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Montoro-Lorite M, Moreno C, Ramos C, Solano MT, Lahoz S, Bonilla-Serrano C, Domènech A, Ayora P. Nursing care for chimeric antigen receptor T cell therapy survivors: A literature review. Asia Pac J Oncol Nurs 2024; 11:100495. [PMID: 38975609 PMCID: PMC11225008 DOI: 10.1016/j.apjon.2024.100495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/19/2024] [Indexed: 07/09/2024] Open
Abstract
Chimeric antigen receptor T cell (CAR-T) therapy is an immunotherapy that involves genetically modifying the patient's own T cells to express a chimeric antigen receptor, enabling them to recognize and destroy cancer cells. This treatment has revolutionized the prognosis and management of hematological malignancies, leading to a significant increase in long-term survivors. However, there is limited evidence regarding late sequelae and post-treatment care due to the recent emergence of this therapy. The rapid advancement of CAR-T therapies has created opportunities for advanced practice nurses to play a crucial role in coordinating care, providing education, and ensuring the ongoing well-being of survivors. This article provides an overview of the physical, psychosocial, and financial challenges faced by long-term survivors of CAR-T therapy and proposes a comprehensive nursing care plan to address these issues.
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Affiliation(s)
| | - Cristina Moreno
- Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Carla Ramos
- Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Barcelona, Spain
| | - María Teresa Solano
- Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Silvia Lahoz
- Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Ariadna Domènech
- Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Pilar Ayora
- Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Barcelona, Spain
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2
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Saiganesh H, Duffy C, Chrysanthopoulou SA, Dizon DS. Predictors and impact of survivorship care plans and survivorship care visits. J Cancer Surviv 2024; 18:836-843. [PMID: 36692704 PMCID: PMC9871419 DOI: 10.1007/s11764-023-01334-z] [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: 08/25/2022] [Accepted: 01/08/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE We performed this study to characterize the population at the Lifespan Cancer Institute (LCI) who received a survivorship care plan (SCP) with or without a survivorship care visit (SCV) to determine both the impact on specialty referrals and the demographic and clinical predictors of SCPs and SCVs. METHODS We retrospectively reviewed EMR records on 1960 patients at LCI between 2014 and 2017 for SCPs and SCVs and extracted demographics, distress thermometer (DT) scores collected at the time of initial presentation, and subsequent referrals. We evaluated the bivariate associations of SCP and SCV with continuous and categorical factors and assessed the adjusted effect of these factors on receipt of SCP and SCV independently. All analyses were performed in R v4.0.2. RESULTS SCPs were completed in 740 (37.8%) patients, and of those, 65.9% had a SCV. The mean age was 63.9, 67% were female, and 51.2% were married or partnered. Patients treated for breast, lung, and prostate cancers most received an SCP. Compared to SCP alone, the SCV was associated with more specialty referrals. Those who were younger and had breast cancer were more likely to receive a SCP, and those who were younger and female and had breast cancer were more likely to receive a SCV. CONCLUSIONS Gender, age, and type of cancer are significant predictors of receipt of SCP and SCV. Patients who received either SCP, SCV, or both were more likely to receive specialty referrals than those who received neither. IMPLICATIONS FOR CANCER SURVIVORS Identifying predictive factors of SCP and SCV can help facilitate earlier receipt of specialty services and specialty referrals as needed.
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Affiliation(s)
- Harish Saiganesh
- Brown University, 593 Eddy Street, George 302, Providence, RI, 02903, USA.
