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Heyda A, Księżniak-Baran D, Wygoda A, Składowski K. Low Post-Treatment Quality of Life and the High Incidence of Pain Are Common and Significantly Exacerbated in Depressed Head and Neck Patients Treated with Definitive Accelerated Radiotherapy. Cancers (Basel) 2023; 16:79. [PMID: 38201507 PMCID: PMC10777976 DOI: 10.3390/cancers16010079] [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: 09/26/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: The goal of this study is to evaluate psychological tolerance and health-related quality of life (QOL) in head and neck (HN) cancer patients treated with definitive accelerated radiotherapy (DART). (2) Methods: 76 recurrence-free patients eligible for the study, who were treated with DART in the CAIR-2 phase III clinical study (median of follow-up = 47 months), completed EORTC QLQ-C30 with the H&N35 module, Hospital Anxiety and Depression Scale (HADS) and Visual-Analog Scales (VAS) of pain in HN and the neck/arm areas. (3) Results: The most dominant symptoms measured with QLQ-C30 were as follows: fatigue (44/100), sleeplessness (39/100), financial problems (38/100) and pain (32/100). Within the H&N35, the highest scores were reported on the subscales of sticky saliva (60/100), mouth dryness (65/100) and increased intake of painkillers (50/100). Pain (VAS) was reported by 87% (HN area) and 78% (shoulder area) of the patients, with a mean score of 3/10. One-third of the patients reported depressive moods (HADS ≥ 15 points) with an average score of 12.5/42 p. The depressed group, who smoked more as compared to the non-depressed group before DART (96% vs. 78%) and required steroids treatment (85% vs. 58%) during DART, also scored significantly worse on 23 of the 35 subscales of QLQ-C30 and H&N35 and experienced more intense pain (VAS). Women and less-advanced patients scored better in several aspects of quality of life. (4) Conclusions: Patients treated with DART struggle with low quality of life and persistent treatment-related symptoms including constant pain. HNC survivors, especially those who are depressed, may require additional psychosocial, rehabilitation and medical intervention programmes.
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Affiliation(s)
- Alicja Heyda
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-102 Gliwice, Poland
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Manne SL, Hudson SV, Preacher KJ, Imanguli M, Pesanelli M, Frederick S, Singh N, Schaefer A, Van Cleave JH. Prevalence and correlates of fear of recurrence among oral and oropharyngeal cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01449-3. [PMID: 37584880 PMCID: PMC10921339 DOI: 10.1007/s11764-023-01449-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE Fear of recurrence (FoR) is a prevalent and difficult experience among cancer patients. Most research has focused on FoR among breast cancer patients, with less attention paid to characterizing levels and correlates of FoR among oral and oropharyngeal cancer survivors. The purpose was to characterize FoR with a measure assessing both global fears and the nature of specific worries as well as evaluate the role of sociodemographic and clinical factors, survivorship care transition practices, lifestyle factors, and depressive symptoms in FoR. METHODS Three hundred eighty-nine oral and oropharyngeal survivors recruited from two cancer registries completed a survey assessing demographics, cancer treatment, symptoms, alcohol and tobacco use, survivorship care practices, depression, and FoR. RESULTS Forty percent reported elevated global FoR, with similar percentages for death (46%) and health worries (40.3%). Younger, female survivors and survivors experiencing more physical and depressive symptoms reported more global fears and specific fears about the impact of recurrence on roles, health, and identity, and fears about death. Depression accounted for a large percent of the variance. Lower income was associated with more role and identity/sexuality worries, and financial hardship was associated with more role worries. CONCLUSIONS FoR is a relatively common experience for oral and oropharyngeal cancer survivors. Many of its correlates are modifiable factors that could be addressed with multifocal, tailored survivorship care interventions. IMPLICATIONS FOR CANCER SURVIVORS Assessing and addressing depressive symptoms, financial concerns, expected physical symptoms in the first several years of survivorship may impact FoR among oral and oropharyngeal cancer survivors.
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Affiliation(s)
- Sharon L Manne
- Rutgers Cancer Institute of New Jersey, 120 Albany St, 8th Floor, New Brunswick, NJ, 08901, USA.
| | - Shawna V Hudson
- Institute for Health, Health Care Policy and Aging Research, Robert Wood Johnson Medical School, 112 Paterson St, New Brunswick, NJ, 08901, USA
| | - Kristopher J Preacher
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Matin Imanguli
- Rutgers Cancer Institute of New Jersey, 120 Albany St, 8th Floor, New Brunswick, NJ, 08901, USA
- Department of Otolaryngology-Head and Neck Surgery, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Morgan Pesanelli
- Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
| | - Sara Frederick
- Rutgers Cancer Institute of New Jersey, 120 Albany St, 8th Floor, New Brunswick, NJ, 08901, USA
| | - Neetu Singh
- Rutgers Cancer Institute of New Jersey, 120 Albany St, 8th Floor, New Brunswick, NJ, 08901, USA
| | - Alexis Schaefer
- Rutgers Cancer Institute of New Jersey, 120 Albany St, 8th Floor, New Brunswick, NJ, 08901, USA
| | - Janet H Van Cleave
- NYU Rory Meyers College of Nursing, 433 First Avenue, New York, NY, 10010, USA
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Singh AK, J F N, Sharma NK, Anandkumar J, Mishra N, Pandey A. Bipaddled Pectoralis Major Myocutaneous Flap in Complex Oral Cancer Defects- A Single Center Experience with Quality of Life Assessment. Indian J Otolaryngol Head Neck Surg 2023; 75:641-648. [PMID: 37274991 PMCID: PMC10235259 DOI: 10.1007/s12070-022-03324-6] [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: 03/05/2021] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Advanced stage malignancies of oral cavity commonly result in complex full thickness defects with subsequent functional and aesthetic loss. Through this article we describe our center's experience in reconstruction of such defects with bipaddled pectoralis myocutaneous (PMMC) flap through an immediate, single-staged procedure. Materials And Methods The study included a total of 54 patients who underwent composite resection and neck dissection followed by reconstruction of the defect with bipaddled PMMC flap. All patients were followed up post-operatively for 1 year and were monitored for flap and donor site related complications. Using University of Washington Quality of life v4 questionnaire (UW-QOL4), we assessed the QOL of 54 patients. The mean scores were compared to other similar studies. Results: The overall complication rate was 66.6%, whereas, 33.3% patients had no complications. The most common complication was wound dehiscence seen in 31.5% of cases in the recipient site and 12.9% in the donor site. Other complications were seroma, hematoma, plate exposure, orocutaneous fistula etc. Around 73.7% patients reported a good, very good or outstanding overall quality of life in the post-operative period. The mean composite QOL score was 65.84. Our study showed comparable domains of pain, appearance, activity, recreation, swallowing, chewing, speech, shoulder function and taste with other similar studies. Conclusion: Bipaddled PMMC flap proves to be a considerable alternative for microvascular free flaps in reconstruction of full-thickness defects of oral cavity owing to its reliable blood supply, accessibility, easier harvesting technique, cost effectiveness, high success rate and acceptable quality of life. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03324-6.
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Affiliation(s)
- Akhilesh Kumar Singh
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
| | - Neville J F
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
| | - Naresh Kumar Sharma
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
| | - Janani Anandkumar
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
| | - Nitesh Mishra
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
| | - Arun Pandey
- Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P India
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4
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Quan L, Wang X, Lu W, Zhao X, Sun J, Sang Q. The relationship between fear of recurrence and depression in patients with cancer: The role of invasive rumination and catastrophizing. Front Psychiatry 2022; 13:920315. [PMID: 36203832 PMCID: PMC9530246 DOI: 10.3389/fpsyt.2022.920315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To examine the relationship between fear of recurrence and depression in patients with cancer. Materials and methods Two hundred and fifty-nine participants completed self-report questionnaires, including the Fear of Progression Questionnaire-Short Form, Rumination Inventory, Cognitive Emotion Regulation Questionnaire (Chinese version), and Center for Epidemiological Studies Depression Scale. Results Fear of recurrence in patients with cancer was moderate, and the level of depression was significantly higher than that in the normal population. Fear of recurrence, invasive rumination, catastrophizing, and depression in patients with cancer were significantly positively correlated. The level of fear of recurrence was a significant positive predictor of the level of depression. Invasive rumination played a partial mediating role between fear of recurrence and depression; that is, fear of recurrence directly affected depression, and fear of recurrence indirectly affected depression through invasive rumination. Catastrophizing played a moderating role in the mediation model, in which fear of recurrence affected depression through invasive rumination. Conclusion Invasive rumination plays a mediating role between fear of recurrence and depression in patients with cancer. Catastrophizing moderates the relationship between fear of recurrence and depression as well as the relationship between invasive rumination and depression.
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Affiliation(s)
- Lijuan Quan
- School of Educational Science, Anhui Normal University, Wuhu, Anhui, China
| | - Xinxin Wang
- School of Educational Science, Anhui Normal University, Wuhu, Anhui, China
- Foreign Language School of Ma'anshan No. 2 Middle School, Ma'anshan, China
| | - Wei Lu
- School of Educational Science, Anhui Normal University, Wuhu, Anhui, China
| | - Xintong Zhao
- School of Educational Science, Anhui Normal University, Wuhu, Anhui, China
| | - Jialei Sun
- School of Educational Science, Anhui Normal University, Wuhu, Anhui, China
| | - Qingsong Sang
- School of Educational Science, Anhui Normal University, Wuhu, Anhui, China
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Riggauer J, Blaser D, Elicin O, Gahl B, Giger R, Mueller SA. Risk Factors for Fear of Recurrence in Head and Neck Cancer Patients. Laryngoscope 2022. [DOI: 10.1002/lary.30340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/06/2022] [Accepted: 07/26/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Julia Riggauer
- Inselspital Head and Neck Anticancer Center Bern University Hospital Bern Switzerland
- Department of ENT, Head and Neck Surgery, Inselspital Bern University Hospital, University of Bern Bern Switzerland
| | - Daniela Blaser
- Inselspital Head and Neck Anticancer Center Bern University Hospital Bern Switzerland
- Department of ENT, Head and Neck Surgery, Inselspital Bern University Hospital, University of Bern Bern Switzerland
| | - Olgun Elicin
- Inselspital Head and Neck Anticancer Center Bern University Hospital Bern Switzerland
- Department of Radiation Oncology, Inselspital Bern University Hospital Bern Switzerland
| | - Brigitta Gahl
- Clinical Trials Unit University of Bern Bern Switzerland
| | - Roland Giger
- Inselspital Head and Neck Anticancer Center Bern University Hospital Bern Switzerland
- Department of ENT, Head and Neck Surgery, Inselspital Bern University Hospital, University of Bern Bern Switzerland
| | - Simon Andreas Mueller
- Inselspital Head and Neck Anticancer Center Bern University Hospital Bern Switzerland
- Department of ENT, Head and Neck Surgery, Inselspital Bern University Hospital, University of Bern Bern Switzerland
- Department of Otolaryngology, Head & Neck Surgery University Hospital Zurich, University of Zurich Zurich Switzerland
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Nik Jaafar NR, Abd Hamid N, Hamdan NA, Rajandram RK, Mahadevan R, Mohamad Yunus MR, Zakaria H, Mohd Shariff N, Hami R, Isa S, Shari NI, Leong Bin Abdullah MFI. Posttraumatic Growth, Positive Psychology, Perceived Spousal Support, and Psychological Complications in Head and Neck Cancer: Evaluating Their Association in a Longitudinal Study. Front Psychol 2022; 13:920691. [PMID: 35814154 PMCID: PMC9266623 DOI: 10.3389/fpsyg.2022.920691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
Despite head and neck cancer (HNC) association with various negative impacts, collective evidence is accumulating regarding the positive impacts of positive psychology on cancer survivors. However, data on how positive psychology is related to the psychological complications of HNC across time are lacking. This longitudinal study examined the trends of positive psychology (e.g., posttraumatic growth [PTG], hope, and optimism), perceived spousal support, and psychological complications (e.g., depression, anxiety, and posttraumatic stress symptoms) and determined the association between them, psychological complications, and PTG across two timelines among a cohort of HNC patients. A total of 175 HNC respondents exhibited an increasing trend of positive psychology and perceived spousal support while reporting a decreasing trend of psychological complications between baseline and follow-up assessments. A greater degree of hope and perceived spousal support contributed to a higher degree of PTG across time. Conversely, a higher severity of anxiety symptoms was associated with a lower degree of PTG over time. Female gender had a moderating effect on the association between severity of anxiety symptoms and PTG, but did not moderate the association between hope, perceived spousal support and PTG. This study indicates the pivotal role of incorporating psychosocial interventions into the treatment regimen to enhance the degree of hope and perceived spousal support and reduce the severity of anxiety symptoms, which, in turn, will facilitate the development of PTG in HNC patients.
