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Leibring I, Kihlgren A, Anderzén Carlsson A. Fear, coping and support- from the perspective of children aged 10-17-year old having acute lymphoblastic leukemia. Int J Qual Stud Health Well-being 2024; 19:2310147. [PMID: 38324664 PMCID: PMC10851796 DOI: 10.1080/17482631.2024.2310147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE To describe experiences of fear, coping, and support in 10-17-year-old children under treatment for acute lymphoblastic leukaemia (ALL). METHODS A longitudinal descriptive qualitative design was adopted. Ten children participated in one to three interviews each (24 interviews in all). Interviews were analysed using a matrix-based qualitative method. RESULTS The variety of fears described related to uncertainty, pain and medical procedures, bodily changes and loss of control, complications, professionals' attitudes, affected school results, and social isolation. Children used various strategies to deal with fear: some more general, to cope with the whole situation, and others more related to specific events such as treatment and tests. The most reported strategies we labelled Accepting the situation, Positive thinking, and Being an active agent. Less favourable strategies were also reported. Health care professionals, families, and friends offered valuable, but different kinds of, support. CONCLUSIONS Children aged 10 to 17 undergoing treatment for ALL experience various fears. Each experience is individual and changes over time, but there are common patterns. Most children used problem-solving or emotional-regulation strategies, but withdrawal was also reported. Even children who can deal with fear need support from their health care professionals, families, and friends.
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Affiliation(s)
- Ingela Leibring
- Faculty of Health, Science and Technology, Institution for Health, Karlstad University, Karlstad, Sweden
| | - Annica Kihlgren
- Faculty of Health and Medicine, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Agneta Anderzén Carlsson
- Faculty of Medicine and Health, University Health Care Research Center, Örebro University, Örebro, Sweden
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
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Gerstl B, Signorelli C, Wakefield CE, Deans R, Vaishnav T, Johnston K, Neville K, Cohn RJ, Anazodo A. Sexual and reproductive complications and concerns of survivors of childhood, adolescent and adult cancer. J Cancer Surviv 2024; 18:1201-1210. [PMID: 36991269 PMCID: PMC11324690 DOI: 10.1007/s11764-023-01349-6] [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: 08/11/2022] [Accepted: 02/10/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE Cancer survivors may experience infertility and sexual dysfunction following cancer treatment. Survivors report significant gaps in oncofertility care and consider these issues important, yet they are rarely discussed. The aims of this study were to evaluate survivors' sexual and reproductive complications across age groups and to identify specific groups of survivors at risk for sexual and reproductive complications. METHOD We report data collected from survivors of cancers diagnosed in childhood, adolescence and adulthood following the development and piloting of a reproductive survivorship patient reported outcome measure (RS-PROM). RESULTS One hundred and fifty survivors participated in the study (mean age at cancer diagnosis was 23.2 years [SD, 10.3 years]). About 68% of participants expressed concerns about their sexual health and function. Survivors (50%) expressed at least one body image concern, with the female gender the most common risk factor for all subgroups. A total of 36% of participants reported at least one concern regarding their fertility, with more male than female survivors reporting fertility preservation prior to treatment. Females compared with male participants were more likely to feel less physically attractive after treatment (OR = 3.83, 95% CI = 1.84-7.95, p < 0.001). More females than males were also more likely to feel dissatisfied with the appearance of a scar(s) after treatment (OR = 2.36, 95% CI = 1.13-4.91, p = 0.02). CONCLUSION The RS-PROM identified multiple reproductive complications and concerns for cancer survivors in the survivorship period. IMPLICATIONS FOR CANCER SURVIVORS Utilising the RS-PROM in conjunction with a clinic appointment could help identify and address cancer patients' concerns and symptoms.
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Affiliation(s)
- Brigitte Gerstl
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia
| | - Christina Signorelli
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Childrens Hospital, Sydney, NSW, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia
| | - Claire E Wakefield
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Childrens Hospital, Sydney, NSW, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia
| | - Rebecca Deans
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia
- Department of Gynaecology, The Royal Hospital for Women, Sydney, NSW, Australia
- Fertility Research Centre, The Royal Hospital for Women, Sydney, NSW, Australia
| | - Tejnei Vaishnav
- Fertility Research Centre, The Royal Hospital for Women, Sydney, NSW, Australia
| | - Karen Johnston
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia
| | - Kristen Neville
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia
- Department of Endocrinology, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Richard J Cohn
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Childrens Hospital, Sydney, NSW, Australia
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Childrens Hospital, Randwick, Sydney, NSW, 2031, Australia.
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Discipline of Paediatrics, UNSW , Sydney, Australia.
- Fertility Research Centre, The Royal Hospital for Women, Sydney, NSW, Australia.
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia.
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Yang F, Ho KY, Yorke J, Wai Lam KK, Liu Q, Guo L, Fai NC, Anthony Liu PY, Yuen J, Belay GM, Mao T, Law K, Ying CS, Chan Chi Fung G, Xu X, Shi H, Wong FKY. Research progress on sexual functioning and associated factors in childhood cancer survivors: a scoping review. EClinicalMedicine 2024; 73:102695. [PMID: 39050584 PMCID: PMC11266477 DOI: 10.1016/j.eclinm.2024.102695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 05/24/2024] [Accepted: 05/31/2024] [Indexed: 07/27/2024] Open
Abstract
Background Childhood Cancer Survivors (CCSs) are more likely to report sexual dysfunction than people without cancer history. Sexual functioning encompasses more than just sexual dysfunction. The scarcity of information regarding the status and influencing factors of sexual functioning in CCSs, hampers to devise suitable screening or interventions. This review aims to summarize research progress on sexual functioning and associated factors among CCSs. Methods This review protocol is registered in PROSPERO(CRD42023427939) and performed according to PRISMA guidelines. From inception to November 15, 2023, a comprehensive search was conducted in PubMed, EMBASE, CINAHL, Web of Science, SCOPUS, PsycINFO, CNKI Database, Wanfang of Chinese Database, SinoMed Database and Cochrane Library on sexual functioning and childhood cancer survivors. Inclusion criteria were English or Chinese studies focusing on sexual functioning and related factors of cancer survivors, who diagnosed with cancer before 18 years old, and were adult and disease-free when participating in the study. Studies were excluded if the focus was on adult cancer patients or without age information. Findings 395 records were retrieved, and 22 studies were finally included in this review. Results suggest that CCSs experience a substantial burden of sexual issues, including delayed psychosexual development, low satisfaction, and high prevalence of dysfunction. Underlying factors related to sexual functioning of CCSs were identified, including demographic, cancer treatment-related, psychological, and physiological factors. The historical change in research on sexual functioning was summarized. Interpretation Research on sexual functioning among CCSs is limited. The extent to which cancer and related treatments affect sexual functioning remains largely unknown. The relationships between various factors and mechanisms underlying sexual functioning need to be confirmed by more rigorous studies to enable effective interventions to be developed. Funding None.
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Affiliation(s)
- Funa Yang
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Ka Yan Ho
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Janelle Yorke
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | | | - Qi Liu
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Lanwei Guo
- Henan Office for Cancer Control and Research, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan, China
| | - N.G. Chi Fai
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Pak Yin Anthony Liu
- Department of Pediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China
| | - John Yuen
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | | | - Ting Mao
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Kate Law
- Christie Patient Centred Research, The Christie NHS Foundation Trust, Manchester, UK
| | - Chiu Sau Ying
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Godfrey Chan Chi Fung
- Department of Pediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China
| | - Xiaoxia Xu
- Department of Nursing, The Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Henan, China
| | - Hongying Shi
- Office of the Dean, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Henan, China
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Bentsen L, Aagesen M, Bidstrup P, Hjerming M, Pappot H. Sexuality, intimacy, and body image among adolescents and young adults with cancer: a qualitative, explorative study. Support Care Cancer 2024; 32:219. [PMID: 38460054 PMCID: PMC10924731 DOI: 10.1007/s00520-024-08405-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/24/2024] [Indexed: 03/11/2024]
Abstract
AIM The aim of this study was threefold: (1) to explore Danish adolescents and young adults' (AYAs) thoughts concerning sexual health particularly focusing on sexuality, intimacy, and body image throughout a cancer trajectory, (2) to investigate how AYAs experience healthcare professionals address of- and respond to sexual health issues, and (3) to identify AYAs' suggestions on how to support conversation about sexual health. METHODS A qualitative, single-center study was conducted, including AYAs (18-29 years) diagnosed with cancer recruited at the University Hospital of Copenhagen, Rigshospitalet. Individual semi-structured interviews were conducted from January-February 2023, recorded, transcribed verbatim, and analyzed using thematic analysis. RESULTS Twelve participants were interviewed, aged 20-29; five were diagnosed with hematological- and seven with oncological cancer. Our analyses yielded three themes: (1) sexuality and body image as part of the identity, (2) excluding relatives in conversations about sexual health, and (3) uncertainty how to discuss sexual health with healthcare professionals. Finally, the AYAs' suggestions to support conversations about sexual health were organized into six thematic categories. CONCLUSION In this study, participants experienced altered sexual subsequent impacts on body image and self-esteem during their cancer trajectory. While some adapted to these changes, discussing them with healthcare providers was difficult, especially in the presence of relatives, as the AYAs wanted to shield them from additional concerns. To enhance support, AYAs suggest regular discussions on sexual health and the use of a dialog tool by healthcare professionals.
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Affiliation(s)
- Line Bentsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Maria Aagesen
- Occupational Science, User Perspectives and Community-Based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Pernille Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Strandboulevarden 49 2100, Copenhagen, Denmark
| | - Maiken Hjerming
- Department of Hematology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
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Schwartz ER, Rensen N, Steur LMH, Gemke R, van Eijkelenburg NKA, van der Sluis IM, Dors N, van den Bos C, Tissing WJE, Grootenhuis MA, Kaspers GJL, Van Litsenburg RRL. Health-related quality of life and its determinants during and after treatment for paediatric acute lymphoblastic leukaemia: a national, prospective, longitudinal study in the Netherlands. BMJ Open 2023; 13:e070804. [PMID: 37899146 PMCID: PMC10619055 DOI: 10.1136/bmjopen-2022-070804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 09/20/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVES Health-related quality of life (HRQoL) is impaired in paediatric patients with acute lymphoblastic leukaemia (ALL). Over the past decades, ALL treatment has successfully been adjusted to the risk of relapse, which is now reflected by the stratification of patients into three risk groups who receive treatment of differing intensities. This study is the first to evaluate the longitudinal course of HRQoL in light of these adjustments and identify determinants of HRQoL. DESIGN Two prospective, national cohort studies (add-on studies within the two most recent treatment protocols for children with ALL (ALL-10 and ALL-11)). SETTING Dutch paediatric oncology hospitals between October 2006 and October 2009 (ALL-10) and between August 2013 and July 2017 (ALL-11). PARTICIPANTS Patients with ALL (2-18 years) are treated according to the ALL-10 or ALL-11 treatment protocol. Patients treated according to the ALL-10 protocol only completed a cancer-specific QoL measure and patients treated according to the ALL-11 protocol completed both a cancer-specific and generic QoL measure (see below). OUTCOME MEASURES HRQoL, assessed with parent-proxy questionnaires (PedsQL Generic and Cancer module) within the first 5 months (T0), at 1 year (T1), 2 years (T2) and 3 years (T3) after diagnosis. The proportion of patients with clinically relevant generic HRQoL impairment was compared with healthy norm values. Multivariable mixed model analyses were used to evaluate the development of HRQoL over time and its medical and sociodemographic determinants (collected on enrolment). RESULTS Of the ALL-10 cohort, 132 families participated and of the ALL-11 cohort, 136 families participated (268 total). Thus, cancer-specific HRQoL assessments were available for 268 patients (median age 5.3 years (IQR 6.15), 56.0% boys, 69.0% medium-risk ALL), and generic HRQoL assessments for 136 patients (median age 4.8 years (IQR 6.13), 60.3% boys, 75.0% medium-risk ALL). Generic HRQoL improved between timepoints T0 and T3 (total score B 16.1, 95% CI 12.2 to 20.1, p<0.001), but did not restore to normal 1 year after the end of treatment: 28.0% of children remained impaired compared with 16% in the general population (p=0.003). Cancer-specific HRQoL generally improved from T0 to T2 (Pain B 11.3, 95% CI 7.1 to 15.5; Nausea B 11.7, 8.4 to 15.1; Procedural Anxiety B 19.1, 14.8 to 23.4; Treatment Anxiety B 12.8, 9.5 to 16.0; Worry B 3.5, 0.6 to 6.3; Communication B 8.5, 5.0 to 11.9; all p<0.001 except for Worry (p=0.02)), while Physical Appearance and Cognitive Functioning remained stable. Higher treatment intensity and experiencing pain or simultaneous chronic illness were associated with lower HRQoL over time for multiple subscales. CONCLUSIONS HRQoL impairment is prevalent during and after ALL treatment. Patients with standard-risk ALL and reduced treatment intensity have better HRQoL than patients in higher risk groups. Systematic monitoring of HRQoL is of utmost importance in order to provide timely psychosocial interventions and supportive care.
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Affiliation(s)
- Emily R Schwartz
- Department of Pediatric Oncology, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
| | - Niki Rensen
- Department of Pediatric Oncology, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
- Department of Hematology-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Lindsay M H Steur
- Department of Pediatric Oncology, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
| | - Reinoud Gemke
- Department of Pediatric Oncology, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
| | | | - Inge M van der Sluis
- Department of Hematology-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Erasmus MC Sophia Children Hospital, Rotterdam, The Netherlands
| | - Natasja Dors
- Department of Hematology-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Radboudumc, Nijmegen, The Netherlands
| | - Cor van den Bos
- Department of Pediatric Oncology, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
- Department of Hematology-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Wim J E Tissing
- Department of Hematology-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Martha A Grootenhuis
- Department of Hematology-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Gertjan J L Kaspers
- Department of Pediatric Oncology, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
- Department of Hematology-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Raphaele R L Van Litsenburg
- Department of Pediatric Oncology, Emma Childrens' Hospital UMC, Amsterdam, The Netherlands
- Department of Hematology-oncology, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Crowder SL, Foster RH, Buro AW, Dillon R, Godder K, Stern M. Mediators of Social Acceptance Among Emerging Adult Survivors of Childhood Cancer. J Adolesc Young Adult Oncol 2023; 12:644-652. [PMID: 36795980 PMCID: PMC10611963 DOI: 10.1089/jayao.2022.0120] [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: 02/18/2023] Open
Abstract
Purpose: Examine associations of social developmental factors (e.g., peer/parent social attachment, romantic relationships) and perceptions of social acceptance among emerging adult survivors of childhood cancer. Methods: A cross-sectional, within-group design was used. Questionnaires included the Multidimensional Body-Self Relations Questionnaire, Inventory of Parent and Peer Attachment, Adolescent Social Self-Efficacy Scale, Personal Evaluation Inventory, Self-Perception Profile for Adolescents, and demographics. Correlations were utilized to determine associations between general demographic, cancer-specific, and the psychosocial outcome variables. Peer and romantic relationship self-efficacy were assessed as potential mediators of social acceptance in three mediation models. Relationships between perceived physical attractiveness, peer attachment, parental attachment, and social acceptance were assessed. Results: Data were collected from N = 52 adult participants (Mage = 21.38 years, standard deviation = 3.11 years) diagnosed with cancer as a child. The first mediation model demonstrated a significant direct effect of perceived physical attraction on perceived social acceptance and retained significance after adjusting for indirect effects of the mediators. The second model demonstrated a significant direct effect of peer attachment on perceived social acceptance; however, significance was not retained after adjusting for peer self-efficacy, suggesting the relationship is partially mediated by peer relationship self-efficacy. The third model demonstrated a significant direct effect of parent attachment on perceived social acceptance; however, significance was not retained after adjusting for peer self-efficacy, suggesting the relationship is partially mediated by peer self-efficacy. Conclusion: Relationships between social developmental factors (e.g., parental and peer attachment) and perceived social acceptance are likely mediated by peer relationship self-efficacy in emerging adult survivors of childhood cancer.
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Affiliation(s)
- Sylvia L. Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa Florida, USA
| | - Rebecca H. Foster
- Department of Psychology, St. Louis Children's Hospital, St. Louis, Missouri, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Acadia W. Buro
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa Florida, USA
| | - Robyn Dillon
- Department of Pediatrics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kamar Godder
- Division of Hematology Malignancies, Oncology Center of Excellence, Silver Spring, Maryland, USA
- Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland, USA
| | - Marilyn Stern
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa