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Moser R, Mayr NA, Nano J, Behzadi ST, Kiesl S, Combs SE, Borm KJ. A survey of cancer patients' interest in undertaking exercise to promote relaxation during radiotherapy for breast cancer and metastatic cancer. Radiat Oncol 2024; 19:68. [PMID: 38822369 PMCID: PMC11143565 DOI: 10.1186/s13014-024-02459-w] [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: 08/24/2023] [Accepted: 05/21/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Approximately 25-50% of patients undergoing radiotherapy (RT) experience psychological distress and anxiety, which can detrimentally affect both their quality of life and treatment outcomes. While previous research has demonstrated that relaxation exercises can enhance the tolerability of RT and alleviate associated stress and anxiety, the specific needs for such therapies in radiation oncology remain under-explored. This study aims to investigate the demand for and preferences toward relaxation exercises among radiotherapy patients, addressing a critical gap in patient-centered care. METHODS A prospective pseudonymized survey study using a one-time paper-based questionnaire was conducted from 2022 to 2023 among patients undergoing curative-intent RT for breast cancer or patients undergoing palliative RT for bone metastases. Patients were asked in a 11-item questionnaire about their anxiety, pre-existing practice of relaxation exercises/interventions, their interest in relaxation exercises, and preferences on the type and format of instruction. Data were analyzed descriptively. RESULTS 100 patients (74 female and 26 male) responded, of whom 68 received curative-intent adjuvant RT and 32 palliative RT. Median age was 62 years. 78% of patients indicated a desire to be actively involved in their radiotherapy, but only 27% had used relaxation exercises prior to RT. 44.8% of both curatively and palliatively treated patients who wanted to be actively involved in their therapy desired to learn how to best relax. 56.4% of respondents were willing to spend extra time learning offered exercises. CONCLUSION The survey indicates that patients undergoing RT, both for curative or palliative intent, desire relaxation exercises to relieve stress and anxiety from RT. It is therefore important to assess the need for relaxation interventions in individual patients and to develop suitable programs or collaborate with other healthcare professionals to meet these needs.
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Affiliation(s)
- Rebecca Moser
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Nina A Mayr
- School of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Jana Nano
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Sophie T Behzadi
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Sophia Kiesl
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany
- Institute of Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Oberschleißheim, Germany
- German Consortium for Translational Cancer Research (dktk), Partner Site Munich, Berlin, Germany
| | - Kai J Borm
- Department of Radiation Oncology, TUM School of Medicine and Health, Technische Universität München (TUM), Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany.
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Zhu W, Li W, Gao J, Wang L, Guo J, Yang H. Factors associated with the sleep disturbances of people with breast cancer during chemotherapy in China: A cross-sectional study. Nurs Open 2023; 10:5453-5461. [PMID: 37099665 PMCID: PMC10333860 DOI: 10.1002/nop2.1784] [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: 09/27/2022] [Revised: 03/10/2023] [Accepted: 04/16/2023] [Indexed: 04/28/2023] Open
Abstract
AIM The aim of the study was to investigate the incidence of sleep disturbance and its relationship with anxiety and depression symptoms, social support and hope in breast cancer patients in China during chemotherapy. DESIGN A single-centre cross-sectional study. METHODS A total of 329 breast cancer patients were selected via convenience sampling method before they began chemotherapy (n = 115), before the 5th week of chemotherapy (n = 117) or 1 month after chemotherapy ended (n = 97) and administered paper-and-pencil questionnaires to evaluate sleep quality, depression and anxiety symptoms, social support and hope. Risk factors significantly associated with sleep disturbance during bivariate were incorporated in the multivariate analysis. Bivariate analyses showed that age, menopausal status, depression and anxiety symptoms, emotional/informational support, tangible support, affectionate support, positive social interaction and total support were predictors of sleep disturbance. RESULTS Sleep disturbance was prevalent in breast cancer patients before (27.0%), during (32.5%) and after (39.2%) chemotherapy, with 37.4%, 41.9% and 52.6% of participants, respectively, reporting sleeping below the recommended 7 h. Only 8.6%-15.5% of patients reported taking sedative-hypnotic drugs during the chemotherapy. Multivariate analyses found that participants reporting clinically significant anxiety (HADS > 8) were 3.5 times more likely to report sleep disturbance (PSQI > 8) than participants without clinically significant anxiety, and each increment in emotional/informational support was associated with a 9.04% reduced risk of sleep disturbance. Moreover, age was an independent predictor of sleep disturbance during multivariate modelling.