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Affiliation(s)
- Nik Ruzyanei Nik Jaafar
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Norhaliza Abd Hamid
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Nur Amirah Hamdan
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Rama Krsna Rajandram
- Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Raynuha Mahadevan
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Mohd Razif Mohamad Yunus
- Department of Otorhinolaryngology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hazli Zakaria
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Noorsuzana Mohd Shariff
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Rohayu Hami
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Salbiah Isa
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
| | - Nurul Izzah Shari
- School of Human Resource Development and Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Skudai, Malaysia
- *Correspondence: Nurul Izzah Shari
| | - Mohammad Farris Iman Leong Bin Abdullah
- Department of Community Health, Advance Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Malaysia
- Mohammad Farris Iman Leong Bin Abdullah
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7
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Deuning‐Smit E, Custers JAE, Miroševič Š, Takes RP, Jansen F, Langendijk JA, Terhaard CHJ, Baatenburg de Jong RJ, Leemans CR, Smit JH, Kwakkenbos L, Verdonck‐de Leeuw IM, Prins JB. Prospective longitudinal study on fear of cancer recurrence in patients newly diagnosed with head and neck cancer: Course, trajectories, and associated factors. Head Neck 2022; 44:914-925. [PMID: 35084079 PMCID: PMC9305148 DOI: 10.1002/hed.26985] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/06/2021] [Accepted: 01/12/2022] [Indexed: 01/08/2023] Open
Abstract
Background This study assessed the course of fear of cancer recurrence (FCR) in patients newly diagnosed with head and neck cancer (HNC), identified FCR trajectories and factors associated with FCR trajectories. Methods Six hundred and seventeen HNC patients from the NET‐QUBIC cohort study completed the Cancer Worry Scale‐6 at diagnosis, 3 and 6 months post‐treatment. FCR trajectories were identified using Latent Class Growth Analysis. Associations were explored between FCR trajectories and baseline demographic and medical variables, coping and self‐efficacy. Results Overall, FCR decreased slightly between baseline and 3 months post‐treatment and remained stable up to 6 months. Two FCR trajectories were identified: “high stable” (n = 125) and “low declining” (n = 492). Patients with high stable FCR were younger, reported more negative adjustment, passive coping, and reassuring thoughts, and less avoidance. Conclusions The majority of HNC patients have low declining FCR after diagnosis, but one in five patients experience persistent high FCR up to 6 months post‐treatment.
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Affiliation(s)
- Esther Deuning‐Smit
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
| | - José A. E. Custers
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
| | - Špela Miroševič
- Department of Family Medicine Faculty of Medicine, University of Ljubljana Ljubljana Slovenia
| | - Robert P. Takes
- Department of Otorhinolaryngology—Head and Neck Surgery Radboud University Medical Center Nijmegen The Netherlands
| | - Femke Jansen
- Department of Otolaryngology—Head and Neck Surgery Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Department of Clinical, Neuro and Development Psychology Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Johannes A. Langendijk
- Department of Radiation Oncology University Medical Center Groningen, University of Groningen Groningen The Netherlands
| | | | - Robert J. Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery Erasmus Cancer Institute, ErasmusMC Rotterdam The Netherlands
| | - C. René Leemans
- Department of Otolaryngology—Head and Neck Surgery Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Johannes H. Smit
- Department of Psychiatry Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Linda Kwakkenbos
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
- Clinical Psychology, Behavioural Science Institute Radboud University Nijmegen The Netherlands
| | - Irma M. Verdonck‐de Leeuw
- Department of Otolaryngology—Head and Neck Surgery Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Department of Clinical, Neuro and Development Psychology Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Judith B. Prins
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
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Pradhan P, Sharpe L, Menzies RE. Towards a Stepped Care Model for Managing Fear of Cancer Recurrence or Progression in Cancer Survivors. Cancer Manag Res 2021; 13:8953-8965. [PMID: 34880676 PMCID: PMC8645945 DOI: 10.2147/cmar.s294114] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/07/2021] [Indexed: 01/08/2023] Open
Abstract
Background Fear of cancer recurrence or progression (FCR) is common amongst cancer survivors and an important minority develop clinically significant levels of FCR. However, it is unclear how current clinical services might best support the growing numbers of cancer survivors. Purpose The aim of this study is to develop recommendations for future research in the management of FCR and propose a model of care to help manage FCR in the growing population of cancer survivors. Methods This is a narrative review and synthesis of empirical research relevant to managing FCR. We reviewed meta-analyses, systematic reviews and individual studies that had investigated interventions for FCR. Results A recent, well-conducted meta-analysis confirmed a range of moderately effective treatments for FCR. However, many survivors continued to experience clinical levels of FCR after treatment, indicating a clear need to improve the gold standard treatments. Accessibility of interventions is arguably a greater concern. The majority of FCR treatments require face-to-face therapy, with highly skilled psycho-oncologists to produce moderate changes in FCR. With increasing numbers of cancer survivors, we need to consider how to meet the unmet need of cancer survivors in relation to FCR. Although there have been attempts to develop minimal interventions, these are not yet sufficiently well supported to warrant implementation. Attempts to help clinicians to provide information which might prevent the development of clinically significant FCR have shown some early promise, but research is needed to confirm efficacy. Conclusion The next decade of research needs to focus on developing preventative approaches for FCR, and minimal interventions for those with mild-to-moderate symptoms. When evidence-based approaches to prevent FCR or manage moderate levels of FCR are available, stepped care approaches that could meet the needs of survivors could be implemented. However, we also need to improve existing interventions for severe FCR.
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Affiliation(s)
- Poorva Pradhan
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Rachel E Menzies
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, 2006, Australia
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Beghean R, Coffey L. "You either sink or you swim, and you're better off swimming": A qualitative study exploring the self-management experiences of soft tissue sarcoma survivors. Eur J Oncol Nurs 2021; 55:102062. [PMID: 34775165 DOI: 10.1016/j.ejon.2021.102062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/02/2021] [Accepted: 11/03/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE To qualitatively explore the consequences of soft tissue sarcoma and its treatment experienced by survivors, the self-management strategies they use to deal with these consequences, and any factors that may act as barriers or facilitators to their self-management. METHODS Semi-structured interviews were conducted with seven soft tissue sarcoma survivors who had completed their primary treatment. Interviews were audio-recorded, transcribed and thematically analysed. RESULTS Physical, psychological and social consequences of soft tissue sarcoma and its treatment were identified, with side-effects, physical restrictions, body image issues, fear of recurrence, feeling depressed, familial relationships and sexual activity being the most frequently reported. Nine different types of self-management strategy encompassing eighteen specific strategies were identified, including cognitive strategies, lifestyle changes and utilisation of resources. Personal, social and environmental facilitators of self-management were identified; being in a relationship, being at an appropriate life stage, and having support from family, friends and medical staff were most commonly reported. Finally, personal and environmental barriers to self-management included the adaptation period, ongoing complications, rareness of sarcoma and poor patient-healthcare provider communication. CONCLUSIONS The findings of this study suggest that soft tissue sarcoma survivors, especially those who are younger and experience physical limitations, may find the immediate post-treatment period particularly challenging and may benefit from nurse-led self-management support.
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Affiliation(s)
- Rahela Beghean
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland
| | - Laura Coffey
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland.
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10
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Pradhan P, Sharpe L, Butow PN, Smith AB, Russell H. Is a Brief Online Booklet Sufficient to Reduce Fear of Cancer Recurrence or Progression in Women With Ovarian Cancer? Front Psychol 2021; 12:634136. [PMID: 33716902 PMCID: PMC7947198 DOI: 10.3389/fpsyg.2021.634136] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/03/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Fear of cancer recurrence or progression (FCR/P) is a common challenge experienced by people living with and beyond cancer and is frequently endorsed as the highest unmet psychosocial need amongst survivors. This has prompted many cancer organizations to develop self-help resources for survivors to better manage these fears through psychoeducation, but little is known about whether they help reduce FCR/P. Method: We recruited 62 women with ovarian cancer. Women reported on their medical history and demographic characteristics and completed the Fear of Progression Questionnaire-Short Form (FoP-Q-SF). They then read a booklet on FCR specifically created for Ovarian Cancer Australia by two of the authors (ABS and PB). One week after reading the booklet, 50/62 women (81%) completed the FoP-Q-SF and answered questions about their satisfaction with the booklet. Results: More than half of the women (35/62; 56.5%) scored in the clinical range for FCR/P at baseline. Of the completers, 93% said that they would recommend the booklet to other women. Satisfaction with the booklet was relatively high (75.3/100) and more than two-thirds of women rated it as moderately helpful or better. However, FCR/P did not change significantly over the week following reading the booklet [t(49) = 1.71, p = 0.09]. There was also no difference in change in FCR/P between women in the clinical vs. non-clinical range on the FoP-Q. Women high in FCR/P rated the booklet as less helpful in managing FCR/P (r = −0.316, p = 0.03), but overall satisfaction with the booklet was not associated with degree of FCR/P (r = −0.24, p = 0.10). Conclusions: These results suggest that a simple online FCR booklet is acceptable to women with ovarian cancer and they are satisfied with the booklet, but, it was insufficient to change in FCR/P levels. These results suggest that such resources are valued by women with ovarian cancer, but more potent interventions are necessary to reduce FCR in this population.
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Affiliation(s)
- Poorva Pradhan
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Louise Sharpe
- 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
| | - Allan Ben Smith
- Centre for Oncology Education and Research Translation, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Kensington, NSW, Australia
| | - Hayley Russell
- Ovarian Cancer Australia, Queen Victoria Women's Centre, Melbourne, VIC, Australia
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11
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Pang C, Humphris G. The Relationship Between Fears of Cancer Recurrence and Patient Gender: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:640866. [PMID: 33692731 PMCID: PMC7937637 DOI: 10.3389/fpsyg.2021.640866] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 01/29/2021] [Indexed: 12/11/2022] Open
Abstract
Background: A significant concern for patients treated for cancer is fear of cancer recurrence (FCR). Although a common experience, some patients report high levels of FCR that are difficult to manage and result in over vigilant checking and high use of health services. There has been speculation about the relationship of FCR with gender with mixed reports from several systematic reviews. Aims: To determine the association of FCR with gender in previous reported studies and investigate the strength of this relationship with various moderators including year of publication, type of cancer and measurement attributes of self-reported FCR instruments. Methods: A systematic review was conducted with searches of the literature from the MEDLINE, PubMed, Embase, and PsycINFO databases following PRISMA guidelines. All the included papers were divided into two groups, namely: “pure” that comprise only of patients with cancer types that both men and women can contract and “mixed” that report on patients with a variety of cancer types. The association between gender and FCR level was assessed by meta-analysis. A meta-regression was performed to investigate the moderating effects of factors including: the year of publication, cancer type, mean age of the sample and the length of the FCR scale measurement. This review was registered with PROSPERO, ID: CRD42020184812. Results: Finally, 29 studies were included. The N size of pooled participants was 33,339. The meta-analysis showed females to have an overall higher level of FCR than males (ES = 0.30; 95% CI, 0.23, 0.36). The meta-regression of moderating or control variables found little, if any, systematic variation in effect-sizes. Conclusion: This systematic review has clarified a potentially confused pattern of previous results in understanding the relationship between gender and FCR. Women report higher levels of FCR than men and this feature is one that clinicians and researchers can factor into their practice and future studies. The effect size is moderate, hence there is ample variation in FCR level, independent of gender, that requires further investigation.
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Affiliation(s)
- Chuan Pang
- Department of General Surgery, Chinese PLA General Hospital First Medical Center, Beijing, China.,Division of Population and Behavioural Sciences, Medical School, University of St Andrews, St Andrews, United Kingdom
| | - Gerry Humphris
- Division of Population and Behavioural Sciences, Medical School, University of St Andrews, St Andrews, United Kingdom
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12
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Tsay SL, Wang JY, Lee YH, Chen YJ. Fear of recurrence: A mediator of the relationship between physical symptoms and quality of life in head and neck cancer patients. Eur J Cancer Care (Engl) 2020; 29:e13243. [PMID: 32510671 DOI: 10.1111/ecc.13243] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 02/12/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Head and neck cancer (HNC) patients suffer from symptoms and fear of recurrence (FoR), which both affect their quality of life (QoL). Based on a self-regulation model, the purpose of the study was to examine patients' FoR as a mediator of the relation between symptoms and QoL, and to identify which symptoms may trigger FoR. METHODS A cross-sectional study was conducted, using convenience sampling. Structured questionnaires were used to collect data at a medical centre in Northern Taiwan. The analytic methods included descriptive statistics, structural equation modelling and linear regression. RESULTS A total of 103 participants were recruited. Patients experienced a medium level of symptom severity and QoL but a moderate to high level of FoR. Symptom severity, FoR and QoL were significantly correlated. FoR was a significant partial mediator between symptom severity and QoL. The significant factors of the overall FoR and the subscale of health worry were "pain in general" and "pain in the mouth, throat or neck." "Pain in general" was a significant factor for the subscale of cancer worry. CONCLUSIONS This theory-driven study supports a mediation model of FoR among HNC patients and provides a more comprehensive understanding of the antecedents and consequences of FoR.
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Affiliation(s)
| | - Ju-Yi Wang
- Department of Nursing, Tri-Service Hospital, Taipei, Taiwan
| | - Yun-Hsiang Lee
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Ju Chen
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
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13
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Mahendran R, Liu J, Kuparasundram S, Simard S, Chan YH, Kua EH, Griva K. Fear of cancer recurrence among cancer survivors in Singapore. Singapore Med J 2020; 62:305-310. [PMID: 31989183 DOI: 10.11622/smedj.2020007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Fear of cancer recurrence (FCR) among cancer survivors is a persistent and distressing psychosocial concern that affects recovery and quality of life. The prevalence of FCR in Singapore is unknown. This cross-sectional study was designed to examine FCR and identify factors associated with FCR in mixed-cancer survivors locally. METHODS Cancer survivors in remission (n = 404) were assessed for: FCR using the Fear of Cancer Recurrence Inventory (FCRI); emotional distress using the Hospital Anxiety and Depression Scale; and quality of life using the World Health Organization Quality of Life-BREF. Clinical and severe/pathological FCR was determined based on the severity scale of FCRI, known as FCRI-Short Form. Multivariate logistic regression was performed to examine factors associated with FCR. RESULTS The mean score on the FCRI was 59.5 ± 30.4. 43.6% of cancer survivors had clinical FCR and 32.1% had severe/pathological FCR. Younger age (odds ratio [OR] 0.952, 95% confidence interval [CI] 0.911-0.995, p < 0.05), higher educational status (OR 2.55, 95% CI 1.15-5.65, p < 0.05) and higher levels of emotional distress (OR 1.17, 95% CI 1.10-1.24, p < 0.001) were significantly associated with severe/pathological levels of FCR. CONCLUSION The present study is the first to determine levels of FCR among cancer survivors in Singapore. While the total FCR scores were similar to those of international studies, severe/pathological levels of FCR were found to be four times higher. These findings highlight a problem that is not widely recognised or acknowledged, but which deserves greater attention.
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Affiliation(s)
- Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jianlin Liu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Research Department, Institute of Mental Health, Singapore
| | | | - Sebastian Simard
- Health Science Department, Université du Quebec a Chicoutimi (UQAC), Quebec, Canada
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Konstadina Griva
- Department of Health Psychology and Behavioural Medicine, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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14
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Lee YH, Hu CC, Humphris G, Huang IC, You KL, Jhang SY, Chen JS, Lai YH. Screening for fear of cancer recurrence: Instrument validation and current status in early stage lung cancer patients. J Formos Med Assoc 2019; 119:1101-1108. [PMID: 31677865 DOI: 10.1016/j.jfma.2019.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/27/2019] [Accepted: 10/07/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is one of the most distressing concerns for cancer patients. A psychometrically validated brief scale is urgently needed for use in busy clinical oncology settings. This study aimed to (1) develop and validate the 7-item fear of cancer recurrence scale Chinese version (FCR7-C), and (2) explore the severity of FCR in post-operative early-stage lung cancer patients in Taiwan. METHODS Early-stage lung cancer patients were recruited from a medical center in Taiwan. The FCR7-C was evaluated for content and construct validity and internal consistency reliability. Construct validity of FCR7-C was determined by the empirically supported correlation and confirmatory factor analysis (CFA). RESULTS A total of 160 subjects were recruited. The FCR7-C was shown to have satisfactory content validity and internal consistency reliability (Cronbach's α = 0.9). The uni-dimensional structure was confirmed by CFA that showed a good fit for the model. The FCR7-C score correlates positively with the degree of most of the physical symptoms, anxiety, and depression, but correlates negatively with patient age, performance status, and quality of life. We found that 81.9% of patients reported at least some FCR, with a mean FCR severity of 15.18 (SD = 7.78). CONCLUSION FCR7-C is a brief screening tool with good psychometrics. Patients with early-stage lung cancer still revealed mild to moderate level of FCR. Applying the FCR7-C for to screen cancer patients' distress and further develop personalized psychological interventions would be strongly suggested.
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Affiliation(s)
- Yun-Hsiang Lee
- School of Nursing, National Taiwan University, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chan-Chuan Hu
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Gerry Humphris
- Health Psychology, Bute Medical School, University of St Andrews, St Andrews, UK
| | - I-Chin Huang
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kai-Lin You
- School of Nursing, National Taiwan University, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sin-Yuan Jhang
- Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Jin-Shing Chen
- Department of Thoracic Surgery, National Taiwan University Hospital, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yeur-Hur Lai
- School of Nursing, National Taiwan University, Taipei, Taiwan; Department of Nursing, National Taiwan University Cancer Center, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan.
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15
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Latella LE, Rogers M, Leventhal H, Parker PA, Horwitz S, Matasar MJ, Bylund CL, Kissane DW, Franco K, Banerjee SC. Fear of cancer recurrence in lymphoma survivors: A descriptive study. J Psychosoc Oncol 2019; 38:251-271. [PMID: 31617830 DOI: 10.1080/07347332.2019.1677840] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives: Fear of cancer recurrence (FCR) is a common experience among cancer survivors and often persists after the termination of cancer treatments. The purpose of this paper was to evaluate FCR in survivors of Hodgkin's and diffuse large B-cell lymphomas, given a high rate of survivorship in this patient population.Research Approach: The parent study was a multi-site, cluster-randomized trial to assess a communication skills intervention: survivorship planning consultation (versus a time-attention control - wellness rehabilitation intervention) to promote transition to survivorship.Participants & Methodological Approach: 199 patients enrolled in the study and completed a survivorship (or control) consultation one-month after receiving the news of their survivorship status; 141 of those patients (n = 92 experimental arm, n = 49 control arm) completed an interview at their 6-month follow-up consultation. In the interview, participants described frequency of FCR, causes of FCR, coping mechanisms, and specific things oncologists said to reduce FCR. Both qualitative and quantitative methods were utilized for analyzing participant responses.Findings: The majority (88%) of participants reported experiencing FCR, with a higher number of participants in the experimental arm significantly more likely to endorse FCR compared to the control group participants. The main causes of FCR were having medical appointments and concerns about potential relapse and secondary cancers. Participants endorsed utilizing self-sufficient coping mechanisms. As well, participants reported that oncologists most frequently cited specific cure rates of lymphoma to reduce patients' FCR.Interpretation & Implications for Psychosocial Providers: Communication skills training programs should emphasize FCR in survivorship consultations.
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Affiliation(s)
- Lauren E Latella
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Madeline Rogers
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Howard Leventhal
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
| | - Patricia A Parker
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - Steven Horwitz
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Matthew J Matasar
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Carma L Bylund
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Public Relations, University of Florida, Gainesville, Florida, USA
| | - David W Kissane
- Cunningham Centre for Palliative Care Research, University of Notre Dame Australia and St Vincent's Sydney, Sydney, Australia.,Cabrini Health and Monash Health, Monash University, Melbourne, Australia
| | - Kara Franco
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Smita C Banerjee
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
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16
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Reed SC, Bell JF, Miglioretti DL, Nekhlyudov L, Fairman N, Joseph JG. Fear of cancer recurrence and associations with mental health status and individual characteristics among cancer survivors: Findings from a nationally representative sample. J Psychosoc Oncol 2019; 38:125-142. [PMID: 31510882 DOI: 10.1080/07347332.2019.1649338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Purpose: To describe the prevalence of fear of cancer recurrence (FCR) and test its associations with validated mental health status measures.Design: Cross-sectional survey using the Medical Expenditure Panel Survey Experiences with Cancer Survivorship Supplement.Sample: Post-treatment cancer survivors (n = 1032).Methods: Survey-weighted U.S. population-based estimates describe the prevalence of sociodemographic, health and mental health characteristics of cancer survivors by their level of FCR. Multinomial logistic regression was used to test associations of validated measures of mental health status and individual characteristics on levels of FCR in unadjusted models and those controlling for sociodemographic and health characteristics.Findings: Overall, 34.3% of cancer survivors reported no FCR, 54.4% reported low FCR, and 11.3% reported high FCR. Cancer survivors were at increased risk of reporting high FCR relative to no FCR if they had a low 12-item Short Form Health Survey Mental Component Summary score (≤48) compared to high scores (odds ratio = 2.88; 95% confidence interval = 1.57, 5.29). Reporting depressive symptoms or psychological distress did not significantly increase the risk of reporting high or low FCR relative to no FCR.Conclusions: To our knowledge, this study is the first to provide U.S. population-based estimates of associations between FCR and individual and health characteristics.Implications for Psychosocial Providers or Policy: Our results provide valuable information about which survivors are most at-risk for FCR. Future research is needed to more clearly differentiate FCR from other constructs.
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Affiliation(s)
- Sarah C Reed
- Betty Irene Moore School of Nursing, University of California, Sacramento, CA, USA
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California, Sacramento, CA, USA
| | - Diana L Miglioretti
- Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of California, Davis, CA, USA
| | - Larissa Nekhlyudov
- Harvard Medical School, Department of Medicine, Brigham and Women's Hospital, Boston, CA, USA
| | - Nathan Fairman
- UC Davis Comprehensive Cancer Center, Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Davis, CA, USA
| | - Jill G Joseph
- Betty Irene Moore School of Nursing, University of California, Sacramento, CA, USA
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17
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Prevalence and factors associated with fear of recurrence in a mixed sample of young adults with cancer. J Cancer Surviv 2019; 13:842-851. [DOI: 10.1007/s11764-019-00802-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/19/2019] [Indexed: 12/13/2022]
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18
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Mirosevic S, Thewes B, van Herpen C, Kaanders J, Merkx T, Humphris G, Baatenburg de Jong RJ, Langendijk JA, Leemans CR, Terhaard CHJ, Verdonck-de Leeuw IM, Takes R, Prins J. Prevalence and clinical and psychological correlates of high fear of cancer recurrence in patients newly diagnosed with head and neck cancer. Head Neck 2019; 41:3187-3200. [PMID: 31173429 PMCID: PMC6771492 DOI: 10.1002/hed.25812] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/02/2019] [Accepted: 05/13/2019] [Indexed: 01/04/2023] Open
Abstract
Background Patients with head and neck cancer (HNC) are vulnerable to fear of cancer recurrence (FCR) and psychiatric morbidity. We investigated the prevalence of high FCR and demographic, clinical, psychological, and psychiatric factors associated with high FCR prior to the start of the treatment. Methods In a cross‐sectional substudy of the large ongoing prospective NET‐QUBIC study questionnaires and psychiatric interviews of 216 patients newly diagnosed with HNC were analyzed. Results High FCR was observed in 52.8% of patients and among those 21.1% also had a lifetime history of selected anxiety or major depressive disorder. FCR was not related to any clinical characteristics; however, younger age, higher anxiety symptoms, introversion, greater needs for support regarding sexuality, and being an exsmoker were significantly associated with higher FCR. Conclusion Factors associated with high FCR provide us with a better conceptual understanding of FCR in patients newly diagnosed with HNC.
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Affiliation(s)
- Spela Mirosevic
- Department of Family Medicine, Medical Faculty Ljubljana, Ljubljana, Slovenia
| | - Belinda Thewes
- Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carla van Herpen
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Johannes Kaanders
- Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Thijs Merkx
- Department Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Gerry Humphris
- School of Medicine, University of St. Andrews, St. Andrews, Scotland, UK
| | - Robert J Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, Erasmus Cancer Institute, Erasmus MC, Rotterdam, The Netherlands
| | - Johannes A Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - C René Leemans
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Chris H J Terhaard
- Department of Radiotherapy, University Medical Center, Utrecht, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.,Department of Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands
| | - Robert Takes
- Department of Head and Neck Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Judith Prins
- Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands
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- Project Kubus, Vumc, Afdeling KNO, Amsterdam, The Netherlands
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19
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Korsten LHA, Jansen F, de Haan BJF, Sent D, Cuijpers P, Leemans CR, Verdonck-de Leeuw IM. Factors associated with depression over time in head and neck cancer patients: A systematic review. Psychooncology 2019; 28:1159-1183. [PMID: 30865357 PMCID: PMC6593868 DOI: 10.1002/pon.5058] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 03/05/2019] [Accepted: 03/07/2019] [Indexed: 11/22/2022]
Abstract
Objective To systematically review the literature on factors associated with a clinical diagnosis of depression or symptoms of depression (depression) among head and neck cancer (HNC) patients. Methods The search was conducted in PubMed, PsycINFO, and CINAHL. Studies were included if they investigated factors associated with depression among HNC patients, they were of prospective or longitudinal nature, and English full text was available. The search, data extraction, and quality assessment were performed by two authors. Based on the data extraction and quality assessment, the level of evidence was determined. Results In total, 35 studies were included: 21 on factors associated with depression at a single (later) time point, 10 on the course of depression, and four on both. In total, 77 sociodemographic, lifestyle, clinical, patient‐reported outcome measures, and inflammatory factors were extracted. Regarding depression at a single time point, there was strong evidence that depression at an earlier time point was significantly associated. For all other factors, evidence was inconclusive, although evidence suggests that age, marital status, education, ethnicity, hospital/region, sleep, smoking, alcohol, surgery, treatment, tumor location, and recurrence are not important associated factors. Regarding the course of depression, we found inconclusive evidence for all factors, although evidence suggests that gender, age, chemotherapy, pain, disease stage, treatment, and tumor location are not important associated factors. Conclusion Depression at an earlier time point is significantly associated with depression later on. Several sociodemographic and clinical factors seem not to be important factors associated with depression. For other factors, further research is warranted.
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Affiliation(s)
- Laura H A Korsten
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam
| | - Femke Jansen
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam.,Department of Clinical, Neuro and Development Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam
| | - Ben J F de Haan
- Department of Medical Informatics, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam
| | - Danielle Sent
- Department of Medical Informatics, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam
| | - Pim Cuijpers
- Department of Clinical, Neuro and Development Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam
| | - C René Leemans
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam.,Department of Clinical, Neuro and Development Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam
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20
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Yang Y, Li W, Wen Y, Wang H, Sun H, Liang W, Zhang B, Humphris G. Fear of cancer recurrence in adolescent and young adult cancer survivors: A systematic review of the literature. Psychooncology 2019; 28:675-686. [PMID: 30703261 DOI: 10.1002/pon.5013] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/16/2019] [Accepted: 01/25/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The current systematic review aims to provide an overview of fear of cancer recurrence (FCR) in adolescent and young adult cancer survivors (15-39 years at cancer diagnosis, AYAs). METHODS MEDLINE, PubMed, PsycINFO, and Embase databases were independently searched to identify relevant quantitative articles. PRISMA systematic review procedures were followed with quality assessment. RESULTS Seventeen studies were included in the current review. All were quantitative studies that utilized a cross-sectional study design. Seven articles reported results of FCR prevalence, six studied determinants related to FCR, and 11 articles provided information about consequences of FCR. Prevalence of FCR ranged from 31% to 85.2% among AYA survivors. Associations between sociodemographic/clinical variables and FCR were inconsistent. Psychological distress and higher treatment intensity were positively associated with higher FCR levels. Lower scores on levels of physical, psychological functioning, and overall health-related quality of life (QoL) were identified as consequences of increased FCR. CONCLUSION FCR appears to be a prevalent concern among adolescent and young adult cancer populations. Adequate assessment to determine need for support and intervention is still required. Longitudinal studies in AYAs are warranted to understand the development and potential influence of FCR. Age-appropriate and flexible psychological care would be more successful potentially with this crucial background information.
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Affiliation(s)
- Yuan Yang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China.,Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Wen Li
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Yunhong Wen
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Hongmei Wang
- Department of Radiotherapy, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Centre, Guangdong General Hospital, Guangzhou, Guangdong, China
| | - Weijiang Liang
- Department of Oncology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Bin Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong, China
| | - Gerry Humphris
- School of Medicine, University of St Andrews, North Haugh, St Andrews, Fife, UK
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21
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The existence and importance of patients' mental images of their head and neck cancer: A qualitative study. PLoS One 2019; 13:e0209215. [PMID: 30596669 PMCID: PMC6312291 DOI: 10.1371/journal.pone.0209215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 11/30/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives To explore the existence and importance of mental images of cancer among people with head and neck cancers with a focus on the perceived origins and meaning of mental images, their development over time, and their relationship to illness beliefs. Methods A longitudinal qualitative study consisting of 44 in-depth semi-structured interviews with 25 consecutive, newly-diagnosed head and neck cancer patients. Participants were invited to draw their images during the interviews. Follow-up interviews occurred after treatment completion. Analysis drew upon the principles of Interpretative Phenomenological Analysis (IPA). Results Many participants had mental images of their cancer which appeared to both embody and influence their beliefs about their illness, and affect their emotional response. For those who held them, mental images appeared to constitute an important part of their cognitive representation (understanding) of their illness. For some, their images also had a powerful emotional impact, being either reassuring or frightening. Images often appeared to originate from early clinical encounters, and remained fairly stable throughout treatment. Images could be conceptualised as ‘concrete’ (the perceived reality) and/or ‘similic’ (figurative). Patients’ images reflected the perceived meaning, properties or ‘intent’ of the cancer–that is beliefs concerning the disease’s identity, consequences and prognosis (likelihood of cure or control). Conclusions People with head and neck cancer may develop a mental image of their disease, often generated early within clinical encounters, which can both reflect and influence their understanding of the cancer. Such images tend to be stable over time. We theorise that careful use of images in early consultations could avoid or minimise some distress, including fears of outcome or recurrence. Concrete or similic images and language could be employed later to change perceptions and reduce distress.
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Dunne S, Coffey L, Sharp L, Desmond D, Gooberman-Hill R, O'Sullivan E, Timmons A, Keogh I, Timon C, Gallagher P. Integrating self-management into daily life following primary treatment: head and neck cancer survivors' perspectives. J Cancer Surviv 2018; 13:43-55. [PMID: 30535901 DOI: 10.1007/s11764-018-0726-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 11/27/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Self-management may help cancer survivors to better deal with challenges to their physical, functional, social and psychological well-being presented by cancer and its treatment. Nonetheless, little is known about how people integrate cancer self-management practices into their daily lives. The aim of this study was to describe and characterise the processes through which head and neck cancer (HNC) survivors attempt to integrate self-management into their daily lives following primary treatment. METHODS Using a purposeful critical case sampling method, 27 HNC survivors were identified through four designated cancer centres in Ireland and participated in face-to-face semi-structured interviews. Interviews were audio-recorded, transcribed and analysed using thematic analysis. RESULTS Six themes describing HNC survivors' attempts to integrate self-management into their lives following treatment were identified: grappling with having to self-manage, trying out self-management strategies, becoming an expert self-manager, struggling to integrate self-management strategies into daily life, avoiding recommended self-management and interpreting self-management. CONCLUSIONS This is the first study to describe HNC survivors' attempts to integrate self-management into their daily lives following primary treatment. The findings indicate that HNC survivors exhibit highly individualised approaches to self-management integration and abandon self-management strategies that fail to meet their own specific needs. IMPLICATIONS FOR CANCER SURVIVORS Survivors may benefit from skills training and structured support to assist their transition between in-patient care and having to self-manage after primary treatment, and/or ongoing support to deal with persistent and recurring challenges such as eating difficulties and fear of recurrence.
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Affiliation(s)
- Simon Dunne
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Laura Coffey
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | - Linda Sharp
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Deirdre Desmond
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | | | | | | | - Ivan Keogh
- Academic Department of Oto Rhino Laryngology, National University of Ireland Galway, Galway, Ireland
| | - Conrad Timon
- Head and Neck Cancer Programme, St. James's Hospital, Dublin, Ireland
| | - Pamela Gallagher
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
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Yang Y, Sun H, Liu T, Zhang J, Wang H, Liang W, Chen Y, Zhang B. Factors associated with fear of progression in chinese cancer patients: sociodemographic, clinical and psychological variables. J Psychosom Res 2018; 114:18-24. [PMID: 30314574 DOI: 10.1016/j.jpsychores.2018.09.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Fear of progression (FoP) is a widespread problem among cancer patients and is considered to be one of the most distressing psychological consequences of cancer. The aim of this study was to investigate the association of sociodemographic, clinical, and psychological variables to FoP in Chinese cancer patients. METHODS In this cross-sectional study, six hundred and thirty-six cancer patients were recruited. All participants were asked to complete a personal information sheet, the Chinese version of Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder Questionnaire (GAD-7). Descriptive statistics and hierarchical multiple regression was conducted to analyze the data. RESULTS Hierarchical multiple regression revealed that childhood severe illness experience (P = .011), stress (P < .001), anxiety (P < .001), depressive symptom (P < .001) and personality (P = .042) were independently predictive of higher FoP. The final regression model explained up to 40.0% (adjusted R square: 38.8%) of the observed variance. CONCLUSION There are a number of factors that increase the likelihood of the development of FoP. The findings underline the necessity to provide effective psychological intervention for patients with high FoP in the future.
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Affiliation(s)
- Yuan Yang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Centre, Guangdong General Hospital, Guangzhou, Guangdong 510080, China
| | - Ting Liu
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Jingying Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Hongmei Wang
- Department of Radiotherapy, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Weijiang Liang
- Department of Oncology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Yu Chen
- Nursing School, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Bin Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China.
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Dunne S, Coffey L, Sharp L, Timmons A, Desmond D, Gooberman-Hill R, O'Sullivan E, Keogh I, Timon C, Gallagher P. Barriers to active self-management following treatment for head and neck cancer: Survivors' perspectives. Psychooncology 2018; 27:2382-2388. [DOI: 10.1002/pon.4835] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/05/2018] [Accepted: 06/22/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Simon Dunne
- School of Nursing and Human Sciences; Dublin City University; Dublin Ireland
| | - Laura Coffey
- Department of Psychology; Maynooth University; Maynooth Co. Kildare Ireland
| | - Linda Sharp
- Institute of Health and Society; Newcastle University; Newcastle UK
| | | | - Deirdre Desmond
- Department of Psychology; Maynooth University; Maynooth Co. Kildare Ireland
| | | | | | - Ivan Keogh
- Academic Department of Oto Rhino Laryngology; National University of Ireland Galway; Galway Ireland
| | - Conrad Timon
- Head and Neck Cancer Programme; St. James's Hospital; Dublin Ireland
| | - Pamela Gallagher
- School of Nursing and Human Sciences; Dublin City University; Dublin Ireland
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25
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Jungerman I, Toyota J, Montoni NP, Azevedo EHM, Guedes RLV, Damascena A, Lowe D, Vartanian JG, Rogers SN, Kowalski LP. Patient Concerns Inventory for head and neck cancer: Brazilian cultural adaptation. Rev Assoc Med Bras (1992) 2017; 63:311-319. [PMID: 28614532 DOI: 10.1590/1806-9282.63.04.311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 12/01/2016] [Indexed: 01/05/2023] Open
Abstract
Objective: The purpose of this study was to translate, culturally validate and evaluate the Patients Concerns Inventory - Head and Neck (PCI-H&N) in a consecutive series of Brazilian patients. Method: This study included adult patients treated for upper aerodigestive tract (UADT) cancer. The translation and cultural adaptation of the PCI-H&N followed internationally accepted guidelines and included a pretest sample of patients that completed the first Brazilian Portuguese version of the PCI. Use, feasibility and acceptability of the PCI were tested subsequently in a consecutive series of UADT cancer patients that completed the final Brazilian Portuguese version of the PCI and a Brazilian Portuguese version of the University of Washington Quality of Life Questionnaire (UW-QOL). Associations between physical and socio-emotional composite scores from the UW-QOL and the PCI were analyzed. Results: Twenty (20) patients participated in the pretest survey (translation and cultural adaptation process), and 84 patients were analyzed in the cultural validation study. Issues most selected were: fear of cancer returning, dry mouth, chewing/eating, speech/voice/being understood, swallowing, dental health/teeth, anxiety, fatigue/tiredness, taste, and fear of adverse events. The three specialists most selected by the patients for further consultation were speech therapist, dentist and psychologist. Statistically significant relationships between PCI and UW-QOL were found. Conclusion: The translation and cultural adaptation of the PCI into Brazilian Portuguese language was successful, and the results demonstrate its feasibility and usefulness, making this a valuable tool for use among the Brazilian head and neck cancer population.
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Affiliation(s)
- Ivy Jungerman
- Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Julia Toyota
- Head and Neck Surgery and Otorhinolaryngology Department, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Neyller Patriota Montoni
- Voice, Speech and Swallowing Rehabilitation Department, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | | | - Renata Ligia Vieira Guedes
- Voice, Speech and Swallowing Rehabilitation Department, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Aline Damascena
- Bioinformatics and Biostatistics Department, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Derek Lowe
- Evidence-Based Practice Research Centre (EPRC), Faculty of Health, Edge Hill University, Ormskirk, United Kingdom
| | - José Guilherme Vartanian
- Head and Neck Surgery and Otorhinolaryngology Department, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Simon N Rogers
- Regional Head and Neck Unit, University Hospital Aintree Foundation Trust, Liverpool, United Kingdom
| | - Luiz Paulo Kowalski
- Head and Neck Surgery and Otorhinolaryngology Department, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
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Harding S, Moss TP. The impact of treatment for head and neck cancer on positive psychological change within a year of completing treatment. Int J Oral Maxillofac Surg 2017; 47:302-308. [PMID: 28843885 DOI: 10.1016/j.ijom.2017.07.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/22/2017] [Accepted: 07/31/2017] [Indexed: 11/27/2022]
Abstract
Head and neck cancer carries a high level of morbidity and mortality. So why could anyone find having such a disease a positive event? The adversity hypothesis of "what doesn't kill you makes you stronger" suggests that people can use adversity to develop as human beings. This positive psychological change has received little attention in relation to head and neck cancer. Responses to the Silver Lining Questionnaire, University of Washington Quality of Life Questionnaire, and Short-Form 12 were collected from a postal survey, 3 to 12 months after the completion of treatment for head and neck cancer. Fifty-two (63%) people returned the survey and were included in the analysis. Time since completion of therapy did not show any relationship with positive psychological change. Tumour stage and treatment regimen both had a relationship with positive change. Participants with lower stage tumours had higher levels of positive change than those with tumours of higher stages. Participants who had surgery alone reported more positive change than those who had surgery with radiotherapy. A social factor related to greater change was being married or living with a partner when compared to living alone. Further research would aid the identification of bio-psychosocial factors that influence the development of positive psychological change and inform the development of rehabilitation interventions.
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Affiliation(s)
- S Harding
- Department of Health and Social Sciences, University of the West of England, Bristol, UK.
| | - T P Moss
- Centre for Appearance Research, University of the West of England, Bristol, UK
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27
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Liu J, Mahendran R, Chua SM, Lam KF, Lim HA, Kuparasundram S, Chan YH, Simard S, Kua EH, Griva K. Validation of the English and Mandarin versions of the Fear of Cancer Recurrence Inventory in an Asian population. J Health Psychol 2017; 25:617-628. [PMID: 28840760 DOI: 10.1177/1359105317727819] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The Fear of Cancer Recurrence Inventory has shown adequate psychometric properties to assess for fear of cancer recurrence among cancer survivors. However, the use of the Fear of Cancer Recurrence Inventory in Asia is limited due to the paucity of validation studies. Participants include 331 cancer survivors who completed the English and newly developed Mandarin versions of the Fear of Cancer Recurrence Inventory. The results revealed that both versions of the Fear of Cancer Recurrence Inventory demonstrated satisfactory internal reliability, test-retest reliability, convergent validity, and concurrent validity. A confirmatory factor analysis provided support for the original seven-factor structure. The validated Fear of Cancer Recurrence Inventory is applicable to cancer survivors in Singapore.
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Affiliation(s)
- Jianlin Liu
- National University of Singapore, Singapore.,Institute of Mental Health, Singapore
| | - Rathi Mahendran
- National University of Singapore, Singapore.,National University Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | | | | | - Haikel A Lim
- National University of Singapore, Singapore.,Duke-NUS Medical School, Singapore
| | | | | | | | - Ee Heok Kua
- National University of Singapore, Singapore.,National University Hospital, Singapore
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28
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Dunne S, Mooney O, Coffey L, Sharp L, Timmons A, Desmond D, Gooberman-Hill R, O'Sullivan E, Keogh I, Timon C, Gallagher P. Self-management strategies used by head and neck cancer survivors following completion of primary treatment: A directed content analysis. Psychooncology 2017; 26:2194-2200. [PMID: 28453887 DOI: 10.1002/pon.4447] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/21/2017] [Accepted: 04/26/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Head and neck cancer (HNC) survivors encounter unique challenges following treatment. This study aimed to identify self-management strategies that HNC survivors use to overcome these posttreatment challenges. METHODS Twenty-seven individuals from 4 designated cancer centres in Ireland were interviewed about self-management strategies that helped them overcome challenges following HNC treatment. Interviews were audio-recorded, transcribed, and analysed using directed content analysis. RESULTS Twenty self-management strategy types (encompassing 77 specific strategies) were identified. The most frequently used self-management strategy types were self-sustaining (used by 26 survivors), self-motivating (n = 25), and proactive problem solving (n = 25). The most frequently used specific strategies were adaptive approaches to ongoing physical consequences of HNC and its treatment (n = 24), customising dietary practices (n = 24), and maintaining a positive outlook (n = 22). CONCLUSIONS The study identified strategies that helped HNC survivors to self-manage posttreatment challenges. This information could inform the design/development of self-management interventions tailored towards HNC survivors.
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Affiliation(s)
- Simon Dunne
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Orla Mooney
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Laura Coffey
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | - Linda Sharp
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | | | - Deirdre Desmond
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | | | | | - Ivan Keogh
- Ear Nose and Throat Department, University Hospital Galway, Galway, Ireland
| | - Conrad Timon
- Head and Neck Cancer Programme, St. James's Hospital, Dublin, Ireland
| | - Pamela Gallagher
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
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29
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Cheng MJ, Smith BD, Hourigan CS, Gojo I, Pratz KW, Blackford AL, Mehta AK, Smith TJ. A Single Center Survey of Health-Related Quality of Life among Acute Myeloid Leukemia Survivors in First Complete Remission. J Palliat Med 2017; 20:1267-1273. [PMID: 28537498 DOI: 10.1089/jpm.2017.0069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Acute myeloid leukemia (AML) is one of the most common types of leukemia in adults, but there is limited information on survivors' quality of life (QOL) after remission. OBJECTIVE We piloted a survey exploring patient-reported outcomes for people with AML in first complete remission (CR1) to determine whether patients felt the survey is relevant to their well-being and to summarize patient characteristics. DESIGN/MEASUREMENTS Cross-sectional survey of a convenience sample of AML patients in CR1 assessing QOL and functioning (European Organization for Research and Treatment of Cancer [EORTC] QLQ-C30 v 3.0), well-being (QOL-cancer survivor [QOL-CS]), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue [FACIT-Fatigue]), and anxiety and depression (hospital anxiety and depression scale [HADS]). The survey contained five open-ended questions. RESULTS Eighteen patients completed the survey. Most felt it was completely or mostly relevant (88.8%) in describing their QOL. Participants scored well on the EORTC QLQ-C30, fatigue being the most common symptom (83%).The FACIT-Fatigue mean score was 28.7 and median score was 33.5 (normal ≥30). Two scored in the abnormal range for anxiety and one for depression on the HADS. On the QOL-CS, participants scored more than 6 out of 10 in most domains, except the subscales of distress and fear. CONCLUSIONS The survey content and length were appropriate. Patients reported ongoing fatigue, fears of future test results, getting a second cancer, and recurrence of cancer. Survivors experience ongoing symptoms, highlighting the importance of providers performing ongoing symptom and needs assessments.
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Affiliation(s)
- M Jennifer Cheng
- 1 Pain and Palliative Care Service, Clinical Center, National Institutes of Health , Bethesda, Maryland
| | - B Douglas Smith
- 2 Division of Hematologic Malignancies, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins Hospital , Baltimore, Maryland
| | - Christopher S Hourigan
- 3 Myeloid Malignancies Section, Hematology Branch, National Heart, Lung and Blood Institute , Baltimore, Maryland
| | - Ivana Gojo
- 2 Division of Hematologic Malignancies, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins Hospital , Baltimore, Maryland
| | - Keith W Pratz
- 2 Division of Hematologic Malignancies, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins Hospital , Baltimore, Maryland
| | - Amanda L Blackford
- 4 Division of Biostatistics and Bioinformatics, Department of Oncology, Johns Hopkins University , Baltimore, Maryland
| | - Ambereen K Mehta
- 1 Pain and Palliative Care Service, Clinical Center, National Institutes of Health , Bethesda, Maryland
| | - Thomas J Smith
- 5 Program in Palliative Medicine and Department of Medical Oncology, Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins Hospital , Baltimore, Maryland
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30
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Dieng M, Butow PN, Costa DS, Morton RL, Menzies SW, Mireskandari S, Tesson S, Mann GJ, Cust AE, Kasparian NA. Psychoeducational Intervention to Reduce Fear of Cancer Recurrence in People at High Risk of Developing Another Primary Melanoma: Results of a Randomized Controlled Trial. J Clin Oncol 2016; 34:4405-4414. [DOI: 10.1200/jco.2016.68.2278] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose People with a history of melanoma commonly report a fear of cancer recurrence (FCR), yet psychologic support is not routinely offered as part of ongoing melanoma care. This randomized controlled trial examined the efficacy of a psychoeducational intervention to reduce FCR and improve psychologic adjustment in this patient group compared with usual care. Methods The intervention comprised a newly developed psychoeducational resource and three telephone-based psychotherapeutic sessions over a 1-month period timed in accordance with dermatologic appointments. Participants were randomly assigned to intervention (n = 80) or usual care (n = 84). Assessments were completed at baseline, 1 month, and 6 months after dermatologic appointments. Linear mixed models were used to examine differences between treatment and control groups for patient-reported outcomes, including FCR, anxiety, stress, depression, melanoma-related knowledge, health behaviors, satisfaction with melanoma care, unmet needs, and health-related quality of life. Results At 6 months, the intervention group reported lower FCR severity, trigger, and distress scores than the control group in the baseline-adjusted models; the between-group mean difference was −1.9 for FCR severity (95% CI, −3.1 to −0.7; P = .002), −2.0 for FCR triggers (95% CI, −3.3 to −0.7; P = .003), and −0.7 for FCR distress (95% CI, −1.3 to −0.1; P = .03). The decrease in FCR severity (but not triggers or distress) remained statistically significant after adjustment for other covariates ( P = .04). At 6 months, the intervention group also reported lower stress (−1.6; 95% CI, −3.1 to −0.2; P = .03) and improved melanoma-related knowledge (1.7; 95% CI, 0.8 to 2.6; P < .001) compared with the control group. No differences were found between groups for other secondary outcomes. Conclusion This newly developed evidence-based psychoeducational intervention was effective in reducing FCR and stress and increasing melanoma-related knowledge in people at high risk for another melanoma.
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Affiliation(s)
- Mbathio Dieng
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Phyllis N. Butow
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Daniel S.J. Costa
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Rachael L. Morton
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Scott W. Menzies
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Shab Mireskandari
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Stephanie Tesson
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Graham J. Mann
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Anne E. Cust
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
| | - Nadine A. Kasparian
- Mbathio Dieng and Anne E. Cust, Sydney School of Public Health, The University of Sydney; Anne E. Cust, Rachael L. Morton, and Graham J. Mann, The Melanoma Institute Australia, The University of Sydney; Phyllis N. Butow and Stephanie Tesson, School of Psychology, The University of Sydney; Daniel S.J. Costa, Pain Management Research Institute, The University of Sydney; Rachael L. Morton, NHMRC Clinical Trials Centre, The University of Sydney; Scott W. Menzies, Sydney Medical School, The University of
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Kandsberger J, Rogers SN, Zhou Y, Humphris G. Using fundamental frequency of cancer survivors' speech to investigate emotional distress in out-patient visits. PATIENT EDUCATION AND COUNSELING 2016; 99:1971-1977. [PMID: 27506580 DOI: 10.1016/j.pec.2016.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 07/15/2016] [Accepted: 08/02/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Emotions, are in part conveyed by varying levels of fundamental frequency of voice pitch (f0). This study tests the hypothesis that patients display heightened levels of emotional arousal (f0) during Verona Coding Definitions of Emotional Sequences (VR-CoDES) cues and concerns versus during neutral statements. METHODS The audio recordings of sixteen head and neck cancer survivors' follow-up consultations were coded for patients' emotional distress. Pitch (f0) of coded cues and concerns, including neutral statements was extracted. These were compared using a hierarchical linear model, nested for patient and pitch range, controlling for statement speech length. Utterance content was also explored. RESULTS Clustering by patient explained 30% of the variance in utterances f0. Cues and concerns were on average 13.07Hz higher than neutral statements (p=0.02). Cues and concerns in these consultations contained content with a high proportion of recurrence fears. CONCLUSION The present study highlights the benefits and challenges of adding f0 and potential other prosodic features to the toolkit of coding emotional distress in the health communication setting. PRACTICE IMPLICATIONS The assessment of f0 during clinical conversations can provide additional information for research into emotional expression.
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Affiliation(s)
| | - Simon N Rogers
- Merseyside Regional Head & Neck Cancer Centre, Aintree Hospital, Liverpool, L9 7AL, UK
| | - Yuefang Zhou
- Medical School, University of St. Andrews, KY16 9TF, UK
| | - Gerry Humphris
- Medical School, University of St. Andrews, KY16 9TF, UK; Edinburgh Cancer Centre, Western General Hospital, EH4 2XU, UK.
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Yang Y, Cameron J, Humphris G. The relationship between cancer patient's fear of recurrence and radiotherapy: a systematic review and meta-analysis. Psychooncology 2016; 26:738-746. [DOI: 10.1002/pon.4224] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 07/05/2016] [Accepted: 07/12/2016] [Indexed: 01/25/2023]
Affiliation(s)
- Yuan Yang
- School of Medicine; University of St Andrews; St Andrews UK
| | - Josie Cameron
- Edinburgh Cancer Centre; Western General Hospital; Edinburgh UK
| | - Gerry Humphris
- School of Medicine; University of St Andrews; St Andrews UK
- Edinburgh Cancer Centre; Western General Hospital; Edinburgh UK
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Dunne S, Mooney O, Coffey L, Sharp L, Desmond D, Timon C, O'Sullivan E, Gallagher P. Psychological variables associated with quality of life following primary treatment for head and neck cancer: a systematic review of the literature from 2004 to 2015. Psychooncology 2016; 26:149-160. [PMID: 26918648 DOI: 10.1002/pon.4109] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 01/28/2016] [Accepted: 02/04/2016] [Indexed: 01/12/2023]
Abstract
OBJECTIVE There has been a recent proliferation of research on quality of life (QoL) in head and neck cancer (HNC). The objective of this review was to systematically examine the evidence on psychological factors associated with QoL outcomes for HNC survivors in the post-treatment period published during 2004-2015. METHODS Five databases were searched for studies investigating psychological factors associated with QoL in HNC survivors. Empirical studies published between January 2004 and June 2015 were included if they measured QoL as an outcome following treatment using a reliable and valid measure, examined its association with at least one psychological factor and included at least 50 HNC survivors. RESULTS Twenty-four publications describing 19 studies (9 cross-sectional, 10 prospective) involving 2,263 HNC survivors were included. There was considerable heterogeneity in study design and diversity in measurement and analysis. Distress-related variables (depression, anxiety, distress) were most frequently investigated, and mostly reported negative associations with QoL outcomes. Associations were also observed between other psychological factors (e.g., coping, neuroticism and fear of recurrence) and QoL. CONCLUSIONS Several psychological factors predict QoL among HNC survivors who have completed treatment. Routine screening and early interventions that target distress could improve HNC survivors' QoL following treatment. Longitudinal and population-based studies incorporating more systematic and standardised measurement approaches are needed to better understand relationships between psychological factors and QoL and to inform the development of intervention and supportive care strategies.Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
| | | | - Laura Coffey
- Maynooth University, Maynooth, County Kildare, Ireland
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Wells M, Swartzman S, Lang H, Cunningham M, Taylor L, Thomson J, Philp J, McCowan C. Predictors of quality of life in head and neck cancer survivors up to 5 years after end of treatment: a cross-sectional survey. Support Care Cancer 2015; 24:2463-72. [DOI: 10.1007/s00520-015-3045-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 11/29/2015] [Indexed: 11/29/2022]
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Cohee AA, Adams RN, Johns SA, Von Ah D, Zoppi K, Fife B, Monahan PO, Stump T, Cella D, Champion VL. Long-term fear of recurrence in young breast cancer survivors and partners. Psychooncology 2015; 26:22-28. [PMID: 26490953 DOI: 10.1002/pon.4008] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 08/12/2015] [Accepted: 09/25/2015] [Indexed: 01/18/2023]
Abstract
BACKGROUND Fear of a breast cancer recurrence is the most prevalent and disruptive source of distress for long-term survivors and their partners. However, few studies have focused on predictors of fear of recurrence. The aim of this study is to test the efficacy of the Social Cognitive Processing Theory (SCPT) in predicting fear of recurrence in long-term breast cancer survivors diagnosed at age 45 years or younger and their partners. METHODS In a large cross-sectional study, breast cancer survivors (n = 222) 3-8 years from diagnosis and their partners completed a survey assessing demographic characteristics, fear of recurrence, social constraints, and cognitive processing (intrusive thoughts and cognitive avoidance). Mediation analyses were conducted for survivors and partners separately to determine if cognitive processing would mediate the relationship between social constraints and fear of recurrence. RESULTS Cognitive processing mediated the relationship between social constraints and fear of recurrence both for survivors [F(3,213) = 47.541, R2 = 0.401, p < 0.001] and partners [F(3,215) = 27.917, R2 = 0.280, p < 0.001). Demographic variables were not significant predictors of fear of recurrence. CONCLUSIONS As predicted, cognitive processing mediated the relationship between social constraints and fear of recurrence. Results expand the utility of the SCPT in long-term survivors and their partners by supporting its use in intervention design. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Andrea A Cohee
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Rebecca N Adams
- Department of Psychology, Purdue University School of Science, West Lafayette, IN, USA
| | - Shelley A Johns
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Diane Von Ah
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Kathleen Zoppi
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Betsy Fife
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Patrick O Monahan
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Timothy Stump
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, USA
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Rogers SN, Cross B, Talwar C, Lowe D, Humphris G. A single-item screening question for fear of recurrence in head and neck cancer. Eur Arch Otorhinolaryngol 2015; 273:1235-42. [PMID: 25749490 DOI: 10.1007/s00405-015-3585-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 02/25/2015] [Indexed: 11/28/2022]
Abstract
Fear of recurrence (FoR) is the most frequent concern patients wish to discuss in head and neck review clinics. The aim of the study was to design a simple screening question on fear of recurrence to be incorporated into the University of Washington Quality of Life Questionnaire (UW-QOLv4), for use in clinical practice. A cross-sectional survey comprising 528 patients was conducted. 11 % selected the two most severe FoR categories. FoR responses correlated strongly (Spearman r s = -0.82) with the mean score of the seven items of the Fear of Recurrence Questionnaire. There was also a strong association with anxiety and mood dysfunction as measured from the UW-QOL, and with overall QOL. Patients more affected by FoR tended to be younger and post-radiotherapy or chemotherapy. The FoR screening question may be a useful addition to the UW-QOLv4 to help identify patients with significant FoR to receive extra support.
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Affiliation(s)
- Simon N Rogers
- Evidence-Based Practice Research Centre (EPRC), Faculty of Health and Social Care, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK. .,Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 1AE, UK.
| | - Ben Cross
- Liverpool University, Cedar House, Ashton Street, Liverpool, L69 3GE, UK
| | - Cyrus Talwar
- Liverpool University, Cedar House, Ashton Street, Liverpool, L69 3GE, UK
| | - Derek Lowe
- Evidence-Based Practice Research Centre (EPRC), Faculty of Health and Social Care, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, UK.,Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 1AE, UK
| | - Gerry Humphris
- Health Psychology, Bute Medical School, University of St Andrews, Westburn Lane, St Andrews, Fife, Scotland, KY16 8HX, UK
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Cavell S, Broadbent E, Donkin L, Gear K, Morton RP. Observations of benefit finding in head and neck cancer patients. Eur Arch Otorhinolaryngol 2015; 273:479-85. [PMID: 25634065 DOI: 10.1007/s00405-015-3527-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 01/23/2015] [Indexed: 01/10/2023]
Abstract
The management of head and neck cancer (HNC) can lead to potentially severe physical, functional and psychological disturbances. As a result, many HNC patients develop symptoms of depression following diagnosis and treatment. Finding benefit in a disease and its treatment can reduce the symptoms of depression and enhance quality of life (QOL). 92 patients from the Head and Neck Cancer Clinic at Auckland Hospital completed measures of unmet needs and quality of life at diagnosis, and completed measures of benefit finding, coping, fear of recurrence and depression 12-18 months later. Patients reported at least moderate benefit finding in the majority of areas. More benefit finding was predicted by the presence of more advanced disease, Maori/Pacific Island ethnicity, lower baseline QOL, and the use of active coping strategies. These findings support the view that screening for QOL at diagnosis and facilitating the development of coping skills may lead to improved benefit finding and psychological adjustment in people with head and neck cancer. Identification of the factors that facilitate benefit finding may assist management of patients after treatment for HNC.
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Affiliation(s)
- Sandra Cavell
- Department of Otolaryngology, Counties Manukau District Health Board, Auckland, New Zealand
| | - Elizabeth Broadbent
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Liesje Donkin
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Kim Gear
- Oral Health Service, Auckland District Health Board, Auckland, New Zealand
| | - Randall P Morton
- Department of Otolaryngology, Counties Manukau District Health Board, Auckland, New Zealand
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Simard S, Savard J. Screening and comorbidity of clinical levels of fear of cancer recurrence. J Cancer Surviv 2015; 9:481-91. [PMID: 25603948 DOI: 10.1007/s11764-015-0424-4] [Citation(s) in RCA: 180] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 01/03/2015] [Indexed: 01/06/2023]
Abstract
PURPOSE The prevalence of clinical levels of fear of cancer recurrence (FCR) in cancer survivors is unknown, which may be partly explained by the lack of an assessment method that would make it possible to distinguish between normal and clinical levels of FCR. Moreover, despite the apparent overlap between FCR and manifestations of some psychiatric disorders, no study has yet evaluated the comorbidity of clinical levels of FCR. The goals of this study were to assess the capacity of the Fear of Cancer Recurrence Inventory severity subscale, to consider a shorter form of the FCRI (FCRI-SF), to screen for clinical levels of FCR, and to assess its psychiatric comorbidity. METHODS Sixty French-Canadian cancer survivors (73% of those eligible) who had been treated within the past 4 years for localized breast, prostate, lung, or colorectal cancer were randomly selected. Participants were administered a clinical interview assessing FCR, the Structured Clinical Interview for DSM-IV, and self-report scales. RESULTS A cutoff score of 13 or higher on the FCRI-SF was associated with optimal sensitivity (88%) and specificity (75%) rates for the screening of clinical levels of FCR. Cancer survivors with clinical levels of FCR were significantly more likely to meet the criteria for a current psychiatric disorder (60%) than patients with nonclinical levels (29%). Anxiety disorders tended to be the most common comorbid disorders. CONCLUSIONS/IMPLICATIONS FOR CANCER SURVIVORS The FCRI-SF allows rapid and effective screening of clinical levels of FCR, a condition associated with significant psychiatric comorbidity.
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Affiliation(s)
- Sébastien Simard
- Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ), 2725, Chemin Ste-Foy, Québec, G1V 4G5, QC, Canada,
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Selective Attention and Fear of Cancer Recurrence in Breast Cancer Survivors. Ann Behav Med 2014; 49:66-73. [DOI: 10.1007/s12160-014-9632-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Lebel S, Maheu C, Lefebvre M, Secord S, Courbasson C, Singh M, Jolicoeur L, Benea A, Harris C, Fung MFK, Rosberger Z, Catton P. Addressing fear of cancer recurrence among women with cancer: a feasibility and preliminary outcome study. J Cancer Surviv 2014; 8:485-96. [PMID: 24756313 DOI: 10.1007/s11764-014-0357-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 03/20/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND Evidence suggests that fear of cancer recurrence (FCR) is one of the most frequently cited unmet needs among cancer survivors and is associated with psychological distress, stress-response symptoms, and lower quality of life, as well as increased use of health care resources. Despite these factors, few manualized interventions exist to address FCR among cancer survivors. PURPOSE To develop, manualize, and pilot test the feasibility and preliminary efficacy of a 6-week cognitive-existential (CE) group intervention designed to address FCR in women with breast or ovarian cancer. METHODS This study was a single-arm multi-site study with pre-, post-, and 3-month follow-up measurement occasions. RESULTS A total of 56 breast or ovarian cancer survivors enrolled in the study; 44 completed the CE group intervention. Following the intervention, women experienced a reduction in the primary study outcome measure of FCR and secondary study outcome measures of cancer-specific distress and uncertainty. They also reported improvements in secondary study outcome measures of quality of life and coping. The effect sizes of the observed changes were for the most part in the medium to large effect range; furthermore, almost all changes were sustained at 3-month follow-up. CONCLUSION This brief intervention appears feasible and has shown promising results in addressing FCR and related secondary outcomes of cancer-specific distress, uncertainty, quality of life, and coping; however, it should be further tested using a randomized controlled study design to more definitively assess its efficacy. IMPLICATIONS FOR CANCER SURVIVORS FCR is a near-universal worry for cancer survivors that, when left unaddressed, tends to remain stable over time. This study has important implications for all cancer survivors as it is the first published intervention that provides preliminary evidence of its efficacy in decreasing fear of cancer recurrence.
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Affiliation(s)
- Sophie Lebel
- School of Psychology, University of Ottawa, 136 Jean Jacques Lussier, room 4016, Ottawa, Ontario, Canada, K1N6N5,
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Barrineau MJ, Zarit SH, King HA, Costanzo ES, Almeida DM. Daily well-being of cancer survivors: the role of somatic amplification. Psychooncology 2014; 23:1027-33. [PMID: 24615865 DOI: 10.1002/pon.3509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 01/18/2014] [Accepted: 01/31/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The current study examined the role that somatic amplification plays in placing cancer survivors at an increased risk of impairments in daily well-being, specifically severity of physical symptoms, positive affect and negative affect. METHODS Participants were drawn from Midlife Development in the United States National Study of daily health and well-being (MIDUS) and the National Study of Daily Experiences (NSDE, Project 2). One hundred eleven individuals with a cancer history were compared with a matched comparison group of individuals who did not have a cancer history. RESULTS Results show that across both groups, somatic amplification is associated with higher negative affect and higher severity of physical symptoms. However, results also show that a somatic amplification by cancer status interaction predicts severity of physical symptoms. The significant interaction indicates that in the comparison group, level of physical symptom severity is the same regardless of whether the individual is high or low on somatic amplification. However, in the group of individuals with a cancer history, individuals who are high on somatic amplification report more severe physical symptoms than individuals who are low on somatic amplification. CONCLUSIONS These findings suggest that heightened attention to minor bodily symptoms impacts individuals with a cancer history differently than individuals who have not experienced cancer, and therefore, may have important implications for the manner in which continued care is provided to cancer survivors.
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Affiliation(s)
- Mary Jon Barrineau
- Department of Human Development and Family Studies, Penn State University, University Park, PA, USA
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Thewes B, Brebach R, Dzidowska M, Rhodes P, Sharpe L, Butow P. Current approaches to managing fear of cancer recurrence; a descriptive survey of psychosocial and clinical health professionals. Psychooncology 2013; 23:390-6. [DOI: 10.1002/pon.3423] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 08/04/2013] [Accepted: 09/10/2013] [Indexed: 01/27/2023]
Affiliation(s)
- B. Thewes
- Psycho-Oncology Co-operative Research Group (PoCoG); University of Sydney; NSW Australia
| | - R. Brebach
- School of Psychology; University of Sydney; Sydney NSW Australia
| | - M. Dzidowska
- Psycho-Oncology Co-operative Research Group (PoCoG); University of Sydney; NSW Australia
| | - P. Rhodes
- School of Psychology; University of Sydney; Sydney NSW Australia
| | - L. Sharpe
- School of Psychology; University of Sydney; Sydney NSW Australia
| | - P. Butow
- Psycho-Oncology Co-operative Research Group (PoCoG); University of Sydney; NSW Australia
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED). School of Psychology; University of Sydney; Sydney NSW Australia
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Lang H, France E, Williams B, Humphris G, Wells M. The psychological experience of living with head and neck cancer: a systematic review and meta-synthesis. Psychooncology 2013; 22:2648-63. [PMID: 23840037 DOI: 10.1002/pon.3343] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 05/29/2013] [Accepted: 05/31/2013] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To summarise patients' experiences of head and neck cancer (HNC) by examining the findings of existing qualitative studies METHODS We undertook a systematic review and meta-synthesis of qualitative studies in 29 published articles using Noblit and Hare's 'meta-ethnography' approach to synthesise findings. The inclusion criteria were primary qualitative studies, focusing on HNC patients' experience and an English abstract. Seven databases were systematically searched. RESULTS The articles focused on the experience of having HNC, the experience of treatments and the role of information. Our synthesis identified six core concepts-uncertainty and waiting, disruption to daily life, the diminished self, making sense of the experience, sharing the burden and finding a path. People experienced significant disruption to normal daily activities, because of the physical and emotional effects of HNC and its treatment. Day-to-day challenges were compounded by social and existential changes and a palpable loss of the individual's sense of self and future. In order to find a way through the considerable uncertainty and daily challenge of living with and beyond HNC, patients made continual efforts to make sense of their experience. Supportive relationships with their social network, HNC peers and healthcare professionals were particularly important, but support following treatment completion was sometimes limited. Perceptions of the future were affected by whether they saw life as diminished, merely changed or even enhanced by the experience of cancer. CONCLUSIONS This review supports further specific research into these emerging themes and provides a context for future work, informing interventions to improve patients' experiences.
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Affiliation(s)
- Heidi Lang
- School of Nursing and Midwifery, University of Dundee, Dundee City, UK
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Butow PN, Bell ML, Smith AB, Fardell JE, Thewes B, Turner J, Gilchrist J, Beith J, Girgis A, Sharpe L, Shih S, Mihalopoulos C. Conquer fear: protocol of a randomised controlled trial of a psychological intervention to reduce fear of cancer recurrence. BMC Cancer 2013; 13:201. [PMID: 23617696 PMCID: PMC3652728 DOI: 10.1186/1471-2407-13-201] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 03/26/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Up to 70% of cancer survivors report clinically significant levels of fear of cancer recurrence (FCR). Despite the known negative impact of FCR on psychological wellbeing and quality of life, little research has investigated interventions for high FCR. Our team has developed and piloted a novel intervention (Conquer Fear) based on the Self-Regulatory Executive Function Model and Relational Frame Theory and is evaluating Conquer Fear in a randomised controlled trial (RCT). We aim to compare the efficacy and cost-efficacy of the Conquer Fear Intervention and relaxation training in reducing the impact of FCR. METHODS/DESIGN This study is a multi-centre RCT with 260 participants randomised either to the Conquer Fear Intervention or relaxation training. Both interventions will be delivered in five sessions over 10 weeks by trained psychologists, psychiatrists and social workers with five or more years experience in oncology. Conquer Fear sessions use attentional training, detached mindfulness, meta-cognitive therapy, values clarification and psycho-education to help patients change the way they regulate and respond to thoughts about cancer recurrence. Relaxation training includes training in progressive and passive muscle relaxation, meditative relaxation, visualisation and "quick relaxation" techniques. Relaxation was chosen to control for therapist time and attention and has good face-validity as an intervention. The primary outcome is fear of cancer recurrence. Secondary outcomes include distress, quality of life, unmet needs, and health care utilisation. Participants complete questionnaires prior to starting the intervention, immediately after completing the intervention, 3 and 6 months later. Eligible participants are early-stage breast or colorectal cancer survivors who have completed hospital-based treatment between 2 months and 5 years prior to study entry and report a score in the clinical range on the Fear of Cancer Recurrence Inventory. The biostatistician is blinded to group allocation and participants are blinded to which intervention is being evaluated. Randomisation is computer generated, stratified by therapist, and uses sequentially numbered sealed envelopes. DISCUSSION If successful, the study will provide an evidence-based intervention to reduce psychological morbidity in cancer survivors, and reduce overall health care costs due to more appropriate use of follow-up care and other health services in this very large population. TRIAL REGISTRATION TRIAL REGISTRATION ACTRN12612000404820.
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Affiliation(s)
- Phyllis N Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Melanie L Bell
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Allan B Smith
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Joanna E Fardell
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Belinda Thewes
- Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Jane Turner
- School of Medicine, University of Queensland, Herston, QLD, 4029, Australia
| | - Jemma Gilchrist
- Crown Princess Mary Cancer Centre, Westmead, NSW, 2145, Australia
| | - Jane Beith
- Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
| | - Afaf Girgis
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW, 2170, Australia
| | - Louise Sharpe
- School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Sophy Shih
- Health Economics Unit, Deakin University, Burwood, VIC, 3125, Australia
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The evolution of fear of cancer recurrence during the cancer care trajectory and its relationship with cancer characteristics. J Psychosom Res 2013; 74:354-60. [PMID: 23497839 DOI: 10.1016/j.jpsychores.2012.12.013] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 12/21/2012] [Accepted: 12/25/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This population-based longitudinal study assessed the prevalence, incidence and evolution of fear of cancer recurrence (FCR) and its relationship with some cancer characteristics in a large sample of patients with mixed cancer sites over an 18-month period. METHODS A total of 962 patients scheduled to undergo surgery for cancer completed the severity subscale of the Fear of Cancer Recurrence Inventory at the peri-operative period and 2, 6, 10, 14, and 18 months later. RESULTS Results indicated that FCR levels were highest at baseline, significantly decreased at the 2-month evaluation and then remained stable throughout the remainder of the study. Between 44.0% and 56.1% of the patients reported a clinical level of FCR during the study, with the highest proportion found at baseline. A relationship was obtained between greater FCR and some indices of poorer prognosis (i.e., diagnosis of head and neck cancer, more advanced cancer, cancer recurrence), as well as with the administration of adjuvant treatment, particularly chemotherapy. Patients with clinical FCR at baseline continued to display clinical levels at all subsequent time points. The incidence rate of clinical levels of FCR was 51.7% overall. CONCLUSION FCR is a highly prevalent and persistent condition. More efforts should be devoted to developing effective treatments for patients with clinical levels of FCR. Early interventions appear particularly relevant in order to prevent the problem from becoming chronic, although patients' acceptability and the efficacy of this approach remain to be demonstrated.
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Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Surviv 2013; 7:300-22. [DOI: 10.1007/s11764-013-0272-z] [Citation(s) in RCA: 537] [Impact Index Per Article: 48.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 02/16/2013] [Indexed: 12/31/2022]
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Ghazali N, Kanatas A, Bekiroglu F, Scott B, Lowe D, Rogers SN. The Patient Concerns Inventory: A Tool to Uncover Unmet Needs in a Cancer Outpatient Clinic. ACTA ACUST UNITED AC 2013. [DOI: 10.1308/147363513x13500508919899] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The Patient Concerns Inventory (PCI) is a holistic, patient reported tool that aids in identifying concerns and issues. it is a 55-item checklist of issues that may be grouped into categories of general function, specific head and neck function, emotional-psychological and others, which include finances, treatment related matters and social care. The PCI also gives patients an opportunity to identify from a list of 15 multidisciplinary team (MDT) members whom they would like to see or be referred on to.
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Affiliation(s)
- N Ghazali
- Clinical Research Fellow, Aintree University Hospitals NHS Foundation Trust
| | - A Kanatas
- Specialist Registrar, Leeds Teaching Hospitals NHS Trust
| | - F Bekiroglu
- Consultant, Aintree University Hospitals NHS Foundation Trust
| | - B Scott
- Senior Physiotherapist, Aintree University Hospitals NHS Foundation Trust
| | - D Lowe
- Medical Statistician, Aintree University Hospitals NHS Foundation Trust
| | - SN Rogers
- Consultant, Aintree University Hospitals NHS Foundation Trust
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van der Meulen IC, May AM, Ros WJG, Oosterom M, Hordijk GJ, Koole R, de Leeuw JRJ. One-year effect of a nurse-led psychosocial intervention on depressive symptoms in patients with head and neck cancer: a randomized controlled trial. Oncologist 2013; 18:336-44. [PMID: 23429740 PMCID: PMC3607532 DOI: 10.1634/theoncologist.2012-0299] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 01/03/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Many patients with head and neck cancer (HNC) experience depressive symptoms after treatment. This randomized controlled trial investigated the effects of a psychosocial nurse counseling and after intervention (NUCAI) versus usual care on the depressive and HNC-related physical symptoms of patients with HNC at 1 year after diagnosis. METHODS A total of 205 patients with HNC were randomly assigned to either intervention (n = 103) or usual care (n = 102), with stratification for gender and tumor stage. The NUCAI, which consisted of six bimonthly 45-minute counseling sessions, was a problem-focused intervention aimed at helping patients to manage the physical, psychological, and social consequences of HNC and its treatment. It was nurse-led and offered in combination with regular medical follow-up visits at the University Medical Center Utrecht, the Netherlands. Depressive symptoms at 1 year after diagnosis were the primary outcome. Analyses were performed on an intention-to-treat basis for the total sample and for a predefined subgroup of patients with raised levels of depressive symptoms (Center for Epidemiologic Studies-Depression score ≥ 12; n = 91) at baseline using mixed-effect models. RESULTS One year after HNC treatment, levels of depressive symptoms were significantly lower in the intervention group than in the control group in the total sample and in the subgroup of patients with raised levels of depressive symptoms. CONCLUSION The NUCAI was feasible and effective in reducing depressive symptoms in patients with HNC 1 year after HNC treatment, and especially in patients with raised levels of depressive symptoms. The results of this study need to be confirmed in future studies before the NUCAI can be used in daily clinical practice.
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Affiliation(s)
- Ingeborg C van der Meulen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
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