1
|
Nghiem VT, Jin J, Mennemeyer ST, Wong FL. Health-related risk behaviors among U.S. childhood cancer survivors: a nationwide estimate. BMC Cancer 2024; 24:180. [PMID: 38321375 PMCID: PMC10845633 DOI: 10.1186/s12885-024-11894-7] [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: 09/05/2023] [Accepted: 01/17/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Childhood cancer survivors (CCS) are subject to a substantial burden of treatment-related morbidity. Engaging in health protective behaviors and eliminating risk behaviors are critical to preventing chronic diseases and premature deaths. This study is aimed to provide updated information on currently smoking, physical inactivity, binge drinking patterns and associated factors among CCS using a nationwide dataset. METHODS We constructed a sample of CCS (cancer diagnosis at ages < 21y) and healthy controls (matched on age, sex, residency, race/ethnicity) using 2020 Behavioral Risk Factor Surveillance System. We used Chi-square tests and Wilcoxon rank-sum test to examine differences in sociodemographics and clinical characteristics between two groups. Logistic, ordinal regression and multivariable models (conditional models for matching) were used to determine factors associated with risk behaviors. RESULTS The final sample (18-80y) included 372 CCS and 1107 controls. Compared to controls, CCS had a similar proportion of binge drinking (~ 18%) but higher prevalence of currently smoking (26.6% vs. 14.4%, p < 0.001), physical inactivity (23.7% vs. 17.7%, p = 0.012), and of having 2-or-3 risk behaviors (17.2% vs. 8.1%, p < 0.001). Younger age, lower educational attainment, and having multiple chronic health conditions were associated with engaging in more risk behaviors among CCS. Females, compared to male counterparts, had lower odds of binge drinking (adjusted odds ratio (aOR) = 0.30, 95% confidence interval (CI): 0.16-0.57) among CCS but not in all sample. Having multiple chronic health conditions increased odds of both currently smoking (aOR = 3.52 95%CI: 1.76-7.02) and binge drinking (aOR = 2.13 95%CI: 1.11-4.08) among CCS while it only increased odds of currently smoking in all sample. DISCUSSION Our study provided risk behavior information for wide age-range CCS, which is currently lacking. Every one in four CCS was currently smoking. Interventions targeting risk behavior reduction should focus on CCS with multiple chronic health conditions.
Collapse
Affiliation(s)
- Van T Nghiem
- Department of Health Policy and Organization, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA.
| | - Jing Jin
- Department of Health Policy and Organization, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Stephen T Mennemeyer
- Department of Health Policy and Organization, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - F Lennie Wong
- Department of Population Sciences, City of Hope, Duarte, CA, USA
| |
Collapse
|
2
|
Gavioli C, Vlooswijk C, Janssen SHM, Kaal SEJ, Kerst JM, Tromp JM, Bos MEMM, van der Hulle T, van der Graaf WTA, Lalisang RI, Nuver J, Bijlsma RM, Kouwenhoven MCM, Husson O, Beijer S. Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention in adolescent and young adult (AYA) cancer survivors: results from the SURVAYA study. J Cancer Surviv 2024:10.1007/s11764-023-01529-4. [PMID: 38224397 DOI: 10.1007/s11764-023-01529-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE For adolescent and young adult (AYA) cancer survivors with a good prognosis, having a healthy lifestyle prevents morbidity and mortality after treatment. The aim of this study was to investigate the prevalence of (un)healthy lifestyle behaviors and related determinants in AYA cancer survivors. METHODS A population-based, cross-sectional study was performed among long-term (5-20 years) AYA cancer survivors (18-39 years old at diagnosis) registered within the Netherlands Cancer Registry. Self-reported questionnaires data about health behaviors were used to calculate the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) adherence score. Associations between the score and clinical/sociodemographic determinants of (un)healthy behaviors were investigated using logistic regression models. RESULTS The mean WCRF/AICR score was low to moderate, 3.8 ± 1.2 (0.5-7.0) (n = 3668). Sixty-one percent adhered to "limit the consumption of sugar sweetened drinks," 28% to "be a healthy weight," 25% to "fruit and vegetable consumption," and 31% to "limit alcohol consumption." Moderate and high adherence were associated with being a woman (ORmoderate = 1.46, 95% CI = 1.14-1.85, and ORhigh = 1.87, 95% CI = 1.46-2.4) and highly educated (ORmoderate = 1.54, 95% CI = 1.30-1.83, and ORhigh = 1.87, 95% CI = 1.46-2.4). Low adherence was associated with smoking (ORmoderate = 0.68, 95% CI = 0.50-0.92, and ORhigh = 0.30, 95% CI = 0.21-0.44) and diagnosis of germ cell tumor (ORmoderate = 0.58, 95% CI = 0.39-0.86, and ORhigh = 0.45, 95% CI = 0.30-0.69). CONCLUSIONS Adherence to the 2018 WCRF/AICR lifestyle recommendations was low to moderate, especially regarding body weight, fruit, vegetables, and alcohol consumption. Men, current smokers, lower-educated participants, and/or those diagnosed with germ cell tumors were less likely to have a healthy lifestyle. IMPLICATIONS FOR CANCER SURVIVORS Health-promotion programs (e.g., age-specific tools) are needed, focusing on high-risk groups.
Collapse
Affiliation(s)
- Costanza Gavioli
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, 3511 DT, Utrecht, The Netherlands
| | - Carla Vlooswijk
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, 3511 DT, Utrecht, The Netherlands
| | - Silvie H M Janssen
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
| | - Suzanne E J Kaal
- Department of Medical Oncology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - J Martijn Kerst
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
| | - Jacqueline M Tromp
- Department of Medical Oncology, Amsterdam University Medical Center, 1105 AZ, Amsterdam, The Netherlands
| | - Monique E M M Bos
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD, Rotterdam, The Netherlands
| | - Tom van der Hulle
- Department of Medical Oncology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD, Rotterdam, The Netherlands
| | - Roy I Lalisang
- Department of Internal Medicine, GROW-School of Oncology and Reproduction, Maastricht UMC+ Comprehensive Cancer Center, 6229 HX, Maastricht, The Netherlands
| | - Janine Nuver
- Department of Medical Oncology, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Rhodé M Bijlsma
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
| | - Mathilde C M Kouwenhoven
- Department of Neurology, Amsterdam UMC, Amsterdam University Medical Centers, Location VUmc, 1081 HV, Amsterdam, The Netherlands
| | - Olga Husson
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands.
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands.
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD, Rotterdam, The Netherlands.
| | - Sandra Beijer
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, 3511 DT, Utrecht, The Netherlands
| |
Collapse
|
3
|
van der Meer DJ, van der Graaf WTA, van de Wal D, Karim-Kos HE, Husson O. Long-term second primary cancer risk in adolescent and young adult (15-39 years) cancer survivors: a population-based study in the Netherlands between 1989 and 2018. ESMO Open 2024; 9:102203. [PMID: 38171190 PMCID: PMC10837779 DOI: 10.1016/j.esmoop.2023.102203] [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: 09/24/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Few studies have comprehensively investigated the long-term second cancer risk among adolescent and young adult (AYA, aged 15-39 years) cancer survivors. This study investigated the long-term second cancer risk by including the full range of first and second cancer combinations with at least 10 observations in the Netherlands between 1989 and 2018. MATERIALS AND METHODS First and second primary cancer data of all 6-month AYA cancer survivors were obtained from the nationwide population-based Netherlands Cancer Registry. Excess cancer risk compared to the general population was assessed with standardized incidence ratio (SIR) and absolute excess risk (AER) statistics up to 25 years after diagnosis. Cumulative incidences were estimated, using death as a competing risk factor. Analyses were carried out with and without applying multiple cancer rules. RESULTS The cohort included 99 502 AYA cancer survivors. Male survivors had a 2-fold higher risk of developing any cancer compared to the general population, whereas this was around 1.3-fold in females. AERs were 17.5 and 10.1 per 10 000 person-years for males and females. The long-term excess risk of cancer was significantly higher for most first and second primary cancer combinations, but comparable and lower risk estimates were also observed. Application of the multiple cancer rules resulted in a noticeable risk underestimation in melanoma, testicular, and breast cancer survivors. Risk outcomes remained similar in most cases otherwise. The cumulative incidence of second cancer overall increased over time up to 8.9% in males and 10.3% in females at 25 years' follow-up. Highest long-term cumulative incidences were observed among lymphoma survivors (13.3% males and 18.9% females). CONCLUSIONS AYA cancer survivors have a higher cancer risk compared to the general population for most cancers up to 25 years after their initial cancer diagnosis. Additional studies that investigate risk factors for the specific cancer type combinations are needed to develop personalized follow-up strategies.
Collapse
Affiliation(s)
- D J van der Meer
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam.
| | - W T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam
| | - D van de Wal
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam
| | - H E Karim-Kos
- Princess Máxima Center for Pediatric Oncology, Utrecht; Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht
| | - O Husson
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam; Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam; Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
4
|
Youlden DR, Roder DM, Walker R, Bradford NK, Aitken JF. Second Primary Cancers Following Cancer Among Adolescents and Young Adults in Queensland, Australia, 1982-2018. J Adolesc Young Adult Oncol 2023; 12:537-545. [PMID: 36178981 DOI: 10.1089/jayao.2022.0074] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Increased risk of second primary cancers is an unwanted consequence of cancer survivorship. While the epidemiology of second cancers is well-documented for children and older people, less is known about second cancers among adolescent and young adult (AYA) cancer survivors. Methods: Unit record data were obtained from the Queensland Cancer Register. The study cohort comprised Queensland residents aged 15 to 39 years who were diagnosed with a first primary invasive cancer between 1982 and 2013. Follow-up on second cancers was available for a minimum of 5 years to the end of 2018. Standardized incidence ratios (SIRs) were used to approximate the risk of a second primary cancer relative to the general population. Results: In total, 3086 second primary cancers were observed among 34,431 eligible AYA patients (9%), equating to an overall SIR of 1.59 (95% confidence interval [CI] 1.53-1.64). Melanoma (n = 853, 28%) and female breast cancer (n = 594, 19%) were the most common types of second primary cancer in the study cohort. Relative risk of all second primary cancers combined among AYA patients was inversely associated with age and was highest within the period immediately after first diagnosis irrespective of age group; for example, patients aged 15-24 at first diagnosis recorded more than four times as many second primary cancers than expected within 2 years of their first cancer (SIR = 4.40, 95% CI 2.83-6.82). Conclusions: Detailed data on second primary cancers among AYA cancer survivors are important in promoting increased awareness and to inform the development of targeted prevention and surveillance strategies.