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Affiliation(s)
- Wenjuan Zhu
- Shanxi Medical UniversityTaiyuanChina
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi HospitalThird Hospital of Shanxi Medical UniversityTaiyuanChina
| | - Wanling Li
- Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyHubeiChina
| | - Jinnan Gao
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi HospitalThird Hospital of Shanxi Medical UniversityTaiyuanChina
| | - Linying Wang
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi HospitalThird Hospital of Shanxi Medical UniversityTaiyuanChina
| | - Jun Guo
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi HospitalThird Hospital of Shanxi Medical UniversityTaiyuanChina
| | - Hui Yang
- Shanxi Medical UniversityTaiyuanChina
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Singer S, Janni W, Kühn T, Flock F, Felberbaum R, Schwentner L, Leinert E, Wöckel A, Schlaiß T. Awareness, offer, and use of psychosocial services by breast cancer survivors in Germany: a prospective multi-centre study. Arch Gynecol Obstet 2023; 307:945-956. [PMID: 35835919 PMCID: PMC9984346 DOI: 10.1007/s00404-022-06665-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/08/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE This study examined the pattern of psychosocial care in breast cancer survivors. METHODS In a prospective study with measurements before surgery, 1 month, 8 months, and 5 years thereafter, we examined the proportion of breast cancer survivors who were aware about, had been offered and received various types of psychosocial services from psychologists, social workers, doctors, self-help groups etc. The degree of helpfulness per service among users was ascertained with Likert scales. Determinants of awareness, offer and use were investigated using binary logistic regression analyses. How the services are inter-related was tested with principal component analyses. RESULTS Among 456 breast cancer survivors who participated until 5 years, psychological services were known by 91%, offered to 68%, and used by 55% of patients. Social services were known by 86%, offered to 65%, and used by 51%. Women ≥ 65 years were less likely to be informed about (odds ratio (OR) 0.2) and get offers for psychosocial services (OR 0.4 for social and 0.5 for psychological services) than women < 65 years. The services rated most helpful were social services in the hospital, psychological counselling by a consultant and psychotherapy in private practices. CONCLUSION These findings underline the importance of psychosocial support by physicians in addition to the "professional" mental health and social care providers. They also show that elderly women in need for support might be in danger of not being well-informed about the services available.
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Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University, Obere Zahlbacher Straße 69, 55131, Mainz, Germany.
- University Cancer Centre, Mainz, Germany.
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Thorsten Kühn
- Department of Gynaecology and Obstetrics, Hospital Esslingen, Memmingen, Germany
| | - Felix Flock
- Department of Gynaecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - Ricardo Felberbaum
- Department of Gynaecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Elena Leinert
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - Achim Wöckel
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
| | - Tanja Schlaiß
- Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany
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Cogan JC, Raghunathan RR, Beauchemin MP, Accordino MK, Huang Y, Elkin EB, Melamed A, Wright JD, Hershman DL. New and Persistent Sedative-Hypnotic Use After Adjuvant Chemotherapy for Breast Cancer. J Natl Cancer Inst 2022; 114:1698-1705. [PMID: 36130058 PMCID: PMC9745429 DOI: 10.1093/jnci/djac170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/19/2022] [Accepted: 08/23/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Sedative-hypnotic medications are used to treat chemotherapy-related nausea, anxiety, and insomnia. However, prolonged sedative-hypnotic use can lead to dependence, misuse, and increased health-care use. We aimed to estimate the rates at which patients who receive adjuvant chemotherapy for breast cancer become new persistent users of sedative-hypnotic medications, specifically benzodiazepines and nonbenzodiazepine sedative-hypnotics (Z-drugs). METHODS Using the MarketScan health-care claims database, we identified sedative-hypnotic-naïve patients who received adjuvant chemotherapy for breast cancer. Patients who filled 1 and more prescriptions during chemotherapy and 2 and more prescriptions up to 1 year after chemotherapy were classified as new persistent users. Univariate and multivariable logistic regression analyses were used to estimate odds of new persistent use and associated characteristics. RESULTS We identified 22 039 benzodiazepine-naïve patients and 23 816 Z-drug-naïve patients who received adjuvant chemotherapy from 2008 to 2017. Among benzodiazepine-naïve patients, 6159 (27.9%) filled 1 and more benzodiazepine prescriptions during chemotherapy, and 963 of those (15.6%) went on to become new persistent users. Among Z-drug-naïve patients, 1769 (7.4%) filled 1 and more prescriptions during chemotherapy, and 483 (27.3%) became new persistent users. In both groups, shorter durations of chemotherapy and receipt of opioid prescriptions were associated with new persistent use. Medicaid insurance was associated with new persistent benzodiazepine use (odds ratio = 1.88, 95% confidence interval = 1.43 to 2.47) compared with commercial or Medicare insurance. CONCLUSIONS Patients who receive sedative-hypnotic medications during adjuvant chemotherapy for breast cancer are at risk of becoming new persistent users of these medications after chemotherapy. Providers should ensure appropriate sedative-hypnotic use through tapering dosages and encouraging nonpharmacologic strategies when appropriate.