| | - Christine Duffy
- Lifespan Cancer Institute, 593 Eddy Street, George 302, Providence, RI, 02903, USA
| | | | - Don S Dizon
- Lifespan Cancer Institute, 593 Eddy Street, George 302, Providence, RI, 02903, USA
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3
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Efstathiou E, Merseburger A, Liew A, Kurtyka K, Panda O, Dalechek D, Heerdegen ACS, Jain R, De Solda F, McCarthy SA, Brookman-May SD, Mundle SD, Yu Ko W, Krabbe LM. Perception of cure in prostate cancer: human-led and artificial intelligence-assisted landscape review and linguistic analysis of literature, social media and policy documents. ESMO Open 2024; 9:103007. [PMID: 38744101 PMCID: PMC11108859 DOI: 10.1016/j.esmoop.2024.103007] [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: 12/15/2023] [Revised: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Understanding stakeholders' perception of cure in prostate cancer (PC) is essential to preparing for effective communication about emerging treatments with curative intent. This study used artificial intelligence (AI) for landscape review and linguistic analysis of definition, context and value of cure among stakeholders in PC. MATERIALS AND METHODS Subject-matter experts (SMEs) selected cure-related key words using Elicit, a semantic literature search engine, and extracted hits containing the key words from Medline, Sermo and Overton, representing academic researchers, health care providers (HCPs) and policymakers, respectively. NetBase Quid, a social media analytics and natural language processing tool, was used to carry out key word searches in social media (representing the general public). NetBase Quid analysed linguistics of key word-specific hit sets for key word count, geolocation and sentiments. SMEs qualitatively summarised key word-specific insights. Contextual terms frequently occurring with key words were identified and quantified. RESULTS SMEs identified seven key words applicable to PC (number of acquired hits) across four platforms: Cure (12429), Survivor (6063), Remission (1904), Survivorship (1179), Curative intent (432), No evidence of disease (381) and Complete remission (83). Most commonly used key words were Cure by the general public and HCPs (11815 and 224 hits), Survivorship by academic researchers and Survivor by policymakers (378 hits each). All stakeholders discussed Cure and cure-related key words primarily in early-stage PC and associated them with positive sentiments. All stakeholders defined cure differently but communicated about it in relation to disease measurements (e.g. prostate-specific antigen) or surgery. Stakeholders preferred different terms when discussing cure in PC: Cure (academic researchers), Cure rates (HCPs), Potential cure and Survivor/Survivorship (policymakers) and Cure and Survivor (general public). CONCLUSION This human-led, AI-assisted large-scale qualitative language-based research revealed that cure was commonly discussed by academic researchers, HCPs, policymakers and the general public, especially in early-stage PC. Stakeholders defined and contextualised cure in their communications differently and associated it with positive value.
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Affiliation(s)
| | - A Merseburger
- University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - A Liew
- Oxford PharmaGenesis Group Pty Ltd, Melbourne, Australia
| | - K Kurtyka
- Oxford PharmaGenesis Inc, Newtown, Pennsylvania, USA
| | - O Panda
- Oxford PharmaGenesis Inc, Newtown, Pennsylvania, USA
| | - D Dalechek
- Oxford PharmaGenesis Inc, Newtown, Pennsylvania, USA
| | - A C S Heerdegen
- Janssen Global Commercial Strategy Organization, Raritan, New Jersey, USA
| | - R Jain
- Janssen Global Commercial Strategy Organization, Raritan, New Jersey, USA
| | - F De Solda
- Janssen Global Commercial Strategy Organization, Raritan, New Jersey, USA
| | - S A McCarthy
- Janssen Research & Development, Raritan, New Jersey, USA
| | - S D Brookman-May
- Janssen Research & Development, Spring House, Pennsylvania, USA; Ludwig-Maximilians-University, Munich, Germany
| | - S D Mundle
- Janssen Research & Development, Raritan, New Jersey, USA
| | - W Yu Ko
- University of British Columbia Men's Health Research Program, Vancouver, British Columbia, Canada
| | - L-M Krabbe
- Vivantes Hospital Network for Health, Berlin, Germany
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4
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Mikesell L, O'Malley DM, Kurtzman RT, Howard J, Bates B, Hemler JR, Fadem SJ, Ferrante JM, Bator A, Hudson SV, Crabtree BF. Identifying priority areas to support primary care engagement in breast cancer survivorship care: A Delphi study. Cancer Med 2024; 13:e7219. [PMID: 38686635 PMCID: PMC11058672 DOI: 10.1002/cam4.7219] [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: 11/16/2023] [Revised: 01/30/2024] [Accepted: 04/14/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION Existing approaches in cancer survivorship care delivery have proven to be insufficient to engage primary care. This study aimed to identify stakeholder-informed priorities to improve primary care engagement in breast cancer survivorship care. METHODS Experts in U.S. cancer survivorship care delivery were invited to participate in a 4-round online Delphi panel to identify and evaluate priorities for defining and fostering primary care's engagement in breast cancer survivorship. Panelists were asked to identify and then assess (ratings of 1-9) the importance and feasibility of priority items to support primary care engagement in survivorship. Panelists were asked to review the group results and reevaluate the importance and feasibility of each item, aiming to reach consensus. RESULTS Respondent panelists (n = 23, response rate 57.5%) identified 31 priority items to support survivorship care. Panelists consistently rated three items most important (scored 9) but with uncertain feasibility (scored 5-6). These items emphasized the need to foster connections and improve communication between primary care and oncology. Panelists reached consensus on four items evaluated as important and feasible: (1) educating patients on survivorship, (2) enabling screening reminders and monitoring alerts in the electronic medical record, (3) identifying patient resources for clinicians to recommend, and (4) distributing accessible reference guides of common breast cancer drugs. CONCLUSION Role clarity and communication between oncology and primary care were rated as most important; however, uncertainty about feasibility remains. These findings indicate that cross-disciplinary capacity building to address feasibility issues may be needed to make the most important priority items actionable in primary care.
