"I am not a statistic" ovarian cancer survivors' views of factors that influenced their long-term survival

Shikonin reduces M2 macrophage population in ovarian cancer by repressing exosome production and the exosomal galectin 3-mediated β-catenin activation

BACKGROUND

Shikonin (SK), a naphthoquinone with anti-tumor effects, has been found to decrease production of tumor-associated exosomes (exo). This study aims to verify the treatment effect of SK on ovarian cancer (OC) cells, especially on the production of exo and their subsequent effect on macrophage polarization.

METHODS

OC cells SKOV3 and A2780 were treated with SK. The exo were isolated from OC cells with or without SK treatment, termed OC exo and SK OC exo, respectively. These exo were used to treat PMA-induced THP-1 cells (M0 macrophages). M2 polarization of macrophages was determined by measuring the M2 specific cell surface markers CD163 and CD206 as well as the secretion of M2 cytokine IL-10. The functions of galectin 3 (LGALS3/GAL3) and β-catenin in macrophage polarization were determined by gain- or loss-of-function assays. CB-17 SCID mice were subcutaneously injected with SKOV3 cells to generate xenograft tumors, followed by OC exo or SK OC exo treatment for in vivo experiments.

RESULTS

SK suppressed viability, migration and invasion, and apoptosis resistance of OC cells in vitro. Compared to OC exo, SK OC exo reduced the M2 polarization of macrophages. Regarding the mechanism, SK reduced exo production in cancer cells, and it decreased the protein level of GAL3 in exo and recipient macrophages, leading to decreased β-catenin activation. M2 polarization of macrophages was restored by LGALS3 overexpression but decreased again by the β-catenin inhibitor FH535. Compared to OC exo, the SK OC exo treatment reduced the xenograft tumor growth in mice, and it decreased the M2 macrophage infiltration within tumor tissues.

CONCLUSION

This study suggests that SK reduces M2 macrophage population in OC by repressing exo production and blocking exosomal GAL3-mediated β-catenin activation.

The role of spirituality in pain experiences among adults with cancer: an explanatory sequential mixed methods study

PURPOSE

Foundational research demonstrates that spirituality may affect the way people with cancer experience pain. One potential route is through alterations in thoughts and beliefs, such as pain-related catastrophizing. The purpose of this study is to understand whether spirituality impacts pain experiences through pain-related catastrophizing.

METHODS

This explanatory sequential mixed methods study was informed by an adapted Theory of Unpleasant Symptoms. Data were collected via online surveys (N = 79) and follow-up qualitative interviews (N = 25). Phase 1 employed Empirical Bayesian analysis. Phase 2 used deductive content analysis. Phase 3 involved creating a mixed methods joint display to integrate findings and draw meta inferences.

RESULTS

Results indicate that total spiritual well-being was directly negatively associated with pain-related catastrophizing, and indirectly negatively associated with the outcomes of pain interference, pain severity, and pain-related distress. Qualitative categories highlight the supportive role of spirituality when facing pain, while also shedding light on the limitations of spirituality in the context of some pain (i.e., severe, neuropathic, and/or chronic). Mixed methods findings reveal the importance of spirituality for some people as they face cancer and cancer-related pain, as well as the need for integrating spirituality as part of a larger pain management plan.

CONCLUSIONS

This research advances supportive cancer care by exploring the complex role of spirituality in pain experiences. Findings will inform further exploration into the role of spirituality in supporting holistic symptom management in the context of cancer, as well as developing and testing interventions to enhance spirituality and address symptom-related suffering.

The Role of Spirituality in Pain Experiences among Adults with Cancer: An Explanatory Sequential Mixed Methods Study

Purpose

Foundational research demonstrates that spirituality may affect the way people with cancer experience pain. One potential route is through alterations in thoughts and beliefs, such as pain-related catastrophizing. The purpose of this study is to understand whether spirituality impacts pain experiences through pain-related catastrophizing.