Collapse
Affiliation(s)
- Danny R Youlden
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - David M Roder
- Cancer Epidemiology and Population Health, University of South Australia, Adelaide, Australia
- Cancer Epidemiology and Population Health, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Rick Walker
- Oncology Service, Queensland Children's Hospital, Brisbane, Australia
- Oncology Service, Princess Alexandra Hospital, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Natalie K Bradford
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Joanne F Aitken
- Viertel Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia
- Institute for Resilient Regions, University of Southern Queensland, Brisbane, Australia
- School of Public Health, The University of Queensland, Brisbane, Australia
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| |
Collapse
|
5
|
Webster RT, Dhaduk R, Gordon ML, Partin RE, Kunin-Batson AS, Brinkman TM, Willard VW, Allen JM, Alberts NM, Lanctot JQ, Ehrhardt MJ, Li Z, Hudson MM, Robison LL, Ness KK. Health behavior profiles in young survivors of childhood cancer: Findings from the St. Jude Lifetime Cohort Study. Cancer 2023; 129:2075-2083. [PMID: 36943740 PMCID: PMC10258145 DOI: 10.1002/cncr.34749] [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: 01/31/2022] [Revised: 12/27/2022] [Accepted: 12/30/2022] [Indexed: 03/23/2023]
Abstract
BACKGROUND There is limited understanding of associations between a combination of health behaviors (physical activity, sedentary/screen-time, diet) and cardiometabolic health risk factors, physical performance, and emotional health among young (<18) childhood cancer survivors (CCS). The aims of this research were to address this gap by 1) deriving health behavior adherence profiles among CCS, and 2) examining associations among demographic, diagnosis and/or treatment exposures, cardiometabolic, physical performance, and emotional functioning with health behavior profile membership. METHODS Participants included 397 CCS (≥5 years post-diagnosis; 10-17 years old) enrolled in the St. Jude Lifetime Cohort Study who completed physical health evaluations and questionnaires assessing health behaviors and psychological functioning. Latent profile analysis was used to derive profiles of health behavior adherence. Logistic regression and t-tests were used to examine mean-level differences and associations between profile membership with demographic, diagnosis, treatment exposures, cardiometabolic health, psychological functioning, and physical performance. RESULTS Two profiles emerged: inactive-unhealthy-diet ("IU") and active-sedentary-unhealthy-diet ("ASU") to guidelines. More participants in IU demonstrated higher resting heart rate (mean [M], 76.54; SD = 12.00) and lower motor proficiency scores (M = 34.73; SD = 29.15) compared to ASU (resting heart rate, M = 71.95, SD = 10.74; motor proficiency, M = 50.40, SD = 31.02). CONCLUSIONS CCS exhibited low adherence to multiple health behavior guidelines, with adherence patterns differentially associated with cardiometabolic health (i.e., resting heart rate) and physical performance. However, robust protection against all health variables was not observed. Findings suggest interventions designed to improve health outcomes should target multiple health behaviors simultaneously. PLAIN LANGUAGE SUMMARY Pediatric cancer survivors are at-risk for detrimental health outcomes associated with cancer and treatment. Engagement in healthy lifestyle behaviors serves to reduce health vulnerabilities among adult survivors but less is known about associations with lifestyle behaviors on young survivors. This study documents patterns of lifestyle behaviors among survivors of pediatric cancer, factors that increase susceptibility to nonadherence, and associations among lifestyle behaviors and health indicators.
Collapse
Affiliation(s)
- Rachel Tillery Webster
- Psychology, St. Jude Children’s Research Hospital, Memphis, TN
- Comprehensive Cancer Center, St. Jude Children’s Research Hospital, Memphis, TN
| | - Rikeenkumar Dhaduk
- Comprehensive Cancer Center, St. Jude Children’s Research Hospital, Memphis, TN
| | | | - Robyn E. Partin
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | | | - Tara M. Brinkman
- Psychology, St. Jude Children’s Research Hospital, Memphis, TN
- Comprehensive Cancer Center, St. Jude Children’s Research Hospital, Memphis, TN
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Victoria W. Willard
- Psychology, St. Jude Children’s Research Hospital, Memphis, TN
- Comprehensive Cancer Center, St. Jude Children’s Research Hospital, Memphis, TN
| | | | | | - Jennifer Q. Lanctot
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Matthew J. Ehrhardt
- Comprehensive Cancer Center, St. Jude Children’s Research Hospital, Memphis, TN
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
- Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Zhenghong Li
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Melissa M. Hudson
- Psychology, St. Jude Children’s Research Hospital, Memphis, TN
- Comprehensive Cancer Center, St. Jude Children’s Research Hospital, Memphis, TN
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
- Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Leslie L. Robison
- Comprehensive Cancer Center, St. Jude Children’s Research Hospital, Memphis, TN
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
- Oncology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Kirsten K. Ness
- Comprehensive Cancer Center, St. Jude Children’s Research Hospital, Memphis, TN
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| |
Collapse
|
6
|
Buro AW, Sauls R, Stern M, Carson TL. A qualitative study of stress experiences, health behaviors, and intervention preferences in young adult cancer survivors. Support Care Cancer 2023; 31:295. [PMID: 37093353 PMCID: PMC10123481 DOI: 10.1007/s00520-023-07756-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/13/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE To inform behavioral intervention development, this study examined experiences and unmet needs related to stress, diet, and physical activity in young adult (YA) cancer survivors. METHODS Twenty-three semi-structured interviews were conducted with a purposive sample of YA cancer survivors (n = 12 aged 18-29 years; n = 11 aged 30-39 years; 57% racial or ethnic minority) between May and July 2022 via Zoom. Data were analyzed using a coding reliability approach to thematic analysis. RESULTS Stressor-related themes included health and health care, economic stability, social and community context, and balancing responsibilities. Transition to independent adulthood was discussed among younger participants (18-29 years). Coping-related themes included letting go, keeping anchored in faith, and distraction. Older participants (30-39 years) reported more diverse coping strategies. Routine and consistency and the impact of stress were themes aligning with health behaviors. Control was a cross-cutting theme regarding stressors, coping, and health behaviors. Themes related to intervention preferences included individualized approach, expert-based content, peer support, integrative self-care, and manageability. Younger participants preferred multiple intervention formats (e.g., website, tracking logs). CONCLUSIONS Findings highlighted unmet needs regarding social and environmental stressors in YA cancer survivors and a preference for individualized, expert-based content and peer support in stress management-enhanced behavioral interventions. Such interventions may be tailored for specific age groups to account for differences in stress experiences and intervention preferences.
Collapse
Affiliation(s)
- Acadia W Buro
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
| | - Rachel Sauls
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Marilyn Stern
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Tiffany L Carson
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| |
Collapse
|
7
|
Reported Mental Health, Diet, and Physical Activity in Young Adult Cancer Survivors. Nutrients 2023; 15:nu15041005. [PMID: 36839363 PMCID: PMC9961696 DOI: 10.3390/nu15041005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023] Open
Abstract
Young adult (YA) cancer survivors are at increased risk for chronic diseases and face age-dependent stressors that may hinder their ability to maintain healthy lifestyle behaviors. This study examined associations between reported mental health, eating beliefs, and health behaviors in YA cancer survivors. YA cancer survivors aged 18-39 years (n = 225) completed a self-administered REDCap® survey, including the Perceived Stress Scale 10, PROMIS® Anxiety and Depression, Eating Beliefs Questionnaire, National Health and Nutrition Examination Survey Dietary Screener Questionnaire, Godin-Shephard Leisure-Time Physical Activity Questionnaire, and demographic and diagnosis-related questions. Descriptive statistics, bivariate analyses, and multiple linear regression were performed. Participants were mean 31.3 years old and 3.7 years post-treatment; 77.3% were women. Most participants reported White (78%) or Black or African American (11.2%) race and non-Hispanic ethnicity (84%). Adjusting for covariates, perceived stress, anxiety, and depression were associated with increased added sugar intake (p < 0.001) and eating beliefs (p < 0.001). Perceived stress and depression were associated with reduced vegetable intake (p < 0.05). There were no associations with fruit intake or physical activity in the adjusted models. Health behavior interventions for this population may address psychosocial needs by including a stress management or mind-body component. Further research including direct measures of health behaviors is warranted.
Collapse
|
8
|
Schaffer M, McLoone JK, Wakefield CE, Brierley ME, Girgis A, McCarthy MC, Thornton-Benko E, Chan RJ, Johnston KA, Cohn RJ, Signorelli C. eHealth tools for childhood cancer survivorship care: A qualitative analysis of survivors', parents', and general practitioners' views. PEC INNOVATION 2022; 1:100010. [PMID: 37364028 PMCID: PMC10194118 DOI: 10.1016/j.pecinn.2021.100010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/11/2021] [Accepted: 11/23/2021] [Indexed: 06/28/2023]
Abstract
Objective We assessed the acceptability of, and perceived benefits/barriers to, using Electronic health (eHealth) technology for childhood cancer survivorship care. Methods We interviewed survivors, their parents, and their nominated GP. We described a hypothetical eHealth tool to manage survivorship care and asked their likely use of, and perceived benefits/concerns for, the use of the tool. Results 31 survivors (mean age = 27.0), 29 parents (survivors' mean age = 12.6), and 51 GPs (mean years practising = 28.2) participated. Most survivors/parents (85%) and GPs (75%) indicated that they would be willing to use an eHealth tool. Survivors/parents reported that an eHealth tool would increase their confidence in their ability, and their GP's ability, to manage their survivorship care. GPs agreed that an eHealth tool would provide easier access to survivors' medical information and increase their capacity to provide support during survivorship. Some GPs (7%) and survivors (43%) reported being hesitant to use eHealth tools due to privacy/security concerns. Conclusion Overall, eHealth tools appear acceptable and may help to improve the management of late effects for childhood cancer survivors and assist their GPs to coordinate their care. Innovation Concerns raised by key stakeholders should be addressed in the design of eHealth technologies to optimise their uptake and effectiveness.