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Affiliation(s)
- Lisa Mikesell
- School of Communication and InformationRutgers UniversityNew BrunswickNew JerseyUSA
- Institute for Health, Health Care Policy, and Aging ResearchRutgers UniversityNew BrunswickNew JerseyUSA
| | - Denalee M. O'Malley
- Department of Family MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
- Rutgers Cancer Institute of New JerseyNew BrunswickNew JerseyUSA
| | - Rachel T. Kurtzman
- Department of Family MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
- NORC at The University of ChicagoChicagoIllinoisUSA
| | - Jenna Howard
- Department of Family MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Benjamin Bates
- Institute for Health, Health Care Policy, and Aging ResearchRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Cancer Institute of New JerseyNew BrunswickNew JerseyUSA
- Department of Medicine, Division of General Internal MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Jennifer R. Hemler
- Department of Family MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Sarah J. Fadem
- Department of Family MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Jeanne M. Ferrante
- Institute for Health, Health Care Policy, and Aging ResearchRutgers UniversityNew BrunswickNew JerseyUSA
- Department of Family MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
- Rutgers Cancer Institute of New JerseyNew BrunswickNew JerseyUSA
| | - Alicja Bator
- Department of Family MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Shawna V. Hudson
- Institute for Health, Health Care Policy, and Aging ResearchRutgers UniversityNew BrunswickNew JerseyUSA
- Department of Family MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
- Rutgers Cancer Institute of New JerseyNew BrunswickNew JerseyUSA
| | - Benjamin F. Crabtree
- Department of Family MedicineRutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
- Rutgers Cancer Institute of New JerseyNew BrunswickNew JerseyUSA
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Liu J, Tan F, Zhang Y, Zhou P, Qian Q, He Q, Xu J. Application Value of High-Quality Nursing in Operating Room in Rectal Cancer Operation and its Influence on Postoperative Rehabilitation. Surg Innov 2024:15533506231221895. [PMID: 38468453 DOI: 10.1177/15533506231221895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
OBJECTIVE To study the value of high-quality care in operating room during operation of patients with rectal cancer and the effect of this nursing model on postoperative rehabilitation. METHODS This study recruited 72 patients with rectal cancer, including 36 in the control group and 36 in the observation group. Patients in the control group received routine care, and those in the observation group received high-quality care in operating room. RESULTS The anxiety score (5.50 ± .77 vs 10. 08 ± 1.13), stress score (6.97 ± .60 vs 8.61 ± .99), and depression score (4.02 ± .65 vs 5.50 ± .91) in the observation group were less than the control group after treatment (P < .05). The measured values of diastolic blood pressure (73.19 ± 1.96 vs 86.13 ± 2.0), systolic blood pressure (121.08 ± 1.62 vs 130.63 ± 2.84), heart rate (73.05 ± 1.63 vs 87.11 ± 2.91) and adrenaline E(E) (58.40 ± 3.02 vs 61.42 ± 3.86) in the observation group were less than the control group after treatment (P < .05). The cooperation degree (94.44 vs 75.00) in the observation group was greater than the control group, but the operation time (308.47 ± 9.92 vs 339.47 ± 12.70), postoperative intestinal function recovery time (16.30 ± 1.14 vs 30.94 ± 2.10) and length of stay (10.47 ± 1.85 vs 13.33 ± 1.95) were all shorter than the control group (P < .05). The nasopharyngeal temperature in the observation group was greater than the control group at 30 minutes during operation (36.16 ± .50 vs 35.19 ± .40) and after operation, and fear score (2.22 ± .42 vs 3.63 ± .72) was less than the control group (P < .05). CONCLUSION The application of high-quality care in the operating room during rectal cancer surgery has a significantly good clinical outcome.
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Affiliation(s)
- Juan Liu
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Feng Tan
- Department of Infection Management, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yihui Zhang
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Ping Zhou
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Qian Qian
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Qiaofang He
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jingpin Xu
- Department of Anesthesiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
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6
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Duggan C, Cushing-Haugen KL, Cole AM, Allen J, Gilles R, Hornecker JR, Gutierrez AI, Warner J, Scott Baker K, Ceballos RM, Chow EJ. Feasibility of delivering survivorship care via lay health educators: A pilot randomized controlled trial among rural cancer survivors. J Rural Health 2023; 39:666-675. [PMID: 36593127 PMCID: PMC10650940 DOI: 10.1111/jrh.12736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE We tested the feasibility of survivorship care plan (SCP) delivery with/without a lay health educator (LHE) telephone-delivered information session among rural cancer survivors, and their effects on health-related self-efficacy and knowledge of cancer history. METHODS Randomized trial of cancer survivors from 3 rural oncology clinics featuring either SCP alone (control) or SCP plus LHE-delivered information session (intervention). Participants completed a questionnaire on health-related self-efficacy and knowledge of cancer-specific medical history. Responses were compared to medical records for accuracy. SCPs were then mailed to participants. Approximately 5 months later, participants completed a follow-up questionnaire. A subset of participants took part in subsequent qualitative interviews about their study experience. FINDINGS Of 301 survivors approached, 72 (23.9%) were randomized (mean age 66.4 years; 3.1 years from diagnosis; 62.5% female), and 65 (90.3%) completed the study. Global mental and physical health or self-efficacy scores did not change significantly from baseline to follow-up for either group. In exploratory analyses, self-efficacy increased in participants with inadequate/marginal health literacy in the intervention arm (+0.7, 95% CI = 0.1-1.2; P = .01). Accuracy of knowledge did not improve but was high at baseline (mean 76.0±14.5%). 60.1% and 48.4% of control and intervention participants, respectively, found SCPs definitely/somewhat useful. Qualitative data (n = 20) suggested that SCPs were helpful to patients when primary and oncology care were less integrated. CONCLUSIONS An LHE-delivered informational session was feasible but had limited benefit to rural cancer survivors versus delivery of SCP alone but may be of benefit to patients with low health literacy or with less integrated care.
