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Cai Y, Zhaoxiong Y, Zhu W, Wang H. Association between sleep duration, depression and breast cancer in the United States: a national health and nutrition examination survey analysis 2009-2018. Ann Med 2024; 56:2314235. [PMID: 38329808 PMCID: PMC10854439 DOI: 10.1080/07853890.2024.2314235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/01/2023] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVE Breast cancer is the most common cancer in women, threatening both physical and mental health. The epidemiological evidence for association between sleep duration, depression and breast cancer is inconsistent. The aim of this study was to determine the association between them and build machine-learning algorithms to predict breast cancer. METHODS A total of 1,789 participants from the National Health and Nutrition Examination Survey (NHANES) were included in the study, and 263 breast cancer patients were identified. Sleep duration was collected using a standardized questionnaire, and the Nine-item Patient Health Questionnaire (PHQ-9) was used to assess depression. Logistic regression yielded multivariable-adjusted breast cancer odds ratios (OR) and 95% confidence intervals (CI) for sleep duration and depression. Then, six machine learning algorithms, including AdaBoost, random forest, Boost tree, artificial neural network, limit gradient enhancement and support vector machine, were used to predict the development of breast cancer and find out the best algorithm. RESULTS Body mass index (BMI), race and smoking were statistically different between breast cancer and non-breast cancer groups. Participants with depression were associated with breast cancer (OR = 1.99, 95%CI: 1.55-3.51). Compared with 7-9h of sleep, the ORs for <7 and >9 h of sleep were 1.25 (95% CI: 0.85-1.37) and 1.05 (95% CI: 0.95-1.15), respectively. The AdaBoost model outperformed other machine learning algorithms and predicted well for breast cancer, with an area under curve (AUC) of 0.84 (95%CI: 0.81-0.87). CONCLUSIONS No significant association was observed between sleep duration and breast cancer, and participants with depression were associated with an increased risk for breast cancer. This finding provides new clues into the relationship between breast cancer and depression and sleep duration, and provides potential evidence for subsequent studies of pathological mechanisms.
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Affiliation(s)
- Yufan Cai
- Zhongshan Hospital of Fudan University, Shanghai, China
| | | | - Wei Zhu
- Zhongshan Hospital of Fudan University, Shanghai, China
| | - Haiyu Wang
- Zhongshan Hospital of Fudan University, Shanghai, China
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Zhu Q, Han Y, He Y, Meng P, Fu Y, Yang H, He G, Long M, Shi Y. Quercetin inhibits neuronal Ferroptosis and promotes immune response by targeting lipid metabolism-related gene PTGS2 to alleviate breast cancer-related depression. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 130:155560. [PMID: 38815404 DOI: 10.1016/j.phymed.2024.155560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 03/06/2024] [Accepted: 03/21/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Quercetin, the key ingredient in Xiaoyao Kangai Jieyu Formula, has been previously found to relieve breast cancer-related depression (BCRD). PURPOSE We want to explore the potential mechanisms and therapeutic targets of quercetin alleviating BCRD. METHODS BALB/c mice were injected subcutaneously with 4T1 cells and corticosterone (CORT) to create a BCRD mice model. The primary hippocampal neurons were co-induced with 10 μg/ml lipopolysaccharide (LPS) and 200 μM CORT for 6 h to establish an in vitro model of BCRD. Quercetin was applied to explore its effect on disease symptoms, gut microbiota, and lipid metabolism of BCRD mice. Lipid metabolism-related genes were screened based on network pharmacology. Molecular docking was employed to prove whether quercetin bound to prostaglandin-endoperoxide synthase 2 (PTGS2). PTGS2 overexpression was carried out to explore the underlying mechanism of quercetin treatment on BCRD. RESULTS Quercetin treatment not only altered the composition and abundance of gut microbiota but also alleviated abnormal lipid metabolism in BCRD mice. In particular, quercetin down-regulated BCRD and lipid metabolism-related genes screened by network pharmacology, especially PTGS2. Further, molecular docking verified the stable binding between quercetin and PTGS2. In hippocampal neurons, quercetin promoted proliferation but reduced ferroptosis-related markers (total Fe, Fe2+, MDA, and ROS) levels by targeting PTGS2. In BCRD mice, quercetin reduced the high immobility time and increased the sucrose preference rate and serotonin (5-HT), dopamine (DA), and noradrenaline (NE) levels. Meanwhile, quercetin increased CD4+/CD8+ T cells ratio and IL-2 and IFN-γ levels but reduced CA153 and IL-10 levels to alleviate BCRD development. However, PTGS2 overexpression reversed these effects of quercetin on BCRD. CONCLUSION Quercetin inhibited neuronal ferroptosis and promoted immune responses in BCRD mice by targeting the lipid metabolism-related gene PTGS2. This provided a reference for quercetin in the treatment of BCRD.
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Affiliation(s)
- Qing Zhu
- Department of Pharmacy, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, PR China
| | - Yuanshan Han
- Research Office of the First Hospital of Hunan University of Chinese Medicine, Changsha 410007, PR China
| | - Ying He
- The Second Department of Breast Surgery, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, PR China
| | - Pan Meng
- Institute of Innovation and Applied Research, Hunan University of Chinese Medicine, Changsha 410208, PR China
| | - Yilan Fu
- Department of Pharmacy, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, PR China
| | - Hui Yang
- Animal Experiment Center, the First Hospital of Hunan University of Chinese Medicine, Changsha 410007, PR China
| | - Gefei He
- Department of Pharmacy, the First Hospital of Changsha, Changsha 410005, PR China
| | - Minghui Long
- Department of Pharmacy, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, PR China.
| | - Yingrui Shi
- Hunan Province Maternal and Child Care Hospital, The Maternal and Child Care Hospital of South University of China, Changsha 410028, PR China.
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Tyrus Korecki JR, Ganz PA, Partridge AH, Wolff AC, Petersen L, Crespi CM, Bower JE. Moderators of Intervention Efficacy in the Pathways to Wellness Trial of Survivorship Education and Mindfulness Meditation for Younger Breast Cancer Survivors. JCO Oncol Pract 2024:OP2300617. [PMID: 38917400 DOI: 10.1200/op.23.00617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 04/23/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
PURPOSE Depression is associated with poor outcomes in breast cancer survivors (BCSs), with higher prevalence among younger women. The Pathways to Wellness (PTW; ClinicalTrials.gov identifier: NCT03025139) randomized controlled trial (RCT) demonstrated beneficial effects of two behavioral interventions (survivorship education [SE] and mindful awareness practices [MAPs]) on depressive symptoms in younger BCS. We conducted an exploratory secondary analysis to identify moderators of intervention effects. METHODS Women diagnosed with stage 0 to III breast cancer at or before age 50 years who completed cancer treatment were randomly assigned to 6 weeks of SE (n = 81), MAPs (n = 85), or waitlist control (WLC; n = 81). Moderators assessed at baseline included psychological distress (depression and anxiety), intervention preference, preparedness for survivorship, and time since initial diagnosis. Linear regression models tested the modifying effects of each variable on postintervention depression in SE versus WLC and MAPs versus WLC. RESULTS Baseline levels of depression (β = -.03, P < .01) and anxiety (β = -.64, P = .02) moderated effects of SE on depressive symptoms, as did preparedness for survivorship (β = 3.17, P = .02). Participants randomly assigned to SE who had the highest levels of depression or anxiety and who felt least prepared for survivorship showed the largest reductions in depressive symptoms from preintervention to postintervention. Similar effects were not observed for MAPs. Intervention preference and time since diagnosis did not moderate intervention effects for either SE or MAPs. CONCLUSION Our 6-week, group-based SE program may be most beneficial for women with higher levels of psychological distress and those who feel least prepared for cancer survivorship. By contrast, a 6-week mindfulness awareness practice intervention appears to benefit younger BCS regardless of pretreatment characteristics.
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Affiliation(s)
| | - Patricia A Ganz
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA
- Department of Medicine (Hematology-Oncology), David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Department of Medicine, Brigham and Women's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Antonio C Wolff
- The Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD
| | - Laura Petersen
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA
| | - Catherine M Crespi
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Julienne E Bower
- Department of Psychology, UCLA, Los Angeles, CA
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLA, Los Angeles, CA
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
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Chirico A, Palombi T, Alivernini F, Lucidi F, Merluzzi TV. Emotional Distress Symptoms, Coping Efficacy, and Social Support: A Network Analysis of Distress and Resources in Persons With Cancer. Ann Behav Med 2024:kaae025. [PMID: 38865355 DOI: 10.1093/abm/kaae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND The study's main aim was to analyze the structure and configuration of distress symptoms and resource factors. PURPOSE Common methods of assessing distress symptoms in cancer patients (i) do not capture the configuration of individual distress symptoms and (ii) do not take into account resource factors (e.g., social support, coping, caring health professionals). Network analysis focuses on the configuration and relationships among symptoms that can result in tailored interventions for distress. Network analysis was used to derive a symptom-level view of distress and resource factors. METHODS Nine hundred and ninety-two cancer patients (mixed diagnoses) completed an abridged Distress Screening Schedule that included 24 items describing symptoms related to distress (depression, anxiety) and resource factors (social support, coping, caring health professionals). RESULTS In network analysis, the centrality strength index (CSI) is the degree to which an item is connected to all other items, thus constituting an important focal point in the network. A depression symptom had the highest CSI value: felt lonely/isolated (CSI = 1.30). In addition, resource factors related to coping efficacy (CSI = 1.20), actively seeking support (CSI = 1.10), perceiving one's doctor as caring (CSI = 1.10), and receiving social support (CSI = 1.10) also all had very high CSI scores. CONCLUSIONS AND IMPLICATIONS These results emphasize the integral importance of the social symptoms of loneliness/isolation in distress. Thus, distress symptoms (loneliness) and resource factors (coping efficacy, seeking social support, and perceiving medical professionals as caring) should be integral aspects of distress management and incorporated into assessment tools and interventions to reduce distress.
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Affiliation(s)
- Andrea Chirico
- Department of Developmental and Social Psychology, Sapienza, University of Rome, Rome, Italy
| | - Tommaso Palombi
- Department of Developmental and Social Psychology, Sapienza, University of Rome, Rome, Italy
| | - Fabio Alivernini
- Department of Developmental and Social Psychology, Sapienza, University of Rome, Rome, Italy
| | - Fabio Lucidi
- Department of Developmental and Social Psychology, Sapienza, University of Rome, Rome, Italy
| | - Thomas V Merluzzi
- Department of Psychology, University of Notre Dame, South Bend, Indiana, USA
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Xu F, Zhang J, Xie S, Li Q. Effects of Mindfulness-Based Cancer Recovery training on anxiety, depression, post-traumatic stress disorder, and cancer-related fatigue in breast neoplasm patients undergoing chemotherapy. Medicine (Baltimore) 2024; 103:e38460. [PMID: 38847730 PMCID: PMC11155580 DOI: 10.1097/md.0000000000038460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/03/2024] [Indexed: 06/10/2024] Open
Abstract
RATIONALE Mindfulness-Based Cancer Recovery (MBCR) program is a group course training for cancer patients that combines cancer knowledge and psychological knowledge, emphasizing focusing on the psychosomatic symptoms of cancer patients. Currently, the application value of Mindfulness-Based Cancer Recovery in improving psychosomatic health of cancer patients has been confirmed, however, its intervention effect on breast neoplasm patients has not yet been widely studied in China. PATIENT CONCERNS AND DIAGNOSES This study introduced the Mindfulness-Based Cancer Recovery protocol into the rehabilitation process of breast cancer patients, aiming to elucidate the effects of Mindfulness-Based Cancer Recovery on anxiety, depression, post-traumatic stress disorder, and cancer-related fatigue in breast neoplasm patients, to provide a practical basis for improving the physical and mental health of breast cancer patients. INTERVENTION In this study, 80 patients with chemotherapy-stage breast neoplasm attending the oncology department of a tertiary-level hospital from January 2022 to December 2022 were selected, 40 patients attending from January 2022 to June 2022 were included in the study group, and 40 patients attending from July 2022 to December 2022 were included in the control group. The control group was administered conventional care, and the study group was administered Mindfulness-Based Cancer Recovery based on conventional care in the control group for 8 weeks. After the intervention, hospital anxiety and depression scale, impact of event scale-revised, and cancer fatigue scale were used for evaluation. OUTCOMES After the intervention, hospital anxiety and depression scale scores decreased in both groups compared with pre-intervention, with the study group scoring lower than the control group (P < .05). After the intervention, the impact of event scale-revised scores of the 2 groups decreased from the preintervention period, with the study group scoring lower than the control group (P < .05). After the intervention, cancer fatigue scale scores decreased in the 2 groups compared with the preintervention period, with the study group scoring lower than the control group (P < .05). LESSONS Mindfulness-Based Cancer Recovery can effectively reduce the levels of anxiety, depression and post-traumatic stress disorder in breast neoplasm patients undergoing chemotherapy, reduce the levels of cancer-related fatigue, and promote the physical and mental health of patients.
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Affiliation(s)
- Fan Xu
- Oncology Department, Deyang People’s Hospital, Deyang, China
| | - Jiquan Zhang
- Nephrology Department, Deyang People’s Hospital, Deyang, China
| | - Shaoju Xie
- Oncology Department, Deyang People’s Hospital, Deyang, China
| | - Qiao Li
- Oncology Department, Deyang People’s Hospital, Deyang, China
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Zeng Y, Huang R, Zhao L, He X, Mao S. The effectiveness of mind-body therapy and physical training in alleviating depressive symptoms in adult cancer patients: a meta-analysis. J Cancer Res Clin Oncol 2024; 150:289. [PMID: 38836958 PMCID: PMC11153279 DOI: 10.1007/s00432-024-05813-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 05/20/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE The aim of this study was to assess the effectiveness of mind-body therapy (MBT) and/or physical training in alleviating depressive symptoms among adult cancer patients through a meta-analysis. METHODS PubMed, Embase, EBSCO, Web of Science, and Cochrane Library databases were searched from up to October 21, 2023. Effect sizes, 95% confidence intervals, and other pertinent values were computed utilizing a random-effects model with Review Manager 5.3 and StataMP 14. The reporting of findings adhered to the guidelines for systematic reviews and meta-analyses. The PROSPERO registration code for this review is 4,203,477,316. RESULTS 10 randomized controlled trials (11 datasets) involving a total of 620 participants were selected for analysis. The results demonstrated that complementary therapies, encompassing MBT and physical training, were effective in alleviating depressive symptoms in adult cancer patients (SMD= -0.47; 95%CI: -0.87, -0.08; P = 0.02). Subgroup analysis indicate that physical training may effectively alleviate depressive symptoms (SMD= -0.72; 95%CI: -1.31, -0.13; P = 0.02), demonstrating moderate effect sizes. Conversely, MBT does not seem to significantly influence depressive symptoms (P = 0.69). CONCLUSIONS Complementary therapy lasting four weeks or more, incorporating physical training and MBT, has been shown to alleviate depressive symptoms in adult cancer patients. And physical training has a significant effect on depressive symptoms, while MBT has no effect. Nevertheless, given the constraints of the included studies, further research is required in the future to provide more robust evidence.
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Affiliation(s)
- Yixian Zeng
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, China
| | - Ruixin Huang
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, China
| | - Li Zhao
- School of Sports Science, Beijing Sport University, Beijing, 100084, China
| | - Xingfei He
- Wuxi Huishan District Rehabilitation Hospital, Wuxi, 214001, China.
| | - Shanshan Mao
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, 100084, China.
