18/desk 21 6th, Floor Hunter Wing, Cranmer Terrace, London, SW17 0RE, UK
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18
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Soejima T, Shiohara M, Ishida Y, Inoue M, Hayakawa A, Sato A, Kamibeppu K, Atsuta Y, Yamashita T. Impact of cGVHD on socioeconomic outcomes in survivors with pediatric hematopoietic stem cell transplant in Japan: a cross-sectional observational study. Int J Hematol 2021; 113:566-575. [PMID: 33386599 DOI: 10.1007/s12185-020-03058-7] [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: 06/05/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
We conducted a cross-sectional observational study investigating socioeconomic status among Japanese survivors of pediatric hematopoietic stem cell transplantation (HCT) and the impact of chronic graft-versus-host disease (cGVHD) on socioeconomic outcomes, which are topics not well explored in the previous research. We collected data on socioeconomic outcomes from 442 HCT survivors through a questionnaire and obtained demographic and clinical information from their attending physicians and a national database between February 2013 and November 2014. We used logistic regression analysis to examine the relationship between cGVHD and socioeconomic outcomes in allogeneic HCT (allo-HCT) survivors. Most survivors did not experience socioeconomic problems. Nevertheless, allo-HCT survivors with cGVHD aged 8-15 years had poorer economic status (p = 0.013), and allo-HCT survivors with cGVHD aged ≥ 16 years were more likely to have never married (p = 0.034) and less likely to have more than a high school education (p = 0.023), compared with allo-HCT survivors without cGVHD. Thus, cGVHD in Japanese allo-HCT survivors was a risk factor for economic difficulties for those aged 8-15 years, and for never marrying and low educational achievement in those aged ≥ 16 years.
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Affiliation(s)
- Takafumi Soejima
- Department of Family Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Department of Health Quality and Outcome Research, Division of Nursing Systems, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Masaaki Shiohara
- Department of Pediatrics, Matsumoto Dental University Hospital, Shiojiri, Japan
| | - Yasushi Ishida
- Pediatric Medical Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Masami Inoue
- Department of Hematology/Oncology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Akira Hayakawa
- Department of Palliative Care, Yodogawa Christian Hospital, Osaka, Japan
| | - Atsushi Sato
- Department of Hematology/Oncology, Miyagi Children's Hospital, Sendai, Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Department of Health Quality and Outcome Research, Division of Nursing Systems, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuya Yamashita
- Department of Hematology/Oncology, St. Luke's International Hospital, Tokyo, Japan
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19
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Dhillon VK, Silver Karcioglu A, Bloom G, Randolph G, Lango M. What the thyroid cancer patient wants to know: ThyCa survey by the American Head and Neck Society Endocrine Surgery Section. Head Neck 2020; 42:2496-2504. [PMID: 32530116 DOI: 10.1002/hed.26185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/05/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To survey a large cohort of thyroid cancer survivors from ThyCa on information needs and expectations of their treatment to better understand the pretreatment counseling, information, and support needs of this population. METHODS Anonymous survey of thyroid cancer survivors. RESULTS One thousand one hundred twenty-four patients with thyroid cancer participated in the survey. Three hundred sixty-two (37.44%) reported not having had a full understanding of their treatment plan and 407 (46.41%) reported that their thyroid cancer treatment did not conform to expectations. Patients diagnosed at younger ages were significantly more likely to report inadequate understanding of the treatment, failure of treatment to meet expectations, and call for greater attention to psychological well-being. Older patients were more likely to report unexpected effects on speech and swallowing. Regardless of age, patients most frequently called for greater attention to management of energy levels (endorsed by 61% of respondents), psychological well-being (50%), and weight changes (48%). CONCLUSIONS Improvements are needed in age-specific communication of thyroid cancer diagnosis and treatment.
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Affiliation(s)
- Vaninder K Dhillon
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Bethesda, Maryland, USA
| | - Amanda Silver Karcioglu
- Division of Otolaryngology-Head and Neck Surgery, NorthShore University HealthSystem, Evanston, Illinois, USA
| | - Gary Bloom
- ThyCa: Thyroid Cancer Survivors' Association, Inc., Olney, Maryland, USA
| | - Gregory Randolph
- Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Miriam Lango
- Department of Head and Neck Surgery, University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
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20
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Looking under the hood of "the Cadillac of cancers:" radioactive iodine-related craniofacial side effects among patients with thyroid cancer. J Cancer Surviv 2020; 14:847-857. [PMID: 32506220 DOI: 10.1007/s11764-020-00897-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Despite having a generally favorable prognosis, differentiated thyroid cancer is known to have a significant, long-term impact on the quality of life of survivors. We wished to investigate short- and long-term effects among thyroid cancer survivors following radioactive iodine therapy. METHODS We conducted eight focus groups (N = 47) to understand patients' experiences of short- and long-term effects after radioactive iodine treatment and the impact these treatment-related side effects had on patients' quality of life. We elicited responses regarding experiences with side effects following radioactive iodine treatment, particularly salivary, lacrimal, and nasal symptoms. We transcribed audiotapes and conducted qualitative analyses to identify codes and themes. RESULTS We identified eight broad themes from the qualitative analyses. Themes reflecting physical symptoms included dry mouth, salivary gland dysfunction, altered taste, eye symptoms such as tearing or dryness, and epistaxis. Psychosocial themes included lack of knowledge and preparation for treatment, regret of treatment, and distress that thyroid cancer is labeled as a "good cancer." CONCLUSIONS Thyroid cancer survivors reported a wide range of radioactive iodine treatment-related effects and psychosocial concerns that appear to reduce quality of life. The psychosocial concerns reported by participants underscore the significant unmet information and support needs prior to and following RAI treatment among individuals diagnosed with thyroid cancer. IMPLICATIONS FOR CANCER SURVIVORS Future research is needed to help both patients and physicians understand the effect of radioactive iodine on quality of life, and to better assess the benefits versus the risks of radioactive iodine therapy.
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21
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Davies L, Roman BR, Fukushima M, Ito Y, Miyauchi A. Patient Experience of Thyroid Cancer Active Surveillance in Japan. JAMA Otolaryngol Head Neck Surg 2020; 145:363-370. [PMID: 30703198 DOI: 10.1001/jamaoto.2018.4131] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Importance The burden of concern for patients with thyroid cancer who undergo surgical intervention with or without radioactive iodine is known to be substantial. For patients under active surveillance, this aspect of the patient experience has not been described to date and could be a potential barrier to broader acceptance of surveillance as a cancer management strategy. Objective To describe the experiences of patients in the longest-standing and largest thyroid cancer active surveillance program. Design, Setting, and Participants This study used a mixed method of survey, semistructured interviews, and field observation and was conducted at Kuma Hospital in Kobe, Japan. The survey was administered from September 4, 2017, through October 18, 2017, and the field observation was conducted from August 28, 2017, to October 20, 2017. Survey participants were a consecutive sample of 249 patients under active surveillance who were attending the hospital for a surveillance visit, and the semistructured interviewees were a subset of 21 patients. The English-language survey instrument was translated by native Japanese speakers, back-translated into English, and then further refined by a panel of Japanese speakers with expertise in health research. Main Outcomes and Measures Survey and interview responses and field observations. Results In total, 249 surveys were distributed to patients with thyroid cancer on active surveillance. Two hundred forty-three patients (97.6%) completed the survey. Among the respondents, 195 (80.2%) were female and 20 (8.2%) were male (28 [11.5%] responses were missing). Among the subset of 21 patients who participated in the semistructured interview, 3 were male (14.3%), and the mean (range) age was 64 (32-85) years. Thirty-seven percent rated the frequency of cancer worry as occurring sometimes or more. Thirty-two percent said their worry affected their mood somewhat or a lot. Fourteen percent reported that their worry affected their ability to carry out daily activities somewhat or a lot. Cancer spread, later need for surgical intervention, and difficulty with interpreting bodily experiences in the general location of the cancer were among the main sources of worry. Most respondents (60.0%) said their worry was less than it was when they first found out about their cancer. By 3 years after diagnosis, the proportion of participants who reported they were not at all worried increased from 14% (95% CI, 12%-16%) to 25% (95% CI, 23%-26%). Eighty percent (95% CI, 79%-81%) of respondents agreed or strongly agreed that their decision to do active surveillance matched their personal values, and 83% (95% CI, 82%-84%) agreed or strongly agreed that choosing active surveillance was the best decision for them personally. Most patients (77%) had not heard of active surveillance before they were offered the option. Conclusions and Relevance Cancer concern was common among patients with thyroid cancer under active surveillance, which is comparable to the worry among actively treated patients. Levels of cancer worry reported by patients under active surveillance decreased over time, and patients expressed satisfaction with their disease management decision. These findings suggest that the possibility of cancer worry should not be viewed as prohibitive to successful active surveillance in thyroid cancer.