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Affiliation(s)
- Catherine Duggan
- Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA
| | | | - Allison M. Cole
- Institute of Translational Health Sciences, University of Washington, Seattle, WA 98105, USA
| | | | - Ryan Gilles
- Kootenai Health, Coeur d’Alene ID 83814, USA
| | - Jaime R. Hornecker
- University of Wyoming Family Medicine Residency Program, Caspar, WY 82071, USA
| | | | - Jude Warner
- Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA
| | - K. Scott Baker
- Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA
| | - Rachel M. Ceballos
- Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA
| | - Eric J. Chow
- Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, 98109, USA
- University of Washington, Seattle, Washington, USA
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7
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Tevaarwerk AJ, Zhang X, Haine J, Norslien K, Henningfield MF, Stietz C, Hahn D, Sesto ME. Re-engineering Survivorship Care Plans to Support Primary Care Needs and Workflow: Results From an Engineering, Primary Care and Oncology Collaborative for Survivorship Health (EPOCH). JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1654-1661. [PMID: 33904117 PMCID: PMC8546004 DOI: 10.1007/s13187-021-02008-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 06/11/2023]
Abstract
Maintaining the health of survivors requires communication, collaboration and care coordination between oncology and primary care. Primary care clinicians have been acknowledged as important recipients of survivorship care plans (SCPs); however, current SCP templates have not been evaluated for usefulness in the primary care context. We surveyed and interviewed primary care clinicians from a rural research network regarding SCP content, format and layout (phase 1), and potential use and clinical workflows around SCPs (phase 2). Based on these data, an existing SCP template was iteratively redesigned to better support survivorship care in the primary care setting. A total of 13 clinicians (9 MDs, 4 APPs) participated. Interviewees advocated for maintaining a single SCP document shared by survivors and clinicians. Changes to the SCP template included prioritizing follow-up over summary of treatment and removing or down-playing screening recommendations not impacted by cancer or cancer treatment. The re-engineered SCP was regarded as highly relevant for survivors, but clinicians noted the significant effort to "disassemble" SCPs in order to enter the information into on the receiving health record. Primary care clinicians value the information in SCPs but had important recommendations regarding content, layout, and format. Additionally, a significant effort appears to be required by recipients in order to extract SCP information for future use.
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Affiliation(s)
- Amye J Tevaarwerk
- Division of Hematology/Oncology, University of Wisconsin, Madison, 6037 Wisconsin Institutes for Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA.
- Carbone Cancer Center, Madison, WI, USA.
| | | | - James Haine
- Division of Hematology/Oncology, University of Wisconsin, Madison, 6037 Wisconsin Institutes for Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA
| | | | - Mary F Henningfield
- Division of Hematology/Oncology, University of Wisconsin, Madison, 6037 Wisconsin Institutes for Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA
| | | | - David Hahn
- Division of Hematology/Oncology, University of Wisconsin, Madison, 6037 Wisconsin Institutes for Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA
| | - Mary E Sesto
- Division of Hematology/Oncology, University of Wisconsin, Madison, 6037 Wisconsin Institutes for Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA
- Carbone Cancer Center, Madison, WI, USA
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8
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Monsen KV, Fosså SD, Myklebust TÅ, Smeland S, Dahl AA, Stensvold A. Long-term satisfaction with curative treatment and follow-up in prostate cancer survivors. Acta Oncol 2022; 61:357-362. [PMID: 35103559 DOI: 10.1080/0284186x.2021.2006775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE In a cross-sectional observational study to explore long-term satisfaction with treatment among men who had undergone radical prostatectomy (RP) or definitive pelvic radiotherapy (RT) for prostate cancer (PCa). METHODS After mean 7 years from therapy (range: 6-8), 431 PCa-survivors (RP: n = 313, RT: n = 118) completed a mailed questionnaire assessing persistent treatment-related adverse effects (AEs) (Expanded Prostate cancer Index Composite [EPIC-26]) and seven Quality indicators describing satisfaction with the health care service following a most often general practitioner (GP)-led follow-up plan. A logistic regression model evaluated the associations between long-term satisfaction and treatment modality, age, the seven satisfaction-related Quality indicators, and persistent AEs. The significance level was set at p< .05. RESULTS Four of five (81%) PCa-survivors reported long-term satisfaction with their treatment. In a multivariable model, satisfaction was positively associated with sufficient information about treatment and AEs, patient-perceived sufficient cooperation between the hospital and the GP and sufficient follow-up of AEs (ref.: insufficient). Age ≥70 years (ref.: <70) and a rising summary score within the EPIC-26 sexual domain additionally increased long-term satisfaction. The treatment modality itself (RP versus RT) did not significantly impact on satisfaction. CONCLUSIONS The majority of curatively treated PCa-survivors are satisfied with their treatment more than 5 years after primary therapy. Sufficient information, improved cooperation between the hospital specialists and the responsible GP and optimized follow-up of AEs may further increase long-term satisfaction among prostatectomized and irradiated PCa-survivors.
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Affiliation(s)
- Kari V. Monsen
- Section for Clinical Cancer Research, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Norway
| | - Sophie D. Fosså
- Section for Clinical Cancer Research, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Norway
| | - Tor Å. Myklebust
- Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Sigbjørn Smeland
- Faculty of Medicine, University of Oslo, Norway
- Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Alv A. Dahl
- Section for Clinical Cancer Research, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Norway
| | - Andreas Stensvold
- Division of Clinical Oncology, Østfold Hospital Trust, Kalnes, Norway
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9
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Kenzik KM, Rocque G, Williams GR, Cherrington A, Bhatia S. Primary care and preventable hospitalizations among Medicare beneficiaries with non-metastatic breast cancer. J Cancer Surviv 2022; 16:853-864. [DOI: 10.1007/s11764-021-01079-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/23/2021] [Indexed: 11/28/2022]
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10
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Rosenberg J, Butow PN, Shaw JM. The untold story of late effects: a qualitative analysis of breast cancer survivors' emotional responses to late effects. Support Care Cancer 2022; 30:177-185. [PMID: 34245359 DOI: 10.1007/s00520-021-06402-7] [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: 01/18/2021] [Accepted: 06/26/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Breast cancer survivors are at increased risk of adverse outcomes, called late effects, years after the completion of active treatment. Late effects can significantly impair physical functioning. The current study aimed to explore breast cancer survivors' experiences of late effects, their emotional responses to existing or potential late effects and their perceived impact. METHODS A total of 36 women treated for breast cancer in the last 10 years participated in semi-structured telephone interviews. Participant views were sought with respect to knowledge, experience, and perceived longer-term risk. A thematic analysis was conducted. RESULTS Four themes emerged from the data: (1) late effects awareness, (2) framing and coping, (3) uncertainty and (4) management. There was a range of emotional responses to late effects; however, many participants reported being unaware of their risk of late effects. Participants conceptualised late effects as any long-term effect of treatment regardless of the time of onset. Women reported living with constant uncertainty and feared cancer recurrence. Many were focused on managing long-term treatment side effects, rather than late effects. CONCLUSION Many women undergo treatment and remain unaware of associated late effect risks. National guidelines recommend patients be informed about late effects; however, the results of this study suggest a gap between policy and practice. Evidence-based interventions are needed to equip women with strategies to physically and emotionally manage late effects.