Methods

This explanatory sequential mixed methods study was informed by an adapted Theory of Unpleasant Symptoms. Data were collected via online surveys (N = 79) and follow-up qualitative interviews (N = 25). Phase 1 employed Empirical Bayesian analysis. Phase 2 used deductive content analysis. Phase 3 involved creating a mixed methods joint display to integrate findings and draw meta inferences.

Results

Results indicate that spirituality was directly negatively associated with pain-related catastrophizing, and indirectly negatively associated with the outcomes of pain interference, pain severity, and pain-related distress. Qualitative categories highlight the supportive role of spirituality when facing pain, while also shedding light on the limitations of spirituality in the context of some pain (i.e., severe, neuropathic, and/or chronic). Mixed methods findings reveal the importance of spirituality for some people as they face cancer and cancer-related pain, as well as the need for integrating spirituality as part of a larger pain management plan.

Conclusions

This research advances supportive cancer care by exploring the complex role of spirituality in pain experiences. Findings will inform further exploration into the role of spirituality in supporting holistic symptom management in the context of cancer, as well as developing and testing interventions to enhance spirituality and address symptom-related suffering.

Well-being and stress vulnerability in ovarian cancer survivors during the COVID-19 pandemic

OBJECTIVE

This study was designed to examine (1) whether ovarian cancer (OC) survivors would have greater well-being vs. elevated distress compared to community members during a universal health stressor (COVID-19) and (2) how resources and risk factors at diagnosis predicted vulnerability to a subsequent health-related stressor.

METHODS

One hundred seventeen OC survivors were recruited from two academic medical centers and compared to a community-based sample on COVID-related distress and disruption. Latent class analysis identified differentially impacted groups of survivors.

RESULTS

Survivors reported lower distress than community members. Predictors of higher distress included shorter-term survivorship, greater disruption, and poorer emotional well--being (EWB) at diagnosis. Survivors were divided into high- and low-COVID-19-impact subgroups; high-impact individuals endorsed higher perceived stress and lower EWB at diagnosis.

CONCLUSION

Survivors reported lower COVID-related distress than community participants. While depression at diagnosis did not predict later distress, EWB was a strong predictor of response to a novel health-related stressor.

Exploring motivations for participating in research among Australian women with advanced gynaecological cancer: a qualitative study

PURPOSE

With global moves to increase research among those living with advanced cancer and legitimise consumers as part of cancer research, this article aims to build an understanding of women's motivations and reasons for participating in gynaecological cancer research. As a secondary aim, we considered the role of qualitative methods in enabling active involvement of consumers in research.

METHODS

We applied thematic discursive analysis to 18 in-depth interviews with women diagnosed with advanced (stage III-IV) gynaecological cancer living in Australia.

RESULTS

We found that women viewed research as a vehicle for change in two directions: improving the lives of future generations and improving education and awareness. Underpinning these two framings of research, women spoke about their own role and reasons for participating in this interview study. Women's stories were painted against a backdrop of social and medical silences around gynaecological cancer. It was from such silence that women chose to speak up and position themselves as participating in service for knowledge production.

CONCLUSION

We learned that trust, reciprocity and relationships are central to women's decisions to participate in cancer research. Legitimising consumers in cancer research requires methods, methodologies and practices that pay careful attention to power, control and representation.

Lifestyle intervention in ovarian cancer enhanced survival (LIVES) study (NRG/GOG0225): Recruitment, retention and baseline characteristics of a randomized trial of diet and physical activity in ovarian cancer survivors

OBJECTIVE

The Lifestyle Intervention for oVarian cancer Enhanced Survival (LIVES) is a national study of a combined diet and physical activity intervention for stage II-IV ovarian cancer survival, an under-represented cancer in lifestyle behavioral intervention research. Here, we present the data on recruitment, retention, and baseline demographic, clinical and lifestyle behavior characteristics of the LIVES study participants.