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Affiliation(s)
- Jacob C Cogan
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
| | - Rohit R Raghunathan
- Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Melissa P Beauchemin
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
- Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Melissa K Accordino
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
| | - Yongmei Huang
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Elena B Elkin
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Alexander Melamed
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
| | - Jason D Wright
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
| | - Dawn L Hershman
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
- Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA
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Singer S, Kojima E, Deppisch L, Taylor K, Wickert M, Riedel P, Alt J, Heß G, Hechtner M, Bayer O. What is the best time for psychosocial counselling from the perspective of cancer patients and their relatives? A multi‐centre qualitative study. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Erika Kojima
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Larissa Deppisch
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Katherine Taylor
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | | | | | - Jürgen Alt
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Georg Heß
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Marlene Hechtner
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
| | - Oliver Bayer
- Division of Epidemiology and Health Services Research Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI) University Medical Centre of Johannes Gutenberg University Mainz Germany
- University Cancer Centre Mainz (UCT) Mainz Germany
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Lognos B, Glondu-Lassis M, Senesse P, Gutowski M, Jacot W, Lemanski C, Amouyal M, Azria D, Guerdoux E, Bourgier C. [Non-pharmalogical interventions and breast cancer: What benefit in addition to radiotherapy?]. Cancer Radiother 2021; 26:637-645. [PMID: 34756691 DOI: 10.1016/j.canrad.2021.09.011] [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: 06/21/2021] [Revised: 09/20/2021] [Accepted: 09/25/2021] [Indexed: 10/20/2022]
Abstract
Adjuvant radiotherapy is one of the major anticancer treatments in early breast cancer patients. Acute and late radio-induced effects may occur during or after breast cancer radiotherapy, and their medical management is a major issue for radiation oncologists. Here, the present review of literature embraces complementary non-pharmacological interventions, which could be combined to adjuvant radiotherapy in order to improve patients care.
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Affiliation(s)
- Béatrice Lognos
- Département Universitaire de Médecine Générale, Université de Montpellier, 34000 Montpellier, France; UMR UA11 Institut Desbrest d'Épidémiologie et de Santé Publique, Inserm, Université de Montpellier, Montpellier, France; Maison de santé pluriprofessionnelle universitaire Pauline Lautaud, St Georges d'Orques, Prades le Lez, Vendargues, France.
| | - Murielle Glondu-Lassis
- Département Universitaire de Médecine Générale, Université de Montpellier, 34000 Montpellier, France; UMR UA11 Institut Desbrest d'Épidémiologie et de Santé Publique, Inserm, Université de Montpellier, Montpellier, France
| | - Pierre Senesse
- Département des Soins de Support, Institut Régional du Cancer de Montpellier (ICM), France
| | - Marian Gutowski
- Département de Chirurgie, Institut Régional du Cancer de Montpellier (ICM), France
| | - William Jacot
- Département d'oncologie Médicale, Institut Régional du Cancer de Montpellier (ICM), France
| | - Claire Lemanski
- Fédération Universitaire d'Oncologie Radiothérapie, ICM, Institut régional du Cancer Montpellier, rue croix verte, 34298 Montpellier cedex 05, France
| | - Michel Amouyal
- Département Universitaire de Médecine Générale, Université de Montpellier, 34000 Montpellier, France
| | - David Azria
- Fédération Universitaire d'Oncologie Radiothérapie, ICM, Institut régional du Cancer Montpellier, rue croix verte, 34298 Montpellier cedex 05, France; IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Univ Montpellier, avenue des Apothicaires, 34298 Montpellier cedex 05, France
| | - Estelle Guerdoux
- UMR UA11 Institut Desbrest d'Épidémiologie et de Santé Publique, Inserm, Université de Montpellier, Montpellier, France; Département des Soins de Support, Institut Régional du Cancer de Montpellier (ICM), France
| | - Céline Bourgier
- Fédération Universitaire d'Oncologie Radiothérapie, ICM, Institut régional du Cancer Montpellier, rue croix verte, 34298 Montpellier cedex 05, France; IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Univ Montpellier, avenue des Apothicaires, 34298 Montpellier cedex 05, France
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Jacobson G, Kaidar-Person O, Haisraely O, Galper S, Rabin T, Dromi Shahadi I, Lawrence YR, Symon Z, Akiva Ben-David M. Palliative radiation therapy for symptomatic advance breast cancer. Sci Rep 2021; 11:5282. [PMID: 33674709 PMCID: PMC7970854 DOI: 10.1038/s41598-021-84872-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 02/16/2021] [Indexed: 12/11/2022] Open
Abstract
In this study, we evaluated the effectiveness of palliative breast radiation therapy (RT), with single fraction RT compared with fractionated RT. Our study showed that both RT fractionation schemas provide palliation. Single fraction RT allowed for treatment with minimal interference with systemic therapy, whereas fractionated RT provided a more durable palliative response. Due to equivalent palliative response, at our institution we have increasingly been providing single fraction RT palliation during the COVID-19 pandemic.
