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Mackie GM, Boyle F, Lewis S, Smith AL. Finding my tribe: a qualitative interview study of how people living with metastatic breast cancer perceive support groups. J Cancer Surviv 2024:10.1007/s11764-024-01639-7. [PMID: 39048845 DOI: 10.1007/s11764-024-01639-7] [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: 05/02/2024] [Accepted: 06/29/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE This study explored the value of metastatic breast cancer (MBC) support groups, and factors that affect attendance, from the perspective of people with MBC. METHODS Semi-structured interviews were conducted with 28 women with MBC (support group attendees n = 16; non-attendees n = 12) between January 2022 and July 2023. Data were analysed using an inductive approach to thematic analysis. RESULTS Three themes were generated: the value of sharing experiential knowledge, spaces for open and honest conversations, and opportunities to find connection and community. These factors were the main reasons that some participants valued, and chose to attend, an MBC support group. Stage-specificity and professional facilitation were identified as important aspects of group structure. Key reasons for non-attendance were concerns about misinformation, confronting the death of group members, and satisfaction with existing support networks. CONCLUSIONS MBC support groups are beneficial for some people with MBC, providing opportunities to connect with others with the same diagnosis. For others, different forms of peer support such as online forums or one-on-one support may be preferred. We argue that ensuring those with MBC have equal access to the peer support they need will be essential in supporting people to live as well as possible with MBC. IMPLICATIONS FOR CANCER SURVIVORS MBC support groups, if appropriately led, can provide emotional and informational benefits for people with MBC. This research may also have relevance to other metastatic cancers where novel therapies are extending survival, resulting in an emerging cancer population with distinct supportive and survivorship needs.
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Affiliation(s)
- Grace M Mackie
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Frances Boyle
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Mater Hospital, Sydney, NSW, Australia
| | - Sophie Lewis
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Andrea L Smith
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Camperdown, NSW, Australia.
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Campbell EK, Campbell TM, Culakova E, Blanchard L, Wixom N, Guido JJ, Fetten J, Huston A, Shayne M, Janelsins MC, Mustian KM, Moore RG, Peppone LJ. A whole food, plant-based randomized controlled trial in metastatic breast cancer: feasibility, nutrient, and patient-reported outcomes. Breast Cancer Res Treat 2024; 206:273-283. [PMID: 38553649 PMCID: PMC11182786 DOI: 10.1007/s10549-024-07284-z] [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: 10/10/2023] [Accepted: 02/07/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE Quality of life (QOL) is among the most important outcomes for women with metastatic breast cancer (MBC), and it predicts survival. QOL is negatively impacted by cognitive impairment, fatigue, and weight gain. We assessed whether a whole food, plant-based (WFPB) diet-promoting weight loss is feasible and might improve QOL. METHODS Women with MBC on stable systemic treatments were randomized 2:1 to 1) WFPB dietary intervention (n = 21) or 2) usual care (n = 11) for 8 weeks. Participants attended weekly education visits and consumed an ad libitum WFPB diet (3 prepared meals/day provided). Patient-reported outcomes and 3-day food records were assessed at baseline and 8 weeks. The effects of WFPB diet on changes in outcomes were assessed by analysis of covariance model controlling for baseline. RESULTS 20 intervention and 10 control participants completed the trial. Intervention participants were highly adherent to the WFPB diet (94.3 % total calories on-plan). Intervention group nutrient intakes changed significantly including dietary fat (35.8 % to 20.4 % percent calories from fat, p < 0.001) and fiber content (12.7 to 30.8 g fiber/1000 kcal, p < 0.001). Perceived cognitive function (FACT-Cog total + 16.1; 95 % confidence interval [CI] = 0.8-31.7; p = 0.040) and emotional well-being (FACT-B emotional well-being subscale + 2.3; CI = 0.5-4.1; p = 0.016) improved in the WFPB versus the control group. Fatigue, measured by the BFI, improved within the WFPB group for fatigue severity (M = 4.7 ± 2.5[SD] to 3.7 ± 2.3, p = 0.047) and fatigue at its worst (5.8 ± 2.8 to 4.4 ± 2.4, p = 0.011). CONCLUSIONS Significant dietary changes in this population are feasible and may improve QOL by improving treatment-related symptoms. Additional study is warranted. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03045289. Registered 7 February 2017.
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Affiliation(s)
- Erin K Campbell
- Department of Public Health Sciences, University of Rochester Medical Center, 265 Crittenden Blvd, Rochester, NY, 14642, USA.
| | - Thomas M Campbell
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Eva Culakova
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Lisa Blanchard
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Nellie Wixom
- Clinical Research Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Joseph J Guido
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - James Fetten
- Memorial Sloan Kettering Cancer Center, Westchester, NY, USA
| | - Alissa Huston
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle Shayne
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Michelle C Janelsins
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Karen M Mustian
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
| | - Richard G Moore
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - Luke J Peppone
- Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA
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Dibble KE, Rosenberg SM, Zheng Y, Sella T, Poorvu P, Snow C, Darai S, Rene C, Mack JW, Partridge AH. Psychosocial and supportive care concerns of young women living with advanced breast cancer: baseline findings from a prospective virtual support intervention study. Support Care Cancer 2024; 32:336. [PMID: 38727753 DOI: 10.1007/s00520-024-08557-5] [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: 12/20/2023] [Accepted: 05/07/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE Adolescent and young adults (AYAs) with metastatic breast cancer (MBC) experience high physical and psychosocial burdens compounded by a disrupted life trajectory. We sought to determine the psychosocial and supportive care concerns of this population to better understand and address unmet needs. METHODS AYAs diagnosed with MBC (18-39 years) participating in a prospective interventional study (Young, Empowered, and Strong) at Dana-Farber Cancer Institute completed an electronic survey following enrollment. Measures evaluated sociodemographics, health behaviors, quality of life, and symptoms, among others. We used two-sided Fisher's exact tests to determine associations between concerns (e.g., cancer progression, side effects, lifestyle, finances, fertility) and demographic variables. RESULTS Among 77 participants enrolled from 9/2020-12/2022, average age at MBC diagnosis and survey was 35.9 (range: 22-39) and 38.3 years (range: 27-46), respectively. Most were non-Hispanic white (83.8%) and 40.3% reported their diagnosis caused some financial problems. Many were concerned about fertility (27.0%), long-term treatment side effects (67.6%), exercise (61.6%), and diet (54.1%). Select concerns varied significantly by age, race/ethnicity, and education. Younger women at survey reported greater concern about familial cancer risk (p = 0.028). Women from minority racial/ethnic groups more frequently reported issues talking about their cancer to family/friends (p = 0.040) while those with more education were more frequently concerned with long-term effects of cancer on their health (p = 0.021). CONCLUSION Young women living with MBC frequently report psychosocial, health, and cancer management concerns. Tailoring supportive care and communications to address prevalent concerns including disease progression and treatment side effects may optimize wellbeing.