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Affiliation(s)
- Jodie Rosenberg
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia. .,Psycho-Oncology Co-Operative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
| | - Phyllis N Butow
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.,Psycho-Oncology Co-Operative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Joanne M Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.,Psycho-Oncology Co-Operative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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11
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Massoeurs L, Ilie G, Lawen T, MacDonald C, Bradley C, Vo JDCT, Rutledge RDH. Psychosocial and Functional Predictors of Mental Disorder among Prostate Cancer Survivors: Informing Survivorship Care Programs with Evidence-Based Knowledge. Curr Oncol 2021; 28:3918-3931. [PMID: 34677252 PMCID: PMC8534362 DOI: 10.3390/curroncol28050334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/12/2021] [Accepted: 09/28/2021] [Indexed: 11/24/2022] Open
Abstract
Recent research has revealed that prostate cancer (PCa) survivors are facing a silent epidemic of mental disorder. These findings are not surprising when the side effects of highly effective current treatment modalities are considered. Here, we assess the association between urinary function and quality of life indicators to mental disorder among survivors of PCa. This is a cross sectional examination of an analytical sample of 362 men with a history of PCa residing in the Maritimes who took a survey assessing social, physical and health-related quality of life indicators between 2017 and 2021. Mental disorder was assessed using Kessler's Psychological Distress Scale (K-10). Predictor variables included emotional, functional, social/family and spiritual well-being, measured by Functional Assessment of Cancer Therapy-Prostate (FACT-P), and urinary function was measured by International Prostate Symptom Score (IPSS). Multivariate logistic regression analysis evaluated the contribution of predictors while controlling for age, income, survivorship time (months) since diagnosis, relationship status and treatment modality. Mental disorder was identified among 15.8% of PCa survivors in this sample. High emotional (aOR = 0.81, 95% CI: 0.69-0.96) and spiritual well-being (aOR = 0.88, 95% CI: 0.81-0.96) were protective factors against mental disorder. Men who screened positive for moderate to severe urinary tract symptoms had three times higher odds (aOR = 3.02, 95% CI: 1.10, 8.32) of screening positive for mental disorder. Men who were on active surveillance or radical prostatectomy with or without added treatment had higher (aOR = 5.87, 95% CI: 1.32-26.13 or aOR = 4.21, 95% CI: 1.07-16.51, respectively) odds of screening positive for mental disorder compared to men who received radiation treatment with or without hormonal therapy for their PCa diagnosis. Unmet emotional and spiritual needs, increased urinary problems and some forms of treatment (e.g., active surveillance or surgery) were associated with mental disorder among PCa survivors. The development of survivorship care programs and support systems that focus on the long-term effects of PCa treatments and the consequences of unmet psychosocial needs of patients during the survivorship journey are critically needed.
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Affiliation(s)
- Lia Massoeurs
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 1V7, Canada; (L.M.); (C.M.); (C.B.)
| | - Gabriela Ilie
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 1V7, Canada; (L.M.); (C.M.); (C.B.)
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada;
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada;
- Department of Radiation Oncology, Dalhousie University, Halifax, NS B3H 4R2, Canada;
- Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada
| | - Tarek Lawen
- Department of Urology, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Cody MacDonald
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 1V7, Canada; (L.M.); (C.M.); (C.B.)
| | - Cassidy Bradley
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 1V7, Canada; (L.M.); (C.M.); (C.B.)
| | - Jasmine Dang Cam-Tu Vo
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS B3H 4R2, Canada;
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De Felice F, Lei M, Oakley R, Lyons A, Fry A, Jeannon JP, Simo R, Guerrero Urbano T. Risk stratified follow up for head and neck cancer patients - An evidence based proposal. Oral Oncol 2021; 119:105365. [PMID: 34058702 DOI: 10.1016/j.oraloncology.2021.105365] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/11/2021] [Accepted: 05/23/2021] [Indexed: 11/29/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) has a significant impact on patients' quality of life and treatment can be associated with severe morbidity. Following completion of treatment, patients are followed up in order to detect potentially salvageable recurrences and to manage long-term toxicities. In recent years, a growing interest has been given to risk stratified follow-up interventions to prevent and detect recurrences and manage treatment toxicities in other tumour sites as well as to transfer some of that care to community services. We review the literature for HNSCC and propose a risk stratified follow up protocol to address these issues and assist clinicians in decision making. A shift in patterns of care is suggested in order to provide a basis to improve care for HNSCC patients after complete response to primary treatment.
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Affiliation(s)
- Francesca De Felice
- Department of Clinical Oncology, Guy's and St Thomas' NHS Trust, London, UK; Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Mary Lei
- Department of Clinical Oncology, Guy's and St Thomas' NHS Trust, London, UK
| | - Richard Oakley
- Department of Head and Neck Surgery Guys and St Thomas' NHS Trust, London, UK
| | - Andrew Lyons
- Department of Head and Neck Surgery Guys and St Thomas' NHS Trust, London, UK
| | - Alastair Fry
- Department of Head and Neck Surgery Guys and St Thomas' NHS Trust, London, UK
| | - Jean-Pierre Jeannon
- Department of Head and Neck Surgery Guys and St Thomas' NHS Trust, London, UK; King's College London, UK
| | - Ricard Simo
- Department of Head and Neck Surgery Guys and St Thomas' NHS Trust, London, UK
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Takayama T, Inoue Y, Yokota R, Hayakawa M, Yamaki C, Toh Y. New Approach for Collecting Cancer Patients' Views and Preferences Through Medical Staff. Patient Prefer Adherence 2021; 15:375-385. [PMID: 33633445 PMCID: PMC7901553 DOI: 10.2147/ppa.s292239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/21/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE It is crucial for health professionals to understand patients' and families' views and preferences (PVPs) to enhance their adherence to treatments and subsequent satisfaction. Regularly and consistently collecting comprehensive information on the needs and concerns of patients/families and utilizing the information is vital for improving clinical practice and the healthcare environment. As an initial approach, this study aimed to develop a new system for appropriately collecting PVPs regarding cancer from nationwide medical staff and consider the potential utilization of PVPs in clinical practice. METHODS Web-based anonymous surveys were conducted with medical staff in nationwide cancer care hospitals in Japan. The surveys queried the questions, values, desires, and experiences expressed by cancer patients or their families on five topics, namely two cancer sites (colorectal and esophageal cancers) and three symptoms and signs (lymphedema, urinary symptoms, and tingling/numbness/pain) within the past year. The PVPs were compared to the five topics and staff medical specialties, and those on tingling/numbness/pain were analyzed qualitatively. RESULTS Among the 904 medical staff who responded to this survey, the PVPs encountered by the staff differed according to the topic and staff medical specialty. Tingling/numbness/pain was the most frequently encountered symptom, and urinary symptoms were the least encountered. Only half or fewer of the medical staff had information available regarding urinary symptoms and tingling/numbness/pain. Further, qualitative content analysis of the expressed PVPs regarding tingling/numbness/pain raised clinical questions on this topic that led to the construction of a "Questions & Answers" section on a public website in Japan. CONCLUSION This study suggests that collecting PVPs through nationwide cancer-related medical staff might be an efficient way to understand the specific requirements of patients/families. It would also be possible to document PVP trends according to changes in the environments of patients/families by nationwide, consistent, and continuous PVP collection.
