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Ma L, Yang B, Wu J. Revisiting ovarian function suppression with GnRH agonists for premenopausal women with breast cancer: Who should use and the impact on survival outcomes. Cancer Treat Rev 2024; 129:102770. [PMID: 38865794 DOI: 10.1016/j.ctrv.2024.102770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/12/2024] [Accepted: 05/21/2024] [Indexed: 06/14/2024]
Abstract
Breast cancer diagnosed in premenopausal women tends to be more aggressive and the benefit of ovarian function suppression (OFS), at least in certain groups of patients, is well known. There is hesitancy in using OFS in some groups of patients who may otherwise benefit from the treatment. For instance, it is clear that in premenopausal patients with hormone receptor-positive (HR+), high-risk, early-stage breast cancer, gonadotropin-releasing hormone agonists (GnRHa) should be given in the adjuvant setting; however, confusion remains whether premenopausal patients with intermediate-risk disease benefit from GnRHa, given the lack of consensus on its definition in guidelines and clinical practice. Most recent evidence on the long-term efficacy of GnRHa, with up to 20-years of follow-up, reinforced its benefits in premenopausal patients with early-stage breast cancer. In this comprehensive review, we reviewed the long-term efficacy in terms of improvement in disease-free survival (DFS) and overall survival (OS) for early-stage HR+ breast cancer and examined evidence from multiple randomized clinical studies to identify the clinicopathological characteristics that correlated with improved DFS and OS with the addition of OFS to adjuvant endocrine therapy. Other aspects of GnRHa, including its efficacy in advanced breast cancer, safety profile, evidence in ovarian function preservation, and the advantages of long-acting formulations were also discussed. By addressing the existing gaps and grey areas regarding the inclusion of OFS as a crucial treatment component for premenopausal breast cancer patients, physicians are more aware of who to administer and the potential impact on survival outcomes.
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Affiliation(s)
- Linxiaoxi Ma
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, No. 270 Dongan Rd, Xuhui District, Shanghai 200032, China; Key Laboratory of Breast Cancer in Shanghai, Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dongan Rd, Xuhui District, Shanghai, China
| | - Benlong Yang
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, No. 270 Dongan Rd, Xuhui District, Shanghai 200032, China; Key Laboratory of Breast Cancer in Shanghai, Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dongan Rd, Xuhui District, Shanghai, China
| | - Jiong Wu
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, No. 270 Dongan Rd, Xuhui District, Shanghai 200032, China; Key Laboratory of Breast Cancer in Shanghai, Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dongan Rd, Xuhui District, Shanghai, China.
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2
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Cucciniello L, Miglietta F, Guarneri V, Puglisi F. Managing sexual health challenges in breast cancer survivors: A comprehensive review. Breast 2024; 76:103754. [PMID: 38820922 PMCID: PMC11170478 DOI: 10.1016/j.breast.2024.103754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/12/2024] [Accepted: 05/23/2024] [Indexed: 06/02/2024] Open
Abstract
The significant advancements in breast cancer management have led to an increase in the prevalence of breast cancer survivors. Despite their efficacy, these treatments can cause a variable range of side effects, significantly deteriorating the patients' quality of life. Sexual dysfunction, and in particular the genitourinary syndrome of menopause, represent one of the major causes of quality-of-life impairment among breast cancer patients, potentially affecting treatment adherence and compliance. If in the general population, hypoestrogenism-related symptoms are typically managed through systemic or topical estrogen administration, this approach is contraindicated in breast cancer patients for the potential increased risk of disease recurrence, urging the investigation of alternative measures. The aim of this review is to summarize the most up-to-date pharmacological and non-pharmacological interventions, as well as supportive measures, available for the management of sexual dysfunctions in breast cancer patients and survivors.
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Affiliation(s)
- Linda Cucciniello
- Department of Medicine, University of Udine, Udine, Italy; Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.
| | - Federica Miglietta
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Istituto Oncologico Veneto - IOV IRCCS, Padova, Italy.
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Istituto Oncologico Veneto - IOV IRCCS, Padova, Italy.
| | - Fabio Puglisi
- Department of Medicine, University of Udine, Udine, Italy; Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy.
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3
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Molinelli C, Jacobs F, Nader-Marta G, Borea R, Scavone G, Ottonello S, Fregatti P, Villarreal-Garza C, Bajpai J, Kim HJ, Puglisi S, de Azambuja E, Lambertini M. Ovarian Suppression: Early Menopause and Late Effects. Curr Treat Options Oncol 2024; 25:523-542. [PMID: 38478329 PMCID: PMC10997548 DOI: 10.1007/s11864-024-01190-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 04/06/2024]
Abstract
OPINION STATEMENT Around 90% of breast tumours are diagnosed in the early stage, with approximately 70% being hormone receptor-positive. The cornerstone of adjuvant therapy for early-stage hormone receptor-positive breast cancer is endocrine therapy, tailored according to disease stage, biological characteristics of the tumour, patient's comorbidities, preferences and age. In premenopausal patients with hormone receptor-positive breast cancer, ovarian function suppression is a key component of the adjuvant endocrine treatment in combination with an aromatase inhibitor or tamoxifen. Moreover, it can be used during chemotherapy as a standard strategy for ovarian function preservation in all breast cancer subtypes. In the metastatic setting, ovarian function suppression should be used in all premenopausal patients with hormone receptor-positive breast cancer to achieve a post-menopausal status. Despite its efficacy, ovarian function suppression may lead to several side effects that can have a major negative impact on patients' quality of life if not properly managed (e.g. hot flashes, depression, cognitive impairment, osteoporosis, sexual dysfunction, weight gain). A deep knowledge of the side effects of ovarian function suppression is necessary for clinicians. A correct counselling in this regard and proactive management should be considered a fundamental part of survivorship care to improve treatment adherence and patients' quality of life.
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Affiliation(s)
- Chiara Molinelli
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
- Department of Medical Oncology, U.O. Clinical Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Flavia Jacobs
- Humanitas Clinical and Research Center - IRCCS, Humanitas Cancer Center, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Guilherme Nader-Marta
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B), 90, Rue Meylemeersch, 1070, Anderlecht, Brussels, Belgium
| | - Roberto Borea
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
- Department of Medical Oncology, U.O. Clinical Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Graziana Scavone
- Department of Medical Oncology, U.O. Clinical Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Silvia Ottonello
- Department of Medical Oncology, U.O. Clinical Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Piero Fregatti
- Department of Surgery, U.O. Senologia Chirurgica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostic (DISC), School of Medicine, University of Genoa, 16132, Genoa, Italy
| | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion - TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
| | - Jyoti Bajpai
- Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Ernest Borges Rd, Parel East, Parel, Mumbai, Maharashtra, 400012, India
| | - Hee Jeong Kim
- Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, South Korea
| | - Silvia Puglisi
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - Evandro de Azambuja
- Academic Trials Promoting Team, Institut Jules Bordet and l'Université Libre de Bruxelles (U.L.B), 90, Rue Meylemeersch, 1070, Anderlecht, Brussels, Belgium
| | - Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy.