METHODS

The LIVES study (NRG Oncology/GOG 0225) is a Phase III diet plus physical activity intervention trial testing the hypothesis that ovarian cancer survivors in the lifestyle intervention will demonstrate better progression-free survival than those in the control condition. Study interventions were delivered via centralized telephone-based health coaching. Baseline descriptive statistics were computed for demographic, clinical, and lifestyle behavior characteristics.

RESULTS

The LIVES study exceeded its recruitment goals, enrolling 1205 ovarian cancer survivors from 195 NRG/NCORP-affiliated oncology practices across 49 states from 2012 to 2018. The mean age of enrollees was 59.6 years; the majority (69.4%) with stage III disease; 89% White, 5.5% Hispanic; 64% overweight/obese. Baseline self-reported diet showed a mean daily intake of 6.6 servings of fruit and vegetables, 62.7 fat grams, and 21.7 g of fiber. Physical activity averaged 13.0 MET-hours/week of moderate to vigorous physical activity; 50.9 h/week of sedentary time. Retention rates exceeded 88%.

CONCLUSION

The LIVES study demonstrates efficiency in recruiting and retaining ovarian cancer survivors in a 24-month study of diet and physical activity intervention with a primary endpoint of progression free survival that will be reported.

TRIAL REGISTRATION

ClinicalTrials.govNCT00719303.

Circ TYMP1 Inhibits Carcinogenesis and Cisplatin Resistance in Ovarian Cancer by Reducing Smad2/3 Phosphorylation via a MicroRNA-182A-3p/TGF1B Axis

TYMP1 is a cancer driver in several human malignancies. However, its significance in ovarian cancer (ovarian carcinoma) remains uncertain. This research aims to understand the TYMP1's role in ovarian carcinoma carcinogenesis and cisplatin (DDP) resistance and its molecular ovarian marchionesses. Circ TYMP1 overexpression in ovarian carcinoma samples led to an accelerated tumor stage. Bioinformatics identified miR-182A-3p as the TYMP1's target transcript. Circ TYMP1 functioned as a sponge for miR-182A-3p, lowering its inhibitory effect on TGF1B. Downregulating circ TYMP1 decreased A2780-Res cell proliferation, invasion, and death resistance. Malignant ovarian carcinoma cells recovered following miR-182A-3p downregulation. TGF1B overexpression boosted A2780-Res cell proliferation, aggression, and cisplatin resistance while reducing Smad2/3 phosphorylation. TYMP1 sequesters miR-182A-3p and promotes TGF1B in ovarian carcinoma, boosting carcinogenesis and cisplatin resistance. This might lead to novel ovarian carcinoma treatments.

Communicating is analogous to caring: A systematic review and thematic synthesis of the patient-clinician communication experiences of individuals with ovarian cancer

OBJECTIVE

To systematically review and synthesize the patient-clinician communication experiences of individuals with ovarian cancer.

METHODS

The CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science databases were reviewed for articles that described (a) original qualitative or mixed methods research, (b) the experiences of individuals with ovarian cancer, and (c) findings related to patient-clinician communication. Relevant data were extracted from study results sections, then coded for descriptive and analytical themes in accordance with Thomas and Harden's approach to thematic synthesis. Data were coded by two authors and discrepancies were resolved through discussion.

RESULTS

Of 1,390 unique articles, 65 met criteria for inclusion. Four descriptive themes captured participants' experiences communicating with clinicians: respecting me, seeing me, supporting me, and advocating for myself. Findings were synthesized into three analytical themes: communication is analogous to caring, communication is essential to personalized care, and communication may mitigate or exacerbate the burden of illness.

SIGNIFICANCE OF RESULTS

Patient-clinician communication is a process by which individuals with ovarian cancer may engage in self-advocacy and appraise the extent to which they are seen, respected, and supported by clinicians. Strategies to enhance patient-clinician communication in the ovarian cancer care setting may promote patient perceptions of patient-centered care.