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Li C, Zhang J, Pan P, Zhang J, Hou X, Wang Y, Chen G, Muhammad P, Reis RL, Ding L, Wang Y. Humanistic Health Management and Cancer: Associations of Psychology, Nutrition, and Exercise with Cancer Progression and Pathogenesis. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2400665. [PMID: 38526194 PMCID: PMC11165509 DOI: 10.1002/advs.202400665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/01/2024] [Indexed: 03/26/2024]
Abstract
The incidence rate of cancer is increasing year by year due to the aging of the population, unhealthy living, and eating habits. At present, surgery and medication are still the main treatments for cancer, without paying attention to the impact of individual differences in health management on cancer. However, increasing evidence suggests that individual psychological status, dietary habits, and exercise frequency are closely related to the risk and prognosis of cancer. The reminder to humanity is that the medical concept of the unified treatment plan is insufficient in cancer treatment, and a personalized treatment plan may become a breakthrough point. On this basis, the concept of "Humanistic Health Management" (HHM) is proposed. This concept is a healthcare plan that focuses on self-health management, providing an accurate and comprehensive evaluation of individual lifestyle habits, psychology, and health status, and developing personalized and targeted comprehensive cancer prevention and treatment plans. This review will provide a detailed explanation of the relationship between psychological status, dietary, and exercise habits, and the regulatory mechanisms of cancer. Intended to emphasize the importance of HHM concept in cancer prevention and better prognostic efficacy, providing new ideas for the new generation of cancer treatment.
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Affiliation(s)
- Chenchen Li
- International Joint Research Center of Human‐machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of EducationSchool of Pharmacy & The First Affiliated HospitalHainan Medical UniversityHaikou571199P. R. China
| | - Junfeng Zhang
- Tumor Precision Targeting Research Center & Institute of Nanochemistry and NanobiologySchool of Environmental and Chemical EngineeringShanghai UniversityShanghai200444P. R. China
| | - Pengcheng Pan
- International Joint Research Center of Human‐machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of EducationSchool of Pharmacy & The First Affiliated HospitalHainan Medical UniversityHaikou571199P. R. China
| | - Junjie Zhang
- International Joint Research Center of Human‐machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of EducationSchool of Pharmacy & The First Affiliated HospitalHainan Medical UniversityHaikou571199P. R. China
| | - Xinyi Hou
- International Joint Research Center of Human‐machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of EducationSchool of Pharmacy & The First Affiliated HospitalHainan Medical UniversityHaikou571199P. R. China
| | - Yan Wang
- International Joint Research Center of Human‐machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of EducationSchool of Pharmacy & The First Affiliated HospitalHainan Medical UniversityHaikou571199P. R. China
| | - Guoping Chen
- International Joint Research Center of Human‐machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of EducationSchool of Pharmacy & The First Affiliated HospitalHainan Medical UniversityHaikou571199P. R. China
| | - Pir Muhammad
- International Joint Research Center of Human‐machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of EducationSchool of Pharmacy & The First Affiliated HospitalHainan Medical UniversityHaikou571199P. R. China
| | - Rui L. Reis
- 3B's Research GroupI3Bs‐Research Institute on Biomaterials Biodegradables and BiomimeticsUniversity of MinhoGuimarães4805‐017Portugal
| | - Lin Ding
- Translational Medicine Collaborative Innovation CenterShenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and TechnologyThe Second Clinical Medical College of Jinan University)ShenzhenGuangdong518055P. R. China
- Guangdong Engineering Technology Research Center of Stem Cell and Cell TherapyShenzhen Key Laboratory of Stem Cell Research and Clinical TransformationShenzhen Immune Cell Therapy Public Service PlatformShenzhen518020P. R. China
| | - Yanli Wang
- International Joint Research Center of Human‐machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of EducationSchool of Pharmacy & The First Affiliated HospitalHainan Medical UniversityHaikou571199P. R. China
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Mamczarz J, Lane M, Merchenthaler I. Letrozole delays acquisition of water maze task in female BALB/c mice: Possible involvement of anxiety. Horm Behav 2024; 162:105524. [PMID: 38513526 DOI: 10.1016/j.yhbeh.2024.105524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
Letrozole, an aromatase inhibitor preventing estrogen synthesis from testosterone, is used as an adjuvant therapy in estrogen receptor-positive breast cancer patients. However, like other aromatase inhibitors, it induces many side effects, including impaired cognition. Despite its negative effect in humans, results from animal models are inconsistent and suggest that letrozole can either impair or improve cognition. Here, we studied the effects of chronic letrozole treatment on cognitive behavior of adult female BALB/c mice, a relevant animal model for breast cancer studies, to develop an appropriate animal model aimed at testing therapies to mitigate side effects of letrozole. In Morris water maze, letrozole 0.1 mg/kg impaired reference learning and memory. Interestingly, most of the letrozole 0.1 mg/kg-treated mice were able to learn the new platform position in reversal training and performed similar to control mice in a reversal probe test. Results of the reversal test suggest that letrozole did not completely disrupt spatial navigation, but rather delayed acquisition of spatial information. The delay might be related to increased anxiety as suggested by increased thigmotactic behavior during the reference memory training. The learning impairment was water maze-specific since we did not observe impairment in other spatial tasks such as in Y-maze or object location test. In contrast, the dose of 0.3 mg/kg did not have effect on water maze learning and facilitated locomotor habituation and recognition in novel object recognition test. The current study shows that letrozole dose-dependently modulates behavioral response and that its effects are task-dependent.
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Affiliation(s)
- Jacek Mamczarz
- Division of Translational Toxicology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, United States of America.
| | - Malcolm Lane
- Department of Anatomy & Neurobiology, University of Maryland School of Medicine, Baltimore, MD 21201, United States of America
| | - Istvan Merchenthaler
- Division of Translational Toxicology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, United States of America; Department of Anatomy & Neurobiology, University of Maryland School of Medicine, Baltimore, MD 21201, United States of America
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Lin S, Zhou Z, Qi Y, Chen J, Xu G, Shi Y, Yu Z, Li M, Chai K. Depression promotes breast cancer progression by regulating amino acid neurotransmitter metabolism and gut microbial disturbance. Clin Transl Oncol 2024; 26:1407-1418. [PMID: 38194019 DOI: 10.1007/s12094-023-03367-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024]
Abstract
INTRODUCTION Breast cancer (BC) is the most prevalent type of cancer and has the highest mortality among women worldwide. BC patients have a high risk of depression, which has been recognized as an independent factor in the progression of BC. However, the potential mechanism has not been clearly demonstrated. METHODS To explore the correlation and mechanism between depression and BC progression, we induced depression and tumor in BC mouse models. Depression was induced via chronic unpredictable mild stress (CUMS) and chronic restraint stress (CRS). Amino acid (AA) neurotransmitter-targeted metabonomics and gut microbiota 16S rDNA gene sequencing were employed in the mouse model after evaluation with behavioral tests and pathological analysis. RESULTS The tumors in cancer-depression (CD) mice grew faster than those in cancer (CA) mice, and lung metastasis was observed in CD mice. Metabonomics revealed that the neurotransmitters and plasma AAs in CD mice were dysregulated, namely the tyrosine and tryptophan pathways and monoamine neurotransmitters in the brain. Gut microbiota analysis displayed an increased ratio of Firmicutes/Bacteroides. In detail, the abundance of f_Lachnospiraceae and s_Lachnospiraceae increased, whereas the abundance of o_Bacteroidales and s_Bacteroides_caecimuris decreased. Moreover, the gut microbiota was more closely associated with AA neurotransmitters than with plasma AA. CONCLUSION Depression promoted the progression of BC by modulating the abundance of s_Lachnospiraceae and s_Bacteroides_caecimuris, which affected the metabolism of monoamine neurotransmitters in the brain and AA in the blood.
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Affiliation(s)
- Sisi Lin
- The Second School of Clinical Medical, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Cancer Prevention and Treatment Technology of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
| | - Zhe Zhou
- The Second School of Clinical Medical, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Cancer Prevention and Treatment Technology of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Yiming Qi
- The Second School of Clinical Medical, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Cancer Prevention and Treatment Technology of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Jiabing Chen
- The Second School of Clinical Medical, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Cancer Prevention and Treatment Technology of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Guoshu Xu
- The Second School of Clinical Medical, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Cancer Prevention and Treatment Technology of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Yunfu Shi
- The Second School of Clinical Medical, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Cancer Prevention and Treatment Technology of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Zhihong Yu
- The Second School of Clinical Medical, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China
- Zhejiang Provincial Key Laboratory of Cancer Prevention and Treatment Technology of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China
| | - Mingqian Li
- Zhejiang Provincial Key Laboratory of Cancer Prevention and Treatment Technology of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China.
| | - Kequn Chai
- The Second School of Clinical Medical, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.
- Zhejiang Provincial Key Laboratory of Cancer Prevention and Treatment Technology of Integrated Traditional Chinese and Western Medicine, Zhejiang Academy of Traditional Chinese Medicine, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China.
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10
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An KY, Min J, Lee DH, Kang DW, Courneya KS, Jeon JY. Exercise Across the Phases of Cancer Survivorship: A Narrative Review. Yonsei Med J 2024; 65:315-323. [PMID: 38804025 PMCID: PMC11130592 DOI: 10.3349/ymj.2023.0638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/08/2024] [Indexed: 05/29/2024] Open
Abstract
Exercise has long been recognized as an important component of treatment for various diseases. However, the benefits and risks of exercise interventions must be carefully evaluated to ensure the former outweighs the latter. As cancer patients undergo diverse treatment modalities with distinct objectives, a systematic approach partitioning the cancer journey into distinct phases is necessary to inform tailored exercise prescriptions. This narrative review summarizes exercise benefits and mechanisms for cancer patients and survivors across four distinct survivorship periods-before surgery, after surgery and before adjuvant treatment, during nonsurgical treatment (adjuvant and neoadjuvant), and during extended survival. In summary, exercise reduces the risks of complications and declines in physical functioning while improving fatigue, quality of life, and the ability to manage treatment effects. Although additional research is warranted, existing evidence is sufficient to integrate exercise into clinical oncology practice and cancer survivorship programs.
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Affiliation(s)
- Ki-Yong An
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Jihee Min
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Dong Hoon Lee
- Department of Sport Industry Studies, Yonsei University, Seoul, Korea
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Dong-Woo Kang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Department of Medicine, Harvard Medical School, Boston, MA, United States
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Justin Y Jeon
- Department of Sport Industry Studies, Yonsei University, Seoul, Korea
- Exercise Medicine Center for Diabetes and Cancer Patients, Institute of Convergence Science, Yonsei University, Seoul, Korea
- Cancer Prevention Center, Yonsei Cancer Center, Yonsei University College of Medicine, Yonsei University, Seoul, Korea.
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11
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Zeng Y, Hu CH, Li YZ, Zhou JS, Wang SX, Liu MD, Qiu ZH, Deng C, Ma F, Xia CF, Liang F, Peng YR, Liang AX, Shi SH, Yao SJ, Liu JQ, Xiao WJ, Lin XQ, Tian XY, Zhang YZ, Tian ZY, Zou JA, Li YS, Xiao CY, Xu T, Zhang XJ, Wang XP, Liu XL, Wu F. Association between pretreatment emotional distress and immune checkpoint inhibitor response in non-small-cell lung cancer. Nat Med 2024; 30:1680-1688. [PMID: 38740994 PMCID: PMC11186781 DOI: 10.1038/s41591-024-02929-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/18/2024] [Indexed: 05/16/2024]
Abstract
Emotional distress (ED), commonly characterized by symptoms of depression and/or anxiety, is prevalent in patients with cancer. Preclinical studies suggest that ED can impair antitumor immune responses, but few clinical studies have explored its relationship with response to immune checkpoint inhibitors (ICIs). Here we report results from cohort 1 of the prospective observational STRESS-LUNG study, which investigated the association between ED and clinical efficacy of first-line treatment of ICIs in patients with advanced non-small-cell lung cancer. ED was assessed by Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale. The study included 227 patients with 111 (48.9%) exhibiting ED who presented depression (Patient Health Questionnaire-9 score ≥5) and/or anxiety (Generalized Anxiety Disorder 7-item score ≥5) symptoms at baseline. On the primary endpoint analysis, patients with baseline ED exhibited a significantly shorter median progression-free survival compared with those without ED (7.9 months versus 15.5 months, hazard ratio 1.73, 95% confidence interval 1.23 to 2.43, P = 0.002). On the secondary endpoint analysis, ED was associated with lower objective response rate (46.8% versus 62.1%, odds ratio 0.54, P = 0.022), reduced 2-year overall survival rate of 46.5% versus 64.9% (hazard ratio for death 1.82, 95% confidence interval 1.12 to 2.97, P = 0.016) and detriments in quality of life. The exploratory analysis indicated that the ED group showed elevated blood cortisol levels, which was associated with adverse survival outcomes. This study suggests that there is an association between ED and worse clinical outcomes in patients with advanced non-small-cell lung cancer treated with ICIs, highlighting the potential significance of addressing ED in cancer management. ClinicalTrials.gov registration: NCT05477979 .
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Affiliation(s)
- Yue Zeng
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chun-Hong Hu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Hunan Cancer Mega-Data Intelligent Application and Engineering Research Centre, Changsha, China
| | - Yi-Zheng Li
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Molecular Radiation Oncology Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Jian-Song Zhou
- National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Shu-Xing Wang
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Meng-Dong Liu
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Zhen-Hua Qiu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chao Deng
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Fang Ma
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chun-Fang Xia
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Fei Liang
- Department of Biostatistics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yu-Rong Peng
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ao-Xi Liang
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sheng-Hao Shi
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shi-Jiao Yao
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jun-Qi Liu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wen-Jie Xiao
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Xiao-Qiao Lin
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Xin-Yu Tian
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Ying-Zhe Zhang
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhuo-Ying Tian
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ji-An Zou
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Yun-Shu Li
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Chao-Yue Xiao
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tian Xu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiao-Jie Zhang
- National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiao-Ping Wang
- National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xian-Ling Liu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Fang Wu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China.
- National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China.
- Hunan Cancer Mega-Data Intelligent Application and Engineering Research Centre, Changsha, China.
- Hunan Key Laboratory of Tumor Models and Individualized Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
- Hunan Key Laboratory of Early Diagnosis and Precision Therapy in Lung Cancer, The Second Xiangya Hospital, Central South University, Changsha, China.
- FuRong Laboratory, Changsha, China.