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Affiliation(s)
- Galia Jacobson
- Radiation Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Orit Kaidar-Person
- Radiation Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel.
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
- GROW-School for Oncology and Developmental Biology or GROW (Maastro), Maastricht University, Maastricht, The Netherlands.
| | - Ory Haisraely
- Radiation Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shira Galper
- Radiation Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Tatiana Rabin
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Radiation Oncology, Sourasky Medical Center, Tel Aviv, Israel
| | | | - Yaacov Richard Lawrence
- Radiation Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Zvi Symon
- Radiation Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Merav Akiva Ben-David
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Assuta Medical Center, Tel Aviv, Israel
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Portigliatti Pomeri A, La Salvia A, Carletto S, Oliva F, Ostacoli L. EMDR in Cancer Patients: A Systematic Review. Front Psychol 2021; 11:590204. [PMID: 33536968 PMCID: PMC7847844 DOI: 10.3389/fpsyg.2020.590204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/16/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Psychological distress is common among patients with cancer, with severe consequences on their quality of life. Anxiety and depression are the most common clinical presentation of psychological distress in cancer patients, but in some cases cancer may represent a traumatic event resulting in posttraumatic stress disorder (PTSD). Currently, Eye Movement Desensitization and Reprocessing (EMDR) therapy is considered an evidence-based treatment for PTSD, but recent studies also showed its effectiveness for anxiety and depression. The aim of the present systematic review is to summarize the current literature on the effect of EMDR on cancer-related psychological distress. Methods: A literature search was conducted for peer-reviewed articles about "EMDR" and "cancer patients" in the following electronic databases: PubMed, MEDLINE, Science Direct, Google Scholar, and Cochrane library. Results: Our search identified 7 studies in which EMDR was used with a total of 140 cancer patients. The psychiatric diagnosis was PTSD in 3 studies. Otherwise, the diagnosis concerned the anxious and depressive disorder spectrum. Overall, EMDR treatment schedules used were highly heterogeneous, with a different number of sessions (from 2 to 12) and a different duration of therapy (up to 4 months). However, across all studies analyzed EMDR therapy was judged to be adequate in reducing symptoms of psychological distress in this population. Conclusions: According to the results of our analysis, the level of evidence regarding EMDR efficacy in cancer patients is limited by the scarcity of studies and their low methodological quality. Although better quality research is needed, available data suggest that EMDR could be a promising treatment for psychological distress in patients with cancer.