- Department of Medical Oncology, U.O. Clinical Di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
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4
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Li Y, Chen YY, Wang SX, Dai ZY, Cui JS, Xing YF, Wu Q, Fang Q. Empowerment-Led Guided Self-Help Intervention for Symptom Burden in Breast Cancer Women Treated With Ovarian Function Suppression: A Randomized Trial Protocol. World J Oncol 2024; 15:325-336. [PMID: 38545479 PMCID: PMC10965257 DOI: 10.14740/wjon1817] [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: 01/15/2024] [Accepted: 03/06/2024] [Indexed: 09/28/2024] Open
Abstract
Background Ovarian function suppression (OFS) treatment causes breast cancer patients' estrogens to fall rapidly to postmenopausal levels, and the 5-year treatment duration and 28-day treatment cycles place a heavy physical and psychological symptom burden on them, which in turn directly or indirectly affects the survival benefit. Managing symptom burden early in treatment is critical, but OFS-related studies have yet to be seen. Self-management is essential for patients' symptom burden. However, self-help management is hampered by patients' lack of knowledge, skills, motivation, etc. Guided self-help intervention (GSH) provides a feasible approach. Empowerment theory is a promising theoretical framework to guide self-management. Methods A prospective two-arm parallel randomized controlled single-blind clinical trial will be conducted to investigate the effect of symptom burden GSH based on empowerment theory in breast cancer patients in the early stages of OFS treatment. A block randomization method is used to allocate 144 patients to either the control or intervention group. The program is conducted according to the OFS return-to-hospital treatment cycle. The intervention group will receive a total of two rounds and five sessions of empowering GSH, lasting at least 15 weeks in total; the control group will receive only usual nursing care. Symptom burden and related metrics will be assessed at baseline and 1, 3, and 6 months after OFS treatment, and changes between and within groups will be explored. This paper adhered to the SPIRIT and CONSORT guidelines. Conclusion These results will help to validate the GSH in symptom burden management for breast cancer patients in OFS treatment early stages. It enriches its symptom burden management research and may provide implications for the whole cycle of OFS treatment patients.
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Affiliation(s)
- Yuan Li
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yun Yun Chen
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Su Xing Wang
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China
| | - Zheng Yue Dai
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jia Song Cui
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Fei Xing
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Qing Wu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Qiong Fang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
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Dugan CL, Othieno AA, Goldman ME. Genitourinary Syndrome of Menopause in Cancer Survivors. Clin Obstet Gynecol 2024; 67:89-100. [PMID: 38108399 DOI: 10.1097/grf.0000000000000848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Genitourinary syndrome of menopause (GSM) encompasses the symptoms of estrogen deprivation in the vaginal, vulva, and bladder areas. Because many cancer treatments induce a hypoestrogenic state, GSM is common in cancer survivors. The number of cancer survivors is increasing, and the unique aspects of GSM management for cancer survivors, such as the safety of hormonal therapies, is important to understand. In this review, we cover important considerations in the assessment of GSM; nonpharmacologic, behavioral, integrative, pharmacologic, and medical device treatments for GSM: the unique considerations in GSM by cancer treatment modality; bladder manifestations of GSM; and GSM in specific populations.
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Affiliation(s)
- Catherine L Dugan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
| | - Alisha A Othieno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
| | - Mindy E Goldman
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco
- Midi Health, Menlo Park, California
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Chang YC, Tseng TA, Lin GM, Hu WY, Wang CK, Chang YM. Immediate impact of Mindfulness-Based Cognitive Therapy (MBCT) among women with breast cancer: a systematic review and meta-analysis. BMC Womens Health 2023; 23:331. [PMID: 37349700 PMCID: PMC10288664 DOI: 10.1186/s12905-023-02486-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 06/16/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Mindfulness-based cognitive therapy (MBCT) may have positive physiological and psychological benefits for breast cancer survivors. However, few studies involved a combination of the relevant literatures to confirm the effects. METHODS Our study included randomized controlled trials (RCTs) and non-RCTs comparing interventions of MBCT and control protocols for alleviation of symptoms among breast cancer survivors. We calculated pooled mean differences (MDs), standardized mean differences (SMDs), and 95% confidence intervals (CIs) by using random effects models to estimate summary effect sizes. RESULTS Thirteen trials with 20-245 participants were considered in our studies; for the meta-analysis, 11 of these studies were eligible for assessment. The pooled meta-analysis results revealed that at the end of the MBCT intervention, participants' anxiety (SMD, - 0.70; 95% CI, - 1.26 to - 0.13; I2 = 69%), pain (SMD, - 0.64; 95% CI, - 0.92 to - 0.37; I2 = 0%), and depression (SMD, - 0.65; 95% CI, - 1.14 to - 0.17; I2 = 75%) levels significantly decreased, and their mindfulness (MD, 8.83; 95% CI, 3.88 to 13.78; I2 = 68%) levels significantly increased. CONCLUSION The MBCT may be associated with improved pain, anxiety, depression, and mindfulness. However, the quantitative analysis pointed to an inconclusive result due to moderate to high levels of heterogeneity among indicator of anxiety, depression, and mindfulness. Future work requires more studies to better elucidate the clinical significance of this possible association. The results suggest that MBCT is highly beneficial as an intervention for patients who have received treatment for breast cancer.
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Affiliation(s)
- Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, 406, Taichung, Taiwan
- Nursing Department, China Medical University Hospital, Taichung, Taiwan
| | - Tzuhui Angie Tseng
- Department of Environmental and Cultural Resources, National Tsing Hua University, Hsinchu, Taiwan
| | - Gen-Min Lin
- Departments of Medicine, Hualien-Armed Forces General Hospital, Hualien City, Taiwan
- Tri-Service General Hospital, National Defense Medical Center, Taipei City, 100, Taiwan
| | - Wen-Yu Hu
- School of Nursing, College of Medicine, National Taiwan University, 100, Taipei City, Taiwan
- Department of Nursing, National Taiwan University Hospital, Taipei City, 100, Taiwan
| | - Chih-Kai Wang
- Cancer Center, China Medical University Hospital, Taichung, 404, Taiwan
| | - Yuh-Ming Chang
- Department of Neurology, Hsinchu Mackay Memorial Hospital, No. 690, Sec. 2, Guangfu Rd., East Dist., Hsinchu City, 30071, Taiwan.
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7
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Soldato D, Arecco L, Agostinetto E, Franzoi MA, Mariamidze E, Begijanashvili S, Brunetti N, Spinaci S, Solinas C, Vaz-Luis I, Di Meglio A, Lambertini M. The Future of Breast Cancer Research in the Survivorship Field. Oncol Ther 2023; 11:199-229. [PMID: 37005952 PMCID: PMC10260743 DOI: 10.1007/s40487-023-00225-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/03/2023] [Indexed: 04/04/2023] Open
Abstract
Prevalence of survivors of breast cancer has been steadily increasing in the last 20 years. Currently, more than 90% of women diagnosed with early-stage breast cancer are expected to be alive at 5 years from diagnosis thanks to early detection and breakthrough innovations in multimodal treatment strategies. Alongside this advancement in clinical outcomes, survivors of breast cancer might experience several specific challenges and present with unique needs. Survivorship trajectories after diagnosis and treatment of breast cancer can be significantly impacted by long-lasting and severe treatment-related side effects, including physical problems, psychological distress, fertility issues in young women, and impaired social and work reintegration, which add up to patients' individual risk of cancer recurrence and second primary malignancies. Alongside cancer-specific sequelae, survivors still present with general health needs, including management of chronic preexisting or ensuing conditions. Survivorship care should implement high-quality, evidence-based strategies to promptly screen, identify, and address survivors' needs in a comprehensive way and minimize the impact of severe treatment sequelae, preexisting comorbidities, unhealthy lifestyles, and risk of recurrence on quality of life. This narrative review focuses on core areas of survivorship care and discuss the state of the art and future research perspectives in key domains including selected long-term side effects, surveillance for recurrences and second cancers, well-being promotion, and specific survivors' needs.
