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Garland SN, Tulk J, Savard J, Rash JA, Browne S, Urquhart R, Seal M, Thoms J, Laing K. Randomized Controlled Trial of Virtually Delivered Cognitive Behavioral Therapy for Insomnia to Address Perceived Cancer-Related Cognitive Impairment in Cancer Survivors. J Clin Oncol 2024; 42:2094-2104. [PMID: 38552188 DOI: 10.1200/jco.23.02330] [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: 10/26/2023] [Revised: 12/18/2023] [Accepted: 02/07/2024] [Indexed: 06/07/2024] Open
Abstract
PURPOSE Comorbid insomnia and cancer-related cognitive impairment (CRCI) are experienced by up to 26% of individuals diagnosed with cancer. This study examined the efficacy and durability of cognitive behavioral therapy for insomnia (CBT-I) on perceived CRCI in cancer survivors. METHODS Atlantic Canadian cancer survivors with insomnia and CRCI were randomly assigned to receive seven weekly virtual CBT-I sessions (n = 63) or placed in a waitlist control group (n = 69) to receive treatment after the waiting period. Participants completed assessments at baseline, 1 month (mid-treatment), and 2 months (post-treatment). Age- and education-adjusted mixed-effects models using intention-to-treat principles assessed change at post-treatment. Data from both groups were then pooled to assess the durability of effects at 3 and 6 months. A mediation analysis examined whether change in insomnia symptoms mediated the effect of CBT-I on cognitive outcomes. RESULTS The mean age of the sample was 60 years, 77% were women, and breast cancer was the most common diagnosis (41%). The treatment group reported an 11.35-point reduction in insomnia severity, compared with a 2.67-point reduction in the waitlist control group (P < .001). The treatment group had a greater overall improvement than the waitlist control on perceived cognitive impairment (P < .001; d = 0.75), cognitive abilities (P < .001; d = 0.92), and impact on quality of life (P < .001; d = 1.01). These improvements were maintained at follow-up. Change in insomnia symptoms fully mediated the effect of CBT-I on subjective cognitive outcomes. CONCLUSION Treating insomnia with CBT-I produces clinically meaningful and durable improvements in CRCI. There is an urgent need increase access to evidence-based treatment for insomnia in cancer centers and the community.
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Affiliation(s)
- Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, St John's, NL
- Discipline of Oncology, Faculty of Science, Memorial University, St John's, NL
| | - Joshua Tulk
- Department of Psychology, Faculty of Science, Memorial University, St John's, NL
| | - Josée Savard
- School of Psychology, Université Laval, Quebec, QC, Canada
- CHU de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Joshua A Rash
- Department of Psychology, Faculty of Science, Memorial University, St John's, NL
| | | | - Robin Urquhart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS
| | - Melanie Seal
- Discipline of Oncology, Faculty of Science, Memorial University, St John's, NL
| | - John Thoms
- Discipline of Oncology, Faculty of Science, Memorial University, St John's, NL
| | - Kara Laing
- Discipline of Oncology, Faculty of Science, Memorial University, St John's, NL
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Ibrar M, Rai HK, Main A, McCartney H, Maguire R, Rodriguez MAP. The Experience of Cancer-Related Cognitive Impairment Across Common Cancers: Protocol for a Qualitative Systematic Review. JMIR Res Protoc 2024; 13:e56888. [PMID: 38820581 PMCID: PMC11179027 DOI: 10.2196/56888] [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: 02/01/2024] [Revised: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Cancer-related cognitive impairment (CRCI) is commonly experienced by patients with cancer during treatment, and 35% of patients experience cognitive impairment after treatment completion. Impairments in memory, attention, executive functioning, and information processing speed are most reported and often negatively impact daily functioning and quality of life (QoL). Despite the large scale of reports, this adverse side effect is underinvestigated across common cancer types, and there is a lack of insight into the CRCI experience. OBJECTIVE This qualitative synthesis aims to explore the evidence in relation to the experience of CRCI across common cancers. It also aims to understand the prevalence of CRCI across various cancer types, cognitive domains, and its impact on QoL and functional ability. METHODS A comprehensive search of databases, including PubMed, American Psychological Association PsycINFO, CINAHL, and Scopus, will be conducted. A total of 2 independent reviewers will screen titles and abstracts for inclusion, followed by full-text screening. A third reviewer will resolve any arising conflicts in the process of data screening and inclusion. Subsequently, data extraction and quality assessment using the Critical Appraisal Skills Programme (CASP) tool will be conducted. The results will be analyzed using thematic analysis. RESULTS This review is part of a PhD program funded in January 2023. The review commenced in June 2023, and data analysis is currently in progress. The qualitative synthesis will explore the experiences of CRCI across common cancers. The included studies are expected to report on numerous cancer types such as breast cancer, prostate cancer, leukemia, and lung cancer. The included study types are most likely to be interviews, focus groups, and surveys with qualitative components. CONCLUSIONS This protocol highlights the need for a qualitative synthesis that will explore the experience of CRCI across common cancer types. It will provide valuable insight into the lived experience of CRCI and the cognitive domains that may be disproportionately affected. There is a growing demand for further management interventions and clinically tested treatments of CRCI and the qualitative exploration of patient experience is crucial for their development. This qualitative synthesis will inform future developments and will contribute to improving QoL after cancer. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56888.
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Affiliation(s)
- Maryam Ibrar
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Harleen Kaur Rai
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Ashleigh Main
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Haruno McCartney
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Roma Maguire
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
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Forcino RC, Morrissette KJ, Stevens CJ, Lichtenstein JD, Rotenberg S, Schiffelbein JE, Connolly D, Lyons KD. Strategies to support cancer survivors at work: content analysis of cancer survivor, healthcare provider, and employer perspectives. J Cancer Surviv 2024:10.1007/s11764-024-01539-w. [PMID: 38316725 DOI: 10.1007/s11764-024-01539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/18/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE To (1) describe the challenges identified by cancer survivors, healthcare providers, and employers related to work maintenance and optimization during and after cancer treatment and (2) identify strategies that can address those challenges. METHODS We conducted content analysis of semi-structured interview data collected from cancer survivors, healthcare providers, and employers regarding workplace challenges that cancer survivors face and strategies to address them. Challenges and strategies were summarized according to whether they related to the cancer survivor, the work demands, or the work environment. RESULTS Forty-five total participants identified challenges and strategies primarily related to the cancer survivor's signs and symptoms of treatment. Healthcare providers (n = 17) focused primarily on challenges and strategies related to the cancer survivor, while employers (n = 5) focused on the work environment-especially policies and procedures that facilitate time off work and the importance of bidirectional communication between cancer survivors and employers. Cancer survivors (n = 23) identified challenges and suggestions in all three categories, though they uniquely focused on challenges relating to work demands and adjustments to those demands that would facilitate employment maintenance. CONCLUSIONS Efforts to address the many challenges that cancer survivors experience at work should include the views of cancer survivors, healthcare providers, and employers reflecting their respective domains of expertise in work demands, cancer survivors' medical care, and the work environment. IMPLICATIONS FOR CANCER SURVIVORS Survivors and healthcare providers are able to address many side effects that can create work challenges, but improved collaboration between survivors and employers may identify ways to modify work demands and environments to maximize employment maintenance.
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Affiliation(s)
- Rachel C Forcino
- Department of Population Health, School of Medicine, University of Kansas, Kansas City, KS, USA.
| | | | - Courtney J Stevens
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Jonathan D Lichtenstein
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Geisel School of Medicine, Lebanon, NH, USA
| | - Sivan Rotenberg
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | | | - Deirdre Connolly
- Occupational Therapy Department, Trinity College Dublin, Dublin, Ireland
| | - Kathleen Doyle Lyons
- Occupational Therapy Department, Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
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Vardy JL, Pond GR, Bell ML, Renton C, Dixon A, Dhillon HM. A randomised controlled trial evaluating two cognitive rehabilitation approaches for cancer survivors with perceived cognitive impairment. J Cancer Surviv 2023; 17:1583-1595. [PMID: 36241767 PMCID: PMC9568997 DOI: 10.1007/s11764-022-01261-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/20/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Up to 70% of survivors report cognitive symptoms after chemotherapy. We compared two cognitive rehabilitation programs to a control group in cancer survivors. METHODS Study population were adult cancer survivors with cognitive symptoms 6-60 months after adjuvant chemotherapy. Participants randomised to: Attention Process Training (APT), Compensatory Strategy Training (CST), or control group. Active interventions comprised 6-week, 2-h/week small group sessions. ASSESSMENTS pre- and post-intervention, 6- and 12-months later. Primary outcome was change in cognitive symptoms (FACT-COG-PCI subscale) between baseline and post-intervention. Secondary endpoints included objective neuropsychological performance, Functional Impact Assessment (FIA), patient-reported outcome measures, and associations. Analyses were on an intention-to-treat basis. Analysis of covariance mixed models were used for continuous outcomes. RESULTS Sixty-five participants were randomised (APT n = 21; CST n = 24; controls n = 20): 94% breast cancer, median age 54. Median time since chemotherapy 20.7 months. FACT-COG-PCI, clinical neuropsychological T-scores, and FIA improved in all groups over time, but no significant differences between arms. On mean neuropsychological T-scores 19/65 (29%) were impaired at baseline; post-intervention impairment controls 31.3%, CST 16.7%, APT 20.0%. On FIA at baseline, nine were impaired; this decreased to three post-intervention (one/group). FACT-COG-PCI was weakly associated with neuropsychological tests (rho = 0.24, p = 0.051) at baseline, and had no association with FIA. Neuropsychological total mean T-score was moderately positively associated with FIA (rho = 0.37, p = 0.003). CONCLUSION There were no significant differences between intervention groups and controls using linear mixed models adjusted for baseline scores. IMPLICATIONS FOR CANCER SURVIVORS Cognitive symptoms and neuropsychological test scores improve over time.