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Affiliation(s)
- Kate E Dibble
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
- Department of Medicine, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Shoshana M Rosenberg
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Yue Zheng
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Tal Sella
- Deparment of Medical Oncology, Sheba Medical Center, Ramat Gan, Israel
| | - Philip Poorvu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
- Department of Medicine, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Craig Snow
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
| | - Sonja Darai
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
| | - Christamar Rene
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA
| | - Jennifer W Mack
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
- Department of Medicine, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA.
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R K, L S, P B, S G, R LP. Psychosocial experiences of breast cancer survivors: a meta-review. J Cancer Surviv 2024; 18:84-123. [PMID: 36854799 PMCID: PMC10866753 DOI: 10.1007/s11764-023-01336-x] [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: 10/12/2022] [Accepted: 01/15/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE Advances in breast cancer care have led to a high rate of survivorship. This meta-review (systematic review of reviews) assesses and synthesises the voluminous qualitative survivorship evidence-base, providing a comprehensive overview of the main themes regarding breast cancer survivorship experiences, and areas requiring further investigation. METHODS Sixteen breast cancer reviews identified by a previous mixed cancer survivorship meta-review were included, with additional reviews published between 1998 and 2020, and primary papers published after the last comprehensive systematic review between 2018 and 2020, identified via database searches (MEDLINE, Embase, CINAHL, PsycINFO). Quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and the CASP (Critical Appraisal Skills Programme Qualitative) checklist for primary studies. A meta-ethnographic approach was used to synthesise data. RESULTS Of 1673 review titles retrieved, 9 additional reviews were eligible (25 reviews included in total). Additionally, 76 individual papers were eligible from 2273 unique papers. Reviews and studies commonly focused on specific survivorship groups (including those from ethnic minorities, younger/older, or with metastatic/advanced disease), and topics (including return to work). Eight themes emerged: (1) Ongoing impact and search for normalcy, (2) Uncertainty, (3) Identity: Loss and change, (4) Isolation and being misunderstood, (5) Posttraumatic growth, (6) Return to work, (7) Quality of care, and (8) Support needs and coping strategies. CONCLUSIONS Breast cancer survivors continue to face challenges and require interventions to address these. IMPLICATIONS FOR CANCER SURVIVORS Breast cancer survivors may need to prepare for ongoing psychosocial challenges in survivorship and proactively seek support to overcome these.
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Affiliation(s)
- King R
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Stafford L
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Butow P
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, Australia
| | - Giunta S
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, Australia
| | - Laidsaar-Powell R
- Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, The University of Sydney, Sydney, Australia.
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Lyons-Rahilly T, Meskell P, Carey E, Meade E, O’ Sullivan D, Coffey A. Exploring the experiences of women living with metastatic breast cancer [MBC]: A systematic review of qualitative evidence. PLoS One 2024; 19:e0296384. [PMID: 38181009 PMCID: PMC10769043 DOI: 10.1371/journal.pone.0296384] [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: 01/07/2023] [Accepted: 12/12/2023] [Indexed: 01/07/2024] Open
Abstract
PURPOSE Metastatic breast cancer [MBC] is the leading cause of cancer death in women globally with no cure. Women diagnosed with MBC endure a catastrophic upheaval to multiple aspects of their life and a radically transformed future landscape. Evidence suggests that the provision of care for women living with metastatic breast cancer is inadequate, socially isolating and stigmatising. To date, this topic has received little research attention. To increase understanding of the experiences of women living with MBC, a synthesis of current evidence is required. This paper presents a review of qualitative evidence on women's experiences of MBC. METHODS A qualitative evidence synthesis [QES] was conducted to synthesise primary qualitative research on the experiences of women living with MBC. Searches were performed of electronic databases Medline, Medline Ovid, PsycINFO, Psych articles, PubMED, CINAHL Complete, Scopus and grey literature databases. The methodological quality of the included studies was appraised using a modified version of the Critical Appraisal Skills Programme [CASP]. Title, abstract, and full-text screening were undertaken. A 'best fit' framework approach using the ARC [Adversity, Restoration, Compatibility] framework was used to guide data extraction and synthesis. Confidence in the findings was assessed using the Grading of Recommendations Assessment, Development and Evaluation, Confidence in the Evidence from Reviews of Qualitative research [GRADE-CERQual]. RESULTS 28 papers from 21 research studies containing 478 women's experiences of living with MBC were deemed suitable for inclusion in this qualitative evidence synthesis. Findings are presented in a new conceptual framework RAAW [adapted from ARC] for women living with MBC under themes: Reality, Adversity, Adjustment and Wellbeing. Findings revealed that a diagnosis of MBC impacted every aspect of women's lives; this is different to a diagnosis of early breast cancer. An overarching theme of lack of support extended across various facets of their lives. A lack of psychological, emotional, and psychosocial support was evident, with a critical finding that models of care were not fit for purpose. Deficits included a lack of information, knowledge, inclusion in shared decision-making and MDT support, specifically the need for palliative care/oncology support access. Some women living with MBC wanted to be identified as having a chronic illness not a life-limiting illness. Culture and socioeconomic standing influenced the availability of various types of support. The impact of treatment and symptoms had an adverse effect on women's quality of life and affected their ability to adjust. CONCLUSION This review synthesised the qualitative literature on the experiences of women living with MBC. The ARC framework used in the synthesis was adapted to develop a revised conceptual framework titled RAAW to represent the evidence from this review on experiences for women living with MBC; Reality & Adversity: A diagnosis of MBC; Adjustment: Living with MBC; Wellbeing: Awareness, meaning, engagement [RAAW; MBC].
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Affiliation(s)
- Trína Lyons-Rahilly
- Department of Nursing & Health Care Sciences, Munster Technological University, Tralee, Kerry, Ireland
| | - Pauline Meskell
- Department of Nursing & Midwifery, University of Limerick, Limerick, Ireland
| | - Eileen Carey
- Department of Nursing & Midwifery, University of Limerick, Limerick, Ireland
| | - Elizabeth Meade
- Oncology Department, HSE Dublin Mid Leinster, Midlands Regional Hospital, Tullamore, Co. Offaly, Ireland
| | - Donal O’ Sullivan
- MTU Kerry Library, Munster Technological University, Tralee, Co Kerry, Ireland
| | - Alice Coffey
- Department of Nursing & Midwifery, University of Limerick, Limerick, Ireland
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Roberson ML, Henricks A, Woods J, Glenn L, Maues J, James D, Reid S. Re-imagining metastatic breast cancer care delivery: a patient-partnered qualitative study. Support Care Cancer 2023; 31:735. [PMID: 38055111 PMCID: PMC10700428 DOI: 10.1007/s00520-023-08201-8] [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: 07/24/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE While significant progress in metastatic breast cancer (MBC) treatment has prolonged survival and improved prognosis, there remain substantial gaps in providing patient-centered supportive care. The specific care delivery needs for metastatic cancer differ from that of early-stage cancer due to the incurable nature and lifelong duration of the condition. The objective of this study was to assess how patients living with MBC would re-imagine cancer care delivery. METHODS This qualitative study was conducted in partnership with patient-led organizations Guiding Researchers and Advocates to Scientific Partnerships (GRASP) and Project Life, a nonprofit, online wellness community founded by patients with MBC for patients living with MBC. Virtual semi-structured interviews (n = 36) were conducted with Project Life members purposively sampled from the groups' overall membership. The interview guide contained items surrounding patients' lived experiences of MBC, greatest unmet needs related to care, and perspectives on virtual wellness community involvement. Interviews were coded using two-stage deductive and inductive analysis. RESULTS Three major themes for re-imagining cancer care delivery were identified, including holistic care, information needs, and conceptual shifts. Within these several subthemes emerged with patients re-imagining referrals to non-oncological services, caregiver support, acceptance of integrative medicine, streamlined clinical trial enrollment, curated quality patient resources, MBC-specific terminology and approaches, long-term life and goal-of-care planning, and patient-centered voice throughout. CONCLUSION People living with metastatic cancers have specific supportive care needs. These findings highlight patient-driven areas for re-imagination that are most salient for individuals with MBC.
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Affiliation(s)
- Mya L Roberson
- Gillings School of Global Public Health, Department of Health Policy and Management, University of North Carolina at Chapel Hill, 1106B McGavran Greenberg Hall, 135 Dauer Drive, CB#7411, Chapel Hill, NC, 27599-7411, USA.
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.
| | - Anna Henricks
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Joshua Woods
- Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, USA
| | | | - Julia Maues
- Guiding Researchers and Advocates to Scientific Partnerships (GRASP), Baltimore, MD, USA
| | | | - Sonya Reid
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA
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Vecoso LVZ, Silva MT, Livinalli A, Barreto JOM, Galvao TF. Patients' perspectives on the relevance of biosimilars' outcomes in oncology: qualitative study with nominal group technique. Support Care Cancer 2023; 31:722. [PMID: 38008777 DOI: 10.1007/s00520-023-08184-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/12/2023] [Indexed: 11/28/2023]
Abstract
PURPOSE We aimed to rate the importance of outcomes from a systematic review about biosimilars in oncology from patients' perspective. METHODS This is a qualitative research with nominal group technique. Patients with cancer were selected by convenience sampling and invited for two mediated virtual meetings in 2022. Twelve outcomes from a systematic review on biosimilars for oncology developed following a protocol were explained in plain language to participants who classified them as critical, important, or not important according to the Grading of Recommendations Assessment, Development and Evaluation approach. We employed Iramuteq software for lexical categorization of the meeting transcripts, and content analysis for interpretation. RESULTS Five women participated (three had metastatic cancer, one non-metastatic, one recurrent). Six outcomes were classified as critical: duration of response, progression-free survival, pathological complete response, overall survival, severe adverse events, and quality of life; three as important: mortality, event-free survival, and objective response; and three as non-important: neutralizing anti-drug antibody, any adverse event, and non-neutralizing anti-drug antibody. Duration of response, pathological complete response, severe adverse events, and quality of life were considered secondary in the review protocol, but critical by the patients. The main themes influencing the importance classification were related to the disease (progression and control) and treatment (recognition and healthcare setting). CONCLUSION Patients rated most outcomes as critical or important, some of them previously regarded as secondary by the researchers, which reinforces the need to include stakeholders' perspectives in oncology research. Aspects of the disease progression and treatment effects influenced participants' judgment on outcomes' relevance.
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Campbell EK, Campbell TM, Culakova E, Blanchard LM, Wixom N, Guido J, Fetten J, Huston A, Shayne M, Janelsins M, Mustian K, Moore RG, Peppone LJ. A Whole Food, Plant-Based Randomized Controlled Trial in Metastatic Breast Cancer: Feasibility, Nutrient, and Patient-Reported Outcomes. RESEARCH SQUARE 2023:rs.3.rs-3606685. [PMID: 38045318 PMCID: PMC10690314 DOI: 10.21203/rs.3.rs-3606685/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Purpose Quality of life (QOL) is among the most important outcomes for women with metastatic breast cancer (MBC) and it predicts survival. QOL is negatively impacted by cognitive impairment, fatigue, and weight gain. We assessed whether a whole food, plant-based (WFPB) diet promoting weight loss is feasible and might improve QOL. Methods Women with MBC on stable systemic treatments were randomized 2:1 to 1) WFPB dietary intervention (n = 21) or 2) usual care (n = 11) for 8 weeks. Participants attended weekly education visits and consumed an ad libitum WFPB diet (3 prepared meals/day provided). Patient-reported outcomes and 3-day food records were assessed at baseline and 8 weeks. The effects of WFPB diet on changes in outcomes were assessed by analysis of covariance model controlling for baseline. Results 20 intervention and 10 control participants completed the trial. Intervention participants were highly adherent to the WFPB diet (94.3% total calories on-plan). Intervention group nutrient intakes changed significantly including dietary fat (35.8-20.4% percent calories from fat, p < 0.001) and fiber content (22.1 to 40.8 grams fiber/1000 kcal, p < 0.001). Perceived cognitive function (FACT-Cog total + 16.1; 95% confidence interval [CI] = 0.8-31.7; p = 0.040) and emotional well-being (FACT-B emotional well-being subscale + 2.3; CI = 0.5-4.1; p = 0.016) improved in the WFPB versus the control group. Fatigue, measured by the BFI, improved within the WFPB group for fatigue severity (M = 4.7 ± 2.5[SD] to 3.7 ± 2.3, p = 0.047) and fatigue at its worst (5.8 ± 2.8 to 4.4 ± 2.4, p = 0.011). Conclusions Significant dietary changes in this population are feasible and may improve QOL by improving treatment-related symptoms. Additional study is warranted. Trial registration ClinicalTrials.gov identifier: NCT03045289. Registered 7 February 2017.
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Bertoli J, Bezerra EDS, Winters-Stone KM, Alberto Gobbo L, Freitas IF. Mat Pilates improves lower and upper body strength and flexibility in breast cancer survivors undergoing hormone therapy: a randomized controlled trial (HAPiMat study). Disabil Rehabil 2023; 45:494-503. [PMID: 35107399 DOI: 10.1080/09638288.2022.2032410] [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] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate the effects of 24 weeks of Mat Pilates in breast cancer survivors (BCS) undergoing hormone therapy on lower and upper body muscle strength parameters and flexibility. MATERIALS AND METHODS Forty-three BCS (≥40 years) with confirmed breast cancer stage 0-III undergoing hormone therapy were included. Participants were randomized into Mat Pilates (three times/week, 60 min session) or control group (relaxation activities every two weeks). The difficulty and number of exercise repetitions were increased over the weeks. Assessments were performed at three times points (baseline, 12 weeks, and 24 weeks). The generalized estimating equations (GEE) model was used to compare each outcome measure during the analysis of intention to treat (ITT) and "Per protocol analysis" (PPA). RESULTS The Pilates group presented significantly increased (p < 0.05) isometric flexor-extensor PT, and concentric and eccentric flexor PT and mechanical work (MW) after the intervention. Most of the upper body strength parameters, time to achieve maximal force (TFmax), maximal force (Fmax), and rapid force index (RFI) and right-left upper and lower body flexibility (p < 0.05) also improved. CONCLUSIONS From our findings, we conclude that 24 and 12-weeks of Mat Pilates induced strength and flexibility gains for lower and upper body, respectively.Implications for rehabilitationMat Pilates can be adapted to the fitness level of breast cancer survivors, with a great variety of exercises that can be performed using a mat only or a few pieces of equipment.Patients can practice at home to gain different health benefits (i.e., increasing strength, flexibility, and functional capacity level), which could positively impact on quality of life.Mat Pilates performed three times per week with systematized increments in exercise level, load, and volume throughout the intervention was effective to improve hip extensor-flexor muscles peak torque and mechanical work at different muscle contractions, as well as upper and lower body flexibility.Mat Pilates was also able to improve right-left shoulder abductor and trunk extensor muscles strength parameters after 12 weeks of intervention, as well as both surgery and non-surgery sides of the upper body.
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Affiliation(s)
- Josefina Bertoli
- Faculdade de Ciência e Tecnologia, Universidade Estadual Paulista, Presidente Prudente, Brazil
| | | | - Kerri M Winters-Stone
- School of Nursing, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Luis Alberto Gobbo
- Faculdade de Ciência e Tecnologia, Universidade Estadual Paulista, Presidente Prudente, Brazil
| | - Ismael Forte Freitas
- Faculdade de Ciência e Tecnologia, Universidade Estadual Paulista, Presidente Prudente, Brazil
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Heidary Z, Ghaemi M, Hossein Rashidi B, Kohandel Gargari O, Montazeri A. Quality of Life in Breast Cancer Patients: A Systematic Review of the Qualitative Studies. Cancer Control 2023; 30:10732748231168318. [PMID: 37082898 DOI: 10.1177/10732748231168318] [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: 04/22/2023] Open
Abstract
OBJECTIVE Quality of life (QoL) in breast cancer patients is still an important topic. Despite numerous quantitative scales, qualitative studies can help to in-depth understand the QoL of breast cancer patients. The purpose of this systematic review was to integrate qualitative studies on the QoL of women with breast cancer. METHODS A literature search was performed in electronic databases including PubMed, Scopus, and Web of Science from January 1, 2010 until June 28, 2022 to find out qualitative studies assessing breast cancer patient's QoL. Two authors independently evaluated methodological quality according to the consolidated criteria for reporting qualitative research (COREQ) checklist. Data were extracted and reported by themes for cancer-free women and patients with metastatic cancer separately. RESULTS In all, 1565 citations were retrieved. After removing 1387 duplicate and irrelevant papers, the full texts of 27 articles were reviewed and finally, 9 were eligible for evaluation. In quality checking of the citations, all articles gained the required quality score. After examining and merging similar topics, nine major themes were extracted. Physical, spiritual, and psychological aspects of QoL were the common issues in cancer-free women (before and after the COVID-19 pandemic) and patients with metastatic cancer. Perception of cancer and social life were the other main concerns in cancer-free women, whereas, in metastatic patients' overall survival and planning for the future and their children's life was the focus of interest. Women with metastatic disease showed more vulnerability in coping compared to cancer-free women. CONCLUSION This review provides an opportunity to have a closer look into the several domains of QoL in women with breast cancer. In-depth information provided by this review might help to develop interventions for patients and their families to support women to cope much better with their life challenges.
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Affiliation(s)
- Zohreh Heidary
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Ghaemi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Batool Hossein Rashidi
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Montazeri
- Health Metric Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
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11
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Senkpeil RR, Olson JS, Fortune EE, Zaleta AK. Pain and Nausea Intensity, Social Function, and Psychological Well-Being among Women with Metastatic Breast Cancer. J Patient Exp 2022; 9:23743735221134733. [PMID: 36339375 PMCID: PMC9630886 DOI: 10.1177/23743735221134733] [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: 01/24/2023] Open
Abstract
Advances in diagnostics and therapeutics have improved prognosis for metastatic breast cancer (MBC). Yet, treatment and disease burden-including experiences of pain and nausea-present practical and emotional challenges. To better support patients and enhance quality of life, deeper understanding of the pathways linking physical and psychological health is needed. To this end, we examined associations of pain and nausea with depression and anxiety among women with MBC. In doing so, we highlighted social function as a potentially important mechanism in this relationship. This observational, cross-sectional study included 148 predominantly non-Hispanic White, highly educated women living with MBC. Multivariate regression models demonstrated that more intense pain and nausea were significantly associated with higher levels of depression and anxiety (p < .001). Causal mediation analyses confirmed significant indirect effects whereby decreases in social function associated with pain and nausea contributed to depression and anxiety. Thus, our findings illustrate decreased social function as one pathway through which pain and nausea contribute to escalation of depression and anxiety. Our results, therefore, underscore the importance of supporting social function among women with MBC to potentially reduce psychological sequelae of pain and nausea.
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Affiliation(s)
- Ryan R. Senkpeil
- Research and Training Institute, Cancer Support
Community, Philadelphia, PA, USA
| | - Julie S. Olson
- Research and Training Institute, Cancer Support
Community, Philadelphia, PA, USA
| | - Erica E. Fortune
- Research and Training Institute, Cancer Support
Community, Philadelphia, PA, USA
| | - Alexandra K. Zaleta
- Research and Training Institute, Cancer Support
Community, Philadelphia, PA, USA,Alexandra K. Zaleta, PhD, Research and
Training Institute, Cancer Support Community, 520 Walnut Street, Suite 1170,
Philadelphia, PA, USA, 19106, 267-295-3004.
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12
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Mertz S, Benjamin C, Girvalaki C, Cardone A, Gono P, May SG, Comerford E, Than KS, Birch K, Roach M, Myers S, Sasane M, Lavi L, Cameron A, Cardoso F. Progression-free survival and quality of life in metastatic breast cancer: The patient perspective. Breast 2022; 65:84-90. [PMID: 35870420 PMCID: PMC9307669 DOI: 10.1016/j.breast.2022.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/10/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Objective Materials and methods Results Conclusion Overall survival benefit combined with good QoL are the most important endpoints for mBC patients. Time without disease progression is meaningful to patients when coupled with no worsening in or improvements in QoL. Quality of life is highly individual and evolves throughout the treatment journey. Surrogate endpoints are confusing; more patient-centered language is needed. Healthcare professionals should account for disease and psychological well-being.
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Affiliation(s)
- Shirley Mertz
- Metastatic Breast Cancer Network, 165 West 46th St, Suite 712, New York, NY, 10036, USA
| | - Christine Benjamin
- SHARE Cancer Support, 165 West 46th St, Suite 712, New York, NY, 10036, USA
| | - Charis Girvalaki
- European Cancer Patient Coalition, 40, Rue de Montoyer/Montoyerstraat, B-1000, Brussels, Belgium
| | - Antonella Cardone
- European Cancer Patient Coalition, 40, Rue de Montoyer/Montoyerstraat, B-1000, Brussels, Belgium
| | - Paulina Gono
- European Cancer Patient Coalition, 40, Rue de Montoyer/Montoyerstraat, B-1000, Brussels, Belgium
| | - Suepattra G May
- PRECISIONheor, 60 E 42nd Street, Suite 1325 New York, NY, 10165, USA.
| | - Erin Comerford
- Sanofi Genzyme. 55 Corporate Drive, Bridgewater, NJ, 08807, USA
| | - Kyi-Sin Than
- PRECISIONheor, 60 E 42nd Street, Suite 1325 New York, NY, 10165, USA
| | - Kelly Birch
- PRECISIONheor, 60 E 42nd Street, Suite 1325 New York, NY, 10165, USA
| | - Meaghan Roach
- PRECISIONheor, 60 E 42nd Street, Suite 1325 New York, NY, 10165, USA
| | - Sky Myers
- PRECISIONheor, 60 E 42nd Street, Suite 1325 New York, NY, 10165, USA
| | - Medha Sasane
- Sanofi Genzyme. 55 Corporate Drive, Bridgewater, NJ, 08807, USA
| | - Liat Lavi
- Sanofi Genzyme. 55 Corporate Drive, Bridgewater, NJ, 08807, USA
| | - Anna Cameron
- Sanofi Genzyme. 55 Corporate Drive, Bridgewater, NJ, 08807, USA
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation and ABC Global Alliance, Lisbon, Portugal
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13
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Bertoli J, de Souza Bezerra E, dos Santos SFDS, Gobbo LA, Júnior IFF. The influence of mat Pilates training adherence on strength and flexibility parameters in breast cancer survivors undergoing hormone therapy. J Exerc Rehabil 2022; 18:272-283. [PMID: 36110260 PMCID: PMC9449091 DOI: 10.12965/jer.2244298.149] [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: 06/19/2022] [Accepted: 07/15/2022] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to evaluate the influence of adherence to mat Pilates training on lower and upper body strength and flexibility in breast cancer survivors. Breast cancer survivors ( ≥ 40 years) with cancer stages 0–III undergoing hormone therapy participated in this study. For this secondary investigation only the intervention group was analyzed, divided into low and high training adherence. Participants performed a 60-min session of mat Pilates, 3 times/wk, for 24 weeks. Concentric, eccentric, and isometric hip flexor-extensor muscle peak torque, and isometric maximal strength parameters of the shoulder abductors, trunk extensors, and handgrip were assessed. Physical activity level was analyzed as a control variable. The results showed that high training adherence improved (<i>P</i>< 0.05) left shoulder abductor strength parameters and lower and upper body flexibility compared to baseline. The low training adherence group improved (<i>P</i>< 0.05) trunk extensors, right and left shoulder abductor strength parameters, handgrip strength, and extensor-flexor peak torque compared to baseline. There were no differences (<i>P</i>> 0.05) between high and low adherence for physical activity level before and after the intervention. Therefore, it appears that higher training adherence most influences some strength parameters and flexibility, while fewer sessions enable the achievement of significant results for shoulder abductor and hip extensor-flexor muscle strength parameters.
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Affiliation(s)
- Josefina Bertoli
- Faculdade de Ciência e Tecnologia, Universidade Estadual Paulista, Presidente Prudente-SP,
Brazil
- Corresponding author: Josefina Bertoli, Universidade Estadual Paulista, Faculdade de Ciência e Tecnologia, Rua Roberto Símonsen, 305 – Centro Educacional, Presidente Prudente - SP, 19060-900, Brazil,
| | | | | | - Luis Alberto Gobbo
- Faculdade de Ciência e Tecnologia, Universidade Estadual Paulista, Presidente Prudente-SP,
Brazil
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14
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Mazza M, Piperis M, Aasaithambi S, Chauhan J, Sagkriotis A, Vieira C. Social Media Listening to Understand the Lived Experience of Individuals in Europe With Metastatic Breast Cancer: A Systematic Search and Content Analysis Study. Front Oncol 2022; 12:863641. [PMID: 35719996 PMCID: PMC9205394 DOI: 10.3389/fonc.2022.863641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/06/2022] [Indexed: 02/05/2023] Open
Abstract
Background Despite a wealth of real-world data on metastatic breast cancer (mBC), insights into the lived experience are lacking. This study aimed to explore how the lived experience of mBC is described on social media. Methods A predefined search string identified posts relevant to the lived experience of mBC from Twitter, patient forums, and blogs across 14 European countries. The final data set was analyzed using content analysis. Results A total of 76,456 conversations were identified between November 1, 2018, and November 30, 2020. Twitter was the most commonly used social media platform across all 76,456 conversations from the raw data set (n = 61,165; 80%). Automated and manual relevancy checks followed by a final random sampling filter identified 820 conversations for content analysis. The majority of data from the raw data set was generated from the United Kingdom (n = 31,346; 41%). From this final data set, 61% of posts were authored by patients, 15% by friends and/or family members of patients, and 14% by caregivers. A total of 686 conversations described the patient journey (n = 686/820; 84%); 64% of these (n = 439) concerned breast cancer treatment, with approximately 40% of discussions regarding diagnosis and tests (n = 274/686) and less than 20% of discussions surrounding disease management (n = 123/686; 18%). Key themes relating to a lack of effective treatment, prolonged survival and associated quality of life, debilitating consequences of side effects, and the social impacts of living with mBC were identified. Conclusions The findings from this study provided an insight into the lived experience of mBC. While retrospective data collection inherently limits the amount of demographic or clinical information that can be obtained from the population sample, social media listening studies offer training to healthcare professionals in communication, the importance of quality of life, organization of healthcare, and even the design of clinical trials. As new targeted therapies are gradually incorporated into clinical practice, innovative technologies, such as social media listening, have the potential to support regulatory procedures and drug toxicity monitoring, as well as provide the patient voice in the regulation of new and existing medicines.
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Affiliation(s)
- Manuelita Mazza
- Divison of Medical Senology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Maria Piperis
- CyberKnife and TomoTherapy Department, Iatropolis Medical Group of Companies, Athens, Greece
| | | | - Jyoti Chauhan
- Insights and Analytics, Novartis Pharma AG, Basel, Switzerland
| | | | - Claudia Vieira
- Medical Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil (IPO-PORTO), Porto, Portugal
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15
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Ciria-Suarez L, Jiménez-Fonseca P, Palacín-Lois M, Antoñanzas-Basa M, Fernández-Montes A, Manzano-Fernández A, Castelo B, Asensio-Martínez E, Hernando-Polo S, Calderon C. Breast cancer patient experiences through a journey map: A qualitative study. PLoS One 2021; 16:e0257680. [PMID: 34550996 PMCID: PMC8457460 DOI: 10.1371/journal.pone.0257680] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Breast cancer is one of the most prevalent diseases in women. Prevention and treatments have lowered mortality; nevertheless, the impact of the diagnosis and treatment continue to impact all aspects of patients' lives (physical, emotional, cognitive, social, and spiritual). OBJECTIVE This study seeks to explore the experiences of the different stages women with breast cancer go through by means of a patient journey. METHODS This is a qualitative study in which 21 women with breast cancer or survivors were interviewed. Participants were recruited at 9 large hospitals in Spain and intentional sampling methods were applied. Data were collected using a semi-structured interview that was elaborated with the help of medical oncologists, nurses, and psycho-oncologists. Data were processed by adopting a thematic analysis approach. RESULTS The diagnosis and treatment of breast cancer entails a radical change in patients' day-to-day that linger in the mid-term. Seven stages have been defined that correspond to the different medical processes: diagnosis/unmasking stage, surgery/cleaning out, chemotherapy/loss of identity, radiotherapy/transition to normality, follow-up care/the "new" day-to-day, relapse/starting over, and metastatic/time-limited chronic breast cancer. The most relevant aspects of each are highlighted, as are the various cross-sectional aspects that manifest throughout the entire patient journey. CONCLUSIONS Comprehending patients' experiences in depth facilitates the detection of situations of risk and helps to identify key moments when more precise information should be offered. Similarly, preparing the women for the process they must confront and for the sequelae of medical treatments would contribute to decreasing their uncertainty and concern, and to improving their quality-of-life.
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Affiliation(s)
- Laura Ciria-Suarez
- Clinical Psychology and Psychobiology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Paula Jiménez-Fonseca
- Medical Oncology Department Hospital Universitario Central of Asturias, Oviedo, Spain
| | - María Palacín-Lois
- Social Psychology and Quantitative Psychology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | | | - Ana Fernández-Montes
- Medical Oncology Department, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | | | - Beatriz Castelo
- Medical Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| | | | - Susana Hernando-Polo
- Medical Oncology Department, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Caterina Calderon
- Clinical Psychology and Psychobiology Department, Faculty of Psychology, University of Barcelona, Barcelona, Spain
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16
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Mueller V, Wardley A, Paplomata E, Hamilton E, Zelnak A, Fehrenbacher L, Jakobsen E, Curtit E, Boyle F, Harder Brix E, Brenner A, Crouzet L, Ferrario C, Muñoz-Mateu M, Arkenau HT, Iqbal N, Aithal S, Block M, Cold S, Cancel M, Hahn O, Poosarla T, Stringer-Reasor E, Colleoni M, Cameron D, Curigliano G, Siadak M, DeBusk K, Ramos J, Feng W, Gelmon K. Preservation of quality of life in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer treated with tucatinib or placebo when added to trastuzumab and capecitabine (HER2CLIMB trial). Eur J Cancer 2021; 153:223-233. [PMID: 34214937 DOI: 10.1016/j.ejca.2021.05.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
AIMS In HER2CLIMB, tucatinib significantly improved progression-free and overall survival in patients with human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer. We evaluated the impact of tucatinib on health-related quality of life (HR-QoL) in HER2CLIMB. METHODS Patients were randomised 2:1 to tucatinib or placebo combined with trastuzumab and capecitabine. Starting with protocol version 7, the EuroQol 5 Dimensions 5 Levels (EQ-5D-5L) questionnaire and EQ visual analogue scale (VAS) were administered at day 1 of cycle 1, every two cycles during cycles 3-9, every three cycles during cycle 12 and thereafter and at each patient's 30-day follow-up visit. RESULTS Among 364 patients eligible for HR-QoL assessment, 331 (91%) completed ≥1 assessment. EQ-VAS scores were similar for both arms at baseline and maintained throughout treatment. EQ-5D-5L scores were similar between the treatment arms, stable throughout therapy and worsened after discontinuing treatment. Risk of meaningful deterioration (≥7 points) on EQ-VAS was reduced 19% in the tucatinib vs. placebo arm (hazard ratio [HR]: 0.81; 95% confidence interval [CI]: 0.55, 1.18); the median (95% CI) time to deterioration was not reached in the tucatinib arm and was 5.8 months (4.3, -) in the placebo arm. Among patients with brain metastases (n = 164), risk of meaningful deterioration on EQ-VAS was reduced 49% in the tucatinib arm (HR: 0.51; 95% CI: 0.28, 0.93); the median (95% CI) time to deterioration was not reached in the tucatinib arm and was 5.5 months (4.2, -) in the placebo arm. CONCLUSIONS HR-QoL was preserved for patients with HER2+ metastatic breast cancer who were treated with tucatinib added to trastuzumab and capecitabine and maintained longer with tucatinib therapy than without it among those with brain metastases. CLINICAL TRIAL REGISTRATION NCT02614794.
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Affiliation(s)
- Volkmar Mueller
- Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Andrew Wardley
- Manchester Breast Centre, Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology Medicine & Health, University of Manchester, Manchester, UK
| | - Elisavet Paplomata
- Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Erika Hamilton
- Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN, USA
| | | | | | | | - Elsa Curtit
- University Hospital of Besançon, Besançon, France
| | | | | | - Andrew Brenner
- Mays Cancer Center at the UT Health San Antonio, San Antonio, TX, USA
| | | | | | - Montserrat Muñoz-Mateu
- Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapeutics, Institut d'Investigacions Biomèdiques Pi i Sunyer-IDIBAPS, Barcelona, Spain
| | - Hendrik-Tobias Arkenau
- Sarah Cannon Research Institute UK and Cancer Institute, University College London, London, UK
| | - Nayyer Iqbal
- Saskatoon Cancer Centre, Saskatoon, Saskatchewan, Canada
| | - Sramila Aithal
- Cancer Treatment Centers of America / Eastern Regional Medical Center, Philadelphia, PA, USA
| | | | | | | | - Olwen Hahn
- University of Chicago Medical Center, Chicago, IL, USA
| | - Teja Poosarla
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA
| | - Erica Stringer-Reasor
- Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marco Colleoni
- IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - David Cameron
- Edinburgh Cancer Research Centre, IGMM, University of Edinburgh, Edinburgh, Scotland
| | - Giuseppe Curigliano
- European Institute of Oncology, IRCCS, and University of Milano, Milan, Italy
| | | | - Kendra DeBusk
- Health Economics Outcome Research, Seagen Inc., Bothell, WA, USA
| | - Jorge Ramos
- Clinical Development, Seagen Inc., Bothell, WA, USA
| | | | - Karen Gelmon
- British Columbia Cancer Agency - Vancouver Centre, Vancouver, BC, Canada
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Lormans T, de Graaf E, van de Geer J, van der Baan F, Leget C, Teunissen S. Toward a socio-spiritual approach? A mixed-methods systematic review on the social and spiritual needs of patients in the palliative phase of their illness. Palliat Med 2021; 35:1071-1098. [PMID: 33876676 PMCID: PMC8189005 DOI: 10.1177/02692163211010384] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients express a variety of needs, some of which are labeled social and spiritual. Without an in-depth exploration of patients' expressions of these needs, it is difficult to differentiate between them and allocate appropriate healthcare interventions. AIM To gain insight into the social and spiritual needs of patients with a life-limiting illness and the distinction between these needs, as found in the research literature. DESIGN A mixed-methods systematic review and meta-aggregation were conducted following the Joanna Briggs Institute (JBI) approach to qualitative synthesis and the PALETTE framework and were reported according to the PRISMA statement. This review was registered in PROSPERO (CRD42019133571). DATA SOURCES The search was conducted in PubMed, EMBASE, CINAHL, Scopus, and PsycInfo. Eligible studies reported social and spiritual needs from the patients' perspective and were published between January 1st 2008 and October 2020. The quality of evidence was assessed using JBI Critical Appraisal Tools. RESULTS Thirty-four studies (19 qualitative, 1 mixed-methods, and 14 quantitative) were included. The five synthesized findings encompassing social and spiritual needs were: being autonomous, being connected, finding and having meaning, having a positive outlook, and dealing with dying and death. CONCLUSION What literature labels as social and spiritual needs shows great similarities and overlap. Instead of distinguishing social from spiritual needs based on patients' linguistic expressions, needs should always be explored in-depth. We propose a socio-spiritual approach that honors and preserves the multidimensionality of patients' needs and enables interdisciplinary teamwork to allocate patient-tailored care.