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Affiliation(s)
- D Soldato
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
- Molecular Predictors and New Targets in Oncology, Institut National de la Sante et de la Recherche Medicale Unit 981, Gustave Roussy, Villejuif, France
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - L Arecco
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy
| | - E Agostinetto
- Department of Medical Oncology, Institut Jules Bordet and Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - M A Franzoi
- Molecular Predictors and New Targets in Oncology, Institut National de la Sante et de la Recherche Medicale Unit 981, Gustave Roussy, Villejuif, France
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - E Mariamidze
- Department of Oncology and Hematology, Todua Clinic, Tbilisi, Georgia
| | - S Begijanashvili
- Department of Clinical Oncology, American Hospital Tbilisi, Tbilisi, Georgia
| | - N Brunetti
- Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy
| | - S Spinaci
- Division of Breast Surgery, Villa Scassi Hospital, Genoa, Italy
| | - C Solinas
- Medical Oncology, AOU Cagliari, Policlinico Duilio Casula, Monserrato, Italy
| | - I Vaz-Luis
- Molecular Predictors and New Targets in Oncology, Institut National de la Sante et de la Recherche Medicale Unit 981, Gustave Roussy, Villejuif, France
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - A Di Meglio
- Molecular Predictors and New Targets in Oncology, Institut National de la Sante et de la Recherche Medicale Unit 981, Gustave Roussy, Villejuif, France
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy, Villejuif, France
| | - M Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genoa, Italy.
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
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8
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A Systematic Review Exploring the Effectiveness of Mindfulness for Sexual Functioning in Women with Cancer. PSYCH 2023. [DOI: 10.3390/psych5010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Sexual intimacy is a basic human need that is associated with quality of life whereby its absence can significantly impact both interpersonal and personal wellbeing. This systematic review aimed to provide an up-to-date evaluation of the available literature on mindfulness treatments for sexual functioning in women diagnosed with cancer. Electronic searches including PubMed, PsycINFO, Web of Science and registered clinical trials yielded 10 studies that met the inclusion criteria. The results showed that treatment intervention designs varied and included mixed methods, randomised clinical trials, single arm non-randomised trials and those with the absence of any control. Furthermore, both brief and longer-term mindfulness interventions were trialled across different sexual domains. Whilst inconclusive, mindfulness-based interventions appear to support sexual function and quality of life in both early- and post-cancer survivors. However, in some instances, there were outcome inconsistencies in sexual desire, arousal and orgasm. This review has identified a current shortage in research on the effectiveness of mindfulness-based treatments for supporting sexual functioning in women with cancer; and so far, no research has been conducted in palliative care. This unmet need in supporting sexual functioning in women with cancer, including palliative care, carries important implications for both psychosexual and oncological healthcare services as sexual intimacy does not end with cancer diagnosis or prognosis.
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Di Nardo P, Lisanti C, Garutti M, Buriolla S, Alberti M, Mazzeo R, Puglisi F. Chemotherapy in patients with early breast cancer: clinical overview and management of long-term side effects. Expert Opin Drug Saf 2022; 21:1341-1355. [DOI: 10.1080/14740338.2022.2151584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Paola Di Nardo
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Camilla Lisanti
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Mattia Garutti
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Silvia Buriolla
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Martina Alberti
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Roberta Mazzeo
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Fabio Puglisi
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
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10
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Vegunta S, Kuhle CL, Vencill JA, Lucas PH, Mussallem DM. Sexual Health after a Breast Cancer Diagnosis: Addressing a Forgotten Aspect of Survivorship. J Clin Med 2022; 11:6723. [PMID: 36431200 PMCID: PMC9698007 DOI: 10.3390/jcm11226723] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/12/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
Breast cancer is the most common cancer in women. The life expectancy after a breast cancer diagnosis is improving steadily, leaving many more persons with the long-term consequences of treatment. Sexual problems are a common concern for breast cancer survivors yet remain overlooked in both the clinical setting and the research literature. Factors that contribute to sexual health concerns in breast cancer survivors are biopsychosocial, as are the barriers to addressing and treating these health concerns. Sexual health needs and treatment may vary by anatomy and gender. Multidisciplinary management may comprise lifestyle modifications, medications, sexual health aids such as vibrators, counseling, and referrals to pelvic health physical therapy and specialty care. In this article, we review the contributing factors, screening, and management of sexual difficulties in cisgender female breast cancer survivors. More information is needed to better address the sexual health of breast cancer survivors whose sexual/gender identity differs from that of cisgender women.
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Affiliation(s)
- Suneela Vegunta
- Division of Women’s Health Internal Medicine, Mayo Clinic, 13400 Shea Blvd, Scottsdale, AZ 85259, USA
| | - Carol L. Kuhle
- Menopause and Women’s Sexaul Health Clinic, Mayo Clinic, Rochester, MN 55905, USA
| | - Jennifer A. Vencill
- Menopause and Women’s Sexaul Health Clinic, Mayo Clinic, Rochester, MN 55905, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Pauline H. Lucas
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Dawn M. Mussallem
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL 32224, USA
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11
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Sears C, Santos-Iglesias P, Millman R, Jacox N, Wiebe E, Walker LM. Implementation of individually tailored treatment plans in a group-based intervention for women with mixed vulvo-vaginal and sexual health concerns following cancer treatment: A feasibility study. Eur J Oncol Nurs 2022; 63:102236. [PMID: 36827834 DOI: 10.1016/j.ejon.2022.102236] [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: 08/29/2022] [Revised: 10/26/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE This study evaluated a professionally-led, group-based vulvo-vaginal and sexual health (VSH) workshop for women diagnosed with cancer. The study goals were to: (1) implement and assess a novel group intervention for diverse VSH concerns; (2) explore post-workshop changes in symptom bother, motivation to use VSH treatments, and frequency of VSH treatment use; (3) examine post-workshop changes in sexual well-being. METHODS A group-based educational workshop to address a variety of VSH concerns was developed and implemented. During the workshop, participants created an individualized treatment plan by selecting from various VSH treatment options presented. Treatment plan follow-ups were administered online at one-, two-, and three-months post-workshop. At baseline and three-month follow-up, participants completed online questionnaires to assess self-reported vulvo-vaginal symptoms, sexual function, sexual distress, and use of VSH strategies. RESULTS 195 participants (age 20-81) attended workshops over a 2.5-year period. Individualized treatment plans were effectively completed by most participants (92%). Preliminary results show decreases in bother severity associated with VSH concerns post-workshop, stabilizing after 2 months. At three-month follow-up, participants reported increased use of VSH treatment strategies. Sexual satisfaction, sexual distress, and emotional impact of vulvovaginal symptoms also improved. CONCLUSIONS Workshop attendance was associated with increased uptake of VSH treatment strategies and improvements in several parameters of sexual well-being. Findings indicate that individualized treatment plans can be implemented effectively in a group setting and that a one-time, group-based educational workshop can meaningfully impact VSH-related behavior change, reduce vulvo-vaginal symptom bother and promote sexual well-being in patients with diverse VSH concerns.