Dietary practices after primary treatment for ovarian cancer: A qualitative analysis from the OPAL Study

BACKGROUND

Little is known about dietary practices of women who have completed primary treatment for ovarian cancer, many of whom will go on to experience cancer recurrence and have further treatment. Knowledge of dietary practices is needed to optimize care.

OBJECTIVE

To identify dietary practices after primary treatment for ovarian cancer and evaluate how these practices differ by disease recurrence and treatment status.

DESIGN

Women with invasive epithelial ovarian cancer were provided with an open-ended question after completing a food frequency questionnaire (FFQ): "Is there anything we haven't asked you about your diet in the last 1-2 months that you feel is important?"

PARTICIPANTS/SETTING

Participants in the Ovarian cancer Prognosis And Lifestyle (OPAL) Study in Australia.

MAIN OUTCOMES

Dietary practices after primary treatment for ovarian cancer and factors affecting these practices.

ANALYSIS

Participants' responses were analyzed using content analysis. Individual content codes were categorized and reported by recurrence and treatment status at questionnaire completion.

RESULTS

286 women provided responses on 363 questionnaires. Those undergoing further treatment for recurrence commonly reported dietary regimens with clinical indications (e.g., low fiber to avoid bowel obstructions, high energy/protein to minimize nutritional deficits). Those not undergoing further treatment frequently reported 'popular' diets (e.g., organic, plant-based, alkaline). For women with cancer recurrence, dietary practices were affected by poor appetite and treatment late effects. For women without recurrence, other comorbidities, geographical location, family and friends appeared to influence dietary practices. In both groups, nutrition information sources and personal beliefs informed dietary practices. Participant responses that referenced media or online sources often included misinformation.

CONCLUSIONS

Following primary treatment for ovarian cancer, women report dietary practices that may not be captured in standard FFQs. Dietary practices and factors affecting these practices likely differ by treatment and recurrence status. Improved access to evidence-based dietary information and support is needed.

Exploring perceived risk for COVID-19 and its role in protective behavior and COVID-19 vaccine hesitancy: a qualitative study after the first wave

Background

The novel coronavirus pandemic (COVID-19) has had severe impacts on morbidity and mortality globally.

Methods

This study was set in rural central Kentucky and included participants recruited from public spaces. Fifteen qualitative interviews about personal experiences during the COVID-19 pandemic were conducted by phone from July 3 to July 24, 2020. Interviews were recorded, transcribed, and coded using a grounded theory approach.

Results

Participants who perceived COVID-19 to be a severe risk tended to have personal health concerns and therefore reported taking protective measures for themselves. A slightly smaller proportion of participants reported taking measures to protect others (particularly family). A minority of participants had an ambivalent attitude towards the risk and only took measures if required. COVID-19 vaccine acceptability was low with most participants expressing concerns regarding their need for a vaccine, safety of this vaccine, the value of personal rights, or future vaccine supply.

Conclusions

Most participants perceived some risk of COVID-19 and took steps to prevent infections in themselves and others. Mandates for mask use in certain locations were additionally useful for those who had an ambivalent attitude towards the risk of illness. There was surprisingly little connection between perceiving COVID-19 risk and a desire for the COVID-19 vaccine. In this setting, vaccine acceptability was low, with vaccine concerns outweighing perceived potential benefits. In conclusion, because the risk was often constructed in terms of worries for themselves and others, the framing of health education materials for protective behaviors in these terms may be effective. Furthermore, future COVID-19 vaccine education should address vaccine knowledge and concerns, such as the need for a vaccine and its safety, and emphasize how a vaccination would reduce their chances of severe disease if they were to get sick.

Circ_0067934 reduces JNK phosphorylation through a microRNA-545-3p/PPA1 axis to enhance tumorigenesis and cisplatin resistance in ovarian cancer

BACKGROUND

Circular RNA 0067934 (circ_0067934) has been revealed as a cancer driver in multiple human malignancies, whereas its action in the pathogenesis of ovarian cancer (OC) remains unclear. This study focuses on the function of circ_0067934 in tumorigenesis and cisplatin (DDP) resistance in OC and the molecular mechanism.