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Affiliation(s)
- Louise Davies
- The VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, Vermont.,Section of Otolaryngology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.,The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
| | - Benjamin R Roman
- Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Yasuhiro Ito
- Department of Surgery, Kuma Hospital, Kobe, Japan
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22
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Pitt SC, Wendt E, Saucke MC, Voils CI, Orne J, Macdonald CL, Connor NP, Sippel RS. A Qualitative Analysis of the Preoperative Needs of Patients With Papillary Thyroid Cancer. J Surg Res 2019; 244:324-331. [PMID: 31306889 PMCID: PMC6815701 DOI: 10.1016/j.jss.2019.06.072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/18/2019] [Accepted: 06/14/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Thyroid cancer patients report unmet needs after diagnosis. However, little is known about their specific needs. Therefore, we sought to characterize the needs of patients with thyroid cancer before undergoing surgery. MATERIAL AND METHODS We conducted semistructured interviews with 32 patients with papillary thyroid cancer after their preoperative surgical consultation. Data were analyzed using thematic content analysis. RESULTS The central need of patients with thyroid cancer was a strong patient-surgeon relationship characterized by informational and emotional support, and respect for the patient as a person. Patients preferred disease- and treatment-related information to be individualized and to take into account aspects of their daily life. They wanted adequate time for asking questions with thoughtful answers tailored to their case. Patients additionally desired emotional support from the surgeon characterized by empathy and validation of their cancer experience. They particularly wanted surgeons to address their fears and anxiety. Patients also highly valued the surgeons' ability to see beyond their disease and acknowledge them as a unique person with respect to their occupation, psychosocial state, and other individual characteristics. When surgeons met patients' needs, they felt reassured, comfortable with their cancer diagnosis, and prepared for treatment. Suboptimal support increased patients' anxiety particularly when they felt the surgeon minimized their concerns. CONCLUSIONS Preoperatively, patients with thyroid cancer desire a strong patient-surgeon relationship. They rely on the surgeon to provide adequate informational and emotional support and respect them as individuals. In turn, patients feel reassured and prepared for treatment.
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Affiliation(s)
- Susan C Pitt
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
| | - Elizabeth Wendt
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Megan C Saucke
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Corrine I Voils
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; William Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Jason Orne
- Qualitative Health Research Consultants, LLC, Madison, Wisconsin
| | | | - Nadine P Connor
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Rebecca S Sippel
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Close AG, Dreyzin A, Miller KD, Seynnaeve BKN, Rapkin LB. Adolescent and young adult oncology-past, present, and future. CA Cancer J Clin 2019; 69:485-496. [PMID: 31594027 DOI: 10.3322/caac.21585] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 06/26/2019] [Accepted: 08/20/2019] [Indexed: 12/12/2022] Open
Abstract
There are nearly 70,000 new cancer diagnoses made annually in adolescents and young adults (AYAs) in the United States. Historically, AYA patients with cancer, aged 15 to 39 years, have not shown the same improved survival as older or younger cohorts. This article reviews the contemporary cancer incidence and survival data through 2015 for the AYA patient population based on the National Cancer Institute's Surveillance, Epidemiology, and End Results registry program and the North American Association of Central Cancer Registries. Mortality data through 2016 from the Centers for Disease Control and Prevention's National Center for Health Statistics are also described. Encouragingly, absolute and relative increases in 5-year survival for AYA cancers have paralleled those of childhood cancers since the year 2000. There has been increasing attention to these vulnerable patients and improved partnerships and collaboration between adult and pediatric oncology; however, obstacles to the care of this population still occur at multiple levels. These vulnerabilities fall into 3 significant categories: research efforts and trial enrollment directed toward AYA malignancies, access to care and insurance coverage, and AYA-specific psychosocial support. It is critical for providers and health care delivery systems to recognize that the AYA population remains vulnerable to provider and societal complacency.
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Affiliation(s)
- Allison G Close
- Division of Hematology/Oncology, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alexandra Dreyzin
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | | | - Brittani K N Seynnaeve
- Division of Hematology/Oncology, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Louis B Rapkin
- Division of Hematology/Oncology, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Abstract
Differentiated thyroid cancer (DTC) is the most common cancer in adolescents and young adults. In 2015, the American Thyroid Association published guidelines for management of pediatric DTC. We report our institutional experience and highlight changing practices and new opportunities. A retrospective analysis of all patients diagnosed with DTC from 2001 to 2016 was performed. Among 59 eligible patients, 31 (53%), 15 (25%), and 13 (22%) had low-risk, intermediate-risk, and high-risk disease, respectively. Half (15/31) of low-risk and all intermediate-risk/high-risk patients received radioactive iodine (I-131) ablation. For low-risk patients, average I-131 dose decreased from 80 to 42.05 mCi, and the percentage of patients who received I-131 decreased over time. Eleven of 16 patients with tumor genomic data were found to have somatic targetable (n=6) or germline (n=5) mutations. Persistent/recurrent disease was only present in high-risk (n=8) and intermediate-risk (n=1) patients. Two patients with iodine-refractory disease received trametinib to enhance radioiodine uptake. All patients were alive at follow-up (median, 5 y; range, 1 to 15 y). Coincident with the recent American Thyroid Association guidelines, the use of I-131 in low-risk patients has decreased over time in our practice. Tumor sequencing and cancer genetic evaluation may help redefine opportunities for treatment of high-risk patients and family counseling.
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Lazard AJ, Saffer AJ, Horrell L, Benedict C, Love B. Peer‐to‐peer connections: Perceptions of a social support app designed for young adults with cancer. Psychooncology 2019; 29:173-181. [DOI: 10.1002/pon.5220] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/29/2019] [Accepted: 08/31/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Allison J. Lazard
- School of Media and JournalismUniversity of North Carolina Chapel Hill North Carolina
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina Chapel Hill North Carolina
- Center for Health CommunicationThe University of Texas at Austin Austin Texas
| | - Adam J. Saffer
- School of Media and JournalismUniversity of North Carolina Chapel Hill North Carolina
| | - Lindsey Horrell
- Gillings School of Global Public HealthUniversity of North Carolina Chapel Hill North Carolina
| | | | - Brad Love
- Center for Health CommunicationThe University of Texas at Austin Austin Texas
- Stan Richards School of Advertising and Public RelationsThe University of Texas at Austin Texas
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Zou L, Gao Z, Zeng F, Xiao J, Chen J, Feng X, Chen D, Fang Y, Cui J, Liu Y, Li Z, Zhu F, Duan Q, Lin X. Sulfasalazine suppresses thyroid cancer cell proliferation and metastasis through T-cell originated protein kinase. Oncol Lett 2019; 18:3517-3526. [PMID: 31516569 PMCID: PMC6732979 DOI: 10.3892/ol.2019.10721] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 06/25/2019] [Indexed: 12/13/2022] Open
Abstract
Thyroid cancer patients with radioactive iodine-refractory or rapidly progressing presentation require effective treatment. T-cell originated protein kinase (TOPK) is highly expressed in a number of different tumor types, where it promotes proliferation and metastasis. However, the expression of TOPK in thyroid cancer is poorly documented. Therefore, immunohistochemistry was used to detect the expression of TOPK in thyroid cancer tissues, and its clinical significance in this disease was investigated. Sulfasalazine, a targeted inhibitor of TOPK that directly binds the protein with a dissociation constant (Kd) of 228 µM, was also investigated using microscale thermophoresis. Sulfasalazine inhibited TOPK activity, as determined by an in vitro pull-down assay. Furthermore, sulfasalazine inhibited the proliferation and metastasis of thyroid cancer cells. The results indicated that TOPK may be a potential therapeutic target and diagnostic biomarker for thyroid cancer and may be used as an index to evaluate malignant thyroid nodules. Therefore, sulfasalazine is a potential novel compound for the targeted treatment of thyroid cancer.