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Affiliation(s)
| | - Anna La Salvia
- Department of Oncology, 12 de Octubre University Hospital, Madrid, Spain
| | - Sara Carletto
- Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Torino, Italy
- Clinical Psychology Unit, University Hospital City of Science and Health, Torino, Italy
| | - Francesco Oliva
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Italy
| | - Luca Ostacoli
- Clinical Psychology Unit, University Hospital City of Science and Health, Torino, Italy
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Italy
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9
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Reducing Cardiac Radiation Dose From Breast Cancer Radiation Therapy With Breath Hold Training and Cognitive Behavioral Therapy. Top Magn Reson Imaging 2020; 29:135-148. [PMID: 32568976 DOI: 10.1097/rmr.0000000000000241] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The delivery of radiation therapy shares many of the challenges encountered in imaging procedures. As in imaging, such as MRI, organ motion must be reduced to a minimum, often for lengthy time periods, to effectively target the tumor during imaging-guided therapy while reducing radiation dose to nearby normal tissues. For patients, radiation therapy is frequently a stress- and anxiety-provoking medical procedure, evoking fear from negative perceptions about irradiation, confinement from immobilization devices, claustrophobia, unease with equipment, physical discomfort, and overall cancer fear. Such stress can be a profound challenge for cancer patients' emotional coping and tolerance to treatment, and particularly interferes with advanced radiation therapy procedures where active, complex and repetitive high-level cooperation is often required from the patient.In breast cancer, the most common cancer in women worldwide, radiation therapy is an indispensable component of treatment to improve tumor control and outcome in both breast-conserving therapy for early-stage disease and in advanced-stage patients. High technological complexity and high patient cooperation is required to mitigate the known cardiac toxicity and mortality from breast cancer radiation by reducing the unintended radiation dose to the heart from left breast or left chest wall irradiation. To address this, radiation treatment in daily deep inspiration breath hold (DIBH), to create greater distance between the treatment target and the heart, is increasingly practiced. While holding the promise to decrease cardiac toxicity, DIBH procedures often augment patients' baseline stress and anxiety reaction toward radiation treatment. Patients are often overwhelmed by the physical and mental demands of daily DIBH, including the nonintuitive timed and sustained coordination of abdominal thoracic muscles for prolonged breath holding.While technologies, such as DIBH, have advanced to millimeter-precision in treatment delivery and motion tracking, the "human factor" of patients' ability to cooperate and perform has been addressed much less. Both are needed to optimally deliver advanced radiation therapy with minimized normal tissue effects, while alleviating physical and cognitive distress during this challenging phase of breast cancer therapy.This article discusses physical training and psychotherapeutic integrative health approaches, applied to radiation oncology, to leverage and augment the gains enabled by advanced technology-based high-precision radiation treatment in breast cancer. Such combinations of advanced technologies with training and cognitive integrative health interventions hold the promise to provide simple feasible and low-cost means to improve patient experience, emotional outcomes and quality of life, while optimizing patient performance for advanced imaging-guided treatment procedures - paving the way to improve cardiac outcomes in breast cancer survivors.
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10
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Kazlauskiene J, Bulotiene G. Prevalence of post-traumatic stress disorder among Lithuanian breast cancer patients and its risk factors. J Psychosom Res 2020; 131:109939. [PMID: 32018216 DOI: 10.1016/j.jpsychores.2020.109939] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/20/2020] [Accepted: 01/20/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Post-traumatic stress disorder (PTSD) is more common among oncology patients than in the general population. The purpose of this study was to examine the prevalence of PTSD symptoms among Lithuanian patients with breast cancer and to analyse its clinical, psychosocial and demographic risk factors. METHODS Women with T1-T3/N0-N3/M0 stages of breast cancer took part in this study. There were two phases of the study: the first, before breast surgery (N = 421) and the second, a year after (N = 188). Women were given the following questionnaires: an Impact of Event Scale-Revised (IES-R); Beck's Depression Inventory, second edition (BDI-II); and the Vrana-Lauterbach Traumatic Event Scale, Civilian version (TEQC). RESULTS The prevalence of PTSD symptoms significantly decreased over the year. Before surgery, women who were employed, had experienced emotionally traumatic events during their lifespan and were dissatisfied with delivery of the information about the disease had more PTSD symptoms. One year later, those who had undergone breast-saving surgery, were living in a partnership, had a higher education, were unemployed and had experienced severe traumatic events during the previous year had more PTSD symptoms. The IES-R questionnaire's estimates correlated with BDI-II estimates. CONCLUSIONS Health care professionals, who work with cancer patients, are recommended to pay closer attention to the stress patients' experience, especially in those more vulnerable women who have several of the aforementioned risk factors. Targeted training for doctors, during which they could learn how to report the diagnosis to oncology patients would be of great benefit.
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Affiliation(s)
- Jurgita Kazlauskiene
- Vilniaus Kolegija/University of Applied Sciences, Saltoniskiu str. 58, LT-08105 Vilnius, Lithuania.
| | - Giedre Bulotiene
- National Cancer Institute, Santariskiu str. 1, LT-08660 Vilnius, Lithuania; Vilnius University, Universiteto str. 3, LT-01513 Vilnius, Lithuania
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