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Affiliation(s)
- Tomoko Takayama
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
- Correspondence: Tomoko Takayama Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 104-0045, JapanTel +81-3-3542-2511 Ex. 1621Fax +81-3-3547-8577 Email
| | - Yoji Inoue
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Rie Yokota
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masayo Hayakawa
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Chikako Yamaki
- Cancer Information Service Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Yasushi Toh
- National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
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Toh Y, Inoue Y, Hayakawa M, Yamaki C, Takeuchi H, Ohira M, Matsubara H, Doki Y, Wakao F, Takayama T. Creation and provision of a question and answer resource for esophageal cancer based on medical professionals' reports of patients' and families' views and preferences. Esophagus 2021; 18:872-879. [PMID: 34169363 PMCID: PMC8387257 DOI: 10.1007/s10388-021-00857-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/01/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND In the rapidly-progressing healthcare environment, it is essential to improve treatment quality through continuous clarification of the needs and concerns of esophageal cancer patients and their families. Effective collaboration between information providers and academic associations could help make such clarified information available. METHODS We analyzed esophageal cancer patients' views and preferences (PVPs) using data that were previously obtained from medical staff in Japan. Based on these PVPs, we created a question and answer (Q&A) resource through collaboration with the Cancer Information Service in Japan (CISJ) and the Japan Esophageal Society (JES). RESULTS Regarding esophageal cancer, "diet and eating behavior" was the most frequent PVP mentioned by patients and their families, followed by "treatment-related symptoms and adverse effects" and "daily life, recuperation, and survivorship." These PVPs were noted by a wide variety of medical specialties. By analyzing the PVPs, the CISJ developed 11 proposed questions and sent them to the JES, which then created answers based on evidence and clinical-practice-associated consensus. The resultant Q&A resource was uploaded to the CISJ website with mutual linkage to the JES website. CONCLUSIONS This study showed the usefulness of collecting esophageal-cancer-related PVPs from medical staff and fostering successful collaboration between a cancer-information provider and an academic association. This arrangement may represent a model case for developing a sustainable system that can satisfactorily respond to PVPs regarding other cancers and/or issues.