METHODS

Expression of circ_0067934 in OC tissues and cells was examined, and its correlation with the clinical characteristics of patients was analyzed. Candidate targets of circ_0067934 were predicted using bioinformatics systems. Binding relationships between circ_0067934 and microRNA (miR)-545-3p and between miR-545-3p and inorganic pyrophosphatase 1 (PPA1) were validated via luciferase assays. Gain- and loss-of functions of circ_0067934, miR-545-3p and PPA1 were performed to determine their functions in proliferation, invasion, apoptosis and DDP resistance of OC cells in vitro and in vivo.

RESULTS

Circ_0067934 was overexpressed in OC samples and associated with advanced tumor staging and lymph node metastasis. Downregulation of circ_0067934 reduced DDP resistance of the DDP-resistant A2780/DDP cell line and reduced cell proliferation and invasion, but the malignant behaviors of OC cells were restored after further miR-545-3p downregulation. Circ_0067934 served as a sponge for miR-545-3p and diminished its suppressive effect on PPA1 translation. Artificial upregulation of PPA1 enhanced proliferation, invasion and DDP resistance of A2780/DDP cells, and it reduced phosphorylation of the pro-apoptotic JNK signaling. Similar results were found in vivo.

CONCLUSION

This study suggests that circ_0067934 sequesters miR-545-3p and enhances PPA1 expression to promote tumorigenesis and DDP resistance in OC. This study may provide novel approaches in the management of OC.

Attributions of survival and methods of coping of long-term ovarian cancer survivors: a qualitative study

Background

Only 8–23% of advanced epithelial ovarian cancer patients survive for 10 years or longer. Given the need for targeted interventions to improve survival, we interviewed this relatively rare survivor population to gain personalized insights into the reasons for their survival. The aim of this study was to characterize subjective attributions of survival and specific coping mechanisms long-term survivors of ovarian cancer.

Methods

Twenty-two semi-structured, qualitative interviews assessing survival attributions and coping strategies were conducted from April to November 2014. Data were analyzed in a multistep process using ATLAS.ti.8: codes were identified during review of the transcripts and refined with literature review; the frequency of codes and code co-occurrence was calculated, and codes were grouped into themes. Resulting themes were checked by a national leader of an ovarian cancer advocacy organization and compared against available literature.

Results

Thematic analysis found that participants credited their long-term survival to a variety of factors including medical, social, religious/spiritual, and lifestyle/personal characteristics. Some participants rejected these same attributions, concluding that the reason for survival was due to luck or unknowable. Several of Carver et al.’s theoretical dimensions of coping were evident in our sample: planning, positive reinterpretation, social support, religion and acceptance whereas three relatively new strategies were uncovered: conserving emotional energy, value-based activity coping, and self-care.

Conclusions

Long-term survivors’ perspectives were largely consistent with those of newly diagnosed ovarian cancer patients and ovarian cancer survivors of shorter duration. However, the long-term survivors were also willing to reject conventional attributions for survival and recognized the importance of disciplined self-preservational coping strategies.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-021-01476-1.

Neuroimmunology of cancer and associated symptomology

Evolutionarily the nervous system and immune cells have evolved to communicate with each other to control inflammation and host responses against injury. Recent findings in neuroimmune communication demonstrate that these mechanisms extend to cancer initiation and progression. Lymphoid structures and tumors, which are often associated with inflammatory infiltrate, are highly innervated by multiple nerve types (e.g. sympathetic, parasympathetic, sensory). Recent preclinical and clinical studies demonstrate that targeting the nervous system could be a therapeutic strategy to promote anti-tumor immunity while simultaneously reducing cancer-associated neurological symptoms, such as chronic pain, fatigue, and cognitive impairment. Sympathetic nerve activity is associated with physiological or psychological stress, which can be induced by tumor development and cancer diagnosis. Targeting the stress response through suppression of sympathetic activity or activation of parasympathetic activity has been shown to drive activation of effector T cells and inhibition of myeloid derived suppressor cells within the tumor. Additionally, there is emerging evidence that sensory nerves may regulate tumor growth and metastasis by promoting or inhibiting immunosuppression in a tumor-type specific manner. Since neural effects are often tumor-type specific, further study is required to optimize clinical therapeutic strategies. This review examines the emerging evidence that neuroimmune communication can regulate anti-tumor immunity as well as contribute to development of cancer-related neurological symptoms.