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12
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Bai Y, Niu L, Song L, Dai G, Zhang W, He B, San W, Li S. Uncovering the effect and mechanism of Jiawei Xiaoyao Wan in treating breast cancer complicated with depression based on network pharmacology and experimental analysis. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 128:155427. [PMID: 38513380 DOI: 10.1016/j.phymed.2024.155427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Depression is a clinically common co-morbidity in breast cancer cases that brings negative outcomes on quality of life and potentially survival. Jiawei Xiaoyao Wan (JXW) is widely used in treating breast cancer and depressive disorder, but its potential pharmacological mechanisms remain elusive. PURPOSE We aimed to explore the dual therapeutic effects and mechanisms of JXW acting on breast cancer complicated with depression (BCCD) by network pharmacology and in vivo experimental verification. METHODS The chemical constituents of JXW were characterized using liquid chromatography-quadrupole time-of-flight tandem mass spectrometry (LC-Q-TOF/MS). The targets related to constituents of JXW were predicted by the TCMSP and Swiss Target Prediction databases, and targets of breast cancer and depression were screened by the GeneCards and OMIM databases. Gene Ontology annotation and KEGG enrichment analysis were performed with the DAVID database. Ultimately, a BCCD mouse model induced by chronic restraint stress (CRS) was used to explore therapeutic effects and mechanisms of JXW against BCCD. The efficacy of JXW in the treatment of BCCD was evaluated based on behavioral tests, tumor volume and weight, and pathological examination. Additionally, the underlying mechanisms were explored by measuring the levels of neurotransmitter and inflammatory factors, as well as detecting the expression of genes or proteins associated with candidate targets and the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway through RT-PCR, western blotting, and immunohistochemistry. RESULTS Totals of 108 components were identified in JXW using LC-Q-TOF/MS. By network pharmacology analysis, 714 compound targets of JXW, 2114 breast cancer targets, 1122 depression targets, and 98 overlapping proteins were obtained. PPI network and KEGG analysis implied that TP53, ESR1, VEGFA, AKT1, IL6, TNF, EGFR and the JAK/STAT pathway might be the potential targets of JXW in treating BCCD. In vivo experiments indicated that JXW significantly ameliorated depressive symptoms and tumor progression in BCCD mice. Further mechanistic studies showed that JXW could reduce the levels of inflammatory factors, increase 5-HT level, and regulate mRNA expression levels of TP53, VEGFA, AKT1, IL6, TNF, and EGFR targets. Moreover, the expression levels of proteins related to the JAK2/STAT3 signaling pathway in BCCD mice were effectively regulated by JXW. CONCLUSION JXW exerts dual therapeutic effects in a BCCD mouse via multiple targets. The underlying mechanisms might be associated with regulating the levels of neurotransmitter and inflammatory factors; more importantly, the JAK2/STAT3 pathway plays a significant role in this process.
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Affiliation(s)
- Yongtao Bai
- Department of Pharmacy, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Lianjie Niu
- Department of Breast Disease, Henan Breast Cancer Center, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Lihua Song
- Department of Pharmacy, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Guoliang Dai
- Department of Clinical Pharmacology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
| | - Wenzhou Zhang
- Department of Pharmacy, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Baoxia He
- Department of Pharmacy, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China
| | - Wenqing San
- Department of Pharmacology, School of Pharmacy, Nantong University, Nantong 226001, China
| | - Shuolei Li
- Department of Pharmacy, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou 450008, China.
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13
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Chen Y, Markowitz JC, Blanco C, Hershman DL, Zhang JT, Hellerstein DJ. Geographical distance predicts psychiatric treatment retention for Hispanic women with comorbid major depression and breast cancer. Breast Cancer Res Treat 2024; 205:249-256. [PMID: 38376796 DOI: 10.1007/s10549-024-07250-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 01/05/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE Depression is among the most common comorbid psychiatric disorders of patients with breast cancer. Depression decreases patient quality of life and, if untreated, can adversely affect cancer treatment. We sought to identify treatment barriers for women with breast cancer receiving psychotherapy for depression. Findings may help policy makers and researchers determine funding and design of future studies involving this population, especially in communities with high rates of health disparities. METHODS We used data from a randomized trial for women with breast cancer and current DSM-IV non-psychotic unipolar major depressive disorder (MDD). Patients were randomly assigned to 12 weeks of one of three psychotherapies and attrition was assessed by whether subjects completed 12 weekly treatment sessions. We used descriptive analyses and logistic regression to identify treatment barriers. R shiny was used to determine study patient residences. RESULTS Of 134 randomized patients, 84 (62.7%) were Hispanic. Fifty-nine patients (44%) either did not start or dropped out of treatment, 49 (83.1%) of them being Hispanic. Being a Hispanic woman, less educated, and geographically distant from treatment significantly predicted attrition. Single Hispanic mothers had significantly higher attrition risk than married and/or childless women. CONCLUSION Identifying barriers to treatment is important to improve treatment adherence for patients with concurrent diagnoses of breast cancer and MDD, especially for traditionally underserved minorities. Additional support such as affordable tele-medicine, multi-language assistance, financial aid for transportation and child-care, and allocation of more funds to address some identified barriers deserve consideration to improve treatment adherence and outcomes.
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Affiliation(s)
- Ying Chen
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA.
- Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA.
| | - John C Markowitz
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
- Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA
| | - Carlos Blanco
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse (NIDA), Gaithersburg, MD, 20892, USA
| | - Dawn L Hershman
- Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA
| | - Joy T Zhang
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
- University of Virginia, Charlottesville, VA, 22904, USA
| | - David J Hellerstein
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
- Columbia University Irving Medical Center (CUIMC), New York, NY, 10032, USA
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14
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Guo L, Hong SC, Wang X, Wang SQ, Wang N, Wei XQ, Situ HL, Wang ZY. Modulatory Effects of XIAOPI Formula on CXCL1 and Selected Outcomes in Triple-Negative Breast Cancer: A Randomized Controlled Clinical Trial. BREAST CANCER (DOVE MEDICAL PRESS) 2024; 16:289-303. [PMID: 38835647 PMCID: PMC11149640 DOI: 10.2147/bctt.s462296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/07/2024] [Indexed: 06/06/2024]
Abstract
Background Triple-negative breast cancer (TNBC) is the most aggressive malignancy. Psychological distress and elevated CXCL1 level have been reported to be closely associated with the poor prognosis and quality of life of patients with TNBC. In preclinical studies using xenograft mouse models, XIAOPI formula, a nationally approved drug prescribed to patients at high risk for breast cancer, inhibited CXCL1 expression and improved survival. Traditional Chinese medicine has unique advantages in improving patients' emotional disorders and quality of life. However, the impact of XIAOPI formula on the serum level of CXCL1, psychological distress, and quality of life among patients with TNBC is currently unknown. Methods In this study, we designed a randomized, double-blind, placebo-controlled trial. Patients with TNBC were randomly assigned to receive either the XIAOPI formula or a placebo for three months. The primary outcomes include serum CXCL1 expression, Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS). Secondary outcomes included the Pittsburgh Sleep Quality Index (PSQI) and the Functional Assessment of Cancer Therapy-Breast (FACT-B). Results A total of 60 patients with TNBC were enrolled in the investigation. The results showed that the XIAOPI formula significantly decreased CXCL1 expression compared with the control group. Moreover, in comparison to the placebo, the XIAOPI formula increased FACT-B scores while decreasing SDS, SAS, and PSQI scores. Conclusion In patients with TNBC, XIAOPI formula may be effective in reducing CXCL1 levels, enhancing psychological well-being, and quality of life. While our research offers a natural alternative therapy that may enhance the prognosis of TNBC, future validation of its therapeutic effects will require large-scale, long-term clinical trials. Clinical Registration Number Registration website: www.chictr.org.cn, Registration date: 2018-1-19, Registration number: ChiCTR1800014535.
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Affiliation(s)
- Li Guo
- Breast Disease Specialist Hospital of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Shi-Cui Hong
- Breast Disease Specialist Hospital of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Xuan Wang
- Breast Disease Specialist Hospital of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Sheng-Qi Wang
- Breast Disease Specialist Hospital of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
- Guangdong-Hong Kong-Macau Joint Laboratory on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Neng Wang
- Guangdong-Hong Kong-Macau Joint Laboratory on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
- The Research Center for Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Xiao-Qing Wei
- Breast Disease Specialist Hospital of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Hong-Lin Situ
- Breast Disease Specialist Hospital of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
- Guangdong-Hong Kong-Macau Joint Laboratory on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Zhi-Yu Wang
- Breast Disease Specialist Hospital of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
- Guangdong-Hong Kong-Macau Joint Laboratory on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
- The Research Center for Integrative Medicine, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China
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Bao C, Feng Y, Huang J, Wang Z, Wang X, Hou Y, He C. The efficacy of exercise training for improving body composition in patients with breast cancer: A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2024:2692155241232399. [PMID: 38794843 DOI: 10.1177/02692155241232399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
OBJECTIVES To evaluate the efficacy of exercise in improving body composition in patients with breast cancer; the effects of exercise on weight and BMI were evaluated as secondary outcomes. DATA SOURCES Cochrane Library, EMBASE, PubMed and Web of Science were searched for randomized controlled trials published in English from database inception to 29 November 2023. METHODS The effects of exercise on body composition in patients with breast cancer were explored. After separately extracting the data, two reviewers assessed the overall quality of the evidence as well as the methodological quality of the included studies. RESULTS Fourteen studies with 1241 participants were included, of which 12 studies were eligible for meta-analysis. Exercise significantly reduced body fat (mean difference [MD], -0.33; 95% CI, -0.37 to -0.29; P < 0.00001) and increased lean mass (MD, 0.42; 95% CI, 0.34 to 0.49; P < 0.00001) in patients with breast cancer. Further, exercise intervention was associated with increased BMI of patients with breast cancer (MD, 0.03; 95% CI, 0.01 to 0.06; P = 0.01), while no significant difference in weight was detected between the exercise and the non-exercise groups. Subgroup analysis results showed that only resistance exercise reduced fat mass (MD, -0.22; 95% CI, -0.27 to -0.16; P < 0.00001). CONCLUSIONS Exercise effectively improves body composition in patients with breast cancer. Clinicians should encourage patients to engage in exercise and develop optimized exercise prescriptions.
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Affiliation(s)
- Chuncha Bao
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yuan Feng
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jiapeng Huang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Zezhang Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Xiaoyi Wang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yue Hou
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Chengqi He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
- Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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16
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Haywood D, Kotov R, Krueger RF, Wright AGC, Forbes MK, Dauer E, Baughman FD, Rossell SL, Hart NH. Is it time to discard the Diagnostic and Statistical Manual of Mental Disorders (DSM) in psycho-oncology? Cancer Lett 2024; 589:216818. [PMID: 38554804 DOI: 10.1016/j.canlet.2024.216818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/12/2024] [Accepted: 03/12/2024] [Indexed: 04/02/2024]
Abstract
The conceptual basis of psychopathology within cancer survivorship is critical, as the chosen conceptualisation informs assessment and explanatory models, as well as interventions and supportive care approaches. The validity of a chosen conceptualisation of psychopathology is therefore paramount for ensuring cancer survivors receive high-quality and efficacious care and support that can be iteratively improved via coordinated research efforts. In this paper, we discuss the traditional diagnostic approach to conceptualising psychopathology within cancer care, including the diagnostic system the 'Diagnostic and Statistical Manual of Mental Disorders' (DSM) [1], and the significant issues it presents within cancer survivorship. We detail and discuss how an alternate conceptualisation of psychopathology may enhance both research and practice within psycho-oncology. We ultimately pose, and provide our perspective, on the question "Is it Time to Discard the DSM in Psycho-Oncology?"
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Aidan G C Wright
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA; Eisenberg Family Depression Center, University of Michigan, Ann Arbor, MI, USA
| | - Miriam K Forbes
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Evan Dauer
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Frank D Baughman
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Susan L Rossell
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
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Rogge AA, Liegl G, Snyder C, Rose M, Nolte S. EORTC QLQ-C30 general population normative data for the United States. Eur J Cancer 2024; 202:114030. [PMID: 38552543 DOI: 10.1016/j.ejca.2024.114030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is a frequently used cancer-specific health-related quality of life (HRQoL) questionnaire. To aid interpretation of data obtained via EORTC QLQ-C30, general population norm data have been published for many countries. However, despite its frequent use in the United States, no normative data by sex and age exist to date. Therefore, this study aimed to generate sex- and age-specific EORTC QLQ-C30 normative data for the United States. METHODS Recruitment and data collection were carried out via online panels as part of a larger cross-sectional study. For the recruitment, the sample was stratified by sex and age (18-39, 40-49, 50-59, 60-69, ≥ 70 years) to achieve a balanced distribution, with n = 100 per subgroup. Descriptive statistics are presented by age and age/sex. RESULTS A total of N = 1009 respondents completed the survey (n = 508 females, n = 501 males). More than two thirds of participants (72.5%) reported at least one health condition, e.g., arthritis (26%). Across EORTC QLQ-C30 scales, women and men 60 years and older reported generally better/higher functioning and better/lower symptom scores compared to the younger age groups. CONCLUSION To date, no specific EORTC QLQ-C30 general population normative data have been published for the United States. This paper provides these important normative data, which will greatly support the interpretation of EORTC QLQ-C30 scale scores obtained from US cancer patients, and also enable comparison with European norms.
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Affiliation(s)
- Alizé A Rogge
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Gregor Liegl
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claire Snyder
- Johns Hopkins Schools of Medicine and Public Health, Baltimore, MD, USA
| | - Matthias Rose
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; German Centre for Mental Health (DZPG) - - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sandra Nolte
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia; School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
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18
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Beiner C, Qureshi MM, Zhao J, Hu B, Jimenez R, Hirsch AE. Depression and Anxiety Among English- and Spanish-Speaking Patients With Breast Cancer Receiving Radiation Therapy. Int J Radiat Oncol Biol Phys 2024; 119:185-192. [PMID: 38070714 DOI: 10.1016/j.ijrobp.2023.11.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/16/2023] [Accepted: 11/19/2023] [Indexed: 12/25/2023]
Abstract
PURPOSE An estimated 30% and 40% of patients with breast cancer experience depression and anxiety, respectively. However, distress experienced by patients with breast cancer receiving radiation therapy may vary among patients and vary at different time points. This study sought to describe the changes in levels of depression and anxiety experienced by English- and Spanish-speaking patients throughout a course of radiation therapy for breast cancer, along with the effect of different variables to better understand potential gaps. METHODS AND MATERIALS Eligibility criteria included English- and Spanish-speaking females, aged 18 or older, undergoing radiation therapy treatment for breast cancer at 2 institutions. Pre- and posttreatment surveys were completed before and after delivery of radiation therapy. Sociodemographic characteristics collected included race, ethnicity, marital status, education level, longest residency location, religion, housing, and food insecurity. The survey ended with the standardized PHQ-4 questionnaire to assess anxiety and depression. Results were analyzed using the analysis of covariance procedure. RESULTS A total of 160 participants completed pre- and posttreatment surveys, with an initial response rate of 100% (169 patients), though 9 were lost to follow-up. Most of the participants were nonwhite (50%), primarily married (42.5%), and had a high school or associate's level education (46.9%). The total baseline distress mean (BDM) was 2.96 and the final distress mean was 2.78. English-speaking patients comprised 82.5% (n = 132) of the sample and had a BDM of 2.91 with an adjusted change mean decrease of 0.45. Spanish-speaking patients comprised 17.5% (n = 28) of the sample, with a baseline distress mean of 3.21 and an adjusted change mean increase of 1.03 (P = .002). Housing (P = .017) and food insecurity (P = .0002) also showed increasing distress with increased insecurity at baseline. CONCLUSIONS Patients who speak Spanish, identify as Hispanic, or are experiencing food and housing insecurity are at an increased risk for depression and anxiety, and could benefit from more support during their course of radiation therapy to minimize distress.
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Affiliation(s)
- Corina Beiner
- Boston University Chobanian & Avedisian School of Medicine.
| | | | - Jenny Zhao
- Boston University Chobanian & Avedisian School of Medicine
| | - Bonnie Hu
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Rachel Jimenez
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts
| | - Ariel E Hirsch
- Boston University Chobanian & Avedisian School of Medicine; Department of Radiation Oncology, Boston Medical Center
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19
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Xu Q, Qu B, Li L, Chen Y. Geographical association of biodiversity with cancer and cardiovascular mortality rates: analysis of 39 distinct conditions. Front Public Health 2024; 12:1368017. [PMID: 38746003 PMCID: PMC11091335 DOI: 10.3389/fpubh.2024.1368017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/08/2024] [Indexed: 05/16/2024] Open
Abstract
Background Biodiversity has been recognized as a positive contributor to human health and wellbeing. Cardiovascular disease and cancer are the two most significant global health burdens, and understanding their relationship with biodiversity forms an essential step toward promoting biodiversity conservation and human health. Methods The species richness of birds is a common indicator of biodiversity, given their vast numbers, distinctive distribution, and acute sensitivity to environmental disturbances. This ecological study utilized avian observation data derived from the eBird database, human health data from the International Health Metrics and Evaluation, and county-level statistics, including population characteristics, socio-economics, healthcare service, residential environment, and geographic and climatic characteristics in 2014. We aimed to extensively explore the individual associations between biodiversity (i.e., avian species richness) and age-standardized cause-specific mortalities for different types of cancers (29 conditions) and cardiovascular diseases (10 conditions) across the United States (US). Results Our multiple regression analyses that adjusted for a variety of socio-demographic and geographical factors showed that increased rarefied species richness of birds was associated with reduced mortality rates for three of the five most common cancers, namely, tracheal, bronchus, and lung cancer, breast cancer (in women only), and colon and rectal cancer. For cardiovascular conditions, a similar relationship was observed for ischemic heart disease and cerebrovascular disease-the two most frequent causes of mortality. This study provided extended details regarding the beneficial effects of biodiversity on human health.
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Affiliation(s)
- Qiaochu Xu
- Department of Geography and Planning, School of Environmental Science, University of Liverpool, Liverpool, United Kingdom
- Wisdom Lake Academy of Pharmacy, Xi’an Jiaotong-Liverpool University, Suzhou, China
| | - Bingjie Qu
- Wisdom Lake Academy of Pharmacy, Xi’an Jiaotong-Liverpool University, Suzhou, China
| | - Li Li
- Department of Health and Environmental Sciences, Xi’an Jiaotong-Liverpool University, Suzhou, China
| | - Ying Chen
- Wisdom Lake Academy of Pharmacy, Xi’an Jiaotong-Liverpool University, Suzhou, China
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20
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Da C, Duan Y, Ji Z, Chen J, Xia H, Weng Y, Zhou T, Yuan C, Cai T. Assessing the needs of patients with breast cancer and their families across various treatment phases using a Latent Dirichlet Allocation model: a text-mining approach to online health communities. Support Care Cancer 2024; 32:314. [PMID: 38683417 DOI: 10.1007/s00520-024-08513-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/17/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE This study aimed to assess the different needs of patients with breast cancer and their families in online health communities at different treatment phases using a Latent Dirichlet Allocation (LDA) model. METHODS Using Python, breast cancer-related posts were collected from two online health communities: patient-to-patient and patient-to-doctor. After data cleaning, eligible posts were categorized based on the treatment phase. Subsequently, an LDA model identifying the distinct need-related topics for each phase of treatment, including data preprocessing and LDA topic modeling, was established. Additionally, the demographic and interactive features of the posts were manually analyzed. RESULTS We collected 84,043 posts, of which 9504 posts were included after data cleaning. Early diagnosis and rehabilitation treatment phases had the highest and lowest number of posts, respectively. LDA identified 11 topics: three in the initial diagnosis phase and two in each of the remaining treatment phases. The topics included disease outcomes, diagnosis analysis, treatment information, and emotional support in the initial diagnosis phase; surgical options and outcomes, postoperative care, and treatment planning in the perioperative treatment phase; treatment options and costs, side effects management, and disease prognosis assessment in the non-operative treatment phase; diagnosis and treatment options, disease prognosis, and emotional support in the relapse and metastasis treatment phase; and follow-up and recurrence concerns, physical symptoms, and lifestyle adjustments in the rehabilitation treatment phase. CONCLUSION The needs of patients with breast cancer and their families differ across various phases of cancer therapy. Therefore, specific information or emotional assistance should be tailored to each phase of treatment based on the unique needs of patients and their families.
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Affiliation(s)
- Chaojin Da
- Department of Nursing, School of Clinical Nursing, Gansu Health Vocational College, Lanzhou, China
| | - Yiwen Duan
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Zhenying Ji
- Department of Nursing, School of Clinical Nursing, Gansu Health Vocational College, Lanzhou, China
| | - Jialin Chen
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Haozhi Xia
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Yajuan Weng
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Tingting Zhou
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Changrong Yuan
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China.
| | - Tingting Cai
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China.
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Brick RS, Gallicchio L, Mollica MA, Zaleta AK, Tonorezos ES, Jacobsen PB, Castro KM, Miller MF. Survivorship concerns among individuals diagnosed with metastatic cancer: Findings from the Cancer Experience Registry. J Cancer Surviv 2024:10.1007/s11764-024-01573-8. [PMID: 38592607 DOI: 10.1007/s11764-024-01573-8] [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: 01/05/2024] [Accepted: 03/17/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Individuals with metastatic cancer experience many medical, physical, and emotional challenges due to changing medical regimens, oscillating disease states, and side effects. The purpose of this study was to describe the type and prevalence of survivorship concerns reported by individuals with metastatic cancer, and their associations with cancer diagnosis, treatment, and socio-demographic variables. METHODS This study utilized data from the Cancer Support Community's Cancer Experience Registry. Individuals were included if they self-reported a solid tumor metastatic cancer and completed CancerSupportSource, which evaluates five domains of concerns (emotional well-being, symptom burden, body image/healthy lifestyle, healthcare team communication, and relationships/intimacy). Multivariable linear regression examined associations between independent predictors of each survivorship concern domain. RESULTS Of the 403 included participants, individuals reported a metastatic diagnosis of breast (43%), colorectal (20%), prostate (7%), lung (7%), gynecologic cancer (6%) and other. Nearly all (96%) reported at least one survivorship concern, with the most prevalent concern about cancer progression or recurrence. Survivorship concerns were higher across multiple domains for individuals unemployed due to disability. Individuals who were less than five years since diagnosis reported higher concerns related to emotional well-being, symptom burden, and healthcare communication compared to those more than five years since diagnosis. CONCLUSION Individuals with metastatic cancer experience a variety of moderate-to-severe survivorship concerns that warrant additional investigation. IMPLICATIONS FOR CANCER SURVIVORS As the population of individuals with metastatic cancer lives longer, future research must investigate solutions to address modifiable factors associated with survivorship concerns, such as unemployment due to disability.
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Affiliation(s)
- Rachelle S Brick
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Lisa Gallicchio
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Michelle A Mollica
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Alexandra K Zaleta
- Department of Research, CancerCare, 275 Seventh Avenue, New York, NY, 10001, USA
| | - Emily S Tonorezos
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Paul B Jacobsen
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Kathleen M Castro
- Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Melissa F Miller
- Research and Training Institute, Cancer Support Community, 5614 Connecticut Avenue NW, Suite 280, Washington, D.C, 20015, USA.
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Xia S, Zhu Y, Luo L, Wu W, Ma L, Yu L, Li Y. Prognostic value of depression and anxiety on colorectal cancer-related mortality: a systematic review and meta-analysis based on univariate and multivariate data. Int J Colorectal Dis 2024; 39:45. [PMID: 38563889 PMCID: PMC10987367 DOI: 10.1007/s00384-024-04619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Depression and anxiety are common mental disorders in patients with colorectal cancer (CRC); however, it remains unclear whether they are related to cancer mortality. METHOD Based on a systematic literature search, 12 eligible studies involving 26,907 patients with CRC were included in this study. RESULTS Univariate analysis revealed that anxiety was associated with an all-cause mortality rate of 1.42 (1.02, 1.96), whereas multivariate analysis revealed that anxiety was not associated with an all-cause mortality rate of 0.73 (0.39, 1.36). In univariate and multivariate analyses, depression was associated with all-cause mortality rates of 1.89 (1.68, 2.13) and 1.62 (1.27, 2.06), respectively, but not with the cancer-associated mortality rate of 1.16 (0.91, 1.48) in multivariate analyses. Multivariate subgroup analysis of depression and all-cause mortality showed that younger age (≤65 years), being diagnosed with depression/anxiety after a confirmed cancer diagnosis, and shorter follow-up time (<5 years) were associated with poor prognosis. CONCLUSIONS Our study emphasizes the key roles of depression and anxiety as independent factors for predicting the survival of patients with CRC. However, owing to the significant heterogeneity among the included studies, the results should be interpreted with caution. Early detection and effective treatment of depression and anxiety in patients with CRC have public health and clinical significance.
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Affiliation(s)
- Shijun Xia
- Shenzhen Hospital of Guangzhou University of Chinese Medicine<Futian>, Shenzhen, 518000, Guangdong, China
| | - Yuwen Zhu
- Shenzhen Hospital of Guangzhou University of Chinese Medicine<Futian>, Shenzhen, 518000, Guangdong, China
| | - Lidan Luo
- Shenzhen Hospital of Guangzhou University of Chinese Medicine<Futian>, Shenzhen, 518000, Guangdong, China
| | - Wenjiang Wu
- Shenzhen Hospital of Guangzhou University of Chinese Medicine<Futian>, Shenzhen, 518000, Guangdong, China.
| | - Lijuan Ma
- Shenzhen Traditional Chinese Medicine Anorectal Hospital<Futian>, Shenzhen, 518000, Guangdong, China
| | - Linchong Yu
- Shenzhen Hospital of Guangzhou University of Chinese Medicine<Futian>, Shenzhen, 518000, Guangdong, China
| | - Yue Li
- Shenzhen Hospital of Guangzhou University of Chinese Medicine<Futian>, Shenzhen, 518000, Guangdong, China
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23
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Koç Z, Kaplan E, Tanrıverdi D. The effectiveness of telehealth programs on the mental health of women with breast cancer: A systematic review. J Telemed Telecare 2024; 30:405-419. [PMID: 35108131 DOI: 10.1177/1357633x211069663] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objective: The purpose of this systematic review is to determine the evidence-based information and results about the effectiveness of telehealth programs on the mental health of women with breast cancer. Methods: The research process was carried out using PRISMA guidelines. Randomized controlled trials with available abstract and full text, which were published in English with the keywords "telehealth," "telemedicine," "web-based therapy," "telepsychiatry," "online therapy" and "breast cancer" in Pub Med, PsycINFO, Medline, Science Direct, Scopus, Web of Sciences and Cochrane databases between 2015-2019 were searced. As a result of the evaluations, the research was completed with 16 studies meeting the research criteria. Results: There was strong evidence for reduce the fear of relapse of cancer, depressive symptoms and severity of depression, distress, intrusive thoughts, anxiety, sleep disorder, insomnia, improve quality of life and for improve cognitive functions, improve psychological strength and sleep quality of telehealth programs in women with breast cancer. Furthermore, evidence was found for increase psychological health, functionality, optimism and control over the future, positive mood and life appreciation, and drug compliance of these programs. Conclusion: This review found evidence for the effectiveness of telehealth programs on the mental problems of women with breast cancer. In this sense, it is recommended to expand the use of telehealth programs, which can save time and cost, are accessible and easily applicable by nurses, to improve the mental health of women with breast cancer, and further studies are recommended.
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Affiliation(s)
- Zeynep Koç
- Faculty of Health Sciences, Department of Nursing, Gaziantep University, Gaziantep, Turkey
| | - Ece Kaplan
- Faculty of Health Sciences, Department of Nursing, Gaziantep University, Gaziantep, Turkey
| | - Derya Tanrıverdi
- Faculty of Health Sciences, Department of Nursing, Gaziantep University, Gaziantep, Turkey
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Abstract
Although there is little direct evidence supporting that stress affects cancer incidence, it does influence the evolution, dissemination and therapeutic outcomes of neoplasia, as shown in human epidemiological analyses and mouse models. The experience of and response to physiological and psychological stressors can trigger neurological and endocrine alterations, which subsequently influence malignant (stem) cells, stromal cells and immune cells in the tumour microenvironment, as well as systemic factors in the tumour macroenvironment. Importantly, stress-induced neuroendocrine changes that can regulate immune responses have been gradually uncovered. Numerous stress-associated immunomodulatory molecules (SAIMs) can reshape natural or therapy-induced antitumour responses by engaging their corresponding receptors on immune cells. Moreover, stress can cause systemic or local metabolic reprogramming and change the composition of the gastrointestinal microbiota which can indirectly modulate antitumour immunity. Here, we explore the complex circuitries that link stress to perturbations in the cancer-immune dialogue and their implications for therapeutic approaches to cancer.
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Affiliation(s)
- Yuting Ma
- National Key Laboratory of Immunity and Inflammation, Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Suzhou, China.
| | - Guido Kroemer
- National Key Laboratory of Immunity and Inflammation, Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Suzhou, China
- Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, INSERM U1138, Centre de Recherche des Cordeliers, Institut Universitaire de France, Paris, France
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Campus, Villejuif, France
- Pôle de Biologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
- Karolinska Institute, Department of Women's and Children's Health, Karolinska University Hospital, Stockholm, Sweden
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25
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Valente S, Roesch E. Breast cancer survivorship. J Surg Oncol 2024. [PMID: 38534002 DOI: 10.1002/jso.27627] [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: 02/20/2024] [Accepted: 03/11/2024] [Indexed: 03/28/2024]
Abstract
Breast cancer survivorship care transitions from active treatment to focus on surveillance and health maintenance. This review article discusses the crucial aspects of breast cancer survivorship, which include cancer surveillance, management of treatment side effects, implementation of a healthy lifestyle, and psychosocial support.
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Affiliation(s)
| | - Erin Roesch
- Hematology/Medical Oncology, Cleveland Clinic, Cleveland, Ohio, USA
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Zhang Y, He Y, Pang Y, Su Z, Wang Y, Zhou Y, Lu Y, Jiang Y, Han X, Song L, Wang L, Li Z, Lv X, Wang Y, Yao J, Liu X, Zhou X, He S, Song L, Li J, Wang B, Tang L. Suicidal ideation in Chinese patients with advanced breast cancer: a multi-center mediation model study. BMC Psychol 2024; 12:139. [PMID: 38475847 DOI: 10.1186/s40359-024-01607-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
PURPOSE The pathways underpinning suicide ideation (SI) and certain physical and psychological factors in patients with advanced breast cancer remain unclear. This study develops and validates a mediation model that delineates the associations between several multidimensional variables and SI in Chinese patients with advanced breast cancer. METHODS Patients with advanced breast cancer (n = 509) were recruited as study participants from 10 regional cancer centers across China from August 2019 to December 2020. Participants were required to complete five questionnaires using an electronic patient-reported outcomes (ePRO) system: 9 item- Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), 5-level EQ-5D (EQ-5D-5L), and MD Anderson Symptom Inventory (MDASI). Risk factors for SI were identified using multivariable logistic regression, and inputted into serial multiple mediation models to elucidate the pathways linking the risk factors to SI. RESULTS SI prevalence was 22.8% (116/509). After adjusting for covariates, depression (odds ratio [OR] = 1.384), emotional distress (OR = 1.107), upset (OR = 0.842), and forgetfulness (OR = 1.236) were identified as significant independent risk factors (all p < 0.05). The ORs indicate that depression and distress have the strongest associations with SI. Health status has a significant indirect effect (OR=-0.044, p = 0.005) and a strong total effect (OR=-0.485, p < 0.001) on SI, mediated by insomnia severity and emotional distress. CONCLUSIONS There is a high SI prevalence among Chinese patients with advanced breast cancer. Our analysis revealed predictive pathways from poor health to heightened SI, mediated by emotional distress and insomnia. Regular management of distress and insomnia can decrease suicide risk in this vulnerable population.
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Affiliation(s)
- Yening Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China
| | - Yi He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China
| | - Ying Pang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China
| | - Zhongge Su
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China
| | - Yu Wang
- Department of Breast Cancer Radiotherapy, Cancer Hospital, Chinese Academy of Medical Sciences, Shanxi Medical University, Taiyuan, China
| | - Yuhe Zhou
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China
| | - Yongkui Lu
- The Fifth Department of Chemotherapy, The Affiliated Cancer Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yu Jiang
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xinkun Han
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China
| | - Lihua Song
- Department of Breast Medical Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Liping Wang
- Department of Oncology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zimeng Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China
| | - Xiaojun Lv
- Department of Oncology, Xiamen Humanity Hospital, Xiamen, China
| | - Yan Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China
| | - Juntao Yao
- Department of Integrated Chinese and Western Medicine, Shaanxi Provincial Cancer Hospital Affiliated to Medical College of Xi'an Jiaotong University, Xi'an, China
| | - Xiaohong Liu
- Department of Clinical Spiritual Care, The Affiliated Cancer Hospital of Xiangya School of Medicine, Hunan Cancer Hospital, Central South University, Changsha, China
| | - Xiaoyi Zhou
- Radiotherapy Center, Hubei Cancer Hospital, Wuhan, China
| | - Shuangzhi He
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China
| | - Lili Song
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China
| | - Jinjiang Li
- Department of Psycho-oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China
| | - Bingmei Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China
| | - Lili Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &Institute, Fu-Cheng Road 52, Hai-Dian District, 100142, Beijing, China.
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Verschoor CP, Theou O, Ma J, Montgomery P, Mossey S, Nangia P, Saskin R, Savage DW. Age- and sex-specific associations of frailty with mortality and healthcare utilization in community-dwelling adults from ontario, Canada. BMC Geriatr 2024; 24:223. [PMID: 38438981 PMCID: PMC10913570 DOI: 10.1186/s12877-024-04842-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/23/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Understanding how health trajectories are related to the likelihood of adverse outcomes and healthcare utilization is key to planning effective strategies for improving health span and the delivery of care to older adults. Frailty measures are useful tools for risk stratification in community-based and primary care settings, although their effectiveness in adults younger than 60 is not well described. METHODS We performed a 10-year retrospective analysis of secondary data from the Ontario Health Study, which included 161,149 adults aged ≥ 18. Outcomes including all-cause mortality and hospital admissions were obtained through linkage to ICES administrative databases with a median follow-up of 7.1-years. Frailty was characterized using a 30-item frailty index. RESULTS Frailty increased linearly with age and was higher for women at all ages. A 0.1-increase in frailty was significantly associated with mortality (HR = 1.47), the total number of outpatient (IRR = 1.35) and inpatient (IRR = 1.60) admissions over time, and length of stay (IRR = 1.12). However, with exception to length of stay, these estimates differed depending on age and sex. The hazard of death associated with frailty was greater at younger ages, particularly in women. Associations with admissions also decreased with age, similarly between sexes for outpatient visits and more so in men for inpatient. CONCLUSIONS These findings suggest that frailty is an important health construct for both younger and older adults. Hence targeted interventions to reduce the impact of frailty before the age of 60 would likely have important economic and social implications in both the short- and long-term.
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Affiliation(s)
- Chris P Verschoor
- Health Sciences North Research Institute, Sudbury, ON, Canada.
- NOSM University, Sudbury/Thunder Bay, ON, Canada.
- , 56 Walford Road, Rm. 119, P3E 2H2, Sudbury, ON, Canada.
| | - Olga Theou
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | - Jinhui Ma
- Dept. of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | | | - Sharolyn Mossey
- School of Nursing, Laurentian University, Sudbury, ON, Canada
| | - Parveen Nangia
- School of Social Sciences, Laurentian University, Sudbury, ON, Canada
| | | | - David W Savage
- Health Sciences North Research Institute, Sudbury, ON, Canada
- NOSM University, Sudbury/Thunder Bay, ON, Canada
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MIROŠEVIČ Š, PRINS J, BEŠIĆ N, BORŠTNAR S, ŠKUFCA SMRDEL AC, HOMAR V, POPOVIĆ M, KLEMENC-KETIŠ Z. Symptoms of Anxiety and Depression Among Slovenian Breast Cancer Survivors Post-Treatment During the COVID-19 Pandemic: A Cross-Sectional Study. Zdr Varst 2024; 63:55-62. [PMID: 38156338 PMCID: PMC10751885 DOI: 10.2478/sjph-2024-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/30/2023] [Indexed: 12/30/2023] Open
Abstract
Background Although anxiety and depression are important determinants of mental health, the literature in this area is sparse as most studies focus on the period during treatment. Mental health problems can affect cancer recovery as well as quality of life and survival. In this cross-sectional study, we investigated the prevalence of anxiety and depression in Slovenian cancer survivors after treatment and assessed the associated correlates during the COVID-19 pandemic. Methods From September 2021 to January 2022, we collected data from 430 breast cancer survivors one to five years after receiving post-local treatment and (neo)adjuvant chemotherapy. We used the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression levels. Multivariate linear regression was used to identify factors associated with higher levels of anxiety and depression. Results Key findings from this study are increased levels of psychological distress and identification of relevant factors associated with those elevated levels. Approximately one-third of breast cancer survivors exhibited symptoms of elevated anxiety and depression, with one in eight meeting clinical thresholds. Multivariate linear regression revealed that age, lower quality of life, heightened fear of cancer recurrence (FCR), reduced resilience, limited social support, and unmet psychosocial and emotional needs correlated with increased anxiety symptoms. Additionally, lower quality of life, higher FCR, diminished resilience, and limited social support were associated with higher depression symptomatology. Conclusions Our study of Slovenian breast cancer survivors one to five years post-treatment observed a significant increase in anxiety and depression symptoms, possibly exacerbated by the COVID-19 pandemic. The demographic and psychosocial factors identified in this study offer valuable insights for future research. The study emphasises the importance of recognising and addressing the psychological needs of breast cancer survivors and the need to follow them throughout their cancer journey.
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Affiliation(s)
- Špela MIROŠEVIČ
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, 1000Ljubljana, Slovenia
- Community Health Centre Ljubljana, Metelkova 9, 1000Ljubljana, Slovenia
| | - Judith PRINS
- Radboud University Medical Centre, Department of Medical Psychology, Nijmegen, Netherlands
| | - Nikola BEŠIĆ
- Institute of Oncology, Department of Surgical Oncology Ljubljana, Zaloška 2, 1000Ljubljana, Slovenia
| | - Simona BORŠTNAR
- Institute of Oncology, Department of Medical Oncology Ljubljana, Zaloška 2, 1000Ljubljana, Slovenia
| | | | - Vesna HOMAR
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, 1000Ljubljana, Slovenia
| | - Marko POPOVIĆ
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, 1000Ljubljana, Slovenia
| | - Zalika KLEMENC-KETIŠ
- University of Ljubljana, Faculty of Medicine, Department of Family Medicine, Poljanski nasip 58, 1000Ljubljana, Slovenia
- Community Health Centre Ljubljana, Metelkova 9, 1000Ljubljana, Slovenia
- University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska 8, 2000Maribor, Slovenia
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Geremew H, Abdisa S, Mazengia EM, Tilahun WM, Haimanot AB, Tesfie TK, Mneneh AL, Mengie MG, Endalew B, Birhanu MY, Asmare L, Simegn MB. Anxiety and depression among cancer patients in Ethiopia: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1341448. [PMID: 38455516 PMCID: PMC10917887 DOI: 10.3389/fpsyt.2024.1341448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction Anxiety and depression are among the common comorbidities of people diagnosed with cancer. However, despite the progress in therapeutic options and outcomes, mental health care and support have lagged behind for cancer patients. Estimating the extent and determinants of mental health disorders among cancer patients is crucial to alert concerned bodies for action. In view of this, we aimed to determine the pooled prevalence and determinants of anxiety and depression among cancer patients in Ethiopia. Methods Relevant literatures were searched on PubMed, African Journals Online, Hinari, Epistemonikos, Scopus, EMBASE, CINAHL, Cochrane Library, and Gray literature sources. Data were extracted into an Excel spreadsheet and analyzed using STATA 17 statistical software. The random effect model was used to summarize the pooled effect sizes with their respective 95% confidence intervals. The I2 statistics and Egger's regression test in conjunction with the funnel plot were utilized to evaluate heterogeneity and publication bias among included studies respectively. Results A total of 17 studies with 5,592 participants were considered in this review. The pooled prevalence of anxiety and depression among cancer patients in Ethiopia were 45.10% (95% CI: 36.74, 53.45) and 42.96% (95% CI: 34.98, 50.93), respectively. Primary and above education (OR= 0.76, 95% CI: 0.60, 0.97), poor social support (OR= 2.27, 95% CI: 1.29, 3.98), occupational status (OR= 0.59; 95% CI: 0.43, 0.82), advanced cancer stage (OR= 2.19, 95% CI: 1.38, 3.47), comorbid illness (OR= 1.67; 95% CI: 1.09, 2.58) and poor sleep quality (OR= 11.34, 95% CI: 6.47, 19.89) were significantly associated with depression. Whereas, advanced cancer stage (OR= 1.59, 95% CI: 1.15, 2.20) and poor sleep quality (OR= 12.56, 95% CI: 6.4 1, 24.62) were the factors associated with anxiety. Conclusion This meta-analysis indicated that a substantial proportion of cancer patients suffer from anxiety and depression in Ethiopia. Educational status, occupational status, social support, cancer stage, comorbid illness and sleep quality were significantly associated with depression. Whereas, anxiety was predicted by cancer stage and sleep quality. Thus, the provision of comprehensive mental health support as a constituent of chronic cancer care is crucial to mitigate the impact and occurrence of anxiety and depression among cancer patients. Besides, families and the community should strengthen social support for cancer patients. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023468621.
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Affiliation(s)
- Habtamu Geremew
- College of Health Science, Oda Bultum University, Chiro, Ethiopia
| | - Samuel Abdisa
- Department of Midwifery, College of Health Science, Oda Bultum University, Chiro, Ethiopia
| | - Elyas Melaku Mazengia
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Werkneh Melkie Tilahun
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Aysheshim Belaineh Haimanot
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Tigabu Kidie Tesfie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Lamesgen Mneneh
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Muluye Gebrie Mengie
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Bekalu Endalew
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Molla Yigzaw Birhanu
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Lakew Asmare
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Mulat Belay Simegn
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
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Nardi M, Catalini A, Galiano A, Santangelo OE, Pinto E, Feltrin A, Nucci D, Gianfredi V. Association between malnutrition and anxiety in cancer patients-a retrospective study. Support Care Cancer 2024; 32:152. [PMID: 38334802 DOI: 10.1007/s00520-024-08350-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION The total number of cancer-related deaths and new cancer cases in 2020 was 19.3 billion and 10.8 billion, respectively. Therefore, prevention, diagnosis, and treatment of neoplastic disease, as well as management of comorbidities, are of paramount importance. In this regards, poor nutritional status and mental disorders are comorbidity conditions frequently observed in cancer patients. The aim of this study was to assess the association between malnutrition and anxiety in hospitalized adult cancer patients. METHODS This is a retrospective study. Nutrition Risk Screening (NRS) 2002, body mass index (BMI), daily calorie intake, and weight difference between admission and discharge were used to evaluate nutritional status. Anxiety was assessed with the Hospital Anxiety and Depression Scale (HADS-A). Ordered logistic and linear logistic regressions adjusted for sex and age were used to estimate the association between malnutrition and anxiety in cancer patients. RESULTS A total of 90 patients were included. Higher NRS risk [aβ = 0.85; 95% CI (0.28-1.42); p = 0.004], disease stage [aβ = 0.77; 95% CI (0.08-1.47); p = 0.029], and cachexia [aβ = 2.20; 95% CI (0.75-3.65); p = 0.003] were significantly associated with anxiety symptoms. Moreover, cancer site different than gastrointestinal cancers was associated with a lower risk of anxiety symptoms [aβ = - 2.11; 95% CI (- 3.55/ - 0.66); p = 0.005]. CONCLUSION In the current study, we found a relatively high rate of malnourished patients, indicating the importance of routinely assessing nutritional status and screening cancer patients for mental health issues. This approach could help physicians to treat both in a timely manner, thereby significantly reducing the burden of the disease and improving the quality of life of patients.
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Affiliation(s)
- Mariateresa Nardi
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, 35128, Padua, Italy
| | - Alessandro Catalini
- Department of Biomedical Sciences and Public Health, Università Politecnica Delle Marche, 60100, Ancona, Italy
| | - Antonella Galiano
- Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, 35128, Padua, Italy
| | | | - Eleonora Pinto
- Hospital Psychology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128, Padua, Italy.
| | - Alessandra Feltrin
- Hospital Psychology Unit, Veneto Institute of Oncology IOV-IRCCS, 35128, Padua, Italy
| | - Daniele Nucci
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, 35128, Padua, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
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Mohammed A, Melak D, Demeke Bayou F, Yasin H, Zerga AA, Wagaye B, Yeshanew Ayele F, Hussien Asfaw A, Kebede N, Mekonen AM, Mihiretu MM, Tsega Y, Addisu E, Cherie N, Birhane T, Endris H, Abegaz Z, Endawkie A. Prevalence and associated factors of depression among breast cancer patients in Sub-Saharan Africa: A systematic review and meta-analysis. SAGE Open Med 2024; 12:20503121241226897. [PMID: 38292418 PMCID: PMC10826378 DOI: 10.1177/20503121241226897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Even though breast cancer incidence is lower in Sub-Saharan Africa, its mortality is higher in these countries. However, the impact does not end with diagnosis and treatment; rather many patients struggle with depression which is very common among these patients. This systematic review and meta-analysis helps to provide valuable insights into the overall prevalence of depression and associated factors among breast cancer patients in Sub-Saharan Africa. Method We searched several databases, including MEDLINE, Embase, Scopus, Hinary, CINHAL and Google Scholar to retrieve relevant literatures from inception up to 15 June 2023. All observational studies, published in English at any time were included, while, letters to editor, review articles, commentaries, interventional and qualitative studies, and, abstracts presented in conferences or seminars were excluded. The results of this systematic review and meta-analysis have been written based on the PRISMA 2020 checklist and the protocol have been registered in PROSPERO database (CRD42023428910). Result We have included nine articles with 2226 study participants. The result showed that, the pooled prevalence of depression among breast cancer patients in Sub-Saharan Africa was 45.6% (95% CI: 30%-61%) with significant heterogeneity I2 = 98.9%, (Cochrane) Q < 0.0001. There was no single study effect and publication bias but substantial heterogeneity was observed. In addition, there has been a publication bias with eggers test (p < 0.0033). However, there were no studies imputed after trim and fill analysis. From the factors, breast cancer patients who had poor financial support were 1.47 (95% CI: 1.02-2.13) times more at risk of developing depression than their counterparts. Conclusion The prevalence of depression among breast cancer patients in Sub-Saharan Africa countries were higher than other regions. Thus, Emphasis should be given on developing financial assistance programs designed to cover the medical costs and improving the health care infrastructure.
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Affiliation(s)
- Anissa Mohammed
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Dagnachew Melak
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Fekade Demeke Bayou
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Husniya Yasin
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Aregash Abebayehu Zerga
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Birhanu Wagaye
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Fanos Yeshanew Ayele
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Ahmed Hussien Asfaw
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Asnakew Molla Mekonen
- Department of Health System and Management, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Mengistu Mera Mihiretu
- Department of Health System and Management, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Yawkal Tsega
- Department of Health System and Management, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Elsabeth Addisu
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Niguss Cherie
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Tesfaye Birhane
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Hussien Endris
- Department of Anaesthesia and Critical Care, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Zinet Abegaz
- Department of Reproductive Health, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Abel Endawkie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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Walker II WH, Liu JA, Meléndez-Fernández OH, May LE, Kisamore CO, Brundage KM, Nelson RJ, DeVries AC. Social enrichment alters the response of brain leukocytes to chemotherapy and tumor development in aged mice. Heliyon 2024; 10:e23366. [PMID: 38148808 PMCID: PMC10750159 DOI: 10.1016/j.heliyon.2023.e23366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/28/2023] Open
Abstract
Aging is a risk factor for the development of breast cancer. Foundational science studies have supported associations among neuroinflammation, breast cancer, and chemotherapy, but to date, these associations are based on studies using young adult rodents. The current study examined the neuroinflammatory effects of chemotherapy in aged, tumor-naïve and tumor-bearing mice with or without social enrichment. Mice received two intravenous injections of doxorubicin (A) and cyclophosphamide (C) at a two-week interval. Brain immune cells were enriched/assessed via flow cytometry, seven days following the second chemotherapy injection. Social enrichment enhanced peripheral immune cell trafficking in aged tumor-naive mice treated with AC. Group housed aged tumor bearing mice receiving AC had reduced percentage of IL-6+ monocytes and granulocytes relative to their singly housed counterparts. Notably, group housing aged experimental mice with young cage partners significantly reduced TNF + monocytes, tumor volume, and tumor mass. These data illustrate the importance of social enrichment in attenuating neuroinflammation and are the first to demonstrate that social support with young housing partners reduces tumor growth in aged mice.
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Affiliation(s)
- William H. Walker II
- Department of Neuroscience, Rockefeller Neuroscience Institute, USA
- West Virginia University Cancer Institute, USA
| | - Jennifer A. Liu
- Department of Neuroscience, Rockefeller Neuroscience Institute, USA
| | | | - Laura E. May
- Department of Neuroscience, Rockefeller Neuroscience Institute, USA
| | | | - Kathleen M. Brundage
- Department of Microbiology, Immunology, and Cell Biology, West Virginia University, Morgantown, WV, 26506, USA
| | - Randy J. Nelson
- Department of Neuroscience, Rockefeller Neuroscience Institute, USA
- West Virginia University Cancer Institute, USA
| | - A. Courtney DeVries
- Department of Neuroscience, Rockefeller Neuroscience Institute, USA
- West Virginia University Cancer Institute, USA
- Department of Medicine, USA
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van de Wal D, den Hollander D, Desar IM, Gelderblom H, Oosten AW, Reyners AK, Steeghs N, Husson O, van der Graaf WT. Fear, anxiety and depression in gastrointestinal stromal tumor (GIST) patients in the Netherlands: Data from a cross-sectional multicenter study. Int J Clin Health Psychol 2024; 24:100434. [PMID: 38226006 PMCID: PMC10788803 DOI: 10.1016/j.ijchp.2023.100434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/28/2023] [Indexed: 01/17/2024] Open
Abstract
Background This study aims to (1) investigate the prevalence of anxiety, depression and severe fear of cancer recurrence or progression in gastrointestinal stromal tumor (GIST) patients treated in a curative or palliative setting, (2) compare their prevalence with a norm population, (3) identify factors associated with anxiety, depression and severe fear, and (4) study the impact of these psychological symptoms on health-related quality of life (HRQoL). Methods In a cross-sectional study, GIST patients completed the Hospital Anxiety and Depression Scale, Cancer Worry Scale, and EORTC QLQ-C30. Results Of the 328 patients, 15% reported anxiety, 13% depression, and 43% had severe fear. Anxiety and depression levels were comparable between the norm population and patients in the curative setting, but significantly higher for patients in the palliative setting. Having other psychological symptoms was associated with anxiety, while current TKI treatment and anxiety were associated with depression. Severe fear was associated with age, female sex, palliative treatment setting, anxiety, and GIST-related concerns. Conclusion GIST patients treated in a palliative setting are more prone to experience psychological symptoms, which can significantly impair their HRQoL. These symptoms deserve more attention in clinical practice, in which regular screening can be helpful, and appropriate interventions should be offered.
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Affiliation(s)
- Deborah van de Wal
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Dide den Hollander
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ingrid M.E. Desar
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Astrid W. Oosten
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Anna K.L. Reyners
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Neeltje Steeghs
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Olga Husson
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, the Netherlands
| | - Winette T.A. van der Graaf
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
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Joulaei H, Parhizkar M, Fatemi M, Afrashteh S, Parhizkar P, Akrami M, Foroozanfar Z. Mental Health Care Utilization and its Barriers among Iranian Breast Cancer Survivors: A Cross-sectional Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2024; 12:44-56. [PMID: 38328011 PMCID: PMC10844875 DOI: 10.30476/ijcbnm.2023.99133.2289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/07/2023] [Accepted: 11/21/2023] [Indexed: 02/09/2024]
Abstract
Background Depression and anxiety are common comorbidities complicating the care of breast cancer patients, but many patients do not receive the needed care. We aimed to assess utilization of mental health care and its barriers in breast cancer survivors. Methods This cross-sectional study was conducted on 311 patients with breast cancer, in Iran, November 2021 to March 2022. Perceived need and utilization of mental health care and barriers to service utilization were measured based on self-report. Depression, Anxiety, and Stress Scale-21 and Multidimensional Scale of Perceived Social Support were used to assess depression, anxiety, and stress as well as social support, respectively. A linear and logistic regression model was used to analyze the data using SPSS version 22. A P-value less than 0.05 was considered statistically significant. Results 70.1% of the participants perceived need for mental health care, 28.0% of them had used mental health services, and 72% were classified as having unmet needs. The most common perceived barrier to service use was patients' self-adequacy. The prevalence of extremely severe levels of depression, anxiety, and stress was 14.8%, 23.5%, and 10.6%. Also, 48.6%, 78.5%, and 75.6% of patients received a high level of social support from friends, family, and significant others. Conclusion Findings highlight a substantial unmet need for mental health care and low utilization of mental health services among breast cancer survivors. Given the significant prevalence of depression, anxiety, and stress in this population, it is imperative to address the underutilization of mental health services and to further examine the barriers preventing patients from seeking the care they require.
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Affiliation(s)
- Hassan Joulaei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohamad Parhizkar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Fatemi
- Department of Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
| | - Sima Afrashteh
- Clinical Research Development Center, The Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Pardis Parhizkar
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Majid Akrami
- Breast Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Pezzolato M, Spada GE, Fragale E, Cutica I, Masiero M, Marzorati C, Pravettoni G. Predictive Models of Psychological Distress, Quality of Life, and Adherence to Medication in Breast Cancer Patients: A Scoping Review. Patient Prefer Adherence 2023; 17:3461-3473. [PMID: 38143947 PMCID: PMC10748751 DOI: 10.2147/ppa.s440148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/27/2023] [Indexed: 12/26/2023] Open
Abstract
Purpose An interplay of clinical and psychosocial variables affects breast cancer patients' experiences and clinical trajectories. Several studies investigated the role of socio-demographic, clinical, and psychosocial factors in predicting relevant outcomes in breast cancer care, thus developing predictive models. Our aim is to summarize predictive models for specific psychological and behavioral outcomes: psychological distress, quality of life, and medication adherence. Specifically, we aim to map the determinants of the outcomes of interest, offering a thorough overview of these models. Methods Databases (PubMed, Scopus, Embase) have been searched to identify studies meeting the inclusion criteria: a breast cancer patients' sample, development/validation of a predictive model for selected psychological/behavioral outcomes (ie, psychological distress, quality of life, and medication adherence), and availability of English full-text. Results Twenty-one papers describing predictive models for psychological distress, quality of life, and adherence to medication in breast cancer were included. The models were developed using different statistical approaches. It has been shown that treatment-related factors (eg, side-effects, type of surgery or treatment received), socio-demographic (eg, younger age, lower income, and inactive occupational status), clinical (eg, advanced stage of disease, comorbidities, physical symptoms such as fatigue, insomnia, and pain) and psychological variables (eg, anxiety, depression, body image dissatisfaction) might predict poorer outcomes. Conclusion Predictive models of distress, quality of life, and adherence, although heterogeneous, showed good predictive values, as indicated by the reported performance measures and metrics. Many of the predictors are easily available in patients' health records, whereas others (eg, coping strategies, perceived social support, illness perceptions) might be introduced in routine assessment practices. The possibility to assess such factors is a relevant resource for clinicians and researchers involved in developing and implementing psychological interventions for breast cancer patients.
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Affiliation(s)
- M Pezzolato
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - G E Spada
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy
| | - E Fragale
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy
| | - I Cutica
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - M Masiero
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - C Marzorati
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy
| | - G Pravettoni
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Xiong SY, Wen HZ, Dai LM, Lou YX, Wang ZQ, Yi YL, Yan XJ, Wu YR, Sun W, Chen PH, Yang SZ, Qi XW, Zhang Y, Wu GY. A brain-tumor neural circuit controls breast cancer progression in mice. J Clin Invest 2023; 133:e167725. [PMID: 37847562 PMCID: PMC10721160 DOI: 10.1172/jci167725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 10/12/2023] [Indexed: 10/18/2023] Open
Abstract
Tumor burden, considered a common chronic stressor, can cause widespread anxiety. Evidence suggests that cancer-induced anxiety can promote tumor progression, but the underlying neural mechanism remains unclear. Here, we used neuroscience and cancer tools to investigate how the brain contributes to tumor progression via nerve-tumor crosstalk in a mouse model of breast cancer. We show that tumor-bearing mice exhibited significant anxiety-like behaviors and that corticotropin-releasing hormone (CRH) neurons in the central medial amygdala (CeM) were activated. Moreover, we detected newly formed sympathetic nerves in tumors, which established a polysynaptic connection to the brain. Pharmacogenetic or optogenetic inhibition of CeMCRH neurons and the CeMCRH→lateral paragigantocellular nucleus (LPGi) circuit significantly alleviated anxiety-like behaviors and slowed tumor growth. Conversely, artificial activation of CeMCRH neurons and the CeMCRH→LPGi circuit increased anxiety and tumor growth. Importantly, we found alprazolam, an antianxiety drug, to be a promising agent for slowing tumor progression. Furthermore, we show that manipulation of the CeMCRH→LPGi circuit directly regulated the activity of the intratumoral sympathetic nerves and peripheral nerve-derived norepinephrine, which affected tumor progression by modulating antitumor immunity. Together, these findings reveal a brain-tumor neural circuit that contributes to breast cancer progression and provide therapeutic insights for breast cancer.
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Affiliation(s)
- Si-Yi Xiong
- Breast and Thyroid Surgery, Southwest Hospital
| | - Hui-Zhong Wen
- Department of Neurobiology, Chongqing Key Laboratory of Neurobiology, College of Basic Medical Sciences
| | - Li-Meng Dai
- Department of Medical Genetics, College of Basic Medical Sciences
| | - Yun-Xiao Lou
- Department of Neurobiology, Chongqing Key Laboratory of Neurobiology, College of Basic Medical Sciences
| | - Zhao-Qun Wang
- Department of Neurobiology, Chongqing Key Laboratory of Neurobiology, College of Basic Medical Sciences
| | - Yi-Lun Yi
- Experimental Center of Basic Medicine, Chongqing Key Laboratory of Neurobiology, College of Basic Medical Sciences
| | - Xiao-Jing Yan
- Department of Biochemistry and Molecular Biology, College of Basic Medical Sciences
| | - Ya-Ran Wu
- Department of Clinical Biochemistry, Faculty of Pharmacy and Laboratory Medicine, and
| | - Wei Sun
- Biomedical Analysis Center, Army Medical University, Chongqing, China
| | - Peng-Hui Chen
- Department of Neurobiology, Chongqing Key Laboratory of Neurobiology, College of Basic Medical Sciences
| | - Si-Zhe Yang
- Breast and Thyroid Surgery, Southwest Hospital
| | - Xiao-Wei Qi
- Breast and Thyroid Surgery, Southwest Hospital
| | - Yi Zhang
- Breast and Thyroid Surgery, Southwest Hospital
| | - Guang-Yan Wu
- Experimental Center of Basic Medicine, Chongqing Key Laboratory of Neurobiology, College of Basic Medical Sciences
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Liu JY, Zheng JQ, Yin CL, Tang WP, Zhang JN. Hotspots and frontiers of the relationship between gastric cancer and depression: A bibliometric study. World J Gastroenterol 2023; 29:6076-6088. [PMID: 38130743 PMCID: PMC10731158 DOI: 10.3748/wjg.v29.i46.6076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/02/2023] [Accepted: 12/02/2023] [Indexed: 12/13/2023] Open
Abstract
BACKGROUND A significant relationship between gastric cancer (GC) and depression has been found in the last 20 years. However, there is no comprehensive information that helps researchers find popular and potential research directions on GC and depression. AIM To determine the research status and hotspots by bibliometric analysis of relevant publications on the relationship between GC and depression. METHODS We used the Web of Science Core Collection to search and collate the literature on GC and depression from 2000 to 2022 on 31 May, 2023. Then, visualization analysis was performed using VOSviewer software (version 1.6.19) and the Bibliometrix package in R software. RESULTS We retrieved 153 pertinent publications from 2000 to 2022. The annual publication count showed an overall upward trend. China had the most prominent publications and significant contributions to this field (n = 64, 41.83%). Before 2020, most studies focused on "the effect of GC on the development and progression of depression in patients." The latest research trends indicate that "the effect of depression on the occurrence and development of GC and its mechanism" will receive more attention in the future. CONCLUSION The study of "the effect of depression on the occurrence and development of GC and its mechanism" has emerged as a novel research theme over the past two years, which may become a research hotspot in this field. This study provides new insights into the hotpots and frontiers of the relationship between GC and depression, potentially guiding researchers toward hot research topics in the future.
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Affiliation(s)
- Jia-Yu Liu
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Ji-Qi Zheng
- School of Health Humanities, Peking University, Beijing 100191, China
| | - Cheng-Liang Yin
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing 100853, China
- National Engineering Research Center for Medical Big Data Application Technology, Chinese PLA General Hospital, Beijing 100853, China
| | - Wen-Pei Tang
- School of Health Humanities, Peking University, Beijing 100191, China
| | - Jian-Ning Zhang
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
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Liu L, Lu J, Yang J, Dong Y, Yin P, Chen Y. A marginal structural model analysis for the effect modification by education on the association between cancer diagnosis history and major depressive symptoms: Findings from Midlife Development in the U.S. (MIDUS). J Affect Disord 2023; 341:202-210. [PMID: 37640112 DOI: 10.1016/j.jad.2023.08.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Limited research has employed a longitudinal approach to investigate the role of education level as an effect modifier on the relationship between cancer diagnosis history and the experience of major depressive disorder (MDD) with a nationally representative sample. METHODS We harnessed data from three installments of the MIDUS Longitudinal study (n = 7108). A Marginal Structural Model facilitated the investigation of associations between a history of cancer diagnosis, MDD, and potential modifying effects of education level. Inverse probability weighting helped manage confounding factors. RESULTS Findings indicated that a cancer diagnosis made one year prior was linked with 3.741 times greater odds of experiencing MDD (95 % CI: 1.411-9.918, p < 0.01). This connection was absent for diagnoses made two years earlier. Among individuals with education up to high school, a recent cancer diagnosis significantly increased the likelihood of MDD in the subsequent wave by 3.45 times (95 % CI: 1.31-9.08, p < 0.05). This pattern was not apparent among better-educated individuals. LIMITATIONS As the exposure variable was dependent on self-reported questionnaires, recall bias could be a potential limitation. Moreover, unaccounted variables like genetic factors could introduce confounding. CONCLUSIONS A recent cancer diagnosis, particularly among less educated individuals, correlated with an increased probability of MDD, while the impact was not observed for older diagnoses. These findings emphasize that the timing of a cancer diagnosis and education level need consideration in the mental health assessment of cancer survivors.
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Affiliation(s)
- Lumin Liu
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Junjie Lu
- Department of Social and Behavioral Sciences, Harvard University T.H. Chan School of Public Health, Boston, USA.
| | - Jiarui Yang
- Department of Biomedical Engineering, Boston University, Boston, USA.
| | - Yiyue Dong
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ping Yin
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Yuelai Chen
- LongHua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Mahlaq S, Lahlou L, Rammouz I, Abouqal R, Belayachi J. Factors associated with psychological burden of breast cancer in women in Morocco: cross‑sectional study. BMC Womens Health 2023; 23:590. [PMID: 37950247 PMCID: PMC10638816 DOI: 10.1186/s12905-023-02769-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Depression and anxiety are among the psychological diagnoses impacting individuals diagnosed with breast cancer. This study aims to estimate the prevalence, as well as the predictors, of anxiety and depression in women with breast cancer. MATERIALS AND METHODS This was a cross-sectional, multi-center study conducted over an eight-month period among women with breast cancer in oncology centers in southern Morocco. Anxiety and depression were assessed using the validated Moroccan dialectal version of the Hospital Anxiety and Depression Scale (HADs). To identify the predictors of anxiety and depression in the study population. Multiple linear regression analyses were performed, including variables for which univariate analyses were significant with a p < 0.05 value. Statistical analyses were performed using Jamovi software version 2.2.3. RESULTS A total of 230 participant responses were collected. The prevalence of anxiety and depression was 77.4% and 62.6%, respectively. Multiple linear regression analysis revealed the following factors increased anxiety: being younger than 50 years old, not having studied beyond elementary school, having children aged between 10 and 18 and having TNM stage III and IV. The following factors decreased anxiety in patients with breast cancer: good physical functioning (Karnofsky score), satisfaction with social support and financial support. Regarding depression, the following factors decreased depression: good physical functioning (Karnofsky score), a minimum of 2.5 h per week of physical activity, active occupational status, satisfaction with social support and financial support. In contrast, the recurrence of breast cancer was an associated factor with increased depression. CONCLUSION The prevalence of anxiety and depression in women with breast cancer is very high in our context. Therefore, routine screening tests for depression and anxiety as well as psychosocial management care are necessary for patients with breast cancer in Morocco.
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Affiliation(s)
- Safiya Mahlaq
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, 10100, Morocco.
| | - Laila Lahlou
- Faculty of Medicine and Pharmacy of Agadir, Ibn-Zohr University, Agadir, Morocco
| | - Ismail Rammouz
- Faculty of Medicine and Pharmacy of Agadir, Ibn-Zohr University, Agadir, Morocco
| | - Redouane Abouqal
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, 10100, Morocco
| | - Jihane Belayachi
- Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, 10100, Morocco
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Nakamura ZM, Small BJ, Zhai W, Ahles TA, Ahn J, Artese AL, Bethea TN, Breen EC, Cohen HJ, Extermann M, Graham D, Irwin MR, Isaacs C, Jim HSL, Kuhlman KR, McDonald BC, Patel SK, Rentscher KE, Root JC, Saykin AJ, Tometich DB, Van Dyk K, Zhou X, Mandelblatt JS, Carroll JE. Depressive symptom trajectories in older breast cancer survivors: the Thinking and Living with Cancer Study. J Cancer Surviv 2023:10.1007/s11764-023-01490-2. [PMID: 37924476 PMCID: PMC11068856 DOI: 10.1007/s11764-023-01490-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/21/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE To identify trajectories of depressive symptoms in older breast cancer survivors and demographic, psychosocial, physical health, and cancer-related predictors of these trajectories. METHODS Recently diagnosed nonmetastatic breast cancer survivors (n = 272), ages 60-98 years, were evaluated for depressive symptoms (Center for Epidemiological Studies Depression Scale, CES-D; scores ≥16 suggestive of clinically significant depressive symptoms). CES-D scores were analyzed in growth-mixture models to determine depression trajectories from baseline (post-surgery, pre-systemic therapy) through 3-year annual follow-up. Multivariable, multinomial logistic regression was used to identify baseline predictors of depression trajectories. RESULTS Survivors had three distinct trajectories: stable (84.6%), emerging depressive symptoms (10.3%), and recovery from high depressive symptoms at baseline that improved slowly over time (5.1%). Compared to stable survivors, those in the emerging (OR = 1.16; 95% CI = 1.08-1.23) or recovery (OR = 1.26; 95% CI = 1.15-1.38) groups reported greater baseline anxiety. Greater baseline deficit accumulation (frailty composite measure) was associated with emerging depressive symptoms (OR = 3.71; 95% CI = 1.90-7.26). Less social support at baseline (OR = 0.38; 95% CI = 0.15-0.99), but greater improvement in emotional (F = 4.13; p = 0.0006) and tangible (F = 2.86; p = 0.01) social support over time, was associated with recovery from depressive symptoms. CONCLUSIONS Fifteen percent of older breast cancer survivors experienced emerging or recovery depressive symptom trajectories. Baseline anxiety, deficit accumulation, and lower social support were associated with worse outcomes. IMPLICATIONS FOR CANCER SURVIVORS Our results emphasize the importance of depression screening throughout the course of cancer care to facilitate early intervention. Factors associated with depressive symptoms, including lower levels of social support proximal to diagnosis, could serve as intervention levers.
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Affiliation(s)
- Zev M Nakamura
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, Campus Box #7160, Chapel Hill, NC, 27599, USA.
| | - Brent J Small
- School of Aging Studies, University of South Florida, and Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Wanting Zhai
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Ashley L Artese
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Traci N Bethea
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Elizabeth C Breen
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Harvey J Cohen
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Martine Extermann
- Department of Oncology, Moffitt Cancer Center, University of South Florida, Tampa, FL, USA
| | - Deena Graham
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Michael R Irwin
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Claudine Isaacs
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Kate R Kuhlman
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychological Science, University of California, Irvine, CA, USA
- Institute for Interdisciplinary Salivary Bioscience Research, School of Social Ecology, University of California, Irvine, CA, USA
| | - Brenna C McDonald
- Department of Radiology and Imaging Sciences, Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sunita K Patel
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Kelly E Rentscher
- Department of Psychiatry and Behavioral Medicine, MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Danielle B Tometich
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Kathleen Van Dyk
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Xingtao Zhou
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Jeanne S Mandelblatt
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Judith E Carroll
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
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Lin YS, Kuan CH, Lo C, Tsai LW, Wu CH, Huang CH, Yeong EK, Tai HC, Huang CS. Is Immediate Lymphatic Reconstruction on Breast Cancer Patients Oncologically Safe? A Preliminary Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5385. [PMID: 37941816 PMCID: PMC10629743 DOI: 10.1097/gox.0000000000005385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/20/2023] [Indexed: 11/10/2023]
Abstract
Background In breast cancer patients receiving axillary lymph node dissection (ALND), immediate lymphatic reconstruction (ILR) with lymphovenous anastomosis is an emerging technique for reducing the risk of arm lymphedema. However, the oncologic safety of surgically diverting lymphatic ducts directly into venules in a node-positive axilla is still a concern of inadvertently inducing metastasis of remaining cancer cells. This study aimed to assess the oncologic safety of ILR. Methods From January 2020 to January 2022, 95 breast cancer patients received ALND, and 45 of them also received ILR. Patients with recurrent cancer, with follow-up less than 12 months, and with missed data were excluded. Variables were compared between ILR and non-ILR groups, and the outcome of interest was the rate of distant recurrence after follow-up for at least 1 year. Results Thirty-four patients in the ILR group and 32 patients in the non-ILR group fulfilled the inclusion criteria for analysis. No statistically significant difference was noted between groups in terms of age, body mass index, type of breast surgery, pathologic cancer staging, histologic type and grade of breast cancer, molecular subtypes, frequency of axillary lymph node metastasis, or adjuvant therapy. For the patients receiving follow-up for at least 1 year, no statistically significant difference was found in terms of distant recurrence rates between ILR and non-ILR groups (P = 0.44). Conclusion For breast cancer patients receiving ALND, ILR with lymphovenous anastomosis is oncologically safe, within an average follow-up period of 21 months.
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Affiliation(s)
- Ying-Sheng Lin
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
| | - Chen-Hsiang Kuan
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Chiao Lo
- Division of General Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Wei Tsai
- Division of General Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Department of Surgical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Chien-Hui Wu
- Division of General Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Chieh-Huei Huang
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Eng-Kean Yeong
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Hao-Chih Tai
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Chiun-Sheng Huang
- From the Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
- Division of General Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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Weitz MV, Bloch JR, Birati Y, Rundio A, Fisher K, Byrne S, Guerra L. The Relationship Between Yoga Practice Dosage and Perceived Stress, Anxiety, and Self-reported Health Among Breast Cancer Survivors Who Practice Yoga. Holist Nurs Pract 2023; 37:347-355. [PMID: 37851351 DOI: 10.1097/hnp.0000000000000610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
The aim of this anonymous online study was to explore the yoga practice of breast cancer survivors to determine if yoga dosage (frequency and duration of practice) was related to stress, anxiety, and self-reported health in female survivors. Participants were recruited from online breast cancer support groups during a 3-month period (June-September 2019). Demographic information, stage and treatment of breast cancer, and frequency of yoga participation, including a home yoga practice were reported. Measures include the Perceived Stress Scale, State-Trait Anxiety Inventory, and self-reported health. Cumulative yoga dosage was calculated. Thirty-five women participated (mean age = 55 years) and were divided into low and high yoga dosage groups based on the sample distribution. Low dosage of yoga was operationally defined as a cumulative dosage that fell within the lowest quartile (≤25%). Findings indicated no difference between the low-dosage group compared with the high-dosage group for perceived stress and self-reported health; but the high dosage yoga group had lower state anxiety scores (P < .05). All participants reported good self-reported health. These findings contribute to our knowledge of the psychosocial aspects of breast cancer survivorship and raise questions for further research quantifying the therapeutic dosing of yoga practice.
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Affiliation(s)
- M Velma Weitz
- M Velma Weitz Wellness Practice, Philadelphia, Pennsylvania (Dr Weitz); Graduate Nursing Department, College of Nursing and Health Professions, Drexel University (Drs Bloch, Rundio, and Fisher); Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University Safed, Isreal (Dr Birati); and Department of Nursing & Public Health, School of Nursing and Health Science, The College of New Jersey (Dr Byrne). Dr Guerra, is in private practice at Bala Cynwyd, Pennsylvania
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Goel N, Hernandez AE, Ream M, Clarke ES, Blomberg BB, Cole S, Antoni MH. Effects of neighborhood disadvantage on cortisol and interviewer-rated anxiety symptoms in breast cancer patients initiating treatment. Breast Cancer Res Treat 2023; 202:203-211. [PMID: 37561280 DOI: 10.1007/s10549-023-07050-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/13/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE Shorter breast cancer (BC) survival outcomes persist by neighborhood disadvantage independent of patient, tumor, and treatment characteristics. This suggests unaccounted mechanisms by which neighborhood disadvantage "gets under the skin" to impact BC survival outcomes. Here, we evaluate the relationship between neighborhood disadvantage and clinical and neuroendocrine markers of stress in BC patients. METHODS Women with stage 0-III BC were enrolled 2-10 weeks post-surgery and before initiating adjuvant treatment in a study examining stress and stress management processes. Women provided an afternoon-evening (PM) serum cortisol sample and were administered the Hamilton Anxiety Rating Scale (HAM-A). Home addresses were used to determine the Area Deprivation Index (ADI), a validated measure of neighborhood disadvantage. Multiple regression assessed the relationship between ADI and PM serum cortisol and the presence of elevated HAM-A symptoms. RESULTS Our sample (n = 225) was predominately middle-aged (M = 50.4 years; range 23-70 years), non-Hispanic White (64.3%), with stage I (38.1%), or II (38.6%) disease. The majority (n = 175) lived in advantaged neighborhoods (ADI 1-3). After controlling for age, stage, and surgery type, women from high ADI (4-10) (vs low ADI) neighborhoods had higher PM cortisol levels (β = 0.19, 95% CI [0.24, 5.00], p = 0.031) and were nearly two times as likely to report the presence of elevated anxiety symptoms (OR = 1.96, 95% CI [1.00, 3.86], p = 0.050). CONCLUSION Neighborhood disadvantage is significantly associated with higher levels of PM cortisol and elevated anxiety symptoms suggesting stress pathways could potentially contribute to relationships between neighborhood disadvantage and BC survival.
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Affiliation(s)
- Neha Goel
- Division of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1120 NW 14Th Street, Suite 410, Miami, FL, 33136, USA.
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
| | - Alexandra E Hernandez
- Division of Surgical Oncology, Department of Surgery, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1120 NW 14Th Street, Suite 410, Miami, FL, 33136, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Molly Ream
- Department of Psychology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Estefany Saez Clarke
- Department of Psychology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Bonnie B Blomberg
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Microbiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Steve Cole
- Department of Psychiatry/Biobehavioral Sciences and Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael H Antoni
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Psychology, University of Miami Miller School of Medicine, Miami, FL, USA
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44
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Lempesis IG, Georgakopoulou VE, Papalexis P, Chrousos GP, Spandidos DA. Role of stress in the pathogenesis of cancer (Review). Int J Oncol 2023; 63:124. [PMID: 37711028 PMCID: PMC10552722 DOI: 10.3892/ijo.2023.5572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/01/2023] [Indexed: 09/16/2023] Open
Abstract
Stress is a state of disrupted homeostasis, triggered by intrinsic or extrinsic factors, the stressors, which are counteracted by various physiological and behavioural adaptive responses. Stress has been linked to cancer development and incidence for decades; however, epidemiological studies and clinical trials have yielded contradictory results. The present review discusses the effects of stress on cancer development and the various underlying mechanisms. Animal studies have revealed a clear link between stress and cancer progression, revealing molecular, cellular and endocrine processes that are implicated in these effects. Thus, stress hormones, their receptor systems and their intracellular molecular pathways mediate the effects of stress on cancer initiation, progression and the development of metastases. The mechanisms linking stress and cancer progression can either be indirect, mediated by changes in the cancer microenvironment or immune system dysregulation, or direct, through the binding of neuroendocrine stress‑related signalling molecules to cancer cell receptors. Stress affects numerous anti‑ and pro‑cancer immune system components, including host resistance to metastasis, tumour retention and/or immune suppression. Chronic psychological stress through the elevation of catecholamine levels may increase cancer cell death resistance. On the whole, stress is linked to cancer development and incidence, with psychological stressors playing a crucial role. Animal studies have revealed a better link than human ones, with stress‑related hormones influencing tumour development, migration, invasion and cell proliferation. Randomized controlled trials are required to further evaluate the long‑term cancer outcomes of stress and its management.
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Affiliation(s)
- Ioannis G. Lempesis
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Vasiliki Epameinondas Georgakopoulou
- Department of Infectious Diseases-COVID-19 Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pathophysiology, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros Papalexis
- Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece
| | - Georgios P. Chrousos
- Clinical, Translational and Experimental Surgery Research Centre, Biomedical Research Foundation Academy of Athens, 11527 Athens, Greece
- University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, 11527 Athens, Greece
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
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45
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Yang J, Jiang W. A meta-analysis of the association between post-traumatic stress disorder and cancer risk. Front Psychiatry 2023; 14:1281606. [PMID: 37965365 PMCID: PMC10642749 DOI: 10.3389/fpsyt.2023.1281606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/16/2023] [Indexed: 11/16/2023] Open
Abstract
Background Several studies have investigated the link between post-traumatic stress disorder (PTSD) and cancer risk but reported mixed results. The objective of our study was to investigate the association between PTSD and cancer risk. Methods Studies published in English about the relationship between PTSD and cancer incidence were systematically searched. We performed a meta-analysis to estimate the relative risks (RR) and 95% confidence intervals (CI) for cancer incidence. Result A total of 3,129 articles were screened. Finally, 8 articles and 11 studies were included in the meta-analysis. We found that PTSD was not associated with cancer risk compared with controls. For site-specific cancer, our results showed that women with PTSD were associated with higher risk of ovarian cancer than controls. However, PTSD was not associated with the risk of gastrointestinal cancer, breast cancer and lung cancer. Conclusion These analyzes based on studies published in English suggest that PTSD is associated with ovarian cancer risk, although the evidence base is very limited. Future studies are needed to investigate the mechanisms that PTSD diagnosis influenced cancer incidence depending on types of cancer.
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Affiliation(s)
- Juanjuan Yang
- Department of Health Management, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Wei Jiang
- Department of Oncology, The Second Affiliated Hospital of Xi’ an Jiaotong University, Xi’an, Shaanxi, China
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Cohen M, Shamay Y, Czamanski-Cohen J, Shulman K, Keren Rosenberg S, Abu-Amna M, Turgeman I, Merkin Livshits L, Birenboim R, Dines M, Bar-Sela G. Linkage between Psychological Factors and Response to Immune Checkpoint Inhibitor Therapy: A Preliminary Study. Cells 2023; 12:2471. [PMID: 37887315 PMCID: PMC10605722 DOI: 10.3390/cells12202471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/02/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
Substantial evidence has accumulated showing that psychological distress affects immune regulation, the response to cancer treatment, and survival. The effect of psychological parameters on the effectiveness of immune checkpoint inhibitor (ICI) treatment has not yet been studied. This preliminary study aimed to (a) examine the associations between psychological factors and responses to ICI treatment and (b) assess the associations between psychological factors and blood measures of sPD-1, sCTLA-4, and cytokines that may alter the effect of ICI treatment. The participants were 62 individuals with advanced cancer, aged 18 years or older, who were candidates for ICI treatment as a new line of treatment. The participants answered questionnaires and provided blood samples and medical data prior to the start of ICI treatment and 3 months after. Perceived health status was positively associated with better responses to ICI treatment. In the subsample of participants with biomarkers, worse health-related quality of life was associated with higher IL-6 and sCTLA-4; emotional distress and sleep difficulties were associated with higher sCTLA-4; and better perceived health was associated with lower IL-6 and TNFα. sPD-1 was not associated with psychological measures. This preliminary study found for the first time that some psychological measures could be linked to responses to cancer treatment, possibly via pro-inflammatory cytokines and sCTLA-4.
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Affiliation(s)
- Miri Cohen
- School of Social Work, University of Haifa, Haifa 3498838, Israel;
| | - Yosi Shamay
- Biomedical Engineering, Technion—Israel Institute of Technology, Haifa 3109601, Israel;
| | - Johanna Czamanski-Cohen
- Emili Sagol Creative Arts Therapies Research Center, School of Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (J.C.-C.); (M.D.)
| | - Katerina Shulman
- Carmel Medical Center, Haifa 3436212, Israel; (K.S.); (L.M.L.)
- Bruce Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3109601, Israel
- Lin Medical Center, Haifa 6688304, Israel;
| | | | - Mahmoud Abu-Amna
- Cancer Center, Emek Medical Center, Afula 1834111, Israel; (M.A.-A.); (I.T.)
| | - Ilit Turgeman
- Cancer Center, Emek Medical Center, Afula 1834111, Israel; (M.A.-A.); (I.T.)
| | - Ludmila Merkin Livshits
- Carmel Medical Center, Haifa 3436212, Israel; (K.S.); (L.M.L.)
- Lin Medical Center, Haifa 6688304, Israel;
| | | | - Monica Dines
- Emili Sagol Creative Arts Therapies Research Center, School of Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (J.C.-C.); (M.D.)
| | - Gil Bar-Sela
- Bruce Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3109601, Israel
- Cancer Center, Emek Medical Center, Afula 1834111, Israel; (M.A.-A.); (I.T.)
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Cui B, He B, Huang Y, Wang C, Luo H, Lu J, Su K, Zhang X, Luo Y, Zhao Z, Yang Y, Zhang Y, An F, Wang H, Lam EWF, Kelley KW, Wang L, Liu Q, Peng F. Pyrroline-5-carboxylate reductase 1 reprograms proline metabolism to drive breast cancer stemness under psychological stress. Cell Death Dis 2023; 14:682. [PMID: 37845207 PMCID: PMC10579265 DOI: 10.1038/s41419-023-06200-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 09/21/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023]
Abstract
Cancer stem-like cells (CSCs) contribute to cancer metastasis, drug resistance and tumor relapse, yet how amino acid metabolism promotes CSC maintenance remains exclusive. Here, we identify that proline synthetase PYCR1 is critical for breast cancer stemness and tumor growth. Mechanistically, PYCR1-synthesized proline activates cGMP-PKG signaling to enhance cancer stem-like traits. Importantly, cGMP-PKG signaling mediates psychological stress-induced cancer stem-like phenotypes and tumorigenesis. Ablation of PYCR1 markedly reverses psychological stress-induced proline synthesis, cGMP-PKG signaling activation and cancer progression. Clinically, PYCR1 and cGMP-PKG signaling components are highly expressed in breast tumor specimens, conferring poor survival in breast cancer patients. Targeting proline metabolism or cGMP-PKG signaling pathway provides a potential therapeutic strategy for breast patients undergoing psychological stress. Collectively, our findings unveil that PYCR1-enhanced proline synthesis displays a critical role in maintaining breast cancer stemness.
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Affiliation(s)
- Bai Cui
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
| | - Bin He
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Yanping Huang
- Department of Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Cenxin Wang
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
| | - Huandong Luo
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
| | - Jinxin Lu
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
| | - Keyu Su
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
| | - Xiaoyu Zhang
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
| | - Yuanyuan Luo
- CAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China
| | - Zhuoran Zhao
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
| | - Yuqing Yang
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
| | - Yunkun Zhang
- Department of Pathology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Fan An
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China
| | - Hong Wang
- Department of Orthopaedics, The Central Hospital of Dalian University of Technology, Dalian, China
| | - Eric W-F Lam
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Keith W Kelley
- Department of Pathology, College of Medicine and Department of Animal Sciences, College of ACES, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Ling Wang
- Department of Oncology, the First Affiliated Hospital of Dalian Medical University, Dalian, China.
| | - Quentin Liu
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China.
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China.
| | - Fei Peng
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian, China.
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Oliveira MEC, Torres GSV, Franklin RG, Gomes KAL, Nóbrega WFS, Fernandes TP, Santos NA. Cognitive impairments associated with chemotherapy in women with breast cancer: a meta-analysis and meta-regression. Braz J Med Biol Res 2023; 56:e12947. [PMID: 37851791 PMCID: PMC10578133 DOI: 10.1590/1414-431x2023e12947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/19/2023] [Indexed: 10/20/2023] Open
Abstract
Chemotherapy is one of the most widely used treatments for breast cancer (BC). However, there is evidence of side effects like cognitive changes related to the chemotherapy treatment. The aim of the study was not only to summarize the existing evidence on the relationship between chemotherapy and cognitive performance in women with BC but also to identify additional consequences and aspects associated with these impairments. We conducted a systematic review with meta-analysis and meta-regression to present updated information on the matter. We retrieved data from the databases PubMed, Web of Science, PsycINFO, CINAHL, and Scopus. Twenty studies comprising over 2,500 women were examined and the results indicated that chemotherapy can compromise cognition in women with BC (-1.10 OR [95%CI: -1.81 to -0.74], P<0.01), with working memory (-0.49 OR [95%CI: -0.85 to -0.13], P=0.03) being the most affected among the domains. Furthermore, additional data indicated that cognitive impairment is most likely amid women with BC having a lower education level (Q=4.85, P=0.02). Our results suggested that chemotherapy affects cognitive functions in women with BC, and certain characteristics can worsen the deterioration. A comprehensive study of women with breast cancer and existing predictors contributes to optimized personal journeys, elevated life prospects, and advanced care that can also aid prognosis and therapeutic approaches.
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Affiliation(s)
- M E C Oliveira
- Departamento de Psicologia, Universidade Federal da Paraíba, João Pessoa, PB, Brasil
| | - G S V Torres
- Departamento de Psicologia, Universidade Federal da Paraíba, João Pessoa, PB, Brasil
| | - R G Franklin
- Departamento de Psicologia, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | - K A L Gomes
- Departamento de Psicologia, Universidade Federal da Paraíba, João Pessoa, PB, Brasil
| | - W F S Nóbrega
- Departamento de Odontologia, Universidade Estadual da Paraíba, Campina Grande, PB, Brasil
| | - T P Fernandes
- Departamento de Psicologia, Universidade Federal da Paraíba, João Pessoa, PB, Brasil
| | - N A Santos
- Departamento de Psicologia, Universidade Federal da Paraíba, João Pessoa, PB, Brasil
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Chapman B, Grunfeld EA, Derakshan N. Quality of working life can protect against cognitive and emotional vulnerability in women living with metastatic breast cancer: a cross-sectional study. J Cancer Surviv 2023; 17:1295-1308. [PMID: 35038120 PMCID: PMC8761843 DOI: 10.1007/s11764-022-01169-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 01/10/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE Research focusing on the cognitive and emotional health of women with metastatic breast cancer (MBC) is limited. The focal aim of the current study was to explore how quality of working life was related to global health, perceived cognitive function, anxiety and depression. To this end, women's experience of employers after MBC diagnosis and its relationship to quality of working life was also explored. METHODS Women living with MBC (N = 88) completed online questionnaires assessing their global health status, perceived cognitive and emotional vulnerability and their experience of employers following diagnosis. Women working at the time of the study also reported on their quality of working life. RESULTS Women's experience of employers after MBC diagnosis was positively related to their quality of working life. Importantly, greater quality of working life met with better perceived cognitive function and global health, as well as lower levels of depression in working women. CONCLUSIONS Our study is the first to establish the role of quality of working life in protecting against levels of cognitive vulnerability and emotional vulnerability to depression in women with MBC. We also highlight the importance of having a positive experience with employers. Our findings suggest that educational programmes can be provided to employers to enhance their understanding and awareness of the needs of women with MBC. IMPLICATIONS FOR CANCER SURVIVORS Women with MBC may benefit from employers accessing educational (or support) programmes that can increase their awareness of the treatment-related sequelae and needs of women with MBC in the workplace.
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Affiliation(s)
- Bethany Chapman
- Department of Psychological Sciences, The BRiC Centre (Birkbeck Centre for Building Resilience in Breast Cancer), Birkbeck University of London, Malet Street, London, WC1E 7HX, UK.
| | - Elizabeth A Grunfeld
- Department of Psychological Sciences, The BRiC Centre (Birkbeck Centre for Building Resilience in Breast Cancer), Birkbeck University of London, Malet Street, London, WC1E 7HX, UK
| | - Nazanin Derakshan
- Department of Psychological Sciences, The BRiC Centre (Birkbeck Centre for Building Resilience in Breast Cancer), Birkbeck University of London, Malet Street, London, WC1E 7HX, UK
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50
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Wong SSS, Liu TW, Ng SSM. Performance of physical, cardiovascular, and psychological functions in middle-aged women with and without breast cancer. Eur J Oncol Nurs 2023; 66:102399. [PMID: 37689046 DOI: 10.1016/j.ejon.2023.102399] [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: 05/06/2023] [Revised: 07/08/2023] [Accepted: 07/15/2023] [Indexed: 09/11/2023]
Abstract
PURPOSE To compare the physical performance, including upper-limb motor and cardiovascular functions, and psychological functions, including anxiety and depression, sleep, and fatigue, between women with and without breast cancer. METHODS Thirty-two women with breast cancer and 32 healthy counterparts were recruited for the study. Upper-limb muscle strength, shoulder range of motion, and upper-limb function were assessed using a handheld dynamometer, a goniometer, and the short form of the Disabilities of Arm-Shoulder-Hand Questionnaire, respectively. Exercise endurance and cardiovascular functions were assessed using the 6-min walk test and blood pressure and heart rate variability, respectively. The Hospital Anxiety and Depression Scale, the Pittsburgh Sleep Quality Index, and the Fatigue Assessment Scale were used to assess the symptoms of anxiety and depression, sleep quality, and fatigue, respectively. RESULTS Breast cancer participants' body-weight-adjusted upper-limb strength of both the affected and unaffected sides (0.11-0.14) was only 61.1-77.8% of those of the healthy participants (0.18). Their shoulder mobility of the affected side (flexion: 161.64°; abduction: 157.01°) were 94.2% (flexion) and 92.5% (abduction) of those of the healthy participants (flexion: 171.56°; abduction: 169.68°), respectively. Breast cancer participants had higher quickDASH mean score (19.53), HADS-A mean score (6.78), HADS-D mean score (4.72), global PSQI mean score (7.22) and FAS mean score (25.97) as well as shorter mean distance covered by 6 MWT (496.66 m) than those of the healthy participants. CONCLUSIONS Rehabilitative interventions, such as mind-body interventions and exercise training, target physical fitness and promote the psychological health of women with breast cancer are necessary.
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Affiliation(s)
- Sarah Suet Shan Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China; School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong (SAR), China
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong (SAR), China
| | - Shamay Sheung Mei Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China; Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hung Hom, Hong Kong (SAR), China.
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