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Affiliation(s)
- Carly Sears
- Department of Oncology, University of Calgary, 1331 - 29th St., NW, Calgary, AB, Canada
| | - Pablo Santos-Iglesias
- Department of Psychology, Cape Breton University, 1250 Grand Lake Rd, Sydney, NS, Canada
| | - Roanne Millman
- Department of Oncology, University of Calgary, 1331 - 29th St., NW, Calgary, AB, Canada; West Coast Centre for Sex Therapy, 2695 Granville St., # 302, Vancouver, BC, Canada
| | - Natalie Jacox
- Department of Oncology, University of Calgary, 1331 - 29th St., NW, Calgary, AB, Canada
| | - Ericka Wiebe
- Department of Oncology, University of Alberta, 11560 University Ave., Edmonton, AB, Canada
| | - Lauren M Walker
- Department of Oncology, University of Calgary, 1331 - 29th St., NW, Calgary, AB, Canada; Arnie Charbonneau Cancer Research Institute, University of Calgary, 3280 Hospital Dr., NW., Calgary, AB, Canada.
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12
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Lu J, Chen XM, Xie KH. Effectiveness of nursing interventions on the sexual quality of life of patients with breast cancer: A systematic review and meta-analysis. PLoS One 2022; 17:e0277221. [PMID: 36327334 PMCID: PMC9632802 DOI: 10.1371/journal.pone.0277221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Although many studies have reported the effectiveness of nursing interventions on the sexual quality of life of patients with breast cancer, the results have not been synthesized. This study aims to assess the effectiveness of nursing interventions on the sexual quality of life of patients with breast cancer. REVIEW METHODS A comprehensive search was conducted in 11 databases from inception to October 7, 2021. Studies evaluating the effects of nursing interventions on sexual quality of life were included. Study selection, data extraction, and risk of bias assessment were performed by two independent reviewers. RESULTS This review pooled 38 studies with 3,664 participants. Meta-analysis results showed that nursing interventions significantly improved sexual quality of life, including sexual function (standardized mean difference [SMD] = 0.98, 95% confidence interval [CI] = [0.60-1.37], P < 0.001) and sexual satisfaction (SMD = 0.99, 95% CI = [0.41-1.57], P < 0.001). In addition, depression (SMD = -1.16, 95% CI = [-2.08--0.24], P = 0.01) and general quality of life (SMD = 0.20, 95% CI = [0.08-0.33], P = 0.002) were significantly improved, but body image (SMD = 0.17, 95% CI = [-0.08-0.41], P = 0.19) and anxiety (SMD = -0.45, 95% CI = [-0.93-0.02], P = 0.06) did not significantly improve. Subgroup analysis showed that nursing interventions had a stronger long-term effect on sexual function (SMD = 1.15, 95% CI = [0.51-1.80], P = P < 0.001) and was more effective in younger patients (SMD = 1.43, 95% CI = [0.63-2.23], P = P < 0.001). Nursing interventions showed a statistically significant short-term effect on sexual satisfaction (SMD = 1.32, 95% CI = [0.44-2.20], P = 0.003) and a significant effect in older patients (SMD = 1.27, 95% CI = [0.46-2.08], P = 0.002). CONCLUSIONS Nursing intervention may be an effective way to improve the sexual quality of life of patients with breast cancer. Nursing interventions had a stronger long-term effect on sexual function, and the group with the strongest effect is the younger patients. Nursing interventions showed a significant short-term effect on sexual satisfaction, and older patients had significant improvement in sexual satisfaction.
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Affiliation(s)
- Jia Lu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao Min Chen
- Nursing Department, Zhejiang Provincial People’s Hospital, Hangzhou, China
| | - Kai Hong Xie
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
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13
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Chang YC, Chiu CF, Wang CK, Wu CT, Liu LC, Wu YC. Short-term effect of internet-delivered mindfulness-based stress reduction on mental health, self-efficacy, and body image among women with breast cancer during the COVID-19 pandemic. Front Psychol 2022; 13:949446. [PMID: 36389600 PMCID: PMC9640939 DOI: 10.3389/fpsyg.2022.949446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background and aim During the COVID-19 pandemic, an Internet-Mindfulness-Based Stress Reduction (iMBSR) program was delivered and may be better than an in-person approach. Our study evaluated the effects of iMBSR intervention on mental health, self-efficacy, and body image in women with breast cancer in Taiwan. Materials and methods Sixty-seven women with breast cancer were allocated to a 6-week iMBSR (n = 41) program or a waitlist control group (n = 26), without heterogeneity between group characteristics. Patients from both groups were measured at baseline and postintervention using three scales: Depression, Anxiety, and Stress Scale (DASS-21), General self-efficacy scale, and Body Image Scale. Descriptive dataset analysis, paired t-test, and Student’s t-test were used to evaluate the data. Results Although iMBSR did not significantly improve depression and stress between groups, iMBSR could improve anxiety (Δmean: −2.0 vs. −0.4, p = 0.041) with medium effect sizes. Significant benefits were found for body image (Δmean: −3.6 vs. 0.9, p = 0.003) and self-efficacy (Δmean: 4.2 vs. 1.5, p = 0.004), with large effect sizes (Cohen’s d = 0.73). Conclusion Our preliminary study supports iMBSR as a program that can improve mental health, body image, and self-efficacy in women with breast cancer. During the COVID-19 pandemic, medical professionals can use Internet-based clinical health education.
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Affiliation(s)
- Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung, Taiwan
- Nursing Department, China Medical University Hospital, Taichung, Taiwan
- *Correspondence: Yun-Chen Chang,
| | - Chang-Fang Chiu
- Division of Hematology and Oncology, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Chang-Fang Chiu,
| | - Chih-Kai Wang
- Cancer Center, China Medical University Hospital, Taichung, Taiwan
| | - Chen-Teng Wu
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Liang-Chih Liu
- Division of Breast Surgery, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Yao-Chung Wu
- Division of Breast Surgery, China Medical University Hospital, Taichung, Taiwan
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14
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Benedict C, Shaffer KM, Wirtz MR, Ford JS, Reese JB. Current Considerations in Interventions to Address Sexual Function and Improve Care for Women with Cancer. CURRENT SEXUAL HEALTH REPORTS 2022. [DOI: 10.1007/s11930-022-00343-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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15
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Kianpour M, Taleghani F, Noroozi M, Savabi-Esfahani M, Boroumandfar Z, Changiz T, Ravankhah Z, Javanmard SH, Hashemi MS. Design, implementation, and evaluation of self-care program in the prevention of breast cancer among women in Isfahan: a community-based participatory action research protocol. Womens Midlife Health 2022; 8:7. [PMID: 35791001 PMCID: PMC9254568 DOI: 10.1186/s40695-022-00077-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/15/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Breast cancer is one of the most prevalent cancers among women in Isfahan, Iran; however, its prevention is not desirable in this city. This disease poses several health, social and economic challenges for women. To promote women's self-care in breast cancer prevention, this study aims to design, implement and evaluate a self-care program among women in Isfahan through using a community-based participatory action research method. METHODS The present study is based on a community-based participatory action research approach. In this study, the participatory action research includes four general phases of organizing, action planning, action, and rethinking. These phases are summarized as follows: In the organizing phase, the needs of the participants and the action research settings are examined. This means that the current situation is identified and the views of the process owners are assessed. In the action planning phase, using the results of the first phase, some strategies are designed to promote self-care behaviors in the prevention of breast cancer among women in Isfahan. In the implementation phase, the selected strategies are implemented with the help of the process owners. Finally, in the rethinking phase, the results of the implementation of the strategies are monitored and evaluated. This cycle continues until the intended results are achieved. DISCUSSION Changing the role of individuals from a passive status to an aware and active status in the care process requires motivation, responsibility, and active participation of individuals in the disease control process. Moreover, many cultural and social factors affect the active participation of Iranian women. Therefore, individuals can be involved in promoting their health using a community-based participatory action research approach.
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Affiliation(s)
- Maryam Kianpour
- Nursing and Midwifery Care Research Center, Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Nursing Midwifery Care Research Center, Faculty of Nursing Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Noroozi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mitra Savabi-Esfahani
- Nursing and Midwifery Care Research Center, Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Boroumandfar
- Nursing and Midwifery Care Research Center, Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahereh Changiz
- Department of Medical Education, Educational Development Center, Medical Education Research Canter, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Ravankhah
- Isfahan Cancer Registry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shaghayegh Haghjooy Javanmard
- Department of Physiology, School of Medicine Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Sadat Hashemi
- Nursing and Midwifery Care Research Center Department of critical care, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Febrina F, Triyoga IF, White M, Marino JL, Peate M. Efficacy of interventions to manage sexual dysfunction in women with cancer: a systematic review. Menopause 2022; 29:609-626. [PMID: 35486951 DOI: 10.1097/gme.0000000000001953] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
IMPORTANCE Cancer and its treatment negatively affect female sexual health and function. The prevalence of female sexual dysfunction after cancer is between 33% and 43%. Numerous studies have addressed treatment options for sexual dysfunction in women with cancer, but it still remains a challenge to select the most efficacious option for patients. OBJECTIVE To compile and appraise recent evidence of any interventions for managing sexual dysfunction in female cancer survivors. EVIDENCE REVIEW A literature search of the electronic databases MEDLINE, EMBASE, PsycINFO, and Cochrane Central Register of Controlled Trials (January 2011 to February 2021) was conducted using general search terms of "women", "cancer", "intervention", "sexual dysfunction". We included randomized controlled trials (RCTs) and uncontrolled before-after studies that evaluated the efficacy of intervention for female sexual dysfunction in women with history of cancer. Methodological quality of studies was assessed using Risk of Bias (RoB) 2.0 for RCTs and National Institutes of Health (NIH) assessment tools for uncontrolled before-after studies. FINDINGS Thirty-six studies were included for qualitative synthesis (14 RCTs (n = 1284), 17 uncontrolled trials (n = 589), and 5 cohort studies (n = 497). Only four studies were at low risk of bias. Topical interventions (vaginal gels or creams) were able to alleviate vaginal dryness and dyspareunia, with intravaginal dehydroepiandrosterone (DHEA) (6.5 mg) gel showing evidence of improved sexual function. Evidence for estriol-lactobacilli vaginal tablets was unreliable due to a small-scale study. Psychoeducational therapy (internet-based cognitive behavioral therapy [CBT]) studies typically were at high risk of bias, but all displayed significant improvements of sexual function. Both laser therapy (fractional CO2 and erbium) and multimodal approach studies were at concerning risk of bias, although suggesting beneficial effects on sexual function. CONCLUSIONS AND RELEVANCE The most reliable evidence for improvement was from a study of DHEA vaginal gel, but in general, gels or creams were useful in reducing dyspareunia. Pharmacological, psychoeducational, laser therapy, and multimodal approaches demonstrated potential in managing cancer-related sexual issues, but most were small in size (10-70 participants), with moderate to high risk of bias. Therefore, large-scale, double-blind, RCTs with long-period follow-up, and at low risk of bias are needed to show efficacy for these interventions.
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Affiliation(s)
- Fiorentina Febrina
- Department of Obstetrics and Gynecology, Royal Women's Hospital, The University of Melbourne, Melbourne, Australia
| | - Ichsan Fauzi Triyoga
- Department of Obstetrics and Gynecology, Royal Women's Hospital, The University of Melbourne, Melbourne, Australia
| | - Michelle White
- Monash Medical Centre, Melbourne, Australia
- Monash University, Melbourne, Australia
| | - Jennifer L Marino
- Department of Obstetrics and Gynecology, Royal Women's Hospital, The University of Melbourne, Melbourne, Australia
- Department of Pediatrics, Royal Children's Hospital, The University of Melbourne, Melbourne, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Michelle Peate
- Department of Obstetrics and Gynecology, Royal Women's Hospital, The University of Melbourne, Melbourne, Australia
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Chang YC, Lin GM, Yeh TL, Chang YM, Yang CH, Lo C, Yeh CY, Hu WY. Impact of mindfulness-based stress reduction on female sexual function and mental health in patients with breast cancer. Support Care Cancer 2022; 30:4315-4325. [PMID: 35092484 PMCID: PMC8799961 DOI: 10.1007/s00520-021-06540-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/05/2021] [Indexed: 12/02/2022]
Abstract
Purpose There have been few studies using mindfulness-based stress reduction (MBSR) to improve sexual function in Asian women with breast cancer. This study aimed to evaluate the impact of mindfulness intervention on female sexual function, mental health, and quality of life in patients with breast cancer. Methods Fifty-one women with breast cancer were allocated into 6-week MBSR (n=26) sessions or usual care (n=25), without differences in group characteristics. The research tools included the Female Sexual Function Index (FSFI), the Depression Anxiety Stress Scales-21 (DASS-21), and the EuroQol instrument (EQ-5D). The Greene Climacteric Scale (GCS) was used to verify the foregoing scale. The effects of MBSR were evaluated by the differences between the post- and pre-intervention scores in each scale. Statistical analyses consisted of the descriptive dataset and Mann-Whitney ranked-pairs test. Results Although MBSR did not significantly improve sexual desire and depression in patients with breast cancer, MBSR could improve parts of female sexual function [i.e., Δarousal: 5.73 vs. -5.96, Δlubrication: 3.35 vs. -3.48, and Δsatisfaction: 8.48 vs. 1.76; all p <.005], with a range from small to medium effect sizes. A significantly benefits were found on mental health [Δanxiety: -10.92 vs.11.36 and Δstress: -10.96 vs.11.40; both p <.001], with large effect sizes, ranging from 0.75 to 0.87. Conclusion Our study revealed that MBSR can improve female sexual function and mental health except for sexual desire and depression in women with breast cancer. Medical staff can incorporate MBSR into clinical health education for patients with breast cancer to promote their overall quality of life.
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Affiliation(s)
- Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung, 406040, Taiwan.,Department of Nursing, China Medical University Hospital, Taichung, 404332, Taiwan
| | - Gen-Min Lin
- Departments of Medicine, Hualien-Armed Forces General Hospital, Hualien, Tri-Service General Hospital, National Defense Medical Center, Taipei City, 100, Taiwan
| | - Tzu-Lin Yeh
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu 300, and Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei City, 100, Taiwan
| | - Yuh-Ming Chang
- Department of Neurology, Hsinchu Mackay Memorial Hospital, Hsinchu, 300, Taiwan
| | - Ching-Hsu Yang
- Department of Emergency Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu, Taiwan
| | - Chi Lo
- Department of Hospitality Management, Chung Hua University, Hsinchu, Taiwan
| | - Chun-Yin Yeh
- Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, 700, Taiwan
| | - Wen-Yu Hu
- School of Nursing, College of Medicine, National Taiwan University, Taipei City, 100, Taiwan. .,Department of Nursing, National Taiwan University Hospital, Taipei City, 10051, Taiwan.