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Affiliation(s)
- Tom Lormans
- Center of Expertise Palliative Care Utrecht, UMC Utrecht, Utrecht, the Netherlands
| | - Everlien de Graaf
- Center of Expertise Palliative Care Utrecht, UMC Utrecht, Utrecht, the Netherlands
| | | | | | - Carlo Leget
- University of Humanistic Studies, Utrecht, the Netherlands
| | - Saskia Teunissen
- Center of Expertise Palliative Care Utrecht, UMC Utrecht, Utrecht, the Netherlands
- Academic Hospice Demeter, De Bilt, the Netherlands
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18
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Drageset S, Austrheim G, Ellingsen S. Quality of life of women living with metastatic breast cancer and receiving palliative care: A systematic review. Health Care Women Int 2021; 42:1044-1065. [PMID: 33798012 DOI: 10.1080/07399332.2021.1876063] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The quality of life (QoL) of women living with metastatic breast cancer and receiving palliative care needs more attention. We reviewed published studies (1992-2019) examining QoL of women receiving palliative care. The findings were interpreted according to the World Health Organization's (WHO) definition of palliative care. Four themes emerged: (1) the impact of medical treatment on pain relief; (2) the need for psychosocial attention and support; (3) the necessity of an interdisciplinary approach; (4) ambiguous understanding of the term palliative care. A common understanding of the term palliative care and more research is needed to enhance the QoL of women living with metastatic breast cancer.
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Affiliation(s)
- Sigrunn Drageset
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Faculty of Health Studies, VID Specialized University - Haraldsplass, Bergen, Norway
| | - Gunhild Austrheim
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Sidsel Ellingsen
- Faculty of Health Studies, VID Specialized University - Haraldsplass, Bergen, Norway.,Faculty of Health Studies and Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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19
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Dusseldorp LV, Groot M, Adriaansen M, Vught AV, Vissers K, Peters J. Impact of nurse practitioner care on patients with chronic conditions. J Am Assoc Nurse Pract 2020; 33:728-738. [DOI: 10.1097/jxx.0000000000000438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/23/2020] [Indexed: 11/25/2022]
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20
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Faller H, Hass HG, Engehausen D, Reuss-Borst M, Wöckel A. Supportive care needs and quality of life in patients with breast and gynecological cancer attending inpatient rehabilitation. A prospective study. Acta Oncol 2019; 58:417-424. [PMID: 30632891 DOI: 10.1080/0284186x.2018.1543947] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Among patients with breast or gynecological cancer, supportive care needs are both highly prevalent and enduring. However, little is known about whether meeting patients' needs is accompanied by increased quality of life (QoL). We aimed to explore patients' supportive care needs reported at the beginning of inpatient rehabilitation and examined whether meeting these needs resulted in improved QoL. MATERIAL AND METHODS In a multicenter, prospective cohort study with 2 measurement occasions (beginning and end of inpatient rehabilitation), 292 patients with breast and gynecological cancer (mean age 55 years; 71% breast cancer) were enrolled. In 73%, time since diagnosis was longer than 6 months. We obtained self-reports of supportive care needs in 12 domains and measured QoL using the EORTC QLQ-C30 functioning subscales. RESULTS At the beginning of inpatient rehabilitation, top-ranking severe supportive care needs concerned coordination of care (48%), medical information (45%), alleviation of physical symptoms (42%) and support with improving health behaviors (36%). At the end of inpatient rehabilitation, all needs assessed declined significantly, although many patients still expressed strong needs in some domains. However, meeting patients' needs was accompanied by improvements in all functioning subscales. CONCLUSIONS This is the first study to show that meeting breast and gynecological cancer patients' supportive care needs during inpatient rehabilitation resulted in improved QoL. Given the considerable proportions of patients still reporting unmet needs at the end of their stay, stronger and continuing efforts seem warranted to meet these needs and thus further increase QoL.
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Affiliation(s)
- Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | | | - Dirk Engehausen
- Sinntal Clinic Bad Brückenau, German Statutory Pension Insurance of Northern Bavaria, Bad Brückenau, Germany
| | - Monika Reuss-Borst
- Center for Rehabilitation and Prevention Bad Bocklet, Bad Bocklet, Germany
| | - Achim Wöckel
- Department of Gynecology and Obstetrics, University Hospital Würzburg, Würzburg, Germany
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21
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van Dusseldorp L, Groot M, Adriaansen M, van Vught A, Vissers K, Peters J. What does the nurse practitioner mean to you? A patient-oriented qualitative study in oncological/palliative care. J Clin Nurs 2019; 28:589-602. [PMID: 30129072 PMCID: PMC7380134 DOI: 10.1111/jocn.14653] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/01/2018] [Accepted: 08/11/2018] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To explore what meaning patients associate with their experiences with a nurse practitioner (NP) in oncological or palliative care. BACKGROUND Care provided by NPs results in high patient satisfaction, mostly related to the assurance of continuity of care, and to receiving information and advice on coping with the disease. Research shows that health care provided by NPs equals the quality of care provided by physicians. Patients may be even more satisfied with care provided by NPs. Because patients' views have only been examined quantitatively, underlying experiences and meanings remain unclear. DESIGN A qualitative study from a phenomenological perspective. METHODS In 2017, seventeen outpatients aged 45-79 years, receiving oncological or palliative care, were interviewed in depth. Data were analysed by Colaizzi's seven-step method and by the Metaphor Identification Procedure. RESULTS Six fundamental themes emerged: the NP as a human (1) and as a professional (2), the NP providing care (3) and cure (4), NPs organising patient care (5) and the impact on patient's well-being (6). MIP analysis revealed six metaphors: NP means trust; is a travel aid; is a combat unit; is a chain; is a signpost; and is a technician. CONCLUSIONS NPs mean a lot to patients. NPs are valued as reliable, helpful and empathic. Patients feel empowered, at peace and in control as a result of the support, guidance and attention to them as a person as well as to aspects of the disease. Providing expert, integrated care makes patients feel safe and embraced in the NP's expertise. RELEVANCE TO CLINICAL PRACTICE This qualitative insight into patients' experiences will contribute to the body of knowledge on patients' perceptions of the treatment and support provided by NPs. It adds to the further development of the NPs' profession and education.
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Affiliation(s)
- Loes van Dusseldorp
- Radboud University Medical CentreExpertise Center for Pain and Palliative MedicineNijmegenThe Netherlands
| | - Marieke Groot
- Radboud University Medical CentreExpertise Center for Pain and Palliative MedicineNijmegenThe Netherlands
| | | | | | - Kris Vissers
- Radboud University Medical CentreExpertise Center for Pain and Palliative MedicineNijmegenThe Netherlands
| | - Jeroen Peters
- HAN University of Applied ScienceNijmegenThe Netherlands
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