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Affiliation(s)
- Ling Zou
- Department of Internal Medicine, CR and WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei 430080, P.R. China.,Department of Biochemistry and Molecular Biology, School of Basic Medicine, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Zhi Gao
- Department of Internal Medicine, CR and WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei 430080, P.R. China
| | - Fanfan Zeng
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Juanjuan Xiao
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Junmei Chen
- Department of Internal Medicine, CR and WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei 430080, P.R. China
| | - Xiaohong Feng
- Health and Family Planning Committee of Qingshan, Wuhan, Hubei 430080, P.R. China
| | - Di Chen
- Department of Internal Medicine, CR and WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei 430080, P.R. China
| | - Ying Fang
- Department of Internal Medicine, CR and WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei 430080, P.R. China
| | - Jing Cui
- Department of Internal Medicine, CR and WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei 430080, P.R. China
| | - Yang Liu
- Department of Internal Medicine, CR and WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei 430080, P.R. China
| | - Zhi Li
- Department of Internal Medicine, CR and WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei 430080, P.R. China
| | - Feng Zhu
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Qiuhong Duan
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
| | - Xuan Lin
- Department of Internal Medicine, CR and WISCO General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hubei 430080, P.R. China
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Jo HS, Park K, Jung SM. A scoping review of consumer needs for cancer information. PATIENT EDUCATION AND COUNSELING 2019; 102:1237-1250. [PMID: 30772114 DOI: 10.1016/j.pec.2019.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/30/2019] [Accepted: 02/05/2019] [Indexed: 05/08/2023]
Abstract
OBJECTIVE This study was a scoping review of research on cancer-related health information seeking and needs of patients, survivor, non-patients, and caregivers. METHODS This study used the COSI model to search for articles published from 2007 to 2017. RESULTS In total, 117 articles with titles and abstracts including the following terms were selected: cancer, health, information, seeking. Non-patients obtained information from the Internet, doctors, and media, whereas patients obtained information from doctors, the Internet, and media. Information needs were the highest for treatment, prognosis, and psychosocial support. Patients had the highest need for information on prognosis and treatment, whereas non-patients had the highest need for general cancer information, prevention, and cancer examination. Caregivers sought information about treatment, psychosocial support, and prevention. CONCLUSION This study revealed an increase in the number of research articles identifying cancer patients' information needs. Cancer patients rely on health professionals for information; thus, relevant materials are needed. Furthermore, not only medical but also psychosocial support information is needed. PRACTICE IMPLICATIONS There is a need for cancer information from health professionals, and thus for patient-centered training materials. Furthermore, a survey system to evaluate consumers' cancer information needs should be developed.
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Affiliation(s)
- Heui Sug Jo
- Department of Health Policy and Management, Kangwon National University College of Medicine, Chuncheon, South Korea
| | - Keeho Park
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, South Korea
| | - Su Mi Jung
- Department of Health Policy and Management, Kangwon National University College of Medicine, Chuncheon, South Korea.
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Cancer information needs according to cancer type: A content analysis of data from Japan's largest cancer information website. Prev Med Rep 2018; 12:245-252. [PMID: 30377575 PMCID: PMC6205331 DOI: 10.1016/j.pmedr.2018.10.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 10/15/2018] [Accepted: 10/21/2018] [Indexed: 01/05/2023] Open
Abstract
The provision of information about cancer is an important aspect of cancer care. Cancer information provided online is expected to meet the needs of information seekers. Whether information needs vary according to tumor site is largely unknown. We aimed to examine similarities and differences in informational needs by cancer type. Data were collected using a questionnaire administered on Japan's largest cancer information website, “Ganjoho service”. A total of 2782 free descriptive responses in the period from April 2012 to December 2017 were analyzed using text-mining software. We identified the top 10 informational need contents, in order of appearance frequency, for eight tumor sites: gastric, colorectal, esophageal, lung, pancreatic, breast, cervical, and prostate cancer. Frequent information needs common to all tumor sites included symptoms, disease stages, treatments, chance of cure, recovery, metastasis, and recurrence. A need for information about diet, pain, side effects of treatments, complementary and alternative medicine was frequent for some tumor sites. Tumor site-specific information should include the following, according to cancer type: information of scirrhous carcinoma for gastric cancer; unusual feces for colorectal cancer; lung X-ray images for lung cancer; early detection for pancreatic cancer; adenocarcinoma, sexual activity, pregnancy, and childbirth for cervical cancer; breast conservation or reconstruction and triple negative cancer for breast cancer; test values and diagnosis and urinary problems for prostate cancer; and hormone therapy for breast and prostate cancer. Cancer information provided online should meet these frequent informational needs, considering similarities and differences of the information required according to tumor site. We examined similarities and differences in cancer information needs by tumor site. Common needs are symptoms, stages, treatment, cure, recovery, metastasis, recurrence. Site-specific needs include diet, pain, side effects, early detection, test values. Cancer information should be provided to meet frequent needs, by tumor site.
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29
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Yan R, Yang T, Zhai H, Zhou Z, Gao L, Li Y. MicroRNA-150-5p affects cell proliferation, apoptosis, and EMT by regulation of the BRAF V600E mutation in papillary thyroid cancer cells. J Cell Biochem 2018; 119:8763-8772. [PMID: 30126001 DOI: 10.1002/jcb.27108] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 05/09/2018] [Indexed: 01/26/2023]
Abstract
Papillary thyroid cancer (PTC) is the most common endocrine malignancy. Studies have confirmed an association between microRNA (miRNA) and the BRAFV600E mutation in various cellular biological processes of PTC. This study aimed to clarify the potential relationship between miR-150-5p and the BRAFV600E mutation in PTC. Human PTC cell lines B-CPAP and TPC-1 were transfected with the miR-150-5p mimic, an inhibitor, and the corresponding controls. Then, cell proliferation, viability, and apoptosis were detected by bromodeoxyuridine, trypan blue exclusion, and flow cytometry assays. The expressions of the main factors of cell cycle, epithelial mesenchymal transition (EMT), and DNA mismatch repair were examined by Western blot analysis and a real-time quantitative polymerase chain reaction. Additionally, pc-BRAFV600E was transfected into B-CPAP and TPC-1 cells to determine the relationship between miR-150-5p and BRAFV600E . In addition, the methyl ethyl ketone (MEK)/extracellular signal-regulated kinase (ERK) signal pathway was examined using Western blot analysis. Overexpression of miR-150-5p promoted cell proliferation and viability, inhibited apoptosis, and upregulated cell cycle factor expressions at 50 passages of B-CPAP and TPC-1 cells after transfection. Overexpression of miR-150-5p led to an obvious decrease in E-cadherin expression, but enhanced N-cadherin, Slug and Vimentin, ZEB1, and Snail expression. Moreover, overexpression of miR-150-5p markedly suppressed POLD3, MSH2, and MSH3 expression. Furthermore, BRAFV600E overexpression increased the expression level of miR-150-5p in TPC cells, and overexpression of telomerase reverse transcriptase further enhanced the promoting effect of BRAFV600E on miR-150-5p expression in B-CPAP and TPC-1 cells. Finally, BRAFV600E overexpression activated the MEK/ERK signal pathway in B-CPAP and TPC-1 cells. These data indicated that miR-150-5p promoted cell proliferation, suppressed apoptosis, and accelerated the EMT process by regulation of the BRAFV600E mutation. Our findings will help elucidate the pathogenesis of PTC and identify biomarkers.
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Affiliation(s)
- Ruihong Yan
- Department of Nuclear Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Tianzheng Yang
- Department of Nuclear Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Hongyan Zhai
- Department of Nuclear Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Zhenhu Zhou
- Department of Nuclear Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Lei Gao
- Laboratory of Molecular Medicine, Liaocheng People's Hospital, Liaocheng, China
| | - Yuhong Li
- Department of Pathology, Liaocheng People's Hospital, Liaocheng, China
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Papadakos J, McQuestion M, Gokhale A, Damji A, Trang A, Abdelmutti N, Ringash J. Informational Needs of Head and Neck Cancer Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:847-856. [PMID: 28155041 DOI: 10.1007/s13187-017-1176-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The patient journey with head and neck cancer (HNC) is particularly challenging given the physical and functional impact of the cancer and treatment. The ability to perform activities of daily living can be severely compromised and have a profound impact on psychosocial well-being. These complex and long-lasting effects can affect patient quality of life for months to years and the literature shows that information for HNC patients is often insufficient. This observational cross-sectional study utilized survey methodology to investigate the informational needs of HNC patients and the preferred modalities for delivery. This was done to inform the development of resources for HNC patients. Four hundred fifty surveys were analyzed. The median age was 61 years and 58% of the cohort was born in Canada. Most were Caucasian (72%), Chinese being the next largest ethnicity (12%). A third had less than high school education and most had cancer of the oral cavity (28%) and were in long-term follow-up (41%). Comparison of the percentage of items to which a patient responded "very important" across the six domains shows variation of importance by domain (overall mixed effects regression model p < 0.0001). Additionally, each domain was compared to the medical domain and all had significantly lower mean scores (all p < 0.0001) with the medical domain scoring highest (mean score 64.6). The top preferred education modalities were teaching with a healthcare professional and pamphlets. This study highlights the type of information that HNC patients want and the format they wish to receive it in. The design provides a comprehensive way to consult with patients toward building education that responds to their specific needs.
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Affiliation(s)
- Janet Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada.
- ELLICSR: Health, Wellness & Cancer Survivorship Centre, Princess Margaret Cancer Centre, PMB ELLICSR, 585 University Avenue, Toronto, ON, M5G 2N2, Canada.
| | - Maurene McQuestion
- Radiation Medicine Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
- Head and Neck Survivorship Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Anandita Gokhale
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ali Damji
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Aileen Trang
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Nazek Abdelmutti
- Cancer Education Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
| | - Jolie Ringash
- ELLICSR: Health, Wellness & Cancer Survivorship Centre, Princess Margaret Cancer Centre, PMB ELLICSR, 585 University Avenue, Toronto, ON, M5G 2N2, Canada
- Head and Neck Survivorship Program, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada
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Gou J, Cheng W, Lei J, Pan Q, You W, Cai M, Tang H, Lei Y, Li Z, Gong R, Zhu J. Health-related quality-of-life assessment in surgical patients with papillary thyroid carcinoma: A single-center analysis from Mainland China. Medicine (Baltimore) 2017; 96:e8070. [PMID: 28930844 PMCID: PMC5617711 DOI: 10.1097/md.0000000000008070] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Even with a favorable prognosis, the health-related quality of life (HRQoL) of papillary thyroid carcinoma (PTC) patients remains unclear and conflicting. Thus, in the present study, we compared the HRQoL of PTC patients with that of the general population (GP).The study was performed in our thyroid and parathyroid surgery department, and 186 PTC patients who had undergone thyroidectomy were included. The exclusion criteria were an age < 18 years, no follow-up, and the presence of other malignant neoplasms. The control group included 186 volunteers who were matched by age, gender, and socioeconomic status. The survivor and control groups were asked to complete the Chinese version of the SF-36 questionnaire.The 186 volunteers from the GP were well matched to PTC patients with respect to the baseline demographic characteristics. PTC patients showed significantly lower scores than those of the control group in 7 domains of the HRQoL: role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role-emotional (RE), and mental health (MH). PTC was a risk factor for a low Physical Component Summary (PCS) score and a low Mental Component Summary (MCS) score (all P values were less than .05). Significant reductions in the scores of all 8 domains were observed at 1 month after the operation, and obvious recovery was noted at 6 months according to the PCS and MCS scores (all P values were less than .05). However, even 2 years after surgery, few domain scores had recovered to levels found in the GP, including the PCS and MCS scores (all P values were less than .05).Due to the decreased preoperative and postoperative HRQoL scores, much attention should be given to and more long-term observation should be performed for PTC patients, even those who have undergone surgery.
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Affiliation(s)
| | | | | | - Qian Pan
- Thyroid and Parathyroid Surgery Center
| | - Wei You
- Thyroid and Parathyroid Surgery Center
| | - Ming Cai
- Thyroid and Parathyroid Surgery Center
| | - Huairong Tang
- Health and Management Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yali Lei
- Health and Management Center, West China Hospital of Sichuan University, Chengdu, China
| | - Zhihui Li
- Thyroid and Parathyroid Surgery Center
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Abstract
Despite the increase in thyroid cancer incidence among adolescents and young adults (AYAs), this group has received limited attention. We reviewed the epidemiology and challenges of thyroid cancer care among AYAs, and proposed a research agenda to improve their care. Thyroid cancer is the most common cancer in American adults 16-33 years of age. AYAs with thyroid cancer face challenges including overdiagnosis reduced healthcare access and inconsistent care. Successful treatment of these patients results in additional challenges due to ongoing side effects of treatment as well as lasting impacts on their quality of life. These challenges should fuel a collaborative research agenda aimed at improving the quality of care for AYAs with thyroid cancer across the spectrum of diagnosis, treatment and survivorship.
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Affiliation(s)
| | - Archie Bleyer
- Department of Radiation Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Juan P Brito
- Division of Endocrinology, Diabetes, Metabolism, & Nutrition. Knowledge & Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic 200, Rochester, MN 55905, USA
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Li JJ, Zheng PCJR, Wang YZ. The correlations between DNA methylation and polymorphisms in the promoter region of the human telomerase reverse transcriptase (hTERT) gene with postoperative recurrence in patients with thyroid carcinoma (TC). World J Surg Oncol 2017; 15:114. [PMID: 28587656 PMCID: PMC5461729 DOI: 10.1186/s12957-017-1170-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 05/16/2017] [Indexed: 12/28/2022] Open
Abstract
Background This study aims at exploring the correlations between DNA methylation and polymorphisms in the promoter region of the human telomerase reverse transcriptase (hTERT) gene and postoperative recurrence in patients with thyroid carcinoma (TC). Methods A total of 312 patients diagnosed with TC were chosen for the study and categorized into recurrence (n = 75) and non-recurrence (n = 237) groups. The hTERT rs2736100 and rs2736098 polymorphisms were detected by performing polymerase chain reaction-restriction fragment length polymorphism. DNA methylation in the promoter region of hTERT gene was evaluated by pyrosequencing. A telephonic and/or outpatient follow-up was conducted for all patients. The correlations of DNA methylation and polymorphisms in the promoter region of hTERT with postoperative recurrence of TC patients underwent analysis. Results The patient in the recurrence group showed evidently different pathological types and tumor stages in comparison to the non-recurrence group. The GG genotype of hTERT rs2736100 might increase the recurrence risk of TC patients. No correlations between hTERT rs2736098 polymorphisms and recurrence risk were observed. Compared to the TT + TG genotype frequency, the rs2736100 GG genotype frequency increased in patients without multicentricity, patients with extrathyroidal invasion, patients with lymph node metastasis, patients with undifferentiated carcinoma, and patients in the III + IV stage. The recurrence group showed significantly higher DNA methylation level compared to the non-recurrence group. The DNA methylation level was closely associated to tumor stage and lymph node metastasis of TC patients in the recurrence group. Conclusions The DNA methylation and rs2736100 polymorphisms in the promoter region of hTERT gene might be in correlation to postoperative recurrence of TC patients.
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Affiliation(s)
- Jian-Jun Li
- Thyroid Surgery, Ningbo No.2 Hospital, No. 41, Xibei Street, Haishu District, Ningbo, 315010, Zhejiang, People's Republic of China.
| | - Ping Chen Jue-Ru Zheng
- Thyroid Surgery, Ningbo No.2 Hospital, No. 41, Xibei Street, Haishu District, Ningbo, 315010, Zhejiang, People's Republic of China
| | - Yao-Zong Wang
- Thyroid Surgery, Ningbo No.2 Hospital, No. 41, Xibei Street, Haishu District, Ningbo, 315010, Zhejiang, People's Republic of China
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Hu J, Li C, Liu C, Zhao S, Wang Y, Fu Z. Expressions of miRNAs in papillary thyroid carcinoma and their associations with the clinical characteristics of PTC. Cancer Biomark 2017; 18:87-94. [PMID: 28085013 DOI: 10.3233/cbm-161723] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The sensitivity and specificity of biomarkers which have been used in clinical practice for diagnosis of papillary thyroid carcinoma (PTC) are low, it is essential to develop novel diagnostic and prognostic biomarkers for PTC. OBJECTIVE To explore the expressions of miR-940, miR-15a, miR-16 and IL-23 in PTC tissues and plasma and their associations with the clinical characteristics of PTC. METHODS We investigated the expressions of miR-940, miR-15a, miR-16 and IL-23 in plasma and thyroid tissues of PTC, nodular goiter and healthy people with qRT-PCR, and further analyzed the associations between their levels and the clinical characteristics of PTC. RESULTS Level of IL-23 expression was higher while levels of miR-940, miR-15a and miR-16 expression in the PTC tissues were lower compared with the nodular goiter tissues and perineoplastic thyroid tissues. And the levels of miR-940, miR-15a, miR-16 and IL-23 expression in the PTC tissues were associated with some clinical characteristics of PTC, including bilateral tumor, multicentricity, extrallyroidal invasion, cervical lymph node metastasis, distant metastasis and clinical advanced stages (III/IV). CONCLUSIONS Expressions of miR-940, miR-15a, miR-16 and IL-23 in PTC tissues might be useful biomarkers and promising targets in the diagnosis of papillary thyroid carcinoma.
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Affiliation(s)
- Jianxia Hu
- The Laboratory of Thyroid Disease, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,The Laboratory of Thyroid Disease, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Chengqian Li
- Endocrinology Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,The Laboratory of Thyroid Disease, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Chongkai Liu
- Department of Urology, The People's Hospital of Jimo, Qingdao, Shandong, China
| | - Shihua Zhao
- The Laboratory of Thyroid Disease, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yangang Wang
- Endocrinology Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Zhengju Fu
- Endocrinology Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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Fletcher C, Flight I, Chapman J, Fennell K, Wilson C. The information needs of adult cancer survivors across the cancer continuum: A scoping review. PATIENT EDUCATION AND COUNSELING 2017; 100:383-410. [PMID: 27765377 DOI: 10.1016/j.pec.2016.10.008] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/29/2016] [Accepted: 10/08/2016] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To provide an updated synthesis of the literature that investigates the self-reported information needs of people diagnosed with cancer across the cancer continuum. METHODS We conducted a scoping review of the literature published from August 2003 to June 2015 and expanded an existing typology summarizing the information needs of people diagnosed with cancer. RESULTS The majority of the included studies (n=104) focused on questions relevant to the diagnosis/active treatment phase of the cancer continuum (52.9%) and thus the most frequently identified information needs related to this phase (33.4%). Information needs varied across the continuum and the results highlight the importance of recognising this fact. CONCLUSION People diagnosed with cancer experience discrete information needs at different points from diagnosis to survival. Much of the research conducted in this area has focused on their information needs during the diagnosis and treatment of cancer, and literature relating to information needs following completion of treatment is sparse. PRACTICE IMPLICATIONS Further research is needed to discern the specific nature of the treatment concerns and identify the information needs that survivors experience during recurrence of cancer, metastasis or changes in diagnosis, and the end of life phase of the cancer continuum.
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Affiliation(s)
- Chloe Fletcher
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia
| | - Ingrid Flight
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia.
| | - Janine Chapman
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia
| | - Kate Fennell
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia; Cancer Council SA, Adelaide, Australia
| | - Carlene Wilson
- Flinders Centre for Innovation in Cancer, School of Medicine, Flinders University, Adelaide, Australia; Cancer Council SA, Adelaide, Australia
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Hyun YG, Alhashemi A, Fazelzad R, Goldberg AS, Goldstein DP, Sawka AM. A Systematic Review of Unmet Information and Psychosocial Support Needs of Adults Diagnosed with Thyroid Cancer. Thyroid 2016; 26:1239-50. [PMID: 27350421 DOI: 10.1089/thy.2016.0039] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Patient education and psychosocial support to patients are important elements of comprehensive cancer care, but the needs of thyroid cancer survivors are not well understood. METHODS The published English-language quantitative literature on (i) unmet medical information and (ii) psychosocial support needs of thyroid cancer survivors was systematically reviewed. A librarian information specialist searched seven electronic databases and a hand search was conducted. Two reviewers independently screened citations from the electronic search and reviewed relevant full-text papers. There was consensus between reviewers on the included papers, and duplicate independent abstraction was performed. The results were summarized descriptively. RESULTS A total of 1984 unique electronic citations were screened, and 51 full-text studies were reviewed (three from the hand search). Seven cross-sectional, single-arm, survey studies were included, containing data from 6215 thyroid cancer survivor respondents. The respective study sizes ranged from 57 to 2398 subjects. All of the studies had some methodological limitations. Unmet information needs were variable relating to the disease, diagnostic tests, treatments, and co-ordination of medical care. There were relatively high unmet information needs related to aftercare (especially long-term effects of the disease or its treatment and its management) and psychosocial concerns (including practical and financial matters). Psychosocial support needs were incompletely met. Patient information on complementary and alternative medicine was very limited. CONCLUSIONS In conclusion, thyroid cancer survivors perceive many unmet information needs, and these needs extend to aftercare. Psychosocial information and supportive care needs may be insufficiently met in this population. More work is needed to improve knowledge translation and psychosocial support for thyroid cancer survivors.
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Affiliation(s)
- Yong Gyu Hyun
- 1 Department of Volunteer Resources, University Health Network, Toronto, Canada
| | - Ahmad Alhashemi
- 2 Clinical Endocrinology Fellowship, Division of Endocrinology, Department of Medicine, University of Toronto , Toronto, Canada
| | - Rouhi Fazelzad
- 3 University Health Network Library and Information Services , Princess Margaret Cancer Centre, Toronto, Canada
| | - Alyse S Goldberg
- 2 Clinical Endocrinology Fellowship, Division of Endocrinology, Department of Medicine, University of Toronto , Toronto, Canada
| | - David P Goldstein
- 4 Department of Otolaryngology-Head and Neck Surgery, University Health Network and University of Toronto , Toronto, Canada
| | - Anna M Sawka
- 5 Division of Endocrinology, Department of Medicine, University Health Network and University of Toronto , Toronto, Canada
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Drost FM, Mols F, Kaal SEJ, Stevens WBC, van der Graaf WTA, Prins JB, Husson O. Psychological impact of lymphoma on adolescents and young adults: not a matter of black or white. J Cancer Surviv 2016; 10:726-35. [PMID: 26856728 PMCID: PMC4920833 DOI: 10.1007/s11764-016-0518-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/20/2016] [Indexed: 01/11/2023]
Abstract
PURPOSE The purpose of the study is to examine differences in perceived impact of cancer (IOC) between adolescents and young adults (AYAs; 18-35 years at cancer diagnosis), adults (36-64 years) and elderly (65-84 years) with a history of (non-)Hodgkin lymphoma. Furthermore, to investigate the association of socio-demographic, clinical and psychological characteristics with IOC; and the association between IOC and health-related quality of life (HRQoL) among AYAs only. METHODS This study is part of a population-based PROFILES registry survey among lymphoma patients diagnosed between 1999 and 2009. Patients (n = 1.281) were invited to complete the IOCv1 and EORTC-QLQ-C30 questionnaires. Response rate was 67 % (n = 861). RESULTS AYA lymphoma survivors scored higher on the positive IOC summary scale, compared to adult and elderly patients (p < 0.001), while no significant differences were observed for negative IOC. Among AYAs, females, survivors with a partner, and survivors with elevated psychological distress levels scored significantly higher on the negative IOC summary scale. The negative IOC summary scale was negatively associated with all EORTC QLQ-C30 functioning scales (β ranging from -0.39 to -0.063; p < 0.05). The positive IOC summary scale was negatively associated with the EORTC QLQ-C30 subscale 'Emotional functioning' (β = -0.24; p < 0.05). CONCLUSION AYA, adult and elderly with a history of (non-)Hodgkin lymphoma experienced different types of IOC in terms of positive and negative aspects. IMPLICATIONS FOR CANCER SURVIVORS Although AYAs experience a more positive IOC compared to older survivors, some AYAs experience more negative IOC and may require developmentally appropriate interventions to address their specific concerns.
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Affiliation(s)
- F M Drost
- CoRPS - Centre of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - F Mols
- CoRPS - Centre of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands (CCCN), Netherlands Cancer Registry, Eindhoven, The Netherlands
| | - S E J Kaal
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - W B C Stevens
- Department of Haematology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - W T A van der Graaf
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
- The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - J B Prins
- Department of Medical Psychology, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - O Husson
- Department of Medical Psychology, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Thompson CM, Crook B, Love B, Macpherson CF, Johnson R. Understanding how adolescents and young adults with cancer talk about needs in online and face-to-face support groups. J Health Psychol 2016; 21:2636-2646. [PMID: 25921477 DOI: 10.1177/1359105315581515] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We compared adolescent and young adult cancer patient and survivor language between mediated and face-to-face support communities in order to understand how the use of certain words frame conversations about family, friends, health, work, achievement, and leisure. We analyzed transcripts from an online discussion board ( N = 360) and face-to-face support group ( N = 569) for adolescent and young adults using Linguistic Inquiry and Word Count, a word-based computerized text analysis software that counts the frequency of words and word stems. There were significant differences between the online and face-to-face support groups in terms of content (e.g. friends, health) and style words (e.g. verb tense, negative emotion, and cognitive process).
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Affiliation(s)
| | | | - Brad Love
- 2 The University of Texas at Austin, USA
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Goldfarb M, Casillas J. Thyroid Cancer-Specific Quality of Life and Health-Related Quality of Life in Young Adult Thyroid Cancer Survivors. Thyroid 2016; 26:923-32. [PMID: 27161396 DOI: 10.1089/thy.2015.0589] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is a lack of health-related quality of life (HRQOL) research in thyroid cancer (TC) survivors, especially young adults (YAs). This study aims to assess the socio-demographic and clinical factors that most influence TC-specific QOL domains and estimate the impact of different health conditions on HRQOL in a large cohort of YA TC survivors. METHODS TC survivors ≥17 years of age were recruited through the thyroid cancer survivor (ThyCa) Web site. Mean scores for the seven domains and six items of THYCA-QoL, MCS and PCS of SF-12v1, and derived SF-6D were compared between factors as well as age groups (YA: 17-39 years, adult ≥40 years), and to the normal population. Regression analyses estimated the relationship between the socio-demographic, clinical, and THYCA-QoL measures and HRQOL in YAs only. RESULTS Of 1028 survivors, 277 (27%) were YAs. Most YAs were female (93.5%), white (86.6%), insured (96.8%), married or in a stable relationship (69%), and listed a comorbidity (43.7%); all reported their entire thyroid had been removed. Average survivorship time was 46.2 months (SD = 51.0). Almost every socio-demographic and clinical factor significantly influenced one or more domain of THYCA-QoL in both YAs and older adults. In both groups, a higher level of education, female sex, unemployment, and having a comorbidity resulted in significantly higher THYCA-QoL scores (more complaints) and lower SF-6D scores (lower HRQOL; p < 0.05). Current YAs had less neuromuscular, voice, sympathetic, and throat/mouth complaints but more grievances involving their scar, headaches, anxiety, and overall psychological state (p < 0.05). The average SF-6D for YAs was 0.70 (SD = 0.13), which was similar to the older adults but significantly different from the normal age-matched population in females (p < 0.01). All THYCA-QoL domains were strongly associated with a lower HRQOL (adj R(2) > 0.5) in YAs. The simplest, best regression model (adj R(2) = 0.53) in YAs included neuromuscular, concentration, and anxiety complaints, as well as having a comorbidity predicting lower HRQOL. CONCLUSION TC-specific QOL is significantly influenced by many socio-demographic and clinical factors. HRQOL is lower in female YA TC survivors compared with the normal age-matched population. Neuromuscular, concentration, and anxiety complaints had the greatest impact on HRQOL in YA TC survivors.
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Affiliation(s)
- Melanie Goldfarb
- 1 Endocrine Tumor Program, John Wayne Cancer Institute at Providence St. John's Health Center , Santa Monica, California
| | - Jacqueline Casillas
- 2 Department of Pediatrics, University of California , Los Angeles, California
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41
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Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016; 26:1-133. [PMID: 26462967 PMCID: PMC4739132 DOI: 10.1089/thy.2015.0020] [Citation(s) in RCA: 8470] [Impact Index Per Article: 1058.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer. METHODS The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles on adults were eligible for inclusion. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations for therapeutic interventions. We developed a similarly formatted system to appraise the quality of such studies and resultant recommendations. The guideline panel had complete editorial independence from the ATA. Competing interests of guideline task force members were regularly updated, managed, and communicated to the ATA and task force members. RESULTS The revised guidelines for the management of thyroid nodules include recommendations regarding initial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needle aspiration biopsy results, use of molecular markers, and management of benign thyroid nodules. Recommendations regarding the initial management of thyroid cancer include those relating to screening for thyroid cancer, staging and risk assessment, surgical management, radioiodine remnant ablation and therapy, and thyrotropin suppression therapy using levothyroxine. Recommendations related to long-term management of differentiated thyroid cancer include those related to surveillance for recurrent disease using imaging and serum thyroglobulin, thyroid hormone therapy, management of recurrent and metastatic disease, consideration for clinical trials and targeted therapy, as well as directions for future research. CONCLUSIONS We have developed evidence-based recommendations to inform clinical decision-making in the management of thyroid nodules and differentiated thyroid cancer. They represent, in our opinion, contemporary optimal care for patients with these disorders.
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Affiliation(s)
| | - Erik K. Alexander
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | - Susan J. Mandel
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | - Gregory W. Randolph
- Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anna M. Sawka
- University Health Network, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Julie Ann Sosa
- Duke University School of Medicine, Durham, North Carolina
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Aschebrook-Kilfoy B, James B, Nagar S, Kaplan S, Seng V, Ahsan H, Angelos P, Kaplan EL, Guerrero MA, Kuo JH, Lee JA, Mitmaker EJ, Moalem J, Ruan DT, Shen WT, Grogan RH. Risk Factors for Decreased Quality of Life in Thyroid Cancer Survivors: Initial Findings from the North American Thyroid Cancer Survivorship Study. Thyroid 2015; 25:1313-21. [PMID: 26431811 PMCID: PMC4684649 DOI: 10.1089/thy.2015.0098] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The prevalence of thyroid cancer survivors is rising rapidly due to the combination of an increasing incidence, high survival rates, and a young age at diagnosis. The physical and psychosocial morbidity of thyroid cancer has not been adequately described, and this study therefore sought to improve the understanding of the impact of thyroid cancer on quality of life (QoL) by conducting a large-scale survivorship study. METHODS Thyroid cancer survivors were recruited from a multicenter collaborative network of clinics, national survivorship groups, and social media. Study participants completed a validated QoL assessment tool that measures four morbidity domains: physical, psychological, social, and spiritual effects. Data were also collected on participant demographics, medical comorbidities, tumor characteristics, and treatment modalities. RESULTS A total of 1174 participants with thyroid cancer were recruited. Of these, 89.9% were female, with an average age of 48 years, and a mean time from diagnosis of five years. The mean overall QoL was 5.56/10, with 0 being the worst. Scores for each of the sub-domains were 5.83 for physical, 5.03 for psychological, 6.48 for social, and 5.16 for spiritual well-being. QoL scores begin to improve five years after diagnosis. Female sex, young age at diagnosis, and lower educational attainment were highly predictive of decreased QoL. CONCLUSION Thyroid cancer diagnosis and treatment can result in a decreased QoL. The present findings indicate that better tools to measure and improve thyroid cancer survivor QoL are needed. The authors plan to follow-up on these findings in the near future, as enrollment and data collection are ongoing.
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Affiliation(s)
| | - Benjamin James
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Sapna Nagar
- Division of Endocrine Surgery, Department of General Surgery, Beaumont Hospitals, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan
| | - Sharone Kaplan
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Vanessa Seng
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Habibul Ahsan
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois
| | - Peter Angelos
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Edwin L. Kaplan
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Marlon A. Guerrero
- Department of Surgery, University of Arizona School of Medicine, Tucson, Arizona
| | - Jennifer H. Kuo
- Division of GI/Endocrine Surgery, Department of Surgery, Columbia University Medical Center, New York, New York
| | - James A. Lee
- Division of GI/Endocrine Surgery, Department of Surgery, Columbia University Medical Center, New York, New York
| | - Elliot J. Mitmaker
- Department of Surgery and Oncology, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, New York
| | - Jacob Moalem
- Department of Surgery, McGill University Health Centre, Montreal, Canada
| | - Daniel T. Ruan
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Wen T. Shen
- Department of Surgery, University of California, San Francisco, San Francisco, California
| | - Raymon H. Grogan
- Endocrine Surgery Research Program, Department of Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
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Ameringer S, Erickson JM, Macpherson CF, Stegenga K, Linder LA. Symptoms and Symptom Clusters Identified by Adolescents and Young Adults With Cancer Using a Symptom Heuristics App. Res Nurs Health 2015; 38:436-48. [PMID: 26455729 DOI: 10.1002/nur.21697] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2015] [Indexed: 10/23/2022]
Abstract
Adolescents and young adults (AYAs) with cancer experience multiple distressing symptoms during treatment. Because the typical approach to symptom assessment does not easily reflect the symptom experience of individuals, alternative approaches to enhancing communication between the patient and provider are needed. We developed an iPad-based application that uses a heuristic approach to explore AYAs' cancer symptom experiences. In this mixed-methods descriptive study, 72 AYAs (13-29 years old) with cancer receiving myelosuppressive chemotherapy used the Computerized Symptom Capture Tool (C-SCAT) to create images of the symptoms and symptom clusters they experienced from a list of 30 symptoms. They answered open-ended questions within the C-SCAT about the causes of their symptoms and symptom clusters. The images generated through the C-SCAT and accompanying free-text data were analyzed using descriptive, content, and visual analyses. Most participants (n = 70) reported multiple symptoms (M = 8.14). The most frequently reported symptoms were nausea (65.3%), feeling drowsy (55.6%), lack of appetite (55.6%), and lack of energy (55.6%). Forty-six grouped their symptoms into one or more clusters. The most common symptom cluster was nausea/eating problems/appetite problems. Nausea was most frequently named as the priority symptom in a cluster and as a cause of other symptoms. Although common threads were present in the symptoms experienced by AYAs, the graphic images revealed unique perspectives and a range of complexity of symptom relationships, clusters, and causes. Results highlight the need for a tailored approach to symptom management based on how the AYA with cancer perceives his or her symptom experience.
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Affiliation(s)
- Suzanne Ameringer
- Associate Professor School of Nursing, Virginia Commonwealth University, 1100 East Leigh Street Richmond, VA, 23298
| | - Jeanne M Erickson
- Assistant Professor College of Nursing, University of Wisconsin-Milwaukee Milwaukee, WI
| | | | - Kristin Stegenga
- Nurse Researcher Children's Mercy Hospital, Kansas City, Missouri
| | - Lauri A Linder
- Assistant Professor College of Nursing, University of Utah, Clinical Nurse Specialist, Primary Children's Hospital, Salt Lake City, UT
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Pounders K, Stowers K, Wilcox G, Love B, Mackert M. Exploring gender and identity issues among female adolescent and young adults who connect in an anonymous platform. J Health Psychol 2015; 22:548-560. [PMID: 26424810 DOI: 10.1177/1359105315605657] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There has been an increased usage of online cancer support groups as a resource for health-related information and social support. This work analyzes message blog posts from an anonymous online support community to better understand issues related to gender and identity among female adolescent and young adults. This work sheds further light into the nuances of gender and identity issues including motherhood and reproductive issues, physical appearance, and romantic relationships. Specifically, findings reveal that female adolescent and young adults experience issues pertaining to infertility, feeling like a bad mom, hair loss, scarring, dating, and intimacy. These findings of this work offer further guidance about how healthcare providers and caregivers can attempt to meet the needs of female adolescent and young adults.
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Affiliation(s)
| | | | | | - Brad Love
- The University of Texas at Austin, USA
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ZHAO YINLONG, LIU XIAODONG, ZHONG LILI, HE MENGZI, CHEN SILIN, WANG TIEJUN, MA SHUMEI. The combined use of miRNAs and mRNAs as biomarkers for the diagnosis of papillary thyroid carcinoma. Int J Mol Med 2015; 36:1097-103. [DOI: 10.3892/ijmm.2015.2305] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 07/29/2015] [Indexed: 11/06/2022] Open
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Sawka AM, Straus S, Rodin G, Heus L, Brierley JD, Tsang RW, Rotstein L, Ezzat S, Segal P, Gafni A, Thorpe KE, Goldstein DP. Thyroid cancer patient perceptions of radioactive iodine treatment choice: Follow-up from a decision-aid randomized trial. Cancer 2015. [PMID: 26195199 PMCID: PMC4832354 DOI: 10.1002/cncr.29548] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Patient decision aids (P-DAs) inform medical decision making, but longer term effects are unknown. This article describes extended follow-up from a thyroid cancer treatment P-DA trial. METHODS In this single-center, parallel-design randomized controlled trial conducted at a Canadian tertiary/quaternary care center, early-stage thyroid cancer patients from a P-DA trial were contacted 15 to 23 months after randomization/radioactive iodine (RAI) decision making to evaluate longer term outcomes. It was previously reported that the use of the computerized P-DA in thyroid cancer patients considering postsurgical RAI treatment significantly improved medical knowledge in comparison with usual care alone. The P-DA and control groups were compared for the following outcomes: feeling informed about the RAI treatment choice, decision satisfaction, decision regret, cancer-related worry, and physician trust. In a subgroup of 20 participants, in-depth interviews were conducted for a qualitative analysis. RESULTS Ninety-five percent (70 of 74) of the original population enrolled in follow-up at a mean of 17.1 months after randomization. P-DA users perceived themselves to be significantly more 1) informed about the treatment choice (P = .008), 2) aware of options (P = .009), 3) knowledgeable about treatment benefits (P = .020), and 4) knowledgeable about treatment risks/side effects (P = .001) in comparison with controls. There were no significant group differences in decision satisfaction (P = .142), decision regret (P = .199), cancer-related worry (P = .645), mood (P = .211), or physician trust (P = .764). In the qualitative analysis, the P-DA was perceived to have increased patient knowledge and confidence in decision making. CONCLUSIONS The P-DA improved cancer survivors' actual and long-term perceived medical knowledge with no adverse effects. More research on the long-term outcomes of P-DA use is needed.
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Affiliation(s)
- Anna M Sawka
- Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada
| | - Sharon Straus
- Department of Medicine, St. Michael's Hospital/University of Toronto, Toronto, Canada
| | - Gary Rodin
- Department of Psychosocial Oncology, University Health Network/University of Toronto, Toronto, Canada
| | - Lineke Heus
- Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada
| | - James D Brierley
- Department of Radiation Oncology, University Health Network/University of Toronto, Toronto, Canada
| | - Richard W Tsang
- Department of Radiation Oncology, University Health Network/University of Toronto, Toronto, Canada
| | - Lorne Rotstein
- Department of Surgery, University Health Network/University of Toronto, Toronto, Canada
| | - Shereen Ezzat
- Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada
| | - Phillip Segal
- Division of Endocrinology, Department of Medicine, University Health Network/University of Toronto, Toronto, Canada
| | - Amiram Gafni
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - Kevin E Thorpe
- Dalla Lana School of Public Health, University of Toronto/Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada
| | - David P Goldstein
- Department of Otolaryngology and Head and Neck Surgery, University Health Network/University of Toronto, Toronto, Canada
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Abstract
BACKGROUND The number of thyroid cancer (TC) survivors is increasing exponentially worldwide. However, little research details the unmet information, support needs, and survivorship concerns of TC patients. METHODS Two thousand TC survivors completed an online survey examining the importance of and recollection of receiving care addressing three areas at the time of diagnosis and treatment: medical/physical issues, practical matters, and emotional/psychological concerns. A summed score was generated of (1) the "important" responses for each category, and (2) if they remembered receiving that information/support. Regression analyses explored the relationship between each total score of importance and a patient's demographics, treatment, and recollection of receiving each domain of information/support. RESULTS Respondents were generally female (88.6%), part white (91.1%), and had eventual total thyroidectomy (95.8%) and radioiodine (80.6%). Mean age at diagnosis was 42.1 years and average time from diagnosis 5.43 years. Less than 50% of patients recalled receiving information regarding long-term and health effects after treatment, or any practical matter or emotional/psychological concern. Multivariate linear modeling with forward stepwise regression revealed that age, sex, and survivorship time were important predictors for recollecting having received information and support for medical/physical issues, practical needs, and emotional/psychological concerns after controlling for treatment and other demographic factors (all 0.001 or <0.001). Similar modeling demonstrated that female sex and feeling that they received care in a given category (medical/physical issues, practical needs, or emotional/psychological concerns) predicted the importance placed on those specific needs when controlled for other variables (all 0.001 or <0.001). CONCLUSION TC patients place high importance on most types of information and concerns. However, the majority of information and support needs are unmet, which varies based on demographic and treatment factors as well as the importance placed on each specific topic of information. Qualitative research is needed to further focus and refine these unmet needs that should be followed by targeted interventions.
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Affiliation(s)
| | - Melanie Goldfarb
- 2Endocrine Tumor Program, John Wayne Cancer Institute at Providence St. John's Health Center, Santa Monica, California
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48
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Satisfaction with information and unmet information needs in men and women with cancer. J Cancer Surviv 2015; 10:62-70. [DOI: 10.1007/s11764-015-0451-1] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/08/2015] [Indexed: 11/12/2022]
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Bresner L, Banach R, Rodin G, Thabane L, Ezzat S, Sawka AM. Cancer-related worry in Canadian thyroid cancer survivors. J Clin Endocrinol Metab 2015; 100:977-85. [PMID: 25393643 PMCID: PMC4333046 DOI: 10.1210/jc.2014-3169] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
CONTEXT Little is known about cancer-related worry in thyroid cancer survivors. OBJECTIVES We quantified cancer-related worry in Canadian thyroid cancer survivors and explored associated factors. DESIGN, SETTING, AND PARTICIPANTS We performed a cross-sectional, self-administered, written survey of thyroid cancer survivor members of the Thyroid Cancer Canada support group. Independent factors associated with cancer-related worry were identified using a multivariable linear regression analysis. MAIN OUTCOME MEASURE We used the Assessment of Survivor Concerns (ASC) questionnaire, which includes questions on worry about diagnostic tests, second primary malignancy, recurrence, dying, health, and children's health. RESULTS The response rate for eligible members was 60.1% (941 of 1567). Most respondents were women (89.0%; 837 of 940), and the age was < 50 years in 54.0% of participants (508 of 941). Thyroid cancer was diagnosed within ≤ 5 years in 66.1% of participants (622 of 940). The mean overall ASC score was 15.34 (SD, 4.7) (on a scale from 6 [least worry] to 24 [most worry]). Factors associated with increased ASC score included: younger age (P < .001), current suspected or proven recurrent/persistent disease (ie, current proven active disease or abnormal diagnostic tests) (P < .001), partnered marital status (P = .021), having children (P = .029), and ≤5 years since thyroid cancer diagnosis (P = .017). CONCLUSIONS In a population of Canadian thyroid cancer survivors, cancer-related worry was greatest in younger survivors and those with either confirmed or suspected disease activity. Family status and time since thyroid cancer diagnosis were also associated with increased worry. More research is needed to confirm these findings and to develop effective preventative and supportive strategies for those at risk.
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Affiliation(s)
- Lauren Bresner
- Division of Endocrinology (L.B.), Department of Medicine, Toronto General Hospital, Toronto, ON M5G 2C4, Canada; Thyroid Cancer Canada (R.B.), Toronto, ON M5N 3A8, Canada; Department of Psychosocial Oncology (G.R.), Princess Margaret Hospital, Toronto, ON M5G 2M9, Canada; Department of Clinical Epidemiology and Biostatistics (L.T.), St. Joseph's Healthcare and McMaster University, Hamilton, ON L8N 4A6, Canada; and Division of Endocrinology (S.E., A.M.S.), University Health Network and University of Toronto, Toronto, ON M5G 2N2, Canada
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