Collapse
Affiliation(s)
- Maria Schaffer
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Jordana K. McLoone
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Claire E. Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Mary-Ellen Brierley
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Afaf Girgis
- South West Sydney Clinical Campuses, UNSW Medicine & Health, UNSW Sydney, Australia
| | - Maria C. McCarthy
- Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia
- Children's Cancer Centre, Royal Children's Hospital, Parkville, Victoria 3052, Australia
| | - Elysia Thornton-Benko
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
- Bondi Road Doctors, Bondi Junction, NSW, Australia
| | - Raymond J. Chan
- Cancer and Palliative Care Outcomes Centre and School of Nursing, Queensland University of Technology (QUT), Kelvin Grove, Queensland 4059, Australia
- Division of Cancer Services, Princess Alexandra Hospital, Woolloongabba, Queensland 4102, Australia
| | - Karen A. Johnston
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Richard J. Cohn
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Christina Signorelli
- Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | | |
Collapse
|
9
|
Health behaviors in adolescent survivors of cancer: An integrative review. J Pediatr Nurs 2022; 66:e100-e115. [PMID: 35654646 DOI: 10.1016/j.pedn.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 05/04/2022] [Accepted: 05/04/2022] [Indexed: 11/22/2022]
Abstract
PROBLEM Adolescent survivors of cancer face an increased risk of chronic health conditions that can be improved by healthy behaviors. The purpose of this review is to synthesize the extent/prevalence of health behaviors (physical activity [PA], diet, human papillomavirus [HPV] vaccination, alcohol use, smoking, marijuana use, and unprotected sex) compared to age-matched peers and factors associated with those behaviors. ELIGIBILITY CRITERIA Four databases (PubMed, EMBASE, PsycINFO, and CINAHL) were searched for peer-reviewed primary studies published since 2000 including adolescents aged 11-20 years-old, who had completed cancer treatments. Studies reporting at least one behavior were included. SAMPLE Of 1979 articles reviewed, 27 studies reporting any of the following health behaviors were included: PA, diet, HPV vaccination, alcohol use, smoking, marijuana use, or unprotected sex. RESULTS Adolescent survivors of cancer engaged less in health risk behaviors (alcohol use, smoking, marijuana use, and unprotected sex) or health-promoting behaviors (PA, healthy diet, and HPV vaccination) compared to age-matched peers. Their health behaviors were associated with psychosocial factors including emotional discomfort (e.g., feeling depressed or nervous) and influence of others (family, friends, and healthcare providers). CONCLUSIONS Although health risk behaviors in adolescent survivors of cancer are not as prevalent as in their peers, the survivors' low engagement in health-promoting behaviors including PA, diet, and HPV vaccination is concerning. IMPLICATIONS More research is needed to develop and evaluate interventions to improve health-promoting behaviors in adolescent survivors of cancer by strengthening or facilitating psychosocial resources.
Collapse
|
10
|
Darabos K, Barakat LP, Schapira M, Hill-Kayser C, Schwartz LA. Association of Demographic and Cancer-Specific Factors on Health Behavior Recommendations Specific to Cancer Prevention and Control Among Adolescent and Young Adult Survivors of Childhood Cancer. J Adolesc Young Adult Oncol 2021; 10:619-628. [PMID: 33211609 PMCID: PMC8819508 DOI: 10.1089/jayao.2020.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Purpose: Adolescent and young adult survivors of childhood cancer (AYA) are at risk for long-term health problems that are exacerbated by not meeting health behavior recommendations (e.g., exercise). To identify AYA at risk for not meeting health behavior recommendations, we explored demographic (e.g., age) and cancer-specific (e.g., intensity of treatment) factors associated with not meeting specific health behavior recommendations that have implications for cancer prevention and control. Methods: Regression (linear/binary) was used to examine demographic and cancer-specific associates regarding fruit/vegetable intake, binge drinking, sleep duration, sunscreen use, tobacco use, and physical activity among 307 AYA (Mage = 20.33, range = 15-34) across three combined studies, treated at a pediatric cancer center. Health behavior measures were adapted from The Health Behaviors Survey and the Youth Risk Behavior Surveillance System questionnaire. Results: AYA in general did not meet health behavior recommendations. Compared with AYA with public insurance, AYA with private insurance (β = -0.19, p < 0.01) were more likely to meet multiple health behavior recommendations. AYA at greatest risk for not meeting specific health behaviors were more likely to be diagnosed in middle childhood (11.35years) compared with early childhood (8.38years), be closer to diagnosis (8.77years vs. 11.76years) and closer to treatment completion (6.97years vs. 9.91years), and have a solid tumor (32.7%) compared with a brain tumor (10.6%). Conclusion: Not meeting health behavior recommendations is common among AYA survivors of childhood cancer. Early education in the context of survivorship care is critical to provide teachable moments to AYA; such interventions might impact future long-term health and reduce risk for secondary cancers.
Collapse
Affiliation(s)
- Katie Darabos
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lamia P. Barakat
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Marilyn Schapira
- Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christine Hill-Kayser
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Radiation Oncology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lisa A. Schwartz
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
11
|
Murnane A, Kiss N, Fraser SF, Lewin J. Health-related quality of life, fatigue and health behaviours in Australian adolescent and young adult cancer survivors. Pediatr Blood Cancer 2021; 68:e29243. [PMID: 34309171 DOI: 10.1002/pbc.29243] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Current knowledge of the long-term health behaviours and well-being of adolescent and yong adult (AYA) cancer survivors is limited. The aim of this study was to evaluate the health behaviours of AYA cancer survivors compared to Australian normative data and describe their health-related quality of life (HR-QoL) and levels of fatigue. METHOD A cross-sectional online survey of participants aged 15-25 years at diagnosis and 2-7 years post treatment completion was conducted at a comprehensive cancer centre. Validated questionnaires assessed health behaviours and functioning including current physical activity (PA) levels, diet quality, fatigue (FACIT-F) and HR-QoL (AQoL-6D, Short Form 36v2 [SF-36v2]) were compared to Australian normative data. RESULTS Ninety individuals completed the survey (26% response rate) with a mean age of 25.4 years and median time post treatment of 61 months (24-85 months). Compared to normative data, a higher proportion of AYA cancer survivors was consuming the recommended daily serves of fruit and vegetables (16.7% vs. 3.9%, p < .0001), had a lower presence of overweight or obesity (46.7% vs. 57.7%, p = .04) and lower percentage of current smokers (2.2% vs. 16.7%, p < .0001). However, AYA cancer survivors reported increased fatigue (t[df = 596] = -4.1, p < .0001) and reduced HR-QoL compared to normative data (t[df = 533] = 9.2, p < .0001) along with a higher proportion suffering from one or more chronic health conditions (65% vs. 40%, p < .0001). CONCLUSION AYA cancer survivors from a single Australian institution, who were on average 5 years post treatment, exhibited better health behaviours compared to Australian normative data, but still below recommended guidelines. However, they continue to experience issues with fatigue and reduced HR-QoL, especially in those not meeting the PA guidelines.
Collapse
Affiliation(s)
- Andrew Murnane
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia
| | - Nicole Kiss
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia.,Allied Health Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Steve F Fraser
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia
| | - Jeremy Lewin
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
12
|
Trama A, Tittarelli A, Barigelletti G, Botta L, Gatta G, Tagliabue G, Contiero P, Guzzinati S, Andreano A, Manneschi G, Falcini F, Castaing M, Filiberti RA, Gasparotti C, Cirilli C, Mazzucco W, Mangone L, Iacovacci S, Vitale MF, Stracci F, Piffer S, Tumino R, Carone S, Sampietro G, Melcarne A, Ballotari P, Boschetti L, Pisani S, Cavalieri D'Oro L, Cuccaro F, D'Argenzio A, D'Orsi G, Fanetti AC, Ardizzone A, Candela G, Savoia F, Pascucci C, Castelli M, Storchi C, Bernasconi A. Excess risk of subsequent malignant neoplasms in adolescent and young adult cancer survivors: Results from the first Italian population-based cohort. Cancer 2021; 128:364-372. [PMID: 34582036 DOI: 10.1002/cncr.33931] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/15/2021] [Accepted: 08/03/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Evidence about late effects in adolescent and young adult (AYA) cancer survivors is scarce. This study assessed the risk of subsequent malignant neoplasms (SMNs) to identify the most common SMNs to be considered in follow-up care. METHODS Population-based cancer registries retrospectively identified first primary tumors (between 1976 and 2013) and SMNs in AYAs (15-39 years old at their cancer diagnosis). AYA cancer survivors were those alive at least 5 years after their first cancer diagnosis. The excess risk of SMNs was measured as standardized incidence ratios (SIRs) and absolute excess risk together with the cumulative incidence of SMNs. RESULTS The cohort included 67,692 AYA cancer survivors. The excess risk of developing any SMN (SIR, 1.6; 95% confidence interval, 1.5-1.7) was 60%. The excess risk of SMNs was significantly high for survivors of lymphomas; cancers of the breast, thyroid, female genital tract, digestive organs, gonads, and urinary tract; and melanomas. The cumulative incidence of all SMNs in AYA cancer survivors within 25 years of their first cancer diagnosis was approximately 10%. Subsequent tumors contributing to approximately 60% of all SMNs were breast cancer, colorectal cancer, corpus uteri cancer, and ovarian cancer in females and colorectal cancer, bladder cancer, prostate cancer, lung cancer, and lymphomas in males. CONCLUSIONS These results highlight the need to personalize follow-up strategies for AYA cancer survivors.
Collapse
Affiliation(s)
- Annalisa Trama
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Andrea Tittarelli
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Giulio Barigelletti
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Laura Botta
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Gemma Gatta
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Giovanna Tagliabue
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Paolo Contiero
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | | | - Anita Andreano
- Epidemiology Unit, Agency for Health Protection of Milan, Milano, Italy
| | - Gianfranco Manneschi
- Clinical Epidemiology Unit, Istituto per lo Studio, la Prevenzione e la Rete Oncologica, Firenze, Italy
| | - Fabio Falcini
- Department of Clinical and Experimental Oncology and Ematology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Marine Castaing
- Department of Hygiene and Public Health, Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Università di Catania, Catania, Italy
| | - Rosa A Filiberti
- Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Cinzia Gasparotti
- Epidemiology Unit, Agency for Health Protection of Brescia, Brescia, Italy
| | - Claudia Cirilli
- Modena Cancer Registry, Azienda Unità Sanitaria Locale Modena, Modena, Italy
| | - Walter Mazzucco
- Department of Medicine and Surgery, Università degli Studi di Palermo, Palermo, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Iacovacci
- Active Prevention Unit, Azienda Sanitaria Locale Latina, Latina, Italy
| | | | - Fabrizio Stracci
- Department of Experimental Medicine, Università degli Studi di Perugia, Perugia, Italy
| | - Silvano Piffer
- Evaluative and Clinical Epidemiological Service, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, Azienda Sanitaria Provinciale di Ragusa, Ragusa, Italy
| | - Simona Carone
- Taranto Cancer Registry, Azienda Sanitaria Locale di Taranto, Taranto, Italy
| | - Giuseppe Sampietro
- Epidemiological Service, Agenzia di Tutela della Salute di Bergamo, Bergamo, Italy
| | - Anna Melcarne
- Cancer Registry Epidemiology Unit, Azienda Sanitaria Locale di Lecce, Lecce, Italy
| | - Paola Ballotari
- Epidemiologic Observatory, Azienda di Tutela della Salute della Val Padana, Mantova, Italy
| | - Lorenza Boschetti
- Epidemiologic Observatory, Cancer Registry, Agenzia di Tutela della Salute di Pavia, Pavia, Italy
| | - Salvatore Pisani
- Epidemiology Unit, Agenzia di Tutela della Salute dell'Insubria, Varese, Italy
| | - Luca Cavalieri D'Oro
- Epidemiology Unit, Agenzia per la Tutela della Salute della Brianza, Monza, Italy
| | - Francesco Cuccaro
- Epidemiology Unit - Cancer Registry, Azienda Sanitaria Locale di Barletta-Andria-Trani, Barletta, Italy
| | - Angelo D'Argenzio
- Epidemiology Unit, Azienda Sanitaria Locale Caserta 2, Caserta, Italy
| | - Giancarlo D'Orsi
- Department of Prevention, Azienda Sanitaria Locale Napoli 2, Napoli, Italy
| | - Anna C Fanetti
- Epidemiology Unit, Azienda di Tutela della Salute della Montagna, Sondrio, Italy
| | - Antonino Ardizzone
- Statistic and Epidemiology Unit - Cancer Registry, Azienda Sanitaria Locale di Brindisi, Brindisi, Italy
| | - Giuseppa Candela
- Cancer Registry Unit, Azienda Sanitaria Provinciale di Trapani, Trapani, Italy
| | - Fabio Savoia
- Childhood Cancer Registry of Campania Region, AORN Santobono Pausilipon, Napoli, Italy
| | - Cristiana Pascucci
- Department of Experimental Medicine and Public Health, Università di Camerino, Camerino, Italy
| | - Maurizio Castelli
- Prevention Unit, Azienda Unità Sanitaria Locale della Valle d'Aosta, Aosta, Italy
| | - Cinzia Storchi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alice Bernasconi
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| |
Collapse
|
13
|
Cappelli C, Miller KA, Ritt-Olson A, Pentz MA, Salahpour S, Milam JE. Binge Drinking, Tobacco, and Marijuana Use Among Young Adult Childhood Cancer Survivors: A Longitudinal Study. J Pediatr Oncol Nurs 2021; 38:285-294. [PMID: 34096807 DOI: 10.1177/10434542211011036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: Substance use among young adult childhood cancer survivors (YACCSs) has been found to increase during survivorship, resulting in increased risk of developing long-term negative health outcomes. This investigation sought to determine various risk and protective factors of tobacco, alcohol, or marijuana use over time among a sample of YACCSs. Methods: 127 YACCSs (57% Hispanic, 55% female, average age at diagnosis 12.4 years) who were diagnosed with any cancer type (except Hodgkin lymphoma) at two large pediatric medical centers in Los Angeles County between 2000 and 2007 responded to two surveys separated by ∼5 years. Bivariate logistic regression models were used to assess independent clinical and psychosocial Time 1 variables associated with each substance use outcome at Time 2. Time 1 variables significant at p < .10 were included in multivariable logistic regression models for each Time 2 substance use variable. Results: Rates of 30-day use increased over time for binge drinking alcohol (from 25.6% to 37.7%), marijuana (from 10.6% to 22.1%), and cigarette/tobacco (from 8.9% to 12.2%). Of the following Time 1 variables, marijuana use, cigarette use, and binge drinking were associated with Time 2 marijuana, cigarette, and binge drinking, respectively. Of the following clinical factors, receipt of more intensive cancer treatment was associated with decreased tobacco use. All other psychosocial and clinical factors analyzed were not associated with any increase or decrease in substance use. Conclusions: A greater emphasis on early health education efforts regarding the health risks of tobacco, alcohol, and marijuana use is needed in this at-risk population.
Collapse
Affiliation(s)
- Christopher Cappelli
- Department of Preventive Medicine, Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Kimberly A Miller
- Department of Preventive Medicine, Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Anamara Ritt-Olson
- Department of Preventive Medicine, Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Mary A Pentz
- Department of Preventive Medicine, Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Sofia Salahpour
- Department of Preventive Medicine, Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Joel E Milam
- Department of Preventive Medicine, Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
14
|
Marec-Bérard P, Delrieu L, Febvey-Combes O, Mongondry R, Pérol O, Moumjid-Ferdjaoui N, Boyle H, Fervers B, Carretier J. Implementation of a Prevention Program Based on Adapted Physical Activity and Recommendations for Adolescents and Young Adults with Cancer: PREVAPAJA Study. J Adolesc Young Adult Oncol 2021; 11:189-201. [PMID: 34255553 DOI: 10.1089/jayao.2021.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: In Europe, 20,000 Adolescent and Young Adults (AYAs) aged 15-25 years are diagnosed with cancer annually. Although prognosis is good, AYA cancer survivors are at greater risk of second primary cancers, cardiovascular disease, and various long-term effects. Benefits of physical activity (PA) in AYAs reported in current studies remain difficult to generalize; none has been performed in France. This single-arm intervention study tested the feasibility of combining hospital-based supervised and home-based unsupervised physical activity sessions (PAS) and providing cancer prevention recommendations for AYAs. Methods: The AYAs attended PAS concomitant to treatment and participated in one face-to-face prevention interview. PA (international physical activity questionnaire), 6-min walk distance (6MWD), sedentarity, anthropometrics, quality of life (QoL), and fatigue were assessed at baseline (T1) and end of intervention (T2). PA, satisfaction and cancer prevention behaviors were assessed 1 year after baseline (T3). Results: Fifty-nine AYAs (mean 19 years) participated in the study. Acceptability and attrition were 80% and 12%, respectively. Between T1 and T2, 6MWD and global QoL improved (p < 0.001), and fatigue decreased (p = 0.003). Total PA improved and sitting time decreased (p < 0.001) overall (T1-T3). Assessment at T3 showed interindividual differences in how participants considered risk factors (e.g., more attention to PA, UV exposures, nutrition). Conclusion: Combined supervised and unsupervised home-based PAS in AYAs undergoing cancer treatment is acceptable and feasible. The program contributes to maintaining and improving physical fitness and QoL, while reducing fatigue and other cancer and treatment symptoms. Larger randomized controlled trials are needed to confirm these results.
Collapse
Affiliation(s)
- Perrine Marec-Bérard
- Pediatric Department, Hematology and Oncology Pediatric Institute, Centre Léon Bérard, Lyon, France
| | - Lidia Delrieu
- Department Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
| | - Olivia Febvey-Combes
- Clinical Research and Innovation Department, Léon Bérard Cancer Center, Lyon, France
| | - Rodolf Mongondry
- Department Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
| | - Olivia Pérol
- Department Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
| | | | - Helen Boyle
- Department of Medical Oncology, Léon Bérard Cancer Center, Lyon, France
| | - Béatrice Fervers
- Department Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France.,UMR INSERM 1296 "Radiations: Defence, Health and Environment," Lyon, France
| | - Julien Carretier
- Department Prevention, Cancer and Environment, Léon Bérard Cancer Center, Lyon, France
| |
Collapse
|
15
|
Christopherson U, Wells SJ, Parker N, Lyons EJ, Swartz MD, Blozinski A, Basen-Engquist K, Peterson S, Swartz MC. Use of active video games with or without videoconferencing on health outcomes in adolescent and young adult cancer survivors: a systematic review. J Cancer Surviv 2021; 16:714-727. [PMID: 34086184 PMCID: PMC8175926 DOI: 10.1007/s11764-021-01065-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 05/26/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE Adolescent and young adult (AYA) cancer survivors experience greater functional deficits compared to non-cancer peers or older survivors with a similar diagnosis. Physical activity (PA) is a key strategy for mitigating functional decline, and motivation and peer support are critical PA facilitators in AYA cancer survivors. Active video games (AVGs) may be a "gateway" method to promote PA. Further, integrating AVGs into group videoconferencing, a medium used by AYAs to socialize, can capitalize on peer support needed for PA motivation. Thus, we examined the use of AVGs and/or videoconferencing in PA interventions that included AYA survivors and the effect on physical function and health outcomes. METHODS Seven electronic databases were searched from incept to January 2020. Search terms included videoconferencing, video games, exercise, and cancer. The protocol is registered on PROSPERO: CRD42020163491. Two reviewers evaluated eligibility and methodological quality using Cochrane's risk of bias tools. RESULTS Six unique studies were included with 97% reviewer agreement. All used AVGs, none used videoconferencing alone, and one used both. Study designs and outcome measures were heterogeneous. Only one study solely targeted AYA survivors. Most were low to medium quality. Few showed significant improvements in quality of life (QOL) and fatigue (n=3), coordination/balance (n=2), and aerobic capacity (n=1). CONCLUSIONS PA interventions using AVGs and/or videoconferencing may improve QOL and fatigue, but evidence on function is lacking. Rigorous interventions targeting AYA survivors are needed. IMPLICATIONS FOR CANCER SURVIVORS Using AVGs and/or videoconferencing to facilitate PA may improve QOL and fatigue.
Collapse
Affiliation(s)
- Ursela Christopherson
- Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX USA
| | - Stephanie J. Wells
- Department of Pediatrics Research, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Nathan Parker
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Elizabeth J. Lyons
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, TX USA
| | - Michael D. Swartz
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, Houston, TX USA
| | - Anna Blozinski
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, Houston, TX USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Susan Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Maria C. Swartz
- Department of Pediatrics Research, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| |
Collapse
|
16
|
Deleemans JM, Zwicker HM, Reynolds KA, Schulte FSM. Associations Among Health Behaviors and Psychosocial Outcomes in Adolescent and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2021; 10:675-681. [PMID: 33769903 DOI: 10.1089/jayao.2020.0224] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Adolescents and young adults (AYA) experience challenges both during and after their cancer treatment. Health behaviors are important contributors to health, yet little research examines health behaviors in AYA cancer survivors. We examined frequencies of health behaviors and associations between health behaviors, psychosocial, and clinical factors in AYA cancer survivors. Methods: Participants were survivors of AYA cancer (n = 60; 38.3% male; mean age = 25.3 years [standard deviation, SD = 4.6]; mean years since therapy completion = 9.0 [SD = 4.2]) from the Alberta Children's Hospital (ACH). Survivors were 13-21 years old at the time of diagnosis. Measures included demographic and clinical data, and the ACH Long-Term Survivor's Questionnaire. Health behaviors were compared with a control group (n = 600) using data from the 2017 Canadian Community Health Survey. Frequencies, conditional logistic regression, and logistic regression analyses were conducted. Results: Compared with controls, survivors reported engaging in physical activity (91.5% vs. 87.5%; odds ratio [OR] = 0.87, 95% confidence interval [CI] = 0.34-2.24; p = 0.77), smoking tobacco (15.3% vs. 19.7%; OR = 1.85, 95% CI = 0.89-3.85; p = 0.10), and street drug use (27.6% vs. 36.5%; OR = 1.60, 95% CI = 0.88-2.91; p = 0.12) at the same rate. Survivors reported binge drinking significantly less (61.0% vs. 76.6%; OR = 0.53, 95% CI = 0.30-0.92; p = 0.024) than controls. Logistic regression analyses revealed a significant model predicting binge drinking [χ2(5, 58) = 23.17, p < 0.001] with greater time off treatment, fear of another health condition, and higher mean body mass index emerging as significant predictors. Conclusion: AYA cancer survivors engage in risky health behaviors at rates similar to their peers. Further research is needed to understand factors mediating survivors' decision to participate in risky health behaviors.
Collapse
Affiliation(s)
- Julie M Deleemans
- Department of Medical Science, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Hailey M Zwicker
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Kathleen A Reynolds
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, Canada
| | - Fiona S M Schulte
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Hematology, Oncology, Transplant Program, Alberta Children's Hospital, Calgary, Canada
| |
Collapse
|
17
|
Tillery R, Willard VW, Gordon ML, Adams K, Long A, Phipps S. Family and parent-child relationship correlates of pediatric cancer survivors' substance use. J Cancer Surviv 2021; 16:329-337. [PMID: 33733380 DOI: 10.1007/s11764-021-01026-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The primary aims of this research were to examine substance use among adolescent and young adult survivors of pediatric cancer (AYA survivors) and AYA without a history of chronic or life threatening illness (AYA comparisons) and to explore links between demographic, medical, caregiver-AYA, and family system factors with AYA substance use patterns. METHODS Participants included 289 AYA (survivors, n = 171; comparisons = 118; 51% female; Mage = 17.15, SDage = 2.86) and their caregivers (Mage = 46.54, SDage = 6.81; 88% mothers). AYA and caregivers completed the family environment scale, and caregivers completed the parenting relationship questionnaire at the initial assessment. Two years later, AYA completed an assessment of substance use. Chi-square and frequency analyses were used to compare differences in substance use among AYA survivors and comparisons. Multivariate analysis of variance was used to examine links between AYA substance use patterns with family and caregiver-AYA system level factors. RESULTS Patterns of substance use did not differ between AYA survivors and comparisons. AYA survivors were more likely to report polysubstance use if caregivers endorsed problematic caregiver-AYA relationship patterns. Family functioning and caregiver relationship patterns did not predict AYA comparison substance use. CONCLUSION AYA survivors were just as likely as AYA comparisons to engage in substance use, increasing their vulnerability to problematic health outcomes. Findings indicate that the role caregiver-AYA relationship patterns may have on youth at risk for substance use and potential mechanisms for future intervention.
Collapse
Affiliation(s)
- Rachel Tillery
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS, Memphis, TN, 740, USA.
| | - Victoria W Willard
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS, Memphis, TN, 740, USA
| | - Mallorie L Gordon
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS, Memphis, TN, 740, USA
| | - Kristen Adams
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS, Memphis, TN, 740, USA.,School of Public Health, University of Memphis, Memphis, TN, USA
| | - Alanna Long
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS, Memphis, TN, 740, USA
| | - Sean Phipps
- Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS, Memphis, TN, 740, USA
| |
Collapse
|
18
|
Salchow J, Koch B, Mann J, von Grundherr J, Elmers S, Dwinger S, Escherich G, Vettorazzi E, Reer R, Sinn M, Baumann F, Bokemeyer C, Stein A, Jensen W. Effects of a structured counselling-based intervention to improve physical activity behaviour of adolescents and young adult cancer survivors - the randomized phase II Motivate AYA - MAYA trial. Clin Rehabil 2021; 35:1164-1174. [PMID: 33685232 PMCID: PMC8273535 DOI: 10.1177/0269215521997974] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective: To explore whether a structured counselling-based intervention increases vigorous physical activity behaviour of adolescent and young adult cancer survivors. Design: Randomized controlled phase II trial. Setting: University Cancer Center Hamburg, Germany. Subjects: Eighty-nine participants (mean age 24.1 ± 6.3) were randomized to control (n = 44) or intervention group (n = 45). Interventions: The intervention group was consulted about physical activity behaviour via interview (week 0), and telephone counselling (weeks 1, 3 and 12). The control group only received general physical activity guidelines for cancer survivors (week 0). Main measures: The primary outcome was the rate of participants with ⩾9 metabolic equivalent (MET)-hours per week of vigorous activity post-intervention, measured with the International Physical Activity Questionnaire. Secondary outcomes included assessing physical activity behaviour (e.g. amount and type of physical activity) and quality of life. Assessments were completed in weeks 0 (baseline), 12 (post-intervention) and 52 (follow-up). Results: Sixty-nine participants completed the post-intervention- and 47 the follow-up-assessment. The rate of participants performing vigorous physical activity increased from baseline to post-intervention for both without differing significantly (P = 0.541). Both increased their total metabolic equivalent from baseline to post-intervention (intervention group from 55.2 ± 43.7 to 61.7 ± 29.4, control group from 75.3 ± 81.4 to 88.3 ± 80.2). At follow-up the intervention group (73.7 ± 80.2) was more active than baseline when compared to the control group (78.5 ± 50.0). Conclusions: A structured counselling-based physical activity intervention did not significantly impact the level of vigorous physical activity behaviour in adolescent and young adult cancer survivors.
Collapse
Affiliation(s)
- Jannike Salchow
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Barbara Koch
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Mann
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia von Grundherr
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon Elmers
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Dwinger
- Department for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gabriele Escherich
- Department of Pediatric Hematology and Oncology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eik Vettorazzi
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rüdiger Reer
- Institute of Human Movement Science, Faculty of Psychology and Human Movement, University of Hamburg, Hamburg, Germany
| | - Marianne Sinn
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Freerk Baumann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University Hospital of Cologne, Cologne, Nordrhein-Westfalen, Germany
| | - Carsten Bokemeyer
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Stein
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wiebke Jensen
- Department of Oncology and Hematology, BMT with Section Pneumology, Hubertus Wald Tumor Center - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
19
|
Telles CM. A scoping review of literature: What has been studied about adolescents and young adults (AYAs) with cancer? Cancer Treat Res Commun 2021; 27:100316. [PMID: 33545568 DOI: 10.1016/j.ctarc.2021.100316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To map, organize and analyze the articles published in the last five years about AYAs with cancer. METHODS CAPES database and Google Scholar were searched to identify relevant studies from 2015 to February 2020. Eligible articles included empirical or theoretical research, quantitative and/or qualitative studies, targeted AYAs with cancer, addressed different topics related to AYAs such as unmet needs, hospital challenges, interventions or tools based on evidence, as well as political and socioeconomic aspects. RESULTS Of the 161 articles analyzed, 74 (46%) discussed the health system, including hospital dynamics, treatment and interventions during treatment; 63 (39.1%) discussed aspects or interventions that influence the quality of life and mental health of AYAs with cancer; 14 (8.7%) discussed issues related to sexual health; and 10 (6.2%) addressed social, economic and demographic problems of AYAs with cancer. Three types of purposes have been identified in the articles: 118 (73.3%) investigated variables in areas related to AYAs with cancer, aiming to increase the understanding of the phenomenon and the needs of AYAs; 18 (11.2%) intervened on the needs of AYAs with cancer through pilot studies or evidence-based interventions; and 22 (13.7%) aimed to evaluate an intervention previously performed or to evaluate an intervention based on evidence. CONCLUSION There is still much to be researched within the last two categories. In the last three years, these categories have been growing gradually and on a small scale.
Collapse
Affiliation(s)
- Camila M Telles
- Graduating in Psychology - Senior year, Positivo University - Curitiba, Paraná, Brazil (Student); Teen Cancer America - Los Angeles, California, the United States of America (Intern Pro Cancer).
| |
Collapse
|
20
|
Affiliation(s)
- Stephanie M Smith
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Michael P Link
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Karen E Effinger
- Division of Pediatric Hematology/Oncology/BMT, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| |
Collapse
|
21
|
Schulte F, Forbes C, Wurz A, Patton M, Russell KB, Pluijm S, Krull KR. Childhood Cancer Survivorship: Daily Challenges. Pediatr Clin North Am 2020; 67:1083-1101. [PMID: 33131536 DOI: 10.1016/j.pcl.2020.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Survivors of childhood cancer are at risk of experiencing fatigue, pain, lower levels of physical activity, increased engagement in risky health behavior, and poor social adjustment, after finishing treatment. Risks are more pronounced for survivors of specific diagnoses or receiving specific treatment protocols. Interventions to address these outcomes are in their infancy. Future research should focus on exploring the antecedents and consequences of these outcomes. In the meantime, researchers and cancer centers should attempt to provide high-quality and accessible health information to survivors through various media outlets to encourage healthy behaviors.
Collapse
Affiliation(s)
- Fiona Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Hematology, Oncology and Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada.
| | - Caitlin Forbes
- University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Amanda Wurz
- University of Calgary, Calgary, Alberta, Canada
| | | | | | - Saskia Pluijm
- Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Kevin R Krull
- St. Jude Children's Research Hospital, Memphis, TN, USA
| |
Collapse
|
22
|
Wang KM, Wang KJ, Makond B. Survivability modelling using Bayesian network for patients with first and secondary primary cancers. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 196:105686. [PMID: 32777652 DOI: 10.1016/j.cmpb.2020.105686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 07/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVE Multiple primary cancers significantly threat patient survivability. Predicting the survivability of patients with two cancers is challenging because its stochastic pattern relates with numerous variables. METHODS In this study, a Bayesian network (BN) model was proposed to describe the occurrence of two primary cancers and predict the five-year survivability of patients using probabilistic evidence. Eleven types of major primary cancers and contingent occurrences of secondary cancers were investigated. A nationwide two-cancer database involving 7,845 patients in Taiwan was investigated. The BN topology is rigorously examined and imbalanced dataset is processed by the synthetic minority oversampling technique. The proposed BN survivability prognosis model was compared with benchmark approaches. RESULTS The proposed model significantly outperformed the back-propagation neural network, logistic regression, support vector machine, and naïve Bayes in terms of sensitivity, which is a critical performance index for the non-survival group. CONCLUSIONS Using the proposed BN model, one can estimate the posterior probabilities for every query provided appropriate prior evidences. The potential survivability information of patients, treatment effects, and socio-demographics factor effects predicted by the proposed model can help in cancer treatment assessment and cancer development monitoring.
Collapse
Affiliation(s)
- Kung-Min Wang
- Department of Surgery, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC.
| | - Kung-Jeng Wang
- Department of Industrial Management, National Taiwan University of Science and Technology, Taipei, 106, Taiwan, ROC.
| | - Bunjira Makond
- Faculty of Commerce and Management, Prince of Songkla University, Trang, Thailand
| |
Collapse
|
23
|
Hirschey R, Nyrop KA, Mayer DK. Healthy Behaviors: Prevalence of Uptake Among Cancer Survivors. Clin J Oncol Nurs 2020; 24:19-29. [PMID: 32945809 DOI: 10.1188/20.cjon.s2.19-29] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although most cancer survivors adhere to recommendations to refrain from tobacco and minimize alcohol use, survivors of certain cancers are not meeting these recommendations. In addition, most cancer survivors do not achieve optimal recommendations for diet and physical activity, further decreasing survivor health and quality of life. Sun protective and sleep behaviors also tend to be suboptimal among survivors. Uptake of age-appropriate vaccinations is variable among survivors. OBJECTIVES The purpose of this article is to review the prevalence of healthy behavior uptake among cancer survivors and provide nurses with an overview of effective interventions, strategies, and resources to help patients improve these behaviors. METHODS An expert panel was convened to conduct an integrative review and synthesis on the state of the science of healthy behavior uptake among cancer survivors. FINDINGS Not meeting recommendations for healthy lifestyle behaviors increases the risk of second cancers and mortality and decreases overall health and quality of life. Healthy lifestyle behaviors can contribute to improved function, quality of life, and overall survival for cancer survivors. Nurses can help survivors to understand and improve their behaviors.
Collapse
|
24
|
Chan CWH, Choi KC, Chien WT, Sit JWH, Wong R, Cheng KKF, Li CK, Yuen HL, Li CK. Health Behaviors of Chinese Childhood Cancer Survivors: A Comparison Study with Their Siblings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176136. [PMID: 32846965 PMCID: PMC7503484 DOI: 10.3390/ijerph17176136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 11/16/2022]
Abstract
Purpose: This study aimed to compare health behaviors between the childhood cancer survivors (CCS) and their sibling controls and to examine the pattern of health behaviors of the Hong Kong Chinese CCS and its associations with their health-related quality of life and psychological distress. Methods: A cross-sectional telephone survey was conducted. A total of 614 CCS and 208 sibling controls participated in this study. Patterns of health behaviors including lifestyle behaviors, cancer screening practices, and insurance coverage were compared. Multivariate regression analyses were performed for examining factors associated with health behaviors in CCS. Results: CCS had less alcohol consumption when compared with their sibling controls (adjusted odds ratio (AOR) = 0.65, p = 0.035). The sibling controls were more likely to have cancer screening practices (AOR = 0.38, p = 0.005) and health (AOR = 0.27, p < 0.001) and life insurance coverage (AOR = 0.38, p < 0.001). Among the CCS, those who were male, having a job or higher education, shorter time since diagnosis, and type of cancer suffered were significantly associated with alcohol consumption. Those CCS who were drinkers indicated poorer mental health (p = 0.004) and more psychological distress. Female CCS undertaking cancer screening were more likely to be employed, married/cohabiting, and have received intensive cancer treatment. Conclusion: This study reveals that Chinese childhood cancer survivors are less likely to engage in unhealthy lifestyle behaviors, insurance coverage and cancer screening, when compared with their siblings. Implications for Cancer Survivors: It is crucial for healthcare professionals to identify strategies or target interventions for raising CCS's awareness of their cancer risks and healthy lifestyle throughout their life.
Collapse
Affiliation(s)
- Carmen W. H. Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China; (K.C.C.); (W.T.C.); (J.W.H.S.)
- Correspondence: ; Tel.: +852-3943-6218
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China; (K.C.C.); (W.T.C.); (J.W.H.S.)
| | - Wai Tong Chien
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China; (K.C.C.); (W.T.C.); (J.W.H.S.)
| | - Janet W. H. Sit
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China; (K.C.C.); (W.T.C.); (J.W.H.S.)
| | - Rosa Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China;
| | - Karis K. F. Cheng
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore 119077, Singapore;
| | - Chi Kong Li
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China;
| | - Hui Leung Yuen
- Department of Paediatrics, Queen Elizabeth Hospital, Hong Kong, China;
| | - Chi Keung Li
- Department of Paediatrics & Adolescent Medicine, Princess Margaret Hospital, Hong Kong, China;
| |
Collapse
|
25
|
Werk RS, Ford JS. Covariates of risky health behaviors in pediatric cancer survivors during adolescence. J Psychosoc Oncol 2020; 39:74-88. [PMID: 32713264 DOI: 10.1080/07347332.2020.1795779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Adolescent survivors of pediatric cancers may use alcohol and tobacco (73-90% and 10-29%, respectively) at similar rates as their healthy peers despite known adverse health effects of these substances. This is concerning given that these behaviors can increase the risk for adverse late effects among this population. This study explores the beliefs and behaviors associated with alcohol and tobacco use among adolescent survivors of pediatric cancer. DESIGN Cross-sectional study using assessment questionnaires by telephone. PARTICIPANTS Adolescent cancer survivors who had been seen at Memorial Sloan Kettering Cancer Center (n = 128). METHODS Questionnaires concerned participants' medical history, current health behaviors, attitudes about health behaviors, fear of cancer recurrence, cancer worry, knowledge of risk, and perceived risk of future health problems. Univariate and multiple logistic regression analyses determined the association between psychological covariates with having ever used alcohol and cigarettes. RESULTS In multiple logistic regression, higher positive attitude (OR = 3.65; p < 0.001) toward alcohol use and lower knowledge of the risk of binge drinking (OR = 0.38; p < 0.05) were significantly related to alcohol use. Older age (OR = 1.55; p < 0.01), lower knowledge of the risks of smoking (0.41; p < 0.05), and the subjective norm that smoking is desirable to others (OR = 1.90; p < 0.05) were significantly related to cigarette use. CONCLUSION AND IMPLICATIONS FOR PSYCHOSOCIAL PROVIDERS Understanding the uptake of risky health behaviors and factors related to tobacco and alcohol use for adolescent survivors is imperative to promoting lifelong healthy behaviors and potentially reducing future adverse health effects. Despite broadly disseminated public service campaigns and anticipatory guidance of our cancer specialists to inform youth about the adverse effects of alcohol and tobacco use, there remains a gap in adolescent cancer survivors' knowledge of these risks. More effective interventions to increase knowledge of the risks of drinking and smoking are needed to bridge this gap.
Collapse
Affiliation(s)
- Rachel S Werk
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jennifer S Ford
- Hunter College and The Graduate Center, City University of New York, New York, New York, USA
| |
Collapse
|
26
|
Boyd P, Lowry M, Morris KL, Land SR, Agurs-Collins T, Hall K, Byrd DA, Perna FM. Health Behaviors of Cancer Survivors and Population Controls From the National Health Interview Survey (2005-2015). JNCI Cancer Spectr 2020; 4:pkaa043. [PMID: 33134825 DOI: 10.1093/jncics/pkaa043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 12/13/2022] Open
Abstract
Background Population-based data from the National Health Interview Survey were examined to provide estimates of a wide range of health behaviors in cancer survivors (ie, physical activity, sun protection, alcohol use, cigarette and e-cigarette use, sleep, and diet) and trends over time. Methods Data were collected from 92 257 participants across 3 waves of the National Health Interview Survey. A total of 8050 participants reported having had cancer (2428 in 2005, 2333 in 2010, 3289 in 2015). Weighted and adjusted odds ratios (OR) between cancer survivors and controls were calculated using logistic and multivariable regressions in SPSS, and trend analyses from 2005 to 2015 were conducted. All statistical tests are 2-sided. Results After adjusting for demographics (2005-2015), cancer survivors, compared with controls, were more likely to wear sunscreen (OR = 1.41, 95% confidence interval [CI] = 1.32 to 1.51) and protect their skin (P < .001) and were less likely to tan indoors (OR = 0.81, 95% CI = 0.69 to 0.95), but reported less sleep (OR = 0.91, 95% CI = 0.85 to 0.98). In adjusted models, no differences were found for physical activity, sunburns, alcohol use, smoking, e-cigarette use, and diet. Smoking rates for cancer survivors decreased from 2005 to 2015 (P < .001) and physical activity increased (P = .02), but physical activity was not statistically significant after adjusting for multiple comparisons. All other health behavior rates for cancer survivors were unchanged from 2005 to 2015 (P > .14). Conclusion After adjusting for covariates, cancer survivors exhibited healthier sun protection, but not sleep behaviors, compared with controls. Cancer survivors (and controls) exhibited decreased smoking rates over time. These results may inform interventions focused on improving cancer control and prevention of other chronic conditions among cancer survivors.
Collapse
Affiliation(s)
- Patrick Boyd
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Mark Lowry
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | | | - Stephanie R Land
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Tanya Agurs-Collins
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Kara Hall
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Doratha A Byrd
- Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Frank M Perna
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| |
Collapse
|
27
|
An engineered non-erythropoietic erythropoietin-derived peptide, ARA290, attenuates doxorubicin induced genotoxicity and oxidative stress. Toxicol In Vitro 2020; 66:104864. [PMID: 32335150 DOI: 10.1016/j.tiv.2020.104864] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/29/2020] [Accepted: 04/13/2020] [Indexed: 12/22/2022]
Abstract
Erythropoietin (EPO) applies anti-inflammatory, anti-apoptotic, anti-oxidant and cytoprotective effects besides its hematopoietic action. A nonhematopoietic peptide engineered from EPO, ARA 290, interacts selectively with the innate repair receptor and has similar possessions. ARA290 mediates tissue protection without hematopoietic side-effects of EPO which limit its clinical application. Doxorubicin (DOX) is the broad-spectrum chemotherapeutic agent, but its use is limited by the development of nonspecific toxicity on noncancerous tissues especially in cardiac cells. Mechanisms behind the DOX-induced toxicities are enhanced level of oxidative damage, inflammation and apoptosis. In the present study, we have investigated whether ARA290 acts as a chemoprotective agent modulating the cytotoxicity, genotoxicity and oxidative stress induced in vitro by DOX. The genoprotective effect of ARA290 on DOX-induced toxicity in three cell line (HepG2, HGF & Stem cell) were assessed. Cells were treated with ARA290 (50-400 nM) and DOX (1 μM) in pretreatment condition. Cytotoxicity was evaluated using the MTT assay, genoprotective effect of ARA290 were evaluated using the micronucleus test and comet assay. AR290 significantly reduced the percentage of DNA in tail and the frequency of micronuclei induced by DOX. Besides, DOX impaired anti-oxidant defense enzyme activities and induced inflammation and apoptotic cell death. ARA290 markedly attenuated DOX induced oxidative stress and protected against DOX induced inflammation and apoptotic cell death. This result proposes that ARA290 can act as a protective agent, reducing DOX-induced DNA damage and oxidative stress, and it is possible that this protection could also extend to cardiac cells.
Collapse
|
28
|
Asvat Y, King AC, Smith LJ, Lin X, Hedeker D, Henderson TO. Substance use behaviors in adolescent and young adult cancer patients: Associations with mental and physical health. Psychooncology 2020; 29:1068-1076. [PMID: 32154963 DOI: 10.1002/pon.5378] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/25/2020] [Accepted: 03/03/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Cancer diagnosis in adolescents and young adults (AYAs) coincides with the developmental initiation of substance use and emergence of affective disturbance. We examined substance use behaviors and risk-stratified associations with mental and physical health, as well as objective indicators of tobacco and cannabis use and concordance with self-report and medical records. METHODS AYAs were 15 to 39 years at cancer diagnosis and ≥18 years and ≥6 months postdiagnosis at study enrollment. Risk-stratified groups included nonsmoker/nondrinker, nonsmoker/drinker, smoker/drinker. Assessments included demographics, past year tobacco, alcohol, and cannabis use, depression, anxiety, sleep, and physical activity. Urine analysis provided biochemical verification of tobacco and cannabis use. RESULTS Participants included 100 AYAs (60% male) with primarily hematological cancers (88%). Past year alcohol, tobacco, and cannabis use prevalence rates were 80%, 15%, and 33%, respectively. A minority (non-users) refrained from both alcohol and tobacco (20%), while most were exclusively alcohol users (65%) or alcohol and tobacco co-users (15%). Relative to other sub-groups, co-users reported more depressive and anxious symptoms, while non-users reported more physical activity. More frequent tobacco and cannabis use were associated with more depressive and anxious symptoms, while more frequent alcohol use was associated with lower physical activity. There were no group differences or associations with sleep quality. There was considerable discordance between tobacco use self-report, biochemical verification, and medical record documentation. CONCLUSIONS Substance use among AYAs is common and detrimental to mental and physical health, especially among more frequent users and co-users, highlighting the need for early assessment and intervention.
Collapse
Affiliation(s)
- Yasmin Asvat
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Andrea C King
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Lia J Smith
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Xiaolei Lin
- School of Data Science, Fudan University, Shanghai, China, USA
| | - Donald Hedeker
- Department of Public Health Sciences and College, University of Chicago, Chicago, Illinois, USA
| | - Tara O Henderson
- Department of Pediatrics, University of Chicago, Chicago, Illinois, USA
| |
Collapse
|
29
|
Mujcic A, Blankers M, Bommelé J, Boon B, Berman AH, Verdonck‐de Leeuw IM, van Laar M, Engels R. The effectiveness of distance‐based interventions for smoking cessation and alcohol moderation among cancer survivors: A meta‐analysis. Psychooncology 2020; 29:49-60. [PMID: 31663182 PMCID: PMC8246955 DOI: 10.1002/pon.5261] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/13/2019] [Accepted: 10/15/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate current evidence for the effectiveness of distance-based interventions to support smoking cessation (SC) or alcohol moderation (AM) among cancer survivors. Secondary, differences in effectiveness are explored regarding multibehaviour interventions versus single-behaviour interventions targeting SC or AM only. METHODS A systematic search of PubMed, PsycINFO, Web of Science, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials was conducted. Intervention studies with and without control groups and randomized controlled trials were included. Random effects meta-analyses were conducted for the main outcomes: SC and AM rates at the follow-up closest to 6 months. Using subgroup analyses and meta-regression, effectiveness of single-behaviour versus multibehaviour interventions was evaluated. RESULTS A total of 17 studies with 3796 participants; nine studies on SC only, eight studies on multibehaviour interventions including an SC or AM module, and no studies on AM only were included. All studies had at least some concerns regarding bias. Distance-based SC interventions led to higher cessation rates than control conditions (10 studies, odds ratio [OR] = 1.56; 95% CI, 1.13-2.15, P = .007). Single-behaviour SC interventions reduced smoking rates compared with baseline (risk difference [RD] = 0.29; 95% CI, 0.19-0.39, P < .0001), but multibehaviour interventions did not (RD = 0.13; 95% CI, -0.05 to 0.31, P = 0.15). There was insufficient evidence that distance-based multibehaviour interventions reduced alcohol use compared with controls (three studies, standardized mean difference [SMD] = 0.12; 95% CI, -0.08 to 0.31, P = .24). CONCLUSIONS Distance-based SC interventions are effective in supporting SC among cancer survivors. Single-behaviour SC interventions appear more effective than multibehaviour interventions. No evidence was found for the effectiveness of distance-based AM interventions for cancer survivors.
Collapse
Affiliation(s)
- Ajla Mujcic
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
- Erasmus School of Social and Behavioural SciencesErasmus University RotterdamRotterdamThe Netherlands
| | - Matthijs Blankers
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
- Department of Research, Arkin Mental Health CareAmsterdamThe Netherlands
- Amsterdam UMC, Location AMC, Department of PsychiatryUniversity of AmsterdamAmsterdamThe Netherlands
| | - Jeroen Bommelé
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
| | - Brigitte Boon
- Academy Het Dorp Department Scientific Research, Siza Arnhem, The NetherlandsArnhemThe Netherlands
- Department Scientific ResearchSizaArnhemThe Netherlands
| | - Anne H. Berman
- Centre for Psychiatry Research, Department of Clinical NeuroscienceKarolinska InstituteStockholmSweden
- Stockholm Center for Dependency DisordersStockholm Health Care Services, Stockholm RegionStockholmSweden
- Department of Public Health SciencesStockholm UniversityStockholmSweden
| | - Irma M. Verdonck‐de Leeuw
- Department of Otolaryngology—Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center AmsterdamAmsterdamThe Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam Public HealthAmsterdamThe Netherlands
| | - Margriet van Laar
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
| | - Rutger Engels
- Erasmus School of Social and Behavioural SciencesErasmus University RotterdamRotterdamThe Netherlands
| |
Collapse
|
30
|
Youlden DR, Baade PD, Green AC, Valery PC, Moore AS, Aitken JF. Second primary cancers in people who had cancer as children: an Australian Childhood Cancer Registry population-based study. Med J Aust 2019; 212:121-125. [PMID: 31743457 DOI: 10.5694/mja2.50425] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/16/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To investigate the incidence of second primary cancers in people diagnosed with cancer during childhood. DESIGN, SETTING Retrospective, population-based study; analysis of Australian Childhood Cancer Registry data. PARTICIPANTS People alive at least two months after being diagnosed before the age of 15 years with a primary cancer, 1983-2013, followed until 31 December 2015 (2-33 years' follow-up). MAIN OUTCOME MEASURES Risks of second primary cancer compared with the general population, expressed as standardised incidence ratios (SIRs). RESULTS Among 18 230 people diagnosed with cancer during childhood, 388 (2%) were later diagnosed with second primary cancers; the estimated 30-year cumulative incidence of second cancers was 4.4% (95% CI, 3.8-5.0%). The risk of a new primary cancer was five times as high as for the general population (SIR, 5.13; 95% CI, 4.65-5.67). Relative risk of a second primary cancer was greatest for people who had childhood rhabdomyosarcoma (SIR, 19.9; 95% CI, 14.4-27.6). Relative risk was particularly high for children who had undergone both chemotherapy and radiotherapy (SIR, 9.80; 95% CI, 8.35-11.5). Relative risk peaked during the 5 years following the first diagnosis (2 to less than 5 years: SIR, 10.3; 95% CI, 8.20-13.0), but was still significant at 20-33 years (SIR, 2.58; 95% CI, 2.02-3.30). The most frequent second primary cancers were thyroid carcinomas (65 of 388, 17%) and acute myeloid leukaemias (57, 15%). CONCLUSIONS Survivors of childhood cancer remain at increased risk of a second primary cancer well into adulthood. As the late effects of cancer treatment probably contribute to this risk, treatments need to be refined and their toxicity reduced, without reducing their benefit for survival.
Collapse
Affiliation(s)
- Danny R Youlden
- Cancer Council Queensland, Brisbane, QLD.,Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD
| | - Peter D Baade
- Cancer Council Queensland, Brisbane, QLD.,Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD.,Queensland University of Technology, Brisbane, QLD
| | - Adèle C Green
- QIMR Berghofer Medical Research Institute, Brisbane, QLD.,Cancer Research UK Manchester Institute, University of Manchester, Manchester, United Kingdom
| | | | - Andrew S Moore
- University of Queensland Diamantina Institute, Brisbane, QLD.,Queensland Children's Hospital, Brisbane, QLD.,Child Health Research Centre, University of Queensland, Brisbane, QLD
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, QLD.,Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, QLD.,University of Queensland, Brisbane, QLD
| |
Collapse
|
31
|
Winkels RM, Artrip R, Tupinio M, Veldheer S, Dandekar SC, George DR. Opportunities for Growth: Evaluating the Feasibility of a Community Gardening Intervention Pairing Adolescent and Young Adult Cancer Survivors with Experienced Gardeners. J Adolesc Young Adult Oncol 2019; 9:115-119. [PMID: 31580754 DOI: 10.1089/jayao.2019.0035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We evaluated the feasibility of a mentored gardening intervention for adolescent and young adult (AYA) cancer survivors in a hospital-based community garden as a way to improve diet and physical activity, using qualitative data to assess the challenges, facilitators, and areas for future programmatic improvement and replication. Over the course of growing season 2018, AYA cancer survivors tended a garden plot in a community garden under the mentorship of an experienced (master) gardener. AYA cancer survivors were successful in planting and harvesting vegetables from the garden in partnership with their mentors. Qualitative results and future directions for the project are discussed.
Collapse
Affiliation(s)
| | - Rick Artrip
- Department of Penn State College of Medicine, Hershey, Pennsylvania
| | - Maegan Tupinio
- Department of Penn State College of Medicine, Hershey, Pennsylvania
| | - Susan Veldheer
- Department of Family and Community Medicine, Hershey, Pennsylvania
| | - Smita C Dandekar
- Pediatric Hematology/Oncology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | | |
Collapse
|
32
|
The Lifestyle Information and Intervention Preferences of Teenage and Young Adult Cancer Survivors: A Qualitative Study. Cancer Nurs 2019. [PMID: 28622193 PMCID: PMC6259678 DOI: 10.1097/ncc.0000000000000508] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Supplemental digital content is available in the text. Background: Little is currently known about how best to promote healthy lifestyle choices among teenage and young adult (TYA) cancer survivors. Such data gathered from a patient-centered perspective are instrumental for the development of health behavior change interventions for young people with cancer. Objective: This study aimed to explore the lifestyle information needs of TYA cancer survivors and their preferences regarding lifestyle information and intervention delivery. Lifestyle behaviors of interest were physical activity, diet, smoking, alcohol consumption, and sun safety. Methods: A total of 13 TYA cancer survivors (mean age, 22.9 years) participated in 10 individual interviews and 1 focus group (n = 3). Each interview and focus group followed the same semistructured interview guide, which was designed to explore young peoples’ motivation behind leading a healthy lifestyle, their past experience of searching for lifestyle information, and their preferences relating to lifestyle information delivery. Results: Three core themes emerged: cancer as a catalyst to lifestyle behavior change, factors influencing health behavior change, and health behavior information preferences. Social support emerged as facilitator of both health behavior change and self-efficacy. Conclusion: Young people with cancer want age-appropriate lifestyle information on a range of topics delivered in multiple formats at various time points. Implications for Practice: Health professionals working with TYA cancer survivors should address young peoples’ lifestyle information needs throughout the cancer care pathway and support young people to foster the confidence to make, and sustain, positive lifestyle behavior changes.
Collapse
|
33
|
Doidge O, Edwards N, Thompson K, Lewin J. A Conceptual Framework to Identify and Address the Education and Vocational Barriers Experienced by Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2019; 8:398-401. [DOI: 10.1089/jayao.2018.0153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Olivia Doidge
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nicole Edwards
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Kate Thompson
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Australia
- Department of Social Work, The University of Melbourne, Melbourne, Australia
| | - Jeremy Lewin
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia
- Department of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
| |
Collapse
|
34
|
Hughes N, Stark D. The management of adolescents and young adults with cancer. Cancer Treat Rev 2018; 67:45-53. [PMID: 29753962 DOI: 10.1016/j.ctrv.2018.05.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 12/11/2022]
Abstract
Adolescents and Young Adults (AYA) with cancer are young people developing serious illness when at the interface between the responsibilities of paediatric and adult cancer services. Personally, they are in a period of transition both biologically and in major social roles (Sawyer et al., 2018) [1]. For these and other reasons they present a unique set of clinical challenges in their management. Over the last 20 years the requirement for specific services to address their needs has been identified and this has become a growing field of research. Despite this survival rates still lag behind those of children and older adults with cancer (Gatta et al., 2009) [2]. Why do AYA patients have worse outcomes? The observation is that the reason is multifactorial with path to diagnosis, unique cancer biology, uncertainty of treatment protocol, compliance issues and poor recruitment to clinical trials all playing a part. In this review we will discuss the unique challenges faced by healthcare professionals when managing AYA patients who are commonly and accurately described as being in an 'interface' position.
Collapse
Affiliation(s)
- Nicola Hughes
- Leeds Institute of Cardiovascular and Molecular Medicine, University of Leeds, UK.
| | - Dan Stark
- Leeds Institute of Cancer and Pathology, St James's Institute of Oncology, Beckett Street, Leeds, UK
| |
Collapse
|
35
|
Lion A, Marec-Bérard P, Boyle H, Fervers B, Bertrand A, Febvey-Combes O, Carretier J. Mise en œuvre d’un programme d’activité physique adaptée chez les adolescents et jeunes adultes atteints de cancer pour prendre soin de soi : PREVAPAJA. Sci Sports 2018. [DOI: 10.1016/j.scispo.2018.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
|
36
|
Geue K, Brähler E, Faller H, Härter M, Schulz H, Weis J, Koch U, Wittchen HU, Mehnert A. Prevalence of mental disorders and psychosocial distress in German adolescent and young adult cancer patients (AYA). Psychooncology 2018; 27:1802-1809. [DOI: 10.1002/pon.4730] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 03/29/2018] [Accepted: 03/30/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Kristina Geue
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
- Department of Psychosomatic Medicine and Psychotherapy; Universal Medical Center Mainz; Mainz Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken; University of Würzburg; Würzburg Germany
| | - Martin Härter
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Holger Schulz
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Joachim Weis
- Department of Psychooncology, Tumor Biology Center; University Medical Center Freiburg; Freiburg Germany
| | - Uwe Koch
- Department and Outpatient Clinic of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
- Deanery, University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy; Technical University Dresden; Dresden Germany
| | - Anja Mehnert
- Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
| |
Collapse
|
37
|
Nagele E, Fürschuß C, Mohapp A, Wiegele K, Lackner H, Urban C. Psychosoziale Versorgung pädiatrisch-onkologischer PatientInnen. Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-017-0332-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
38
|
Recklitis CJ, Bakan J, Werchniak AE, Mahler H. Using Appearance-Based Messages to Increase Sun Protection in Adolescent Young Adult Cancer Survivors: A Pilot Study of Ultraviolet Light Photography. J Adolesc Young Adult Oncol 2017; 6:477-481. [DOI: 10.1089/jayao.2016.0092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Christopher J. Recklitis
- Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Jennifer Bakan
- Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Veterans Affairs, Center of Excellence for Research on Returning War Veterans, Waco, Texas
| | - Andrew E. Werchniak
- Dana-Farber Cancer Institute, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Brigham and Women's Hospital, Boston, Massachusetts
| | - Heike Mahler
- University of California, San Diego, San Diego, California
| |
Collapse
|
39
|
Pugh G, Hough R, Gravestock H, Williams K, Fisher A. Lifestyle advice provision to teenage and young adult cancer patients: the perspective of health professionals in the UK. Support Care Cancer 2017; 25:3823-3832. [PMID: 28726067 DOI: 10.1007/s00520-017-3814-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 07/03/2017] [Indexed: 01/22/2023]
Abstract
PURPOSE Health professionals are an important source of information for teenage and young adult (TYA) cancer patients. However, little is known about health professionals' provision of lifestyle advice to young people with cancer who are in their care. METHODS An online survey was distributed to health professionals within the UK who identified themselves as working with TYA cancer patients. Health professional awareness of lifestyle guidance, provision of lifestyle advice to young people and views on lifestyle information format and delivery were explored. RESULTS Ninety-five health professionals (44% nurses; 28% allied health professionals; 17% physicians) completed the survey. The majority (72%) of respondents were aware of some lifestyle guidance for cancer patients. However, less than half of TYA health professionals (46%) were able to successfully recall the source of the guidelines and less than a third reported proving specific advice to the majority of their patients on weight management, smoking, alcohol consumption and sun safety. Many health professionals (38%) felt that they were not the right person to provide advice and cited lack of resources as a key barrier to advice provision. The majority (95%) reported being interested in a resource containing relevant lifestyle information that could be given to young people with cancer. CONCLUSIONS TYA health professionals' awareness of lifestyle guidance and provision of advice regarding health behaviour is sub-optimal. Clear and comprehensive guidance written specifically for TYA health professionals could overcome the reported barriers and improve professionals' confidence in addressing and providing advice on lifestyle to young people with cancer.
Collapse
Affiliation(s)
- Gemma Pugh
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Rachael Hough
- University College Hospital's NHS Foundation Trust, 235 Euston Rd, London, NW1 2BU, UK
| | - Helen Gravestock
- CLIC Sargent, No. 1 Farriers Yard, Assembly London, 77-85 Fulham Palace Road, London, W6 8JA, UK
| | - Kate Williams
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Abigail Fisher
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
| |
Collapse
|
40
|
Rosenberg AR, Bona K, Ketterl T, Wharton CM, Wolfe J, Baker KS. Intimacy, Substance Use, and Communication Needs During Cancer Therapy: A Report From the "Resilience in Adolescents and Young Adults" Study. J Adolesc Health 2017; 60:93-99. [PMID: 27769762 PMCID: PMC5228591 DOI: 10.1016/j.jadohealth.2016.08.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/05/2016] [Accepted: 08/11/2016] [Indexed: 11/17/2022]
Abstract
PURPOSE The prevalence of intimacy and substance use among adolescents and young adults during cancer therapy has not been well described. METHODS The "Resilience in Adolescents and Young Adults with Cancer" study was a prospective, multicenter, mixed-methods cohort study. English-speaking patients 14-25 years old with newly diagnosed cancer were invited to complete a comprehensive survey at the time of enrollment (T1) and 3-6 months later (T2). Intimate relationships and health behaviors were assessed with questions adapted from the Guidelines for Adolescent Preventative Services assessment. Descriptive statistics characterized the prevalence of sexual and substance-related behaviors at each time point. RESULTS Of 42 eligible and enrolled participants, 35 (83%) and 25 (59%) completed T1 and T2 surveys, respectively. Their mean age was 17.6 years (standard deviation 2.3), 57% were male, and the most common diagnoses were sarcoma and acute leukemia. Over a third of participants reported dating at each time point; 26% were sexually active at T1, and 32% at T2. Of those endorsing sexual activity, fewer than half reported consistent birth control or condom use and 4 reported their first sexual intercourse during our observation. In addition, 46% (T1) and 44% (T2) reported alcohol use and 23% (T1) and 26% (T2) reported illicit drug use. Despite these activities, fewer than 10% endorsed a worry or need to discuss these behaviors with oncology providers. CONCLUSIONS Intimacy and substance use among adolescents and young adults are common during cancer therapy. Clinical and research implications include the identification of optimal communication and patient-centered supports.
Collapse
Affiliation(s)
- Abby R. Rosenberg
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington,Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, Washington,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington,Address correspondence to: Abby R. Rosenberg, M.D., M.S., Cancer and Blood Disorders Center, Seattle Children’s Hospital, 4800 Sand Point Way NE, M/S MB.8.501, Seattle, WA 98145. (A.R. Rosenberg)
| | - Kira Bona
- Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts,Department of Pediatric Hematology/Oncology, Harvard Medical School, Boston, Massachusetts
| | - Tyler Ketterl
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Claire M. Wharton
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Joanne Wolfe
- Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts,Department of Pediatric Hematology/Oncology, Harvard Medical School, Boston, Massachusetts,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - K. Scott Baker
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington,Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| |
Collapse
|
41
|
Mooney R, Samhouri M, Holton A, Devine KA, Kirchhoff AC, Wright J, Wu YP. Adolescent and Young Adult Cancer Survivors' Perspectives on Their Internet Use for Seeking Information on Healthy Eating and Exercise. J Adolesc Young Adult Oncol 2016; 6:367-371. [PMID: 27845844 DOI: 10.1089/jayao.2016.0059] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To explore adolescent and young adult (AYA) cancer survivors' internet use in seeking healthy lifestyle behavior (HLB) information on diet and exercise. METHODS Twenty-five AYA cancer survivors participated in focus groups or interviews. Data were analyzed using qualitative content analysis. RESULTS Most survivors (92%) sought HLB information from internet sources. Key issues included the following: (1) too much information available, (2) information not meeting survivors' unique needs, and (3) concerns about trustworthiness of information. CONCLUSION Although AYA cancer survivors use the internet to seek HLB information, internet resources could be modified to better meet the needs of AYA cancer survivors.
Collapse
Affiliation(s)
- Ryan Mooney
- 1 Department of Family and Preventive Medicine, University of Utah , Salt Lake City, Utah
| | - Mahasen Samhouri
- 1 Department of Family and Preventive Medicine, University of Utah , Salt Lake City, Utah
| | - Avery Holton
- 2 Department of Communication, University of Utah , Salt Lake City, Utah
| | - Katie A Devine
- 3 Department of Medicine, Section of Population Science, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey , New Brunswick, New Jersey
| | - Anne C Kirchhoff
- 4 Department of Pediatrics, University of Utah , Salt Lake City, Utah.,5 Cancer Control and Population Sciences, Huntsman Cancer Institute , Salt Lake City, Utah
| | - Jennifer Wright
- 4 Department of Pediatrics, University of Utah , Salt Lake City, Utah
| | - Yelena P Wu
- 1 Department of Family and Preventive Medicine, University of Utah , Salt Lake City, Utah.,5 Cancer Control and Population Sciences, Huntsman Cancer Institute , Salt Lake City, Utah
| |
Collapse
|
42
|
Ducassou S, Genelini F, Rochard C, Pérel Y. L’activité physique en cancérologie pédiatrique en pratique. ONCOLOGIE 2016. [DOI: 10.1007/s10269-016-2669-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|