Canadian Resources, Programs, and Models of Care to Support Cancer Survivors' Transition beyond Treatment: A Scoping Review

(1) Background: One in two Canadians will be diagnosed with cancer in their lifetime, but as a result of the progress in diagnosis and treatment, more individuals are surviving cancer than ever before. However, the impact of cancer does not end with treatment. The objectives of this review are to (1) provide a broad overview of the supportive care interventions and models of care that have been researched to support Canadian post-treatment cancer survivors; and (2) analyze how these supportive care interventions and/or care models align with the practice recommendations put forth by Cancer Care Ontario (CCO) and the Canadian Association of Psychosocial Oncology/Canadian Partnership Against Cancer (CAPO/CPAC). (2) Methods: An electronic search was completed in MEDLINE, Embase, PsycINFO, and CINAHL in January 2021. Included studies described supportive care interventions or models of care utilized by adult Canadian cancer survivors. (3) Results: Forty-two articles were included. Survivors utilized a multitude of supportive care interventions, with peer support and physical activity programs being most frequently cited. Four models of follow-up care were identified: primary care, oncology care, shared-care, and transition clinics. The supportive care interventions and models of care variably aligned with the recommendations set by CCO and CAPO/CPAC. The most commonly followed recommendation was the promotion of self-management and quality resources for patients. (4) Conclusions: Results indicate an inconsistency in access to supportive care interventions and the delivery of survivorship care for cancer survivors across Canada. Current efforts are being made to implement the recommendations by CCO and CAPO/CPAC; however, provision of these guidelines remains varied.

E74-like factor 3 suppresses microRNA-485-5p transcription to trigger growth and metastasis of ovarian cancer cells with the involvement of CLDN4/Wnt/β-catenin axis

Ovarian cancer (OC) is one of the most prevailing gynecological malignancies with high mortality rate, while E74 like ETS transcription factor 3 (ELF3) is reported to be associated with tumorigenesis. This work aims to analyze the role of ELF3 on the suppression of miR-485-5p transcription in OC. Expression of ELF3 in OC and its correlation with overall survival were predicted on a bioinformation system GEPIA. Then, the level of ELF3 in OC tissues and cells and in normal ones was evaluated. Binding relationships between ELF3 and microRNA (miR)-485-5p, and between miR-485-5p and claudin-4 (CLND4) were predicted through Bioinformatics tools. Altered expression of ELF3, miR-485-5p and CLND4 was introduced alone or jointly to probe their influences on OC cell growth. ELF3 was suggested to be highly expressed in OC, which was linked to poor prognosis in patients. Abundant expression of ELF3 was identified in OC tissues and cell lines as relative to the normal ones. ELF3 inhibition suppressed growth and metastasis of OC cells. ELF3 transcriptionally suppressed miR-485-5p expression to further enhance CLDN4 expression. Overexpression of miR-485-5p led to similar trends as ELF3 inhibition did. Importantly, upregulation of CLDN4 was found to block the roles of ELF3 inhibition in OC cells. In addition, the Wnt/signaling pathway suppressed by miR-485-5p mimic was reactivated following CLDN4 overexpression. This study evidenced that ELF3 suppresses miR-485-5p transcription to enhance CLDN4 expression, leading to Wnt/β-catenin activation and promoting OC cell growth and metastasis. This work may provide new ideas for gene-based therapies for OC.