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Jiang J, Xu J, Cai L, Man L, Niu L, Hu J, Sun T, Zheng X. Major depressive symptoms in breast cancer patients with ovarian function suppression: a cross-sectional study comparing ovarian ablation and gonadotropin-releasing hormone agonists. BMC Psychiatry 2021; 21:624. [PMID: 34895183 PMCID: PMC8666024 DOI: 10.1186/s12888-021-03611-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 11/22/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Ovarian function suppression (OFS) is indicated in premenopausal women with early or metastasis breast cancer, which may be achieved with similar effect by gonadotropin-releasing hormone agonists (GnRHa) or ovarian ablation (OA). We examined whether there were differences in major depressive symptoms outcomes and its associated factors between gonadotropin-releasing hormone agonists (GnRHa) and ovarian ablation (OA) in premenopausal breast cancer patients. METHODS Premenopausal breast cancer patients from seven hospitals who received OFS participated in the study between June 2019 and June 2020. The correlated variable was the type of ovarian suppression, categorized as either OA (n = 174) or GnRHa (n = 389). Major depressive symptoms was evaluated using the Patient Health Questionnaire (PHQ-9), and the Female Sexual Function Index questionnaire was used to assess sexual function. RESULTS A total of 563 patients completed the surveys. The mean PHQ-9 sum score was slightly lower in the GnRHa cohort than in the OA cohort (11.4 ± 5.7 vs. 12.8 ± 5.8, P = 0.079). There were significantly fewer patients with major depressive symptoms (PHQ-9 ≥ 15) in the GnRHa cohort (31.1% vs. 40.2%, Exp (B)=1.805, P=0.004). Further, breast-conserving surgery and sexual dysfunction were negatively correlated with major depressive symptoms [mastectomy vs. breast-conserving: Exp (B) = 0.461, P <0.001;[sexual dysfunction vs. normal: Exp (B) = 0.512, P = 0.001]. CONCLUSIONS This is the first study to demonstrate that GnRHa results in more favorable depressive symptoms outcomes than OA. Moreover, most patients preferred alternatives to their OFS treatment. These findings can contribute to improving and alleviating the adverse effects of OFS.
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Affiliation(s)
- Junhan Jiang
- grid.412636.4Department of Breast Surgery, First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, 110001 Liaoning China
| | - Junnan Xu
- grid.412449.e0000 0000 9678 1884Department of Breast Medicine, Cancer Hospital of China Medical University, Liaoning Cancer No.44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning 110042 People’s Republic of China
| | - Li Cai
- grid.412651.50000 0004 1808 3502The Fourth Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150040 China
| | - Li Man
- Department of Medical Oncology, Anshan Cancer Hospital, Anshan, 114000 China
| | - Limin Niu
- grid.414008.90000 0004 1799 4638Breast Cancer Center, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, 450003 China
| | - Juan Hu
- grid.410622.30000 0004 1758 2377Department of Breast Cancer Medical Oncology, Hunan Cancer Hospital, Changsha, 410000 China
| | - Tao Sun
- Department of Breast Medicine, Cancer Hospital of China Medical University, Liaoning Cancer No.44 Xiaoheyan Road, Dadong District, Shenyang, Liaoning, 110042, People's Republic of China.
| | - Xinyu Zheng
- Department of Breast Surgery, First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China.
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Sukumar JS, Quiroga D, Kassem M, Grimm M, Shinde NV, Appiah L, Palettas M, Stephens J, Gatti-Mays ME, Pariser A, Cherian M, Stover DG, Williams N, Van Deusen J, Wesolowski R, Lustberg M, Ramaswamy B, Sardesai S. Patient preferences and adherence to adjuvant GnRH analogs among premenopausal women with hormone receptor positive breast cancer. Breast Cancer Res Treat 2021; 190:183-188. [PMID: 34498153 PMCID: PMC8560558 DOI: 10.1007/s10549-021-06368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/13/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Adjuvant ovarian function suppression (OFS) in premenopausal hormone receptor (HR) positive breast cancer (BC) improves survival. Adherence to adjuvant gonadotropin-releasing hormone analogs (GnRHa) remains a challenge and is associated with toxicities and inconvenient parenteral administration. The goal of this study was to describe real-world adherence patterns and patient preferences surrounding adjuvant GnRHa. METHODS We analyzed the medical records of premenopausal women with non-metastatic HR positive BC from January 2000 to December 2017; participants received adjuvant monthly goserelin or leuprolide at The Ohio State University. Data collected included demographics, clinicopathologic characteristics, and OFS adherence/side effects. We defined non-adherence as discontinuation of GnRHa within 3 years for a reason other than switching to an alternate OFS, delay > 7 days from a dose, or a missed dose. Chi-square tests assessed associations between clinical characteristics and outcomes. RESULTS A total of 325 patients met eligibility. Of these, 119 (37%) patients were non-adherent to GnRHa; 137 (42%) underwent elective bilateral salpingo-oophorectomy after initial GnRHa. Those opting for surgery reported significantly more hot flashes (74% vs 48%, p < 0.001), arthralgias (46% vs 30%, p = 0.003), and vaginal dryness (37% vs 21%, p = 0.001) compared with patients remaining on GnRHa. CONCLUSION Non-adherence to adjuvant GnRHa occurred in over a third of patients and almost half the patients initiating GnRHa underwent subsequent surgical ablation. These high frequencies highlight real-world patterns of OFS. Additionally, treatment toxicities may impact personal preference of OFS modality. Personalized practices to target predictors of adjuvant GnRHa non-adherence are critical to optimize symptoms, adherence, and survivorship.
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Affiliation(s)
- Jasmine S Sukumar
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Dionisia Quiroga
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Mahmoud Kassem
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Michael Grimm
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Namrata Vilas Shinde
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Leslie Appiah
- Division of Academic Specialists in Obstetrics and Gynecology, University of Colorado Anshultz, Aurora, CO, USA
| | - Marilly Palettas
- Center for Biostatistics, Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Julie Stephens
- Center for Biostatistics, Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Margaret E Gatti-Mays
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Ashley Pariser
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Mathew Cherian
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Daniel G Stover
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Nicole Williams
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Jeffrey Van Deusen
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Robert Wesolowski
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Maryam Lustberg
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Bhuvaneswari Ramaswamy
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA
| | - Sagar Sardesai
- Division of Medical Oncology, The Ohio State University Wexner Medical Center, The Ohio State University Comprehensive Cancer Center, 1204A Lincoln Tower, 1800 Cannon Dr., Columbus, OH, 43210, USA.
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Esch M. Sexual Health: A Nursing Approach to Supporting the Needs of Young Adult Cancer Survivors. Clin J Oncol Nurs 2021; 25:501-506. [PMID: 34533525 DOI: 10.1188/21.cjon.501-506] [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: 11/17/2022]
Abstract
Sexual health is an important aspect of survivorship for young adult (YA) cancer survivors, who frequently experience physical and psychosocial changes related to sexuality and intimacy during and after treatment for cancer. This article provides an overview of common sexual issues in this population, reviews the integral role that oncology nursing assessment and intervention can play in optimizing patients' sexual well-being and quality of life, and describes specific strategies for incorporating the sexual health needs of YA cancer survivors into the nursing plan of care.
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Affiliation(s)
- Marloe Esch
- Froedtert and the Medical College of Wisconsin
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21
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Interventions to Improve Sexual Health in Women Living with and Surviving Cancer: Review and Recommendations. Cancers (Basel) 2021; 13:cancers13133153. [PMID: 34202477 PMCID: PMC8268945 DOI: 10.3390/cancers13133153] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 01/15/2023] Open
Abstract
Sexual health concerns, both physical and psychological, are common and represent an unmet need among women with and surviving cancer. Sexual challenges and conditions negatively impact body image, satisfaction, relationships, well-being, and quality of life, yet are widely reported to be under-recognized and undertreated. To guide clinical care and future research on sexual function in women with cancer, we performed a scoping review of interventions for sexual health concerns, including sexual function, body image, genitourinary symptoms, and hot flashes. Relevant publications between 2005 and 2020 were identified by searching PubMed with a combination of medical subject headings and keywords. Articles were included if they focused on the aforementioned topics, were primary research publications, and included female cancer survivors. Studies focusing on women receiving hormone therapy for breast cancer were also included. A total of 91 investigations conducted in the US and abroad were reviewed. Most commonly, interventions included a component of psychoeducation, although pharmacologic, exercise, and other approaches have been evaluated. Many studies have focused on survivors of breast or gynecologic cancer, among other sampling and methodological limitations. These limitations underscore the need for more work on this vital survivorship issue. Recommendations for future research in this area are also offered.
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Franzoi MA, Agostinetto E, Perachino M, Del Mastro L, de Azambuja E, Vaz-Luis I, Partridge AH, Lambertini M. Evidence-based approaches for the management of side-effects of adjuvant endocrine therapy in patients with breast cancer. Lancet Oncol 2021; 22:e303-e313. [PMID: 33891888 DOI: 10.1016/s1470-2045(20)30666-5] [Citation(s) in RCA: 117] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/13/2020] [Accepted: 10/22/2020] [Indexed: 12/13/2022]
Abstract
The growing availability of more effective therapies has contributed to an increased survival of patients with breast cancer. In hormone receptor-positive early disease, increased survival is strongly correlated with the use of adjuvant endocrine therapy, but this therapy can cause side-effects that have major consequences in terms of treatment adherence and patients' quality of life. In premenopausal breast cancer survivors, these side-effects might be even more prominent due to the abrupt suppression of oestrogen associated with the most intense endocrine therapies. An important ambition of cancer care in the 21st century is to recover pre-cancer quality of life and emotional and social functions, which is only possible through the mitigation of the side-effects of anticancer treatments. This Review presents a comprehensive summary of the efficacy and safety data of the available interventions (hormonal and non-hormonal pharmacological strategies, non-pharmacological approaches, and complementary and alternative medicine) to control selected side-effects associated with adjuvant endocrine therapy (hot flashes, sexual dysfunction, weight gain, musculoskeletal symptoms, and fatigue), providing updated, evidence-based approaches for their management.
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Affiliation(s)
- Maria Alice Franzoi
- Academic Trials Promoting Team, Jules Bordet Institute and Université Libre de Bruxelles, Brussels, Belgium
| | - Elisa Agostinetto
- Academic Trials Promoting Team, Jules Bordet Institute and Université Libre de Bruxelles, Brussels, Belgium; Medical Oncology and Hematology Unit, IRCCS Istituto Clinico Humanitas-Humanitas Cancer Center, Humanitas Research Hospital, Milan, Italy
| | - Marta Perachino
- Department of Medical Oncology, UOC Clinica di Oncologia Medica, IRCCS Policlinico San Martino Hospital, University of Genoa, Genoa, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genoa, Genoa, Italy
| | - Lucia Del Mastro
- Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genoa, Genoa, Italy; Breast Unit, IRCCS Policlinico San Martino Hospital, Genoa, Italy
| | - Evandro de Azambuja
- Academic Trials Promoting Team, Jules Bordet Institute and Université Libre de Bruxelles, Brussels, Belgium
| | - Ines Vaz-Luis
- Unit 981-Molecular Predictors and New Targets In Oncology, Department of Medical Oncology, INSERM and Institut Gustave Roussy, Paris, France
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Matteo Lambertini
- Department of Medical Oncology, UOC Clinica di Oncologia Medica, IRCCS Policlinico San Martino Hospital, University of Genoa, Genoa, Italy; Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genoa, Genoa, Italy.
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Walker LM, Sears CS, Booker R, Doll C, Glaze S, Phan T, Brennan K, Millman RD, Robinson JW. Development, implementation, and evaluation of a multidisciplinary oncology sexual health clinic in a Canadian cancer care setting. J Cancer Surviv 2021; 15:755-766. [PMID: 33400152 DOI: 10.1007/s11764-020-00967-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/05/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE Untreated cancer-related sexual health concerns cause significant distress for cancer survivors. To appropriately address the complex sexual health needs of cancer patients, we piloted a specialized, multidisciplinary oncology sexual health clinic within a tertiary cancer center. A quality assurance evaluation was conducted. METHODS During once monthly half-day clinics, a multidisciplinary team of psychologists, advanced practice nurses, and radiation and gynecological oncologists offered specialist integrated care to oncology patients. Patients completed assessment questionnaires prior to each clinic appointment and a follow-up telephone interview approximately 4 months after their initial appointment. RESULTS Over the 2-year pilot, 224 patients were referred to the cancer center's broader sexual health program; 100 patients were triaged to the clinic. A total of 79 new and 58 follow-up appointments were offered. Average wait time for an initial visit was 97 days. Patients' most frequent concerns included vulvovaginal atrophy, dyspareunia, reduced sexual desire, and erectile dysfunction. Self-reported sexual distress was well above the clinical cutoff at baseline (N = 77, M = 29.78, SD = 12.74). A significant reduction in sexual distress was observed at follow-up (N = 67, M = 21.90, SD = 11.34, t(66) = 7.41, p < 0.001). CONCLUSIONS Referral rates indicate a high demand for specialized sexual health services within cancer care. Ongoing specialist care is needed to appropriately address the multifaceted sexual concerns of cancer survivors and to adequately manage high distress and symptom comorbidity. IMPLICATIONS FOR CANCER SURVIVORS Results inform a more comprehensive characterization of the presenting concerns of cancer survivors seeking multidisciplinary sexual health care.
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Affiliation(s)
- Lauren M Walker
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre - Holy Cross Site, 2202 2nd St SW, Calgary, AB, T3S 2C1, Canada.
- Department of Oncology, University of Calgary, Calgary, AB, Canada.
| | - Carly S Sears
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre - Holy Cross Site, 2202 2nd St SW, Calgary, AB, T3S 2C1, Canada
| | - Reanne Booker
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre - Holy Cross Site, 2202 2nd St SW, Calgary, AB, T3S 2C1, Canada
- Department of Oncology, University of Calgary, Calgary, AB, Canada
- Palliative and End-of-Life Care Services, Calgary, AB, Canada
| | - Corinne Doll
- Department of Oncology, University of Calgary, Calgary, AB, Canada
- Department of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Sarah Glaze
- Department of Oncology, University of Calgary, Calgary, AB, Canada
- Department of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Tien Phan
- Department of Oncology, University of Calgary, Calgary, AB, Canada
- Department of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Kerrie Brennan
- Department of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Roanne D Millman
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre - Holy Cross Site, 2202 2nd St SW, Calgary, AB, T3S 2C1, Canada
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - John W Robinson
- Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre - Holy Cross Site, 2202 2nd St SW, Calgary, AB, T3S 2C1, Canada
- Department of Oncology, University of Calgary, Calgary, AB, Canada
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Wang H, Su Q, Yan Z, Lu F, Zhao Q, Liu Z, Zhou F. Rehabilitation Treatment of Motor Dysfunction Patients Based on Deep Learning Brain-Computer Interface Technology. Front Neurosci 2020; 14:595084. [PMID: 33192282 PMCID: PMC7642128 DOI: 10.3389/fnins.2020.595084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 09/08/2020] [Indexed: 01/20/2023] Open
Abstract
In recent years, brain-computer interface (BCI) is expected to solve the physiological and psychological needs of patients with motor dysfunction with great individual differences. However, the classification method based on feature extraction requires a lot of prior knowledge when extracting data features and lacks a good measurement standard, which makes the development of BCI. In particular, the development of a multi-classification brain-computer interface is facing a bottleneck. To avoid the blindness and complexity of electroencephalogram (EEG) feature extraction, the deep learning method is applied to the automatic feature extraction of EEG signals. It is necessary to design a classification model with strong robustness and high accuracy for EEG signals. Based on the research and implementation of a BCI system based on a convolutional neural network, this article aims to design a brain-computer interface system that can automatically extract features of EEG signals and classify EEG signals accurately. It can avoid the blindness and time-consuming problems caused by the machine learning method based on feature extraction of EEG data due to the lack of a large amount of prior knowledge.
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Affiliation(s)
| | - Qinglun Su
- Department of Rehabilitation Medicine, The First People’s Hospital of Lianyungang, Lianyungang, China
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Alsuliman T, Baylet C, Casabona A, Dann MP, De Bentzmann N, Fontoura ML, Genty C, Huynh A, Ibled D, Mercier L, Poirot C, Porcheron S, Tourette-Turgis C, Vernant JP, Vexiau-Robert D, Yakoub-Agha I, Nguyen S. [Sexual and emotional life after allogeneic hematopoietic stem cell transplant: Guidelines and patient booklet from the Francophone Society of Bone marrow Transplant and Cellular therapy (SFGM-TC)]. Bull Cancer 2020; 107:S151-S158. [PMID: 32747052 DOI: 10.1016/j.bulcan.2020.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/18/2022]
Abstract
The Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) organises annual workshops in an attempt to harmonise clinical practices among different francophone transplantation centres. The SFGM-TC harmonisation workshops aim at establishing practical guidelines, on the one hand, from data from the literature and international recommendations and, on the other hand, by consensus in the absence of formally proven data. The sexual and emotional life of allogeneic hematopoietic stem cells transplanted (HSCT) patients is often very impacted and remains a subject relatively little addressed by patients and caregivers. This article is an update from a previous workshop and is accompanied by a patient booklet, which will be included in the post allograft follow-up workbook published by the SFGM-TC. The purpose of these two documents is to facilitate discussions between patients and caregivers on the subject and to present proposals for follow-up and tools to better manage the sexual and emotional life of allotransplanted patients.
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Affiliation(s)
- Tamim Alsuliman
- Hôpital Saint-Antoine , AP-HP, Sorbonne université, service d'hématologie et thérapie cellulaire, 184, rue de Faubourg-Saint-Antoine, 75012 Paris, France.
| | - Caroline Baylet
- CHU d'Angers, service des maladies du sang, 4, rue Larrey, 49000 Angers, France.
| | - Audrey Casabona
- AP-HP Sorbonne, site Pitié-Salpêtrière, service d'hématologie clinique, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
| | - Marie-Pierre Dann
- AP-HP Sorbonne, site Pitié-Salpêtrière, service d'hématologie clinique, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
| | - Natacha De Bentzmann
- IUCT-Oncopole, service d'hématologie greffe, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
| | | | - Carole Genty
- CHRU de Dupuytren, service d'hématologie et de thérapie cellulaire, 2, avenue Martin Luther King, 87042 Limoges, France.
| | - Anne Huynh
- IUCT-Oncopole, service d'hématologie greffe, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
| | - Diane Ibled
- AP-HP Sorbonne, site Pitié-Salpêtrière, service d'hématologie clinique, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
| | - Lara Mercier
- IUCT-Oncopole, service d'hématologie greffe, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
| | - Catherine Poirot
- Hôpital Saint-Louis, unité AJA, préservation de la fertilité, service d'hématologie, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - Sophie Porcheron
- CLCC Henri-Becquerel, unité de soins intensifs hématologie, 1, rue d'Amiens, 76038 Rouen cedex, France.
| | | | - Jean-Paul Vernant
- AP-HP Sorbonne, site Pitié-Salpêtrière, service d'hématologie clinique, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
| | | | | | - Stéphanie Nguyen
- AP-HP Sorbonne, site Pitié-Salpêtrière, service d'hématologie clinique, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
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Ang WHD, Lau Y, Ngo LPE, Siew AL, Ang NKE, Lopez V. Path analysis of survivorship care needs, symptom experience, and quality of life among multiethnic cancer survivors. Support Care Cancer 2020; 29:1433-1441. [PMID: 32676855 DOI: 10.1007/s00520-020-05631-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 07/13/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE Cancer survivors continue to experience issues that persist across the survivorship trajectory. This study aims to explore the relationship among survivorship care need, symptom experience, and quality of life (QoL) of multiethnic cancer survivors by using path analytic methods. METHODS Participants were recruited from an academic medical center in Singapore that provides inpatient and outpatient oncology and hematology service. The Cancer Survivor Unmet Needs measure, physical effects subscale of the Cancer Survivors' Survey of Needs tool, and a Global QoL 10-point Likert scale were used to identify survivorship care needs, symptom experience, and QoL. Descriptive statistics were used to compute sociodemographic information, total survivorship needs, symptom experienced, and quality of life scores. The symptom experience model was used as the hypothetical model. The Analysis of Moment Structure was used to conduct the path analysis to evaluate the relationship between survivorship care needs, symptom experience, and quality of life. RESULTS Older cancer survivors were more likely to have spent a longer duration having cancer. Males were unlikely to suffer from solid tumor malignancies. Survivors with solid tumor malignancies were less likely to require supportive care. Survivors who require more supportive care were more likely to have a greater symptom burden. Cancer survivors with more symptoms have poorer QoL. The findings from this study partially supported the symptom experience model. CONCLUSIONS Our findings reveal that cancer survivors continue to experience symptoms across the survivorship trajectory. The results provide information for nurses during the planning and execution of survivorship care.
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Affiliation(s)
- Wei How Darryl Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
| | - Lay Poh Ednajoy Ngo
- Division of Oncology Nursing, National University Cancer Institute, Singapore, Singapore
| | - An Ling Siew
- Department of Nursing, Tan Tock Seng Hospital, Singapore, Singapore
| | - Neo Kim Emily Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Nursing, National University Health System, Singapore, Singapore
| | - Violeta Lopez
- School of Nursing, Hubei University of Medicine, Shiyan, Hubei Province, People's Republic of China
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Nekhlyudov L, Galioto M. Innovations in cancer survivorship care: “Lessons from the Clinic” special section. J Cancer Surviv 2019; 14:1-3. [DOI: 10.1007/s11764-019-00836-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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