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Affiliation(s)
- Yasushi Toh
- The Japan Esophageal Society, Tokyo, Japan ,Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yoji Inoue
- Division of Cancer Information Services, Center for Cancer Control and Information Service, National Cancer Center, Tokyo, Japan
| | - Masayo Hayakawa
- Division of Cancer Information Services, Center for Cancer Control and Information Service, National Cancer Center, Tokyo, Japan
| | - Chikako Yamaki
- Division of Cancer Information Services, Center for Cancer Control and Information Service, National Cancer Center, Tokyo, Japan
| | - Hiroya Takeuchi
- The Japan Esophageal Society, Tokyo, Japan ,Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka Japan
| | - Masaichi Ohira
- The Japan Esophageal Society, Tokyo, Japan ,Department of Gastroenterological Surgery, Osaka City University School of Medicine, Osaka, Japan
| | - Hisahiro Matsubara
- The Japan Esophageal Society, Tokyo, Japan ,Department of Frontier Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yuichiro Doki
- The Japan Esophageal Society, Tokyo, Japan ,Division of Gastroenterological Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Fumihiko Wakao
- Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Tomoko Takayama
- Division of Cancer Information Services, Center for Cancer Control and Information Service, National Cancer Center, Tokyo, Japan
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Ramirez AG, Muñoz E, Long Parma D, Perez A, Santillan A. Quality of life outcomes from a randomized controlled trial of patient navigation in Latina breast cancer survivors. Cancer Med 2020; 9:7837-7848. [PMID: 32979042 PMCID: PMC7643682 DOI: 10.1002/cam4.3272] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Breast cancer survivorship is a life-long process involving challenges to health-care communities and individuals, especially Latinas. Patient Navigation has shown some success in meeting these challenges. The purpose of this study was to compare the effects of an enhanced Patient Navigation program (Intervention; PN+) vs Control (PN) over time on general cancer and breast cancer-specific quality of life (QoL) in Latina breast cancer survivors (BCS). METHODS We conducted a 2-year, two-arm randomized controlled trial of the "Staying Healthy" program among Latina BCS. The design compared PN+ vs PN over time. We recruited 60 patients into each study arm and randomized them by sequential numerical assignment. PN+ participants received culturally tailored educational materials and active, personalized Patient Navigation services, including phone calls, transportation, and care coordination. PN participants were navigated only upon request. Primary outcomes included general cancer (Functional Assessments of Cancer Therapy [FACTS]-G) and breast cancer-specific (FACT-B) QoL. RESULTS PN+ participants had significantly improved QoL measures compared to PN at 6-month follow-up on all subscales (P-values .007-.04) except physical well-being (PWB; P = .11). Intervention effect size coefficient (standard error) for FACT-G overall was 7.9 (3.1); P = .01. For FACT-B, it was 10.9 (3.9); P = .006. Again, all subscales showed significant effects [range 1.7-3.1 (0.8-1.2); P-values .006-.04], except for PWB [1.5 (1.0); P = .16] and social/family well-being (SWB) [2.1 (1.1); P = .06]. There were no differences between groups at baseline. DISCUSSION Multiple cultural, psychosocial, and socioeconomic variables contributing to these intervention effects will be addressed in future studies. As the national BCS population continues to increase, more Patient Navigation-focused partnerships among patients, health-care professionals, research groups, and community organizations are needed to improve BCS experiences. The Staying Healthy program has the potential to serve as a national survivorship care model for improving Latina BCS QoL.
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Affiliation(s)
- Amelie G. Ramirez
- Department of Population Health SciencesUT Health San AntonioSan AntonioTXUSA
- The Mays Cancer CenterUT Health San Antonio MD Anderson Cancer CenterSan AntonioTXUSA
| | - Edgar Muñoz
- Department of Population Health SciencesUT Health San AntonioSan AntonioTXUSA
| | - Dorothy Long Parma
- Department of Population Health SciencesUT Health San AntonioSan AntonioTXUSA
- The Mays Cancer CenterUT Health San Antonio MD Anderson Cancer CenterSan AntonioTXUSA
| | - Arely Perez
- Department of Population Health SciencesUT Health San AntonioSan AntonioTXUSA
| | - Alfredo Santillan
- Department of Population Health SciencesUT Health San AntonioSan AntonioTXUSA
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Building a physical activity intervention into clinical care for breast and colorectal cancer survivors in Wisconsin: a randomized controlled pilot trial. J Cancer Surviv 2019; 13:593-602. [PMID: 31264183 DOI: 10.1007/s11764-019-00778-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/17/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Cancer survivorship care plans ("care plans") often recommend an active lifestyle yet are rarely accompanied by programs to help patients enact the prescribed behavior change. As a step towards bridging this gap, this trial tested the feasibility of augmenting care planning with a multi-level physical activity intervention. METHODS Breast and colorectal cancer survivors were enrolled alongside a self-selected support partner (e.g., spouse, friend). Survivors received a care plan alone (comparison group) versus one augmented with a 12-week physical activity module (intervention group). For the intervention group dyads, both members received a multi-component program including Fitbit trackers, with the survivor's Fitbit linked to his/her electronic health record (EHR). Treating clinicians received periodic updates regarding the survivors' physical activity. The primary outcome was ActiGraph-measured physical activity, analyzed using mixed models. Feedback questionnaires were administered to participants and clinicians at 12 weeks. RESULTS Survivors (n = 50) were 54.4 ± 11.2 years of age and 2.0 ± 1.5 years post-diagnosis. Survivors in the intervention group increased moderate-to-vigorous-intensity physical activity (MVPA) by 69 ± 84 min/week vs. a 20 ± 71 min/week decrease in the comparison group (p = .001). Likewise, daily steps increased by 1470 ± 1881 vs. a 398 ± 1751 decrease (P = .002). Among responding clinicians, 100% looked at survivors' activity data within the EHR at least once and 80% said it provided insight into their patients' lifestyles. CONCLUSIONS Augmenting a standard care plan with a multi-level, technology-based intervention increased physical activity among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Technology-based approaches, including activity trackers, can be used by individuals to work towards an active lifestyle after cancer.
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