Effectiveness of Complementary Therapies in Cancer Patients: A Systematic Review

According to the World Health Organization, cancer is the second leading cause of death in the world. In Spain, about a quarter of a million cases were diagnosed in 2017, and 81% of the Spanish population has used, at least once, some kind of complementary therapy. Said therapies are increasingly being used by cancer patients. The purpose of the study is to analyse the effectiveness of complementary therapies among cancer patients. A systematic peer review was conducted following the PRISMA-ScR guide in four databases (PubMed, CINAHL, Scopus and WOS). The inclusion criteria were Randomised Clinical Trials, published between 2013 and 2018, with a value of 3 or more on the Jadad Scale. The protocol was registered in PROSPERO (CRD42019127593). The study sample amounted to 1845 patients (64.55% women), the most common being breast cancer patients (794), followed by lung cancer patients (341). Fifteen complementary therapies were identified. We found two studies for each of the following: electroacupuncture, phytotherapy, hypnotherapy, guided imagery and progressive muscle relaxation. From the remaining ones, we identified a study on each therapy. The findings reveal some effective complementary therapies: auriculotherapy and acupuncture, laser moxibustion, hypnosis, Ayurveda, electroacupuncture, progressive muscle relaxation and guided imagery, yoga, phytotherapy, music therapy and traditional Chinese medicine. On the other hand, electroacupuncture, laser moxibustion and traditional Chinese medicine presented adverse effects, and kinesiology did not show effectiveness.

Correlation between an integrative oncology treatment program and survival in patients with advanced gynecological cancer

OBJECTIVE

Integrative oncology (IO) is increasingly becoming part of palliative cancer care. This study examined the correlation between an IO treatment program and rates of survival among patients with advanced gynecological cancer.

METHODS

Patients were referred by their oncology healthcare professionals to an integrative physician (IP) for consultation and IO treatments. Those undergoing at least 4 treatments during the 6 weeks following the consultation were considered adherence to the integrative care program (AIC), versus non-adherent (non-AIC). Survival was monitored for a period of 3 years, comparing the AIC vs. non-AIC groups, as well as controls who did not attend the IP consultation.

RESULTS

A total of 189 patients were included: 71 in the AIC group, 44 non-AIC, and 74 controls. Overall 3-year survival was greater in the AIC group (vs. non-AIC, p = 0.012; vs. controls, p = 0.003), with no difference found between non-AIC and controls (p = 0.954). Multimodal IO programs (≥ 3 modalities) were correlated in the AIC group with greater overall 3-year survival (p = 0.027). Greater rates of survival were also found in the AIC group at 12 (p = 0.004) and 18 months (p = 0.001). When compared with the AIC group, a multivariate analysis found higher crude and adjusted hazard ratios for 3-year mortality in the non-AIC group (HR 95% CI 2.18 (1.2-3.9), p = 0.010) and controls (2.23 (1.35-3.7), p = 0.002).

CONCLUSION

Adherence to an IO treatment program was associated with higher survival rates among patients with advanced gynecological cancer. Larger prospective trials are needed to explore whether the IO setting enhances patients' resilience, coping, and adherence to oncology treatment.

A qualitative study of life satisfaction after surgery for adult traumatic brachial plexus injury

Aims

Brachial plexus injury (BPI) is an often devastating injury that affects patients physically and emotionally. The vast majority of the published literature is based on surgeon-graded assessment of motor outcomes, but the patient experience after BPI is not well understood. Our aim was to better understand overall life satisfaction after BPI, with the goal of identifying areas that can be addressed in future delivery of care.

Methods

We conducted semi-structured interviews with 15 BPI patients after initial nerve reconstruction. The interview guide was focused on the patient’s experience after BPI, beginning with the injury itself and extending beyond surgical reconstruction. Inductive and deductive thematic analysis was used according to standard qualitative methodology to better understand overall life satisfaction after BPI, contributors to life satisfaction, and opportunities for improvement.

Results

Among the 15 patients interviewed, the following themes emerged: 1) happiness and life satisfaction were noted despite limitations in physical function; 2) quality of social support influences life satisfaction during recovery from BPI; and 3) social participation and having a sense of purpose impact life satisfaction during recovery from BPI.

Conclusion

How patients perceive their BPI treatment and recovery varies widely, and is not directly linked to their self-reported functional outcome. Patients with stronger social circles and activities that give them a sense of fulfillment were more likely to be satisfied with their current status. Evaluating a patient’s social network, goals, and potential supportive adaptations early in the treatment timeline through coordinated multidisciplinary care may improve overall satisfaction during recovery from BPI.

Cite this article: Bone Joint Open 2020;2(1):9–15.

Needs, preferences, and experiences of adult cancer survivors in accessing dietary information post-treatment: A scoping review

INTRODUCTION

To support provision of healthy lifestyle information tailored to patients' needs and preferences, this review maps adult cancer survivors' self-reported needs, preferences, and experiences accessing dietary information post-treatment.

METHODS

A scoping review of research published within the past decade conducted using PRISMA-ScR guidelines. Seven databases were searched in June 2020.

RESULTS

Of 15,973 articles identified, 57 met eligibility criteria. Studies most frequently included survivors of breast cancer (49%), persons aged 40+ years (95%), ≤5 years post-diagnosis (54%), and residing in North America (44%). Cancer survivors commonly identified needing information regarding healthy eating, particularly practical skills, and support in changing dietary behaviours. Preferences included specific recommendations, direct communication with healthcare professionals, and peer support from other cancer survivors. In practice, survivors frequently reported receiving generic advice from healthcare professionals, limited dietary follow-up, and lack of referral to support. Unmet needs in healthcare settings led to dietary information-seeking elsewhere; however, survivors indicated difficulty identifying credible sources. Personal beliefs and desire for involvement in care motivated dietary information-seeking post-treatment.

CONCLUSION

Cancer survivors' experiences accessing dietary information post-treatment do not align with needs and preferences. Less is known about survivors who are young adults, >5 years post-diagnosis, and living in rural areas.

Role of lncRNAHCP5/microRNA-525-5p/PRC1 crosstalk in the malignant behaviors of ovarian cancer cells

PURPOSE

Owing to the late diagnosis and frequent metastasis, ovarian cancer (OC) exhibits a high mortality rate. The study was intended to figure out the function of long non-coding RNA (lncRNA) HCP5 in OC metastasis.

METHODS

Microarray analysis was conducted to probe aberrantly expressed lncRNAs in OC tissues. Artificial silencing of lncRNA HCP5 was introduced in OC cells to identify its role in cell viability, invasion, migration, and epithelial-mesenchymal transition (EMT). The potential downstream targets of lncRNA HCP5 were predicted by bio-information system and validated through dual luciferase reporter gene assays. Silencing of microRNA-525-5p (miR-525-5p) was introduced in cells to probe its role in cell behaviors. Xenograft tumors were induced in nude mice for in vivo experiments.

RESULTS

High expression of lncRNA HCP5 was found in OC tissues and cells. Silencing of lncRNA HCP5 led to a decrease in cell proliferation, invasion, migration and EMT process. LncRNA HCP5 is mainly sub-localized in cytoplasm. LncRNA HCP5 could act as a sponge for miR-525-5p, which could further bind to polycomb repressive complex 1 (PRC1). Knockdown of miR-525-5p partly recovered the biological behaviors of OC cells inhibited by HCP5 silencing. In addition, HCP5 promoted Wnt/β-catenin signaling pathway activity. Silencing of lncRNA HCP5 also impeded growth and metastasis of tumor in mice.

CONCLUSION

The study suggested that lncRNA HCP5 might promote malignant behaviors of OC cells through the miR-525-5p/PRC1 crosstalk and the Wnt/β-catenin pathway. Silencing of HCP5 might serve as a novel option for OC treatment.