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Affiliation(s)
- Janette L Vardy
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia.
- Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, Australia.
| | | | - Melanie L Bell
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Corrinne Renton
- Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, Australia
| | - Ann Dixon
- Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, Australia
| | - Haryana M Dhillon
- Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, Australia
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Walker H, Rimmer B, Dutton L, Finch T, Gallagher P, Lewis J, Burns R, Araújo-Soares V, Williams S, Sharp L. Experiences of work for people living with a grade 2/3 oligodendroglioma: a qualitative analysis within the Ways Ahead study. BMJ Open 2023; 13:e074151. [PMID: 37770270 PMCID: PMC10546132 DOI: 10.1136/bmjopen-2023-074151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES This study aimed to explore the work experiences of people living with an oligodendroglioma. DESIGN This was a descriptive qualitative study. One-time semi-structured interviews exploring supportive care needs were conducted; work was discussed at various points throughout each interview. An inductive thematic analysis was undertaken. SETTING Participants were recruited across the UK through four National Health Service hospitals and the Brain Tumour Charity research involvement networks. PARTICIPANTS 19 people with grade 2 or 3 oligodendroglioma (mean age 52 years; male n=11). At diagnosis, 16 participants were working, 2 studying and 1 retired. At the interview (mean time since diagnosis 9.6 years; range 1-18 years), seven participants were working, eight retired (four on medical grounds) and four unable to work due to illness. RESULTS Seven themes were constructed: (1) physical and cognitive limitations; (2) work ability and productivity; (3) work accommodations; (4) changing roles; (5) attitudes of clients and coworkers; (6) feelings and ambitions; and (7) financial implications. Fatigue, seizures and cognitive deficits influenced work ability. A stressful work environment could exacerbate symptoms. Changes in job roles and work environment were often required. Employer and coworker support were integral to positive experiences. Work changes could result in financial stress and strain. CONCLUSIONS This study has highlighted, for the first time, influences on work experiences in this understudied population. These findings have implications for clinicians and employers, when considering the importance of work in rehabilitation for people with oligodendrogliomas, and the individually assessed adjustments required to accommodate them, should employment be desired.
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Affiliation(s)
- Hayley Walker
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ben Rimmer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery, and Health, Northumbria University, Newcastle upon Tyne, UK
| | | | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- Centre for Preventive Medicine and Digital Health, Department for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Yang HY, Chou YJ, Shun SC. The Effect of Walking Intervention on Cognitive Function Among Patients With Non-Central Nervous System Cancer: A Systematic Review. Cancer Nurs 2023; 46:375-385. [PMID: 37607373 DOI: 10.1097/ncc.0000000000001106] [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: 11/26/2022]
Abstract
BACKGROUND Cognitive impairment is one of the most frequently reported symptoms in patients with non-central nervous system (non-CNS) cancer. Walking has positive effects on cognitive function. However, the effects of walking interventions on cognitive function outcomes in patients with non-CNS cancer are not well synthesized. OBJECTIVE The aim of this study was to explore the characteristics of walking intervention and its effects on cognitive function in patients with non-CNS cancer. METHODS Ten databases were searched to identify eligible randomized controlled trials from each database's inception to June 7, 2021. The Physiotherapy Evidence Database Scale was used to assess the quality of the included studies. RESULTS Five randomized controlled trials involving 242 adults with non-CNS cancer were included. Two studies involving immediate treadmill walking interventions with moderate intensity at 40% to 60% maximal heart rate reported significantly improved objective cognitive domains of processing speed and spatial working memory with small to moderate effect sizes for cancer survivors. One study delivering home-based, moderate-intensity walking intervention had borderline significantly positive effects on perceived cognitive functioning for patients with non-CNS cancer during chemotherapy. CONCLUSION Walking intervention with moderate intensity is a beneficial approach to improve objective cognitive domains of processing speed and spatial working memory and perceived cognitive function. IMPLICATIONS FOR PRACTICE Nurses may provide moderate-intensity walking with 40% to 60% maximal heart rate monitoring to alleviate cognitive problems during the continuous process of cancer care. The modality and dosage of intervention should be adjusted depending on this population's tolerance to better maintain training.
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Affiliation(s)
- Hui-Ying Yang
- Author Affiliations: School of Nursing, College of Medicine, National Taiwan University (Ms Yang), Taipei; School of Nursing, College of Medicine, Chang Gung University (Dr Chou), Taoyuan; and School of Nursing, National Yang Ming Chiao Tung University (Dr Shun), Taipei, Taiwan
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7
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Du X, Mao L, Leng Y, Chen F. Validation of the FACT-G7 in patients with hematologic malignancies. Front Oncol 2023; 13:1183632. [PMID: 37637033 PMCID: PMC10448388 DOI: 10.3389/fonc.2023.1183632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/21/2023] [Indexed: 08/29/2023] Open
Abstract
Background It is essential to evaluate the quality of life in patients with hematologic malignancies to reflect the therapeutic effect and prognosis, but lengthy assessments are often burdensome. The 7-Item Functional Assessment of Cancer Therapy-General (FACT-G7) is a brief, easy, and rapid index for evaluating quality of life. Nevertheless, there is no report about its application in Chinese patients with hematologic malignancies. Objective The purpose of this study was to validate the Chinese version of the FACT-G7 for patients with hematologic malignancies. Methods This study is a cross-sectional study. A total of 855 patients with hematologic malignancies completed the Functional Assessment of Cancer Therapy-General (FACT-G) and were scored the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) by nurses. Cronbach's alpha, confirmatory factor analyses, Pearson's correlation, and one-way analysis of variance were conducted to evaluate internal consistent reliability, structural validity and concurrent validity. Results The FACT-G7 showed acceptable internal consistency, as indicated by a Cronbach's alpha of 0.73. The confirmatory factor analyses test for single-factor model fit for the FACT-G7 scale was almost adequate. The satisfactory correlations between the FACT-G7 and the FACT-G and its subscales, and ECOG-PS groups differed in FACT-G7 scores demonstrating concurrent validity. Conclusion This study suggested that the Chinese version of the FACT-G7 provides a useful and rapid measure for assessing quality of life in Chinese patients with hematologic malignancies, which providing a reference for further evaluation and care.
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Affiliation(s)
| | | | | | - Fengjiao Chen
- Department of Hematology, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
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Yang HY, Chang YL, Lin BR, Chou YJ, Shun SC. Cognitive Function in Patients at Different Stages of Treatment for Colorectal Cancer: A Comparative Cross-Sectional Study. Semin Oncol Nurs 2023; 39:151446. [PMID: 37183103 DOI: 10.1016/j.soncn.2023.151446] [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: 10/31/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVES To compare subjective and objective cognitive functions among patients at the following three stages of treatment for colorectal cancer (CRC): new diagnosis (Group A), ≤2 years since chemotherapy completion (Group B), and >2 years since chemotherapy completion (Group C). DATA SOURCES A comparative cross-sectional approach was used in this study. The Functional Assessment of Cancer Therapy-Cognitive Function questionnaire and neuropsychological assessments were used to assess patients' subjective cognitive function, attention, memory, and executive functions. A total of 63 patients with stage I to III CRC were recruited from a medical center in northern Taiwan. We performed one-to-one-to-one propensity score matching to identify 36 individuals as eligible for this study. A generalized estimating equation was used to compare subjective and objective cognitive functions. CONCLUSION We observed no significant between-group differences in subjective cognitive function and objective performance in overall cognition and memory. Group B had significantly longer reaction time in attention and processing speed than did Group A. Adjuvant chemotherapy had significantly deleterious effects on attention and processing speed in patients with CRC. These cognitive symptoms last for approximately 2 years after the completion of chemotherapy. IMPLICATIONS FOR NURSING PRACTICE The early detection of cancer-related cognitive impairment is necessary for managing symptom distress. Future studies with a large sample size and longitudinal design may elucidate the trajectory of specific cognitive functions. Developing nursing interventions aimed at improving attention and executive function in patients with CRC are needed.
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Affiliation(s)
- Hui-Ying Yang
- PhD Candidate, School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Ling Chang
- Professor, Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Been-Ren Lin
- Attending Physician, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; Attending Physician, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yun-Jen Chou
- Assistant Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shiow-Ching Shun
- Professor, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Ospina-Romero M, Brenowitz WD, Glymour MM, Westrick A, Graff RE, Hayes-Larson E, Mayeda ER, Ackley SF, Kobayashi LC. Education, incident cancer, and rate of memory decline in a national sample of US adults in mid-to-later-life. J Geriatr Oncol 2023; 14:101530. [PMID: 37210786 PMCID: PMC10332197 DOI: 10.1016/j.jgo.2023.101530] [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: 08/31/2022] [Revised: 03/30/2023] [Accepted: 05/11/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Middle-aged and older adults who develop cancer experience memory loss following diagnosis, but memory decline in the years before and after cancer diagnosis is slower compared to their cancer-free counterparts. Educational attainment strongly predicts memory function during aging, but it is unclear whether education protects against memory loss related to cancer incidence or modifies long-term memory trajectories in middle-aged and older cancer survivors. MATERIALS AND METHODS Data were from 14,449 adults (3,248 with incident cancer, excluding non-melanoma skin cancer) aged 50+ in the population-based US Health and Retirement Study from 1998 to 2016. Memory was assessed every two years as a composite of immediate and delayed word recall tests and proxy assessments for impaired individuals. Memory scores all time points were standardized at to the baseline distribution. Using multivariate-adjusted linear mixed-effects models, we estimated rates of memory decline in the years before cancer diagnosis, shortly after diagnosis, and in the years after diagnosis. We compared rates of memory decline between incident cancer cases and age-matched cancer-free adults, overall and according to level of education (<12 years, "low"; 12 to <16 years, "intermediate"; ≥16 years, "high"). RESULTS Incident cancer diagnoses were followed by short-term declines in memory averaging 0.06 standard deviation (SD) units (95% confidence interval [CI]: -0.084, -0.036). Those with low education experienced the strongest magnitude of short-term decline in memory after diagnosis (-0.10 SD units, 95% CI: -0.15, -0.05), but this estimate was not statistically significantly different from the short-term decline in memory experienced by those with high education (-0.04 SD units, 95% CI: -0.08, 0.01; p-value for education as an effect modifier = 0.15). In the years prior to and following an incident cancer diagnosis, higher educational attainment was associated with better memory, but it did not modify the difference in rate of long-term memory decline between cancer survivors and those who remained cancer-free. DISCUSSION Education was associated with better memory function over time among both cancer survivors and cancer-free adults aged 50 and over. Low education may be associated with a stronger short-term decline in memory after a cancer diagnosis.
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Affiliation(s)
- Monica Ospina-Romero
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America; Department of Pathology and Laboratory Medicine, University of Wisconsin, United States of America.
| | - Willa D Brenowitz
- Department of Psychiatry, University of California San Francisco, United States of America; Kaiser Permanente Center for Health Research, Portland, United States of America
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America
| | - Ashly Westrick
- Department of Epidemiology, School of Public Health, University of Michigan, United States of America
| | - Rebecca E Graff
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America
| | - Eleanor Hayes-Larson
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, United States of America
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, United States of America
| | - Sarah F Ackley
- Department of Epidemiology and Biostatistics, University of California San Francisco, United States of America
| | - Lindsay C Kobayashi
- Department of Epidemiology, School of Public Health, University of Michigan, United States of America
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Hardy SJ, Finkelstein AJ, Tivarus M, Culakova E, Mohile N, Weber M, Lin E, Zhong J, Usuki K, Schifitto G, Milano M, Janelsins-Benton MC. Cognitive and neuroimaging outcomes in individuals with benign and low-grade brain tumours receiving radiotherapy: a protocol for a prospective cohort study. BMJ Open 2023; 13:e066458. [PMID: 36792323 PMCID: PMC9933762 DOI: 10.1136/bmjopen-2022-066458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/27/2023] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION Radiation-induced cognitive decline (RICD) occurs in 50%-90% of adult patients 6 months post-treatment. In patients with low-grade and benign tumours with long expected survival, this is of paramount importance. Despite advances in radiation therapy (RT) treatment delivery, better understanding of structures important for RICD is necessary to improve cognitive outcomes. We hypothesise that RT may affect network topology and microstructural integrity on MRI prior to any gross anatomical or apparent cognitive changes. In this longitudinal cohort study, we aim to determine the effects of RT on brain structural and functional integrity and cognition. METHODS AND ANALYSIS This study will enroll patients with benign and low-grade brain tumours receiving partial brain radiotherapy. Patients will receive either hypofractionated (>2 Gy/fraction) or conventionally fractionated (1.8-2 Gy/fraction) RT. All participants will be followed for 12 months, with MRIs conducted pre-RT and 6-month and 12 month post-RT, along with a battery of neurocognitive tests and questionnaires. The study was initiated in late 2018 and will continue enrolling through 2024 with final follow-ups completing in 2025. The neurocognitive battery assesses visual and verbal memory, attention, executive function, processing speed and emotional cognition. MRI protocols incorporate diffusion tensor imaging and resting state fMRI to assess structural connectivity and functional connectivity, respectively. We will estimate the association between radiation dose, imaging metrics and cognitive outcomes. ETHICS AND DISSEMINATION This study has been approved by the Research Subjects Review Board at the University of Rochester (STUDY00001512: Cognitive changes in patients receiving partial brain radiation). All results will be published in peer-reviewed journals and at scientific conferences. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT04390906.
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Affiliation(s)
- Sara J Hardy
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
| | - Alan J Finkelstein
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
- Center for Advanced Brain Imaging and Neurophysiology, University of Rochester Medical Center, Rochester, New York, USA
| | - Madalina Tivarus
- Center for Advanced Brain Imaging and Neurophysiology, University of Rochester Medical Center, Rochester, New York, USA
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Eva Culakova
- Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA
| | - Nimish Mohile
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
| | - Miriam Weber
- Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, USA
| | - Edward Lin
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Jianhui Zhong
- Department of Biomedical Engineering, University of Rochester, Rochester, New York, USA
- Center for Advanced Brain Imaging and Neurophysiology, University of Rochester Medical Center, Rochester, New York, USA
| | - Kenneth Usuki
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA
| | - Giovanni Schifitto
- Department of Neurology, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Michael Milano
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA
| | - M C Janelsins-Benton
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York, USA
- Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA
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11
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Sacks-Zimmerman A, Bergquist TF, Farr EM, Cornwell MA, Kanellopoulos D. Rehabilitation of Neuropsychiatric Symptoms in Patients With Long COVID: Position Statement. Arch Phys Med Rehabil 2023; 104:350-354. [PMID: 36272444 PMCID: PMC9581644 DOI: 10.1016/j.apmr.2022.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/12/2022] [Accepted: 10/03/2022] [Indexed: 02/07/2023]
Abstract
Long COVID, a term used to describe ongoing symptoms after COVID-19 infection, parallels the course of other postviral syndromes. Neuropsychiatric symptoms of long COVID can be persistent and interfere with quality of life and functioning. Within the biopsychosocial framework of chronic illness, rehabilitation professionals can address the neuropsychiatric sequelae of long COVID. However, current practice models are not designed to address concurrent psychiatric and cognitive symptoms in adults living with long COVID. Thus, we present a biopsychosocial framework for long COVID and provide treatment strategies based on evidence from current literature of postviral chronic illness. These recommendations will guide rehabilitation professionals in identifying common neuropsychiatric symptoms in long COVID that can be targeted for intervention and addressing these symptoms via integrative interventions taking into account the biopsychosocial presentation of long COVID symptoms.
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Affiliation(s)
- Amanda Sacks-Zimmerman
- Weill Cornell Medicine, Brain & Spine Center, Department of Neurological Surgery, New York, NY.
| | - Thomas F Bergquist
- Mayo Clinic, Department of Physical Medicine and Rehabilitation, Rochester, MN; Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN
| | - Ellen M Farr
- Mayo Clinic, Department of Physical Medicine and Rehabilitation, Rochester, MN
| | - Melinda A Cornwell
- Weill Cornell Medicine, Brain & Spine Center, Department of Neurological Surgery, New York, NY
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12
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Nakamura ZM, Deal AM, Park EM, Stanton KE, Lopez YE, Quillen LJ, O'Hare Kelly E, Heiling HM, Nyrop KA, Ray EM, Dees EC, Reeder-Hayes KE, Jolly TA, Carey LA, Abdou Y, Olajide OA, Rauch JK, Joseph R, Copeland A, McNamara MA, Ahles TA, Muss HB. A phase II single-arm trial of memantine for prevention of cognitive decline during chemotherapy in patients with early breast cancer: Feasibility, tolerability, acceptability, and preliminary effects. Cancer Med 2023; 12:8172-8183. [PMID: 36645168 PMCID: PMC10134315 DOI: 10.1002/cam4.5619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Cognitive difficulties have been described after chemotherapy for breast cancer, but there is no standard of care to improve cognitive outcomes in these patients. This trial examined the feasibility, tolerability, acceptability, and preliminary effects of memantine to prevent cognitive decline during chemotherapy for breast cancer. METHODS Patients with stage I-III breast cancer, scheduled for neo/adjuvant chemotherapy, completed a cognitive battery prior to and 4 weeks after completing chemotherapy. Memantine (10 mg BID) was administered concurrent with chemotherapy. Our primary cognitive outcome was visual working memory assessed by the Delayed Matching to Sample test. We used the Brief Medication Questionnaire to assess acceptability. RESULTS Of 126 patients approached, 56 (44%) enrolled. Forty-five (80%) received ≥1 dose of memantine and completed pre-post assessments. Seventy-six percent reported taking ≥90% of scheduled doses. Participants were mean age of 56, 77% White, and 57% had stage I disease. Sixty-four percent had stable or improved Delayed Matching to Sample test scores. Stable or improved cognition was observed in 87%-91% across objective cognitive domain composite measures. Sixty-six percent self-reported stable or improved cognitive symptoms. There were seven greater than or equal to grade 3 adverse events; two were possibly related to memantine. Only 5% reported that taking memantine was a disruption to their lives. CONCLUSIONS Memantine was well-tolerated and consistently taken by a large majority of patients receiving breast cancer chemotherapy. The majority demonstrated stable or improved cognition from pre- to post-assessment. Randomized trials are needed to determine memantine's efficacy to ameliorate cognitive loss. TRIAL REGISTRATION ClinicalTrials.gov NCT04033419.
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Affiliation(s)
- Zev M Nakamura
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eliza M Park
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kate E Stanton
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yesy E Lopez
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Laura J Quillen
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erin O'Hare Kelly
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hillary M Heiling
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kirsten A Nyrop
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily M Ray
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - E Claire Dees
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Katherine E Reeder-Hayes
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Trevor A Jolly
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lisa A Carey
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yara Abdou
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Julia K Rauch
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Ranjit Joseph
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Anureet Copeland
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Megan A McNamara
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Hyman B Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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13
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Carroll JE, Nakamura ZM, Small BJ, Zhou X, Cohen HJ, Ahles TA, Ahn J, Bethea TN, Extermann M, Graham D, Isaacs C, Jim HS, Jacobsen PB, McDonald BC, Patel SK, Rentscher K, Root J, Saykin AJ, Tometich DB, Van Dyk K, Zhai W, Breen EC, Mandelblatt JS. Elevated C-Reactive Protein and Subsequent Patient-Reported Cognitive Problems in Older Breast Cancer Survivors: The Thinking and Living With Cancer Study. J Clin Oncol 2023; 41:295-306. [PMID: 36179271 PMCID: PMC9839283 DOI: 10.1200/jco.22.00406] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/24/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To examine longitudinal relationships between levels of C-reactive protein (CRP) and cognition in older breast cancer survivors and noncancer controls. METHODS English-speaking women age ≥ 60 years, newly diagnosed with primary breast cancer (stage 0-III), and frequency-matched controls were enrolled from September 2010 to March 2020; women with dementia, neurologic disorders, and other cancers were excluded. Assessments occurred presystemic therapy/enrollment and at annual visits up to 60 months. Cognition was measured using the Functional Assessment of Cancer Therapy-Cognitive Function and neuropsychological testing. Mixed linear effect models tested for survivor-control differences in natural log (ln)-transformed CRP at each visit. Random effect-lagged fluctuation models tested directional effects of ln-CRP on subsequent cognition. All models controlled for age, race, study site, cognitive reserve, obesity, and comorbidities; secondary analyses evaluated if depression or anxiety affected results. RESULTS There were 400 survivors and 329 controls with CRP specimens and follow-up data (average age of 67.7 years; range, 60-90 years). The majority of survivors had stage I (60.9%), estrogen receptor-positive (87.6%) tumors. Survivors had significantly higher adjusted mean ln-CRP than controls at baseline and 12-, 24-, and 60-month visits (all P < .05). Higher adjusted ln-CRP predicted lower participant-reported cognition on subsequent visits among survivors, but not controls (P interaction = .008); effects were unchanged by depression or anxiety. Overall, survivors had adjusted Functional Assessment of Cancer Therapy-Cognitive Function scores that were 9.5 and 14.2 points lower than controls at CRP levels of 3.0 and 10.0 mg/L. Survivors had poorer neuropsychological test performance (v controls), with significant interactions with CRP only for the Trails B test. CONCLUSION Longitudinal relationships between CRP and cognition in older breast cancer survivors suggest that chronic inflammation may play a role in development of cognitive problems. CRP testing could be clinically useful in survivorship care.
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Affiliation(s)
- Judith E. Carroll
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Zev M. Nakamura
- Department of Psychiatry, University of North Carolina–Chapel Hill, Chapel Hill, NC
| | - Brent J. Small
- School of Aging Studies, University of South Florida, Tampa, FL
| | - Xingtao Zhou
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
| | - Harvey J. Cohen
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
| | - Tim A. Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
| | - Traci N. Bethea
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
| | - Martine Extermann
- Department of Oncology, Moffitt Cancer Center, University of South Florida, Tampa, FL
| | - Deena Graham
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ
| | - Claudine Isaacs
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
| | | | - Paul B. Jacobsen
- Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Brenna C. McDonald
- Department of Radiology and Imaging Sciences, Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN
| | | | - Kelly Rentscher
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - James Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andrew J. Saykin
- Department of Radiology and Imaging Sciences, Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN
| | | | - Kathleen Van Dyk
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Wanting Zhai
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
| | - Elizabeth C. Breen
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA
| | - Jeanne S. Mandelblatt
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC
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Paltrinieri S, Costi S, Pellegrini M, Díaz Crescitelli ME, Vicentini M, Mancuso P, Giorgi Rossi P, Fugazzaro S, Mazzini E, Escorpizo R, Ghirotto L. Adaptation of the Core Set for Vocational Rehabilitation for Cancer Survivors: A Qualitative Consensus-Based Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:718-730. [PMID: 35334038 PMCID: PMC8949826 DOI: 10.1007/s10926-022-10033-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE The Core Set for Vocational Rehabilitation (CS-VR) of the International Classification of Functioning, Disability and Health (ICF) describes the work functioning of individuals in need of VR. We aimed to adapt the CS-VR from the perspective of cancer survivors (CSs) and stakeholders, developing a CS-VR-Onco. METHODS We held five focus groups with 17 CSs who were employed at the time of diagnosis, to discuss their work reintegration experiences. After analyzing the focus group conversations, the CS-VR-Onco was developed. During a group interview, eleven stakeholders explored barriers/facilitations in assessing the work functioning of CSs by using the CS-VR-Onco. We applied the framework method and thematic analysis. RESULTS For the focus groups, the CS-VR-Onco of 85 categories emerged, and the ICF chapters of Mental functions, Exercise and tolerance functions, Interpersonal interactions and relationships, Major life areas, General tasks and demands, Mobility, Support and relationships, and Attitudes were prioritized. For the group interview, stakeholders' perspectives can be synthetized into two themes: close to the lived experience and usability criteria. Stakeholders confirmed the categories of the CS-VR-Onco, a checklist that should be used through an integrated approach across multiple disciplines. CONCLUSIONS The adapted CS-VR-Onco reflects the CSs' lived experiences of work reintegration and the factors that have influenced this process. The CS-VR-Onco was described as complete and usable through an integrated approach.
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Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy.
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena e Reggio Emilia, 41100, Modena, Italy.
| | - Martina Pellegrini
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Matías Eduardo Díaz Crescitelli
- Qualitative Research Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Elisa Mazzini
- Medical Directorate, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, VT, 05401, USA
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
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15
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Stapleton S, Darlington ASE, de Bono JS, Wiseman T. What is the impact of targeted therapies given within phase I trials on the cognitive function of patients with advanced cancer: a mixed-methods exploratory study conducted in an early clinical trials unit. BMJ Open 2022; 12:e050590. [PMID: 36442900 PMCID: PMC9710342 DOI: 10.1136/bmjopen-2021-050590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Novel therapies such as small protein molecule inhibitors and immunotherapies are tested in early phase trials before moving to later phase trials and ultimately standard practice. A key aim of these clinical trials is to define a toxicity profile, however, the emphasis is often on safety with measurements of organ toxicity. Other subjective side effects can be under-reported because they are not measured formally within the trial protocols. The concern from clinical practice is that cognitive toxicity is poorly studied and may be under-reported in this context. This could lead to toxicity profiles of new treatments not being fully described and patients with unmet need in terms of acknowledgement and support of symptoms. This protocol outlines a framework of an exploratory study with feasibility aspects to investigate the impact and experience of cognitive changes for patients on phase I trials. METHODS AND ANALYSIS This is a mixed-methods study, combining quantitative and qualitative approaches. The sample is 30 patients with advanced cancer who are participating in phase I trials of novel therapies in the early clinical trials unit of a specialist cancer centre. A test battery of validated cognitive assessments will be taken alongside patient reported outcome measures at three time points from baseline, day eight and day 28 post start of treatment. At day 28, a semi-structured interview will be conducted and the narrative thematically analysed. Results will be integrated to offer a comprehensive description of cognitive function in this patient group. ETHICS AND DISSEMINATION The study has received full HRA and ethical approval. It is the first study to introduce formal cognitive assessments in a cancer phase I trial context. The study has the potential to highlight previously unreported side effects and more importantly unmet need in terms of care for patients who are participating in the trials.
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Affiliation(s)
- Sarah Stapleton
- Drug Development Unit, Royal Marsden Hospital Sutton, Sutton, UK
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | | | - J S de Bono
- Drug Development Unit, Royal Marsden Hospital Sutton, Sutton, UK
- Institute of Cancer Research Division of Cancer Therapeutics, London, UK
| | - Theresa Wiseman
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- The Royal Marsden NHS Foundation Trust, London, UK
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16
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Oliveira AF, Fernandes S, Reis JD, Torres A, Santos IM, Von Ah D. Cognitive functioning and work-related outcomes of non-central nervous system cancer survivors: protocol for a systematic review with meta-analysis. BMJ Open 2022; 12:e060300. [PMID: 35820744 PMCID: PMC9277407 DOI: 10.1136/bmjopen-2021-060300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION In recent years, growing attention has been given to the study of the impact of cancer-related cognitive impairment (CRCI) in working non-central nervous system (CNS) cancer survivors. Available literature has shown that working cancer survivors identify cognitive problems at work as very problematic and worrisome. Some reviews have discussed the association between CRCI and work-related outcomes; however, none to date have investigated this association through comprehensive systematic review with meta-analysis. Hence, this work will comprehensively summarise existing evidence from quantitative studies assessing the relationship between CRCI and work-related outcomes of adult non-CNS cancer survivors at working age. METHODS AND ANALYSIS The systematic review procedures and its report will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Electronic searches in the databases Web of Science, Scopus, PubMed, ProQuest, PsycINFO and CINAHL, complemented by a manual search of other relevant articles, will be performed from 2000 onwards to identify relevant publications. Two independent reviewers will assess studies for inclusion and extract data from each article using a standardised form. Studies eligible for inclusion must be quantitative, contain adult non-CNS cancer survivors with CRCI, and a measure of cognitive functioning and work-related outcomes. To assess risk of bias, the Joanna Briggs Institute Critical Appraisal Tool Studies checklists will be independently used by the two researchers. Synthesis of the included articles will be conducted using a narrative method and through meta-analysis. Meta-analysis will be reported via correlation for the association between CRCI and work-related outcomes. The cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation system. ETHICS AND DISSEMINATION Ethics approval is not required since individual patient data will not be collected. The findings will be published in a peer-review indexed journal, presented at scientific meetings and included in a chapter of a Doctoral thesis. PROSPERO REGISTRATION NUMBER CRD42020165458.
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Affiliation(s)
- Ana F Oliveira
- Center for Health Technology and Services Research (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Sofia Fernandes
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Juliana D Reis
- Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Ana Torres
- Center for Health Technology and Services Research (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- Department of Psychology and Education, Faculty of Human and Social Sciences, University of Beira Interior, Covilhã, Portugal
| | - Isabel M Santos
- William James Center for Research (WJCR), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Diane Von Ah
- The Ohio State University, College of Nursing, Columbus, Ohio, USA
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17
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Effectiveness of Cognitive Behavioral Therapy in Improving Functional Health in Cancer Survivors: A Systematic Review and Meta-analysis. Crit Rev Oncol Hematol 2022; 175:103709. [DOI: 10.1016/j.critrevonc.2022.103709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/03/2022] [Accepted: 05/11/2022] [Indexed: 02/07/2023] Open
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18
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Harpur P, Hyseni F, Blanck P. Workplace health surveillance and COVID-19: algorithmic health discrimination and cancer survivors. J Cancer Surviv 2022; 16:200-212. [PMID: 35107794 PMCID: PMC8809228 DOI: 10.1007/s11764-021-01144-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/15/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE This article examines ways COVID-19 health surveillance and algorithmic decision-making ("ADM") are creating and exacerbating workplace inequalities that impact post-treatment cancer survivors. Cancer survivors' ability to exercise their right to work often is limited by prejudice and health concerns. While cancer survivors can ostensibly elect not to disclose to their employers when they are receiving treatments or if they have a history of treatment, the use of ADM increases the chances that employers will learn of their situation regardless of their preferences. Moreover, absent significant change, inequalities may persist or even expand. METHODS We analyze how COVID-19 health surveillance is creating an unprecedented amount of health data on all people. These data are increasingly collected and used by employers as part of COVID-19 regulatory interventions. RESULTS The increase in data, combined with the health and economic crisis, means algorithm-driven health inequalities will be experienced by a larger percentage of the population. Post-treatment cancer survivors, as for people with disabilities generally, are at greater risk of experiencing negative outcomes from algorithmic health discrimination. CONCLUSIONS Updated and revised workplace policy and practice requirements, as well as collaboration across impacted groups, are critical in helping to control the inequalities that flow from the interaction between COVID-19, ADM, and the experience of cancer survivorship in the workplace. IMPLICATIONS FOR CANCER SURVIVORS The interaction among COVID-19, health surveillance, and ADM increases exposure to algorithmic health discrimination in the workplace.
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Affiliation(s)
- Paul Harpur
- TC Beirne School of Law, The University of Queensland, 1 University Drive, Brisbane, 4069, Australia
- The Burton Blatt Institute, Syracuse University, Syracuse, NY, USA
- Harvard Law School Project on Disability, Cambridge, MA, USA
- Help Enterprises Ltd., Eagle Farm, Australia
| | - Fitore Hyseni
- Maxwell School of Citizenship and Public Affairs, Syracuse University, 950 Irving Avenue, Syracuse, NY, 13244, USA
| | - Peter Blanck
- Burton Blatt Institute, Syracuse University, 950 Irving Avenue, Suite 446, Syracuse, NY, 13244, USA.
- Harvard University, Cambridge, MA, USA.
- Stanford University, Stanford, CA, USA.
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19
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Boelhouwer IG, Vermeer W, van Vuuren T. Late Effects of Cancer Treatment, Job Resources, and Burnout Complaints Among Employees With a Breast Cancer Diagnosis 2–10 Years Ago: A Longitudinal Study. Front Psychol 2022; 12:793138. [PMID: 35153917 PMCID: PMC8832114 DOI: 10.3389/fpsyg.2021.793138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/21/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose The aim of this study was to investigate the effect of possible late effects of cancer treatment (physical complaints, fatigue, and cognitive complaints) and of two job resources (autonomy and supportive leadership style) on future burnout complaints, among employees living 2–10 years beyond breast cancer diagnosis. Methods Data at T1 (baseline questionnaire) and at T2 (9 months later) were collected in 2018 and 2019 (N = 287). These data were part of a longitudinal study among Dutch speaking workers with a cancer diagnosis 2–10 years ago. All complaints and job resources were self-reported. Longitudinal multivariate regression analyses were executed, controlling for years since diagnosis, living with cancer (recurrence or metastasis), and other chronic or severe diseases. Mediation by baseline burnout complaints was considered. Results A higher level of fatigue and cognitive complaints at baseline (T1) resulted in higher future burnout complaints (at T2), with partial mediation by baseline burnout complaints. No effect of physical complaints at T1 was observed. Higher levels of autonomy or a supportive leadership style resulted in lower burnout complaints, with full mediation by baseline burnout complaints. Buffering was observed by autonomy in the relationship of cognitive complaints with future burnout complaints. No moderation was observed by supportive leadership. Conclusion The level of burnout complaints among employees 2–10 years beyond breast cancer diagnosis may be an effect of fatigue or cognitive complaints, and awareness of this effect is necessary. Interventions to stimulate supportive leadership and autonomy are advisable, the latter especially in the case of cognitive complaints.
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Affiliation(s)
- Ingrid G. Boelhouwer
- Department of Organisation, Faculty of Management, Open Universiteit, Heerlen, Netherlands
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
- *Correspondence: Ingrid G. Boelhouwer,
| | - Willemijn Vermeer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Tinka van Vuuren
- Department of Organisation, Faculty of Management, Open Universiteit, Heerlen, Netherlands
- Loyalis Knowledge & Consult, Heerlen, Netherlands
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20
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Lieb M, Wünsch A, Schieber K, Bergelt C, Faller H, Geiser F, Goerling U, Hönig K, Hornemann B, Maatouk I, Niecke A, Stein B, Teufel M, Wickert M, Büttner-Teleagă A, Erim Y, Weis J. Return to work after cancer: Improved mental health in working cancer survivors. Psychooncology 2022; 31:893-901. [PMID: 34989051 DOI: 10.1002/pon.5877] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Aim of the study was to compare working and non-working patients over a period of 12 months regarding socio-demographic, cancer-specific and mental health parameters. METHODS This study was conducted as part of a Germany-wide longitudinal survey among 1398 patients in 13 national Comprehensive Cancer Centers. The sample used for analysis consisted of n = 430 cancer patients younger than 65 years (age M = 52.4 years, SD = 8.1; 67.0% females). Socio-demographic, cancer-specific and mental health parameters (Depression: Patient Health Questionnaire, Anxiety: Generalized Anxiety Disorder Scale, Distress: Distress Thermometer) were assessed at baseline during hospitalization and at 12 months follow-up. RESULTS 73.7% of all patients (n = 317) have returned to work after one year. While working and non-working patients did not differ in socio-demographic parameters, there were significant differences in the presence of metastases, tumor and treatment status. Mixed analysis of variances revealed significant interactions between working status and time for depression (p = 0.009), anxiety (p = 0.003) and distress (p = 0.007). Non-working patients reported higher levels of depression, anxiety and distress than working patients over time. A logistic regression showed significant associations between lower depression (p = 0.019), lower distress (p = 0.033) and the absence of a tumor (p = 0.015) with working status. CONCLUSIONS The majority of cancer survivors returned to work. Non-working patients had higher levels of depression, anxiety and distress than working patients. After controlling for cancer-specific factors, mental health parameters were still independently associated with working status. Return to work can thus be associated with an improved mental health in cancer survivors. In order to establish causality, further research is necessary.
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Affiliation(s)
- Marietta Lieb
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital of Erlangen, Erlangen, Germany
| | - Alexander Wünsch
- Clinic for Psychosomatic Medicine and Psychotherapy, Medical Center Freiburg, Faculty of Medicine, University Freiburg in Cooperation with Outpatient Support for Cancer Patients, Comprehensive Cancer Center Freiburg, Freiburg, Germany
| | - Katharina Schieber
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital of Erlangen, Erlangen, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Franziska Geiser
- University of Bonn, Clinic for Psychosomatic Medicine and Psychotherapy, Bonn, Germany
| | - Ute Goerling
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität and Berlin Institute of Health, Berlin, Germany
| | - Klaus Hönig
- Ulm University Clinic Department of Psychosomatic Medicine and Psychotherapy, Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany
| | - Beate Hornemann
- Comprehensive Cancer Center, University Clinic Center Dresden, Dresden, Germany
| | - Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Heidelberg, Germany
| | - Alexander Niecke
- Department of Psychosomatics and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Comprehensive Cancer Center Essen (WTZ) and LVR Hospital, Essen, Germany
| | - Martin Wickert
- Medical University Hospital Tuebingen, Universitätsklinikum Tübingen, Comprehensive Cancer Center Tübingen-Stuttgart, Tübingen, Germany
| | | | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital of Erlangen, Erlangen, Germany
| | - Joachim Weis
- Comprehensive Cancer Center, Department Self-help Research, Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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21
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Oh PJ, Kim JH. The Experience of Chemotherapy Related Cognitive Impairment in Patients with Cancer. ASIAN ONCOLOGY NURSING 2022. [DOI: 10.5388/aon.2022.22.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Pok Ja Oh
- College of Nursing, Sahmyook University, Seoul, Korea
| | - Ji Hyun Kim
- College of Nursing, Sahmyook University, Seoul, Korea
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22
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He S, Lim CYS, Dhillon HM, Shaw J. Australian oncology health professionals' knowledge, perceptions, and clinical practice related to cancer-related cognitive impairment and utility of a factsheet. Support Care Cancer 2022; 30:4729-4738. [PMID: 35122530 PMCID: PMC9046357 DOI: 10.1007/s00520-022-06868-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/24/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Cancer-related cognitive impairment (CRCI) can have debilitating effects on cancer survivors' quality of life. Despite this, patients often report a lack of information provided by health professionals (HPs) to assist with understanding and managing cognitive changes. This study aimed to explore Australian oncology HPs' understanding of and clinical practice related to CRCI including the use of a Cancer Council Australia CRCI factsheet. METHODS Australian oncology HPs (medical oncologists, cancer nurses, and clinical psychologists) completed a questionnaire that assessed CRCI knowledge, prior to receiving the factsheet. Semi-structured interviews were conducted to explore their perceptions of CRCI and the factsheet. Interviews were recorded, transcribed, and analyzed using framework analysis to identify key themes. RESULTS Questionnaires were completed by twenty-nine HPs. Most HPs had moderate to high knowledge of CRCI, yet low knowledge of the relationship between CRCI and cancer. Twenty-six (response rate 90%) HPs; medical oncologists (n = 7), cancer nurses (n = 12), and clinical psychologists (n = 7), consented to be interviewed. Three main themes were identified: (1) Is CRCI impact real or over-rated?; (2) If it is important, they will tell me: identifying and responding to CRCI in clinical practice; and (3) Using a factsheet in clinical practice. CONCLUSION This study's multi-disciplinary exploration of Australian oncology HPs' perceptions of CRCI highlighted that health professional perceptions drive CRCI discussions with patients. Further education to support clinicians to discuss CRCI is required. Consideration of the barriers and facilitators within healthcare settings is important for successful integration of the factsheet into routine care.
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Affiliation(s)
- Sharon He
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia
| | - Chloe Yi Shing Lim
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW Australia
| | - Haryana M. Dhillon
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW Australia
| | - Joanne Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia ,Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW Australia
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23
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Blomjous BS, Gajadin GRS, Voskuyl AE, Falzon L, Hoving JL, Bultink IEM, Ter Wee MM. Work participation in patients with systematic lupus erythematosus: a systematic review. Rheumatology (Oxford) 2021; 61:2740-2754. [PMID: 34792543 PMCID: PMC9258549 DOI: 10.1093/rheumatology/keab855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 10/22/2021] [Accepted: 11/11/2021] [Indexed: 11/14/2022] Open
Abstract
Objectives This systematic review assessed which variables are associated with or are predictors for work participation outcomes in patients with systematic lupus erythematosus (SLE). Methods A literature search using MEDLINE, The Cochrane Library, Embase and CINAHL was conducted to identify all studies published from inception (1947) to June 2021 on factors related to and/or predicting employment status, absenteeism and/or presenteeism in SLE patients aged ≥18 years. The quality of included articles was assessed using the QUIPS tool. Narrative summaries were used to present the data. Results Fifteen studies (nine on associations, four on predictions, and two assessing both) were included, encompassing data of 3800 employed patients. Younger age, Caucasian ethnicity, higher educational level, lower disease activity score, shorter disease duration, absence of specific disease manifestations, higher levels of physical functioning and less physical job demands and higher levels of psychological/cognitive functioning were associated with or predicted favorable work outcomes. Older age, non-Caucasian ethnicity, female gender, never being married, poverty, lower educational level, higher disease activity score, longer disease duration, specific disease manifestations, lower levels of physical functioning, more physical job demands and low job control, less job tenure and lower levels of cognitive functioning were associated with or predicted an unfavorable work outcome. Limitations of the evidence were the quality of the studies and the use of heterogeneous outcome measures, applied statistical methods and instruments used to assess work participation. Conclusion We recommend applying the EULAR points to consider for designing, analysing and reporting on work participation in inflammatory arthritis also to SLE studies on work participation, to enhance the quality and comparability between studies and to better understand the impact of SLE on work participation. Trial registration registration in PROSPERO (CRD42020161275; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=161275).
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Affiliation(s)
- Birgit S Blomjous
- Department of Epidemiology and Data Science, Amsterdam Public Health, Amsterdam UMC
- Department of Rheumatology and Clinical Immunology, Amsterdam Infection & Immunity, Amsterdam UMC Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Gayle R S Gajadin
- Department of Epidemiology and Data Science, Amsterdam Public Health, Amsterdam UMC
| | - Alexandre E Voskuyl
- Department of Rheumatology and Clinical Immunology, Amsterdam Infection & Immunity, Amsterdam UMC Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Louise Falzon
- Center for Personalized Health, Feinstein Institutes for Medical Research, Northwell Health, New York, USA
| | - Jan L Hoving
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Irene E M Bultink
- Department of Rheumatology and Clinical Immunology, Amsterdam Infection & Immunity, Amsterdam UMC Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marieke M Ter Wee
- Department of Epidemiology and Data Science, Amsterdam Public Health, Amsterdam UMC
- Department of Rheumatology and Clinical Immunology, Amsterdam Infection & Immunity, Amsterdam UMC Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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24
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Tan FSI, Shorey S. Experiences of women with breast cancer while working or returning to work: a qualitative systematic review and meta-synthesis. Support Care Cancer 2021; 30:2971-2982. [PMID: 34647131 DOI: 10.1007/s00520-021-06615-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/03/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This systematic review aims to consolidate the available qualitative evidence regarding the experiences of women with breast cancer while working or returning to work. METHODS Six electronic databases were searched until December 2020 for qualitative English-language articles examining the experiences of adult females with reproductive cancers while working or returning to work. The Critical Appraisal Skills Program checklist was used to assess the quality of included studies while the Sandelowski and Barroso's two step approach was used to meta-summarize and meta-synthesize the extracted data. RESULTS Four themes were derived from the 28 included studies: (i) being lost to finding meaning after the cancer diagnosis; (ii) concerns and considerations before returning to work; (iii) reasons for returning to work; and (iv) life at work after cancer diagnosis and treatment. CONCLUSIONS Current findings allowed a deeper understanding into the way the women with breast cancer coped during their cancer journey. Challenges and motivating factors faced by these women while working or returning to work were discussed. Improvements to current support systems and working policies are needed to better support this group of women.
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Affiliation(s)
- Faustine Sze Ing Tan
- KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore.
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25
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Chan RJ, Nekhlyudov L, Duijts SFA, Hudson SV, Jones JM, Keogh J, Love B, Lustberg MB, Mehnert-Theuerkauf A, Nathan P, Ness KK, Sheppard VB, Smith K, Tevaarwerk A, Yu X, Feuerstein M. Future research in cancer survivorship. J Cancer Surviv 2021; 15:659-667. [PMID: 34460055 DOI: 10.1007/s11764-021-01102-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, 5042, Australia.
| | | | - Saskia F A Duijts
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Shawna V Hudson
- Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | | | | | - Brad Love
- Center for Health Communication, University of Texas, Austin, TX, USA
| | | | | | - Paul Nathan
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Kirsten K Ness
- FAPTA, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Vanessa B Sheppard
- School of Medicine and the Massey Cancer Center Office of Outreach Engagement and Health Disparities, Virginia Commonwealth University, Richmond, VA, USA
| | - Katherine Smith
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Amye Tevaarwerk
- Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Xinhua Yu
- University of Memphis School of Public Health, Memphis, TN, USA
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26
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Vardy JL, Fardell J. Understanding Longitudinal Changes in Cognitive Function in Lymphoma Patients: Where to Next? J Natl Cancer Inst 2021; 114:3-4. [PMID: 34255081 DOI: 10.1093/jnci/djab134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Janette L Vardy
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia.,Concord Cancer Centre, Concord Repatriation General Hospital, NSW, Australia
| | - Joanna Fardell
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia
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27
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Boelhouwer IG, Vermeer W, van Vuuren T. Late effects of cancer (treatment) and work ability: guidance by managers and professionals. BMC Public Health 2021; 21:1255. [PMID: 34187437 PMCID: PMC8240423 DOI: 10.1186/s12889-021-11261-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/10/2021] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The prevalence of the group of workers that had a cancer diagnosis in the past is growing. These workers may still be confronted with late effects of cancer (treatment) possibly affecting their work ability. As little is known about the guidance of this group, the aim of this study was to explore the experiences and ideas of managers and professionals about the guidance of these workers in the case of late effects of cancer (treatment). Given the positive associations with work ability of the job resources autonomy, social support by colleagues and an open organisational culture found in several quantitative studies, these job resources were also discussed. Further ideas about the influences of other factors and points of attention in the guidance of this group of workers were explored. METHODS Semi-structured interviews were conducted with managers (n = 11) and professionals (n = 47). Data-collection was from November 2019 to June 2020. The data were coded and analysed using directed content analyses. RESULTS The late effects of cancer or cancer treatment discussed were physical problems, fatigue, cognitive problems, anxiety for cancer recurrence, and a different view of life. The self-employed have less options for guidance but may struggle with late effects affecting work ability in the same way as the salaried. Late effects may affect work ability and various approaches have been described. Autonomy, social support of colleagues and an open organisational culture were regarded as beneficial. It was indicated that interventions need to be tailor-made and created in dialogue with the worker. CONCLUSIONS Especially with respect to cognitive problems and fatigue, guidance sometimes turned out to be complicated. In general, the importance of psychological safety to be open about late effects that affect work ability was emphasized. Moreover, it is important to take the perspective of the worker as the starting point and explore the possibilities together with the worker. Autonomy is an important factor in general, and a factor that must always be monitored when adjustments in work are considered. There is a lot of experience, but there are still gaps in knowledge and opportunities for more knowledge sharing.
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Affiliation(s)
- Ingrid G Boelhouwer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Wibauthuis/Wibautstraat 3b, 1091 GH, Amsterdam, The Netherlands.
| | - Willemijn Vermeer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Wibauthuis/Wibautstraat 3b, 1091 GH, Amsterdam, The Netherlands
| | - Tinka van Vuuren
- Faculty of Management, Open University of The Netherlands, Heerlen, The Netherlands / Loyalis Knowledge & Consult, Heerlen, The Netherlands
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28
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Jin Z, Griffith MA, Rosenthal AC. Identifying and Meeting the Needs of Adolescents and Young Adults with Cancer. Curr Oncol Rep 2021; 23:17. [PMID: 33449203 DOI: 10.1007/s11912-020-01011-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Adolescents and young adults (AYAs) with cancer are a vulnerable population with unique needs that are under-recognized and often overlooked by healthcare providers. This review focuses on identifying and meeting some of those needs including adherence to treatment, financial implications, impact on fertility and intimacy, issues with work/school, isolation, challenges with re-entry, and long-term side effects and survivorship. RECENT FINDINGS Survival rates have not improved in adolescents and young adults with cancer at the same rate as in children and older adults (the so called "AYA gap"). Restricted or delayed access to care and inconsistent cancer treatment and follow-up care contribute to this. Importantly, fertility preservation options have broadened and efforts to provide age appropriate counseling prior to treatment have improved. Additionally, AYAs face a variety of psychosocial issues while dealing with a cancer diagnosis during critical developmental years, and yet data pertaining to the successful identification and management of these issues is lacking. As a result, there has been recent increasing awareness that this patient population warrants strong advocates, additional research, and requires age group specific resources to be successful in navigating their cancer experience during treatment and into survivorship care. Members of the healthcare team should familiarize themselves with the unique needs of AYA cancer patients to provide optimal patient care. In order to build upon early progress, this group calls for additional study particularly when it comes to barriers to enrollment for AYA-specific research (including clinical trials), recognizing psychosocial needs (both during and after treatment), transition planning for returning to life after cancer, and managing long-term effects of treatment (including neuro cognitive changes). In addition, access to financial resources and appropriate mental health support needs to be improved.
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Affiliation(s)
- Zhaohui Jin
- Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Melody A Griffith
- Division of Hematology/Oncology, Mayo Clinic, Phoenix, AZ, 85054, USA
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29
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Relationship of perceived everyday cognitive function and work engagement in breast cancer survivors. Support Care Cancer 2021; 29:4303-4309. [PMID: 33415361 DOI: 10.1007/s00520-020-05950-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Breast cancer survivors (BCS) who represent approximately 3.5 million survivors in the USA frequently report ongoing cognitive dysfunction that may impact work outcomes. However, little is known about how perceived everyday cognitive function may affect work engagement (a measure of work efficacy and work well-being) in BCS who have completed treatment. OBJECTIVES The purpose of this study was to examine the relationship between perceived everyday cognitive function and work engagement in BCS. METHODS A convenience sample of 68 employed BCS seen at a Midwest NCI-Cancer Center who were at least 1-year post-treatment, completed a cross-sectional questionnaire assessing demographic and medical characteristics, and perceived everyday cognitive function (Everyday Cognition Scale) and work engagement (Utrecht Work Engagement Scale). Descriptive statistics, Pearson's r, and separate regression models controlling for age and education were used to analyze the data. RESULTS BCS who were on average 52 (SD = 8.6) years old, 5 (SD = 3.8) years post-treatment, and primarily employed full-time (79%) participated. A subset of BCS (12%) identified poorer everyday cognitive function after BC diagnosis and treatment. Everyday cognition, including subscales vigor and dedication, were correlated with work engagement (p˂0.01), controlling for age and education. CONCLUSIONS Findings indicate the important role of perceived everyday cognitive function in work engagement well into survivorship. Reducing cognitive dysfunction may be an important area for future intervention research to support BCS who return to work. IMPLICATIONS TO PRACTICE Healthcare providers need to assess and address perceived cognitive dysfunction to promote work-related outcomes in BCS well into survivorship.
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30
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Shari NI, Zainal NZ, Ng CG. Effects of brief acceptance and commitment therapy (ACT) on subjective cognitive impairment in breast cancer patients undergoing chemotherapy. J Psychosoc Oncol 2020; 39:695-714. [PMID: 33287685 DOI: 10.1080/07347332.2020.1856283] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE This study examined the efficacy of a brief acceptance and commitment therapy (ACT) on subjective cognitive impairment in breast cancer patients undergoing chemotherapy. METHODS Data collection was carried out in 3-time points: baseline (T1), screening (T2), and post-treatment (T3). Respondents who had significant subjective cognitive impairment were randomly divided into two groups: intervention (n = 30) and waitlist (n = 30). Respondents in the intervention group received 4 sessions of 1 hour of ACT therapy. FINDINGS Respondents in the intervention group showed significant improvement in subjective cognitive impairment, depression, anxiety, and psychological inflexibility after the ACT intervention (p < 0.05). After controlling the covariates, group differences in all variables were significant except for fatigue and psychological inflexibility has the highest effect size (d = 4.69). CONCLUSION ACT could be considered as an effective intervention to ameliorate subjective cognitive impairment, anxiety, depression, and psychological inflexibility in breast cancer patients undergoing chemotherapy. IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS This study highlights the importance of screening for subjective cognitive impairment in breast cancer patients undergoing chemotherapy and heightens their opportunity to receive proper management as earlier as possible.
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Affiliation(s)
- Nurul Izzah Shari
- Faculty of Medicine, Department of Psychological Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Nor Zuraida Zainal
- Faculty of Medicine, Department of Psychological Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Chong Guan Ng
- Faculty of Medicine, Department of Psychological Medicine, University Malaya, Kuala Lumpur, Malaysia
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31
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Mayo SJ, Wozniczka I, Brennenstuhl S, Rourke SB, Howell D, Metcalfe KA, Lipton JH. Late cognitive outcomes among allogeneic stem cell transplant survivors: follow-up data from a 6-year longitudinal study. Support Care Cancer 2020; 29:2621-2630. [PMID: 32965579 DOI: 10.1007/s00520-020-05761-x] [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: 06/12/2020] [Accepted: 09/08/2020] [Indexed: 10/23/2022]
Abstract
CONTEXT Survivors of allogeneic hematopoietic stem cell transplantation (alloHCT) may experience cognitive impairment over time post-treatment, but early identification of these individuals is limited. OBJECTIVES We previously reported a prospective evaluation of cognitive functioning over the first 6 months of alloHCT. Here, we report an extension of this study, with specific aims to (1) evaluate the trajectory of cognitive outcomes over the first 6 years post-alloHCT, and (2) determine the extent to which late cognitive impairment is predicted by earlier impairment. METHODS Participants completed objective and subjective cognitive measures before alloHCT, and at 100 days, 6 months, and 6 years post-alloHCT. Outcome trajectories were determined using linear mixed effects models. Relationships between early and late cognitive impairment were assessed using logistic regression and receiver operator curves. RESULTS This analysis is based on longitudinal data from 59 participants, of whom 20 provided data at 6-year follow-up. Longitudinal models revealed an overall stability of cognitive outcomes over time, except for psychomotor efficiency/processing speed performance, which significantly improved (p = .049). However, poor learning/memory and cognitive complaints were persistently observed. At 6 years, 40% of relapse-free survivors met the impairment criteria. Impairment at 100 days was associated with impairment 6 years (OR = 20.00, p = .028) and demonstrated good accuracy in classifying those who were impaired and not impaired at 6 years (AUC = .79; 95% CI = .56-1.00). CONCLUSION Poor cognitive outcomes among long-term alloHCT survivors are associated with cognitive functioning during the early post-treatment period. Early identification of survivors likely to experience poor cognitive outcomes may be possible, enabling timely intervention to mitigate long-term negative impacts.
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Affiliation(s)
- Samantha J Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada. .,Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
| | - Isabel Wozniczka
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Sarah Brennenstuhl
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sean B Rourke
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Doris Howell
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Kelly A Metcalfe
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.,Women's College Hospital Research Institute, Toronto, Ontario, Canada
| | - Jeffrey H Lipton
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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32
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Jones JM, Fitch M, Bongard J, Maganti M, Gupta A, D’Agostino N, Korenblum C. The Needs and Experiences of Post-Treatment Adolescent and Young Adult Cancer Survivors. J Clin Med 2020; 9:jcm9051444. [PMID: 32413981 PMCID: PMC7291222 DOI: 10.3390/jcm9051444] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Adolescents and young adults (AYAs) who have been diagnosed with and treated for cancer have unique healthcare needs, but more research is needed to inform developmentally targeted cancer care for this population. The purpose of the current analyses was to describe the physical and psychosocial concerns and experiences of AYA cancer survivors during the post-treatment phase. (2) Methods: A national survey was conducted by the Canadian Partnership Against Cancer to evaluate the experiences and unmet needs of cancer survivors (≥18 years) within the first 5 years following cancer treatment. The current analyses were conducted on the AYA survivor population (18-34 years). (3) Results: A total of 575 surveys were completed by AYAs. Of these, 61% were female, 51% were married/partnered, and 52% were 1-3 years post treatment. Approximately three-quarters report their physical or emotional health as good/very good. Overall, 88% reported at least one physical concern [mean of 3.98+2.11 physical concerns (range 0-9)], 90% reported at least one emotional concern [mean of 3.77+1.75 emotional concern (range 0-6)], and 79% reported at least one practical challenge [mean of 2.39+1.28 practical concerns (range 0-5)]. The most common concerns were anxiety/worry about cancer returning (83%), fatigue/tiredness (78%), and depression/loss of interest in daily activities (66%). On average, 43% of those reporting a concern sought help. Common reasons for not seeking help included not wanting to ask, being told that it was normal to feel the way they did, or embarrassment. Of those who did seek help, 37% encountered difficulty obtaining assistance. (4) Conclusions: These results suggest that post-treatment AYA cancer survivors have a high rate and number of physical, psychosocial, and practical concerns and are often not seeking or receiving help to address these. Proactive approaches to characterizing and eliminating barriers to obtaining appropriate care are needed.
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Affiliation(s)
- Jennifer M Jones
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON M5G 2C4, Canada;
- Correspondence: ; Tel.: +1-416-581-8603
| | - Margaret Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada;
| | - Jared Bongard
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON M5G 2C4, Canada;
| | - Manjula Maganti
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada;
| | - Abha Gupta
- Division of Hematology/Oncology, SickKids Hospital Toronto, Ontario, ON M5G 1X8, Canada;
- Adolescent & Young Adult Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada
| | - Norma D’Agostino
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada (C.K.)
| | - Chana Korenblum
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada (C.K.)
- Division of Adolescent Medicine, Department of Paediatrics, SickKids Hospital, Toronto, ON M5G 1X8, Canada
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33
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de Boer AGEM, Greidanus MA, Dewa CS, Duijts SFA, Tamminga SJ. Introduction to special section on: current topics in cancer survivorship and work. J Cancer Surviv 2020; 14:101-105. [PMID: 32206965 PMCID: PMC7182612 DOI: 10.1007/s11764-020-00868-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 01/22/2023]
Abstract
Work is a key contributor to quality of life and an important aspect of cancer survivorship. We call attention to current topics in cancer survivorship and work with 12 articles on cancer survivorship and work in this special section. The focus is on less studied diagnostic groups such as gastrointestinal cancer and prostate cancer, and on long-term effects of cancer diagnosis and treatment on work. Furthermore, studies are included on topics not generally studied including cognitive limitations and pain, the role of the employer on work outcomes among different types of cancer survivors and some countries not typically covered in the existing literature on work and cancer survivorship. We conclude that to improve sustainable work participation in cancer survivors, personalised, tailored interventions should be provided. A prerequisite for this is the identification of groups and individuals at high risk for adverse work outcomes. In order to develop such interventions, research involving new approaches such as matching data registries, participatory approaches and the involvement of many stakeholders and survivors with these different types of cancer diagnoses is necessary. IMPLICATIONS FOR CANCER SURVIVORS: The goal of sustainable work participation in cancer survivors can be improved by the delivery of a personalised or risk-based tailored intervention. Furthermore, successful work outcomes often involve many stakeholders who should all be included Implications for Cancer Survivors. The goal of sustainable work participation in cancer survivors can be improved by the delivery of a personalised or risk-based tailored intervention. Furthermore, successful work outcomes often involve many stakeholders who should all be included.
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Affiliation(s)
- A G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
| | - M A Greidanus
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - C S Dewa
- Departments of Psychiatry and Behavioral Sciences and Public Health Sciences, University of California, Davis, CA, USA
| | - S F A Duijts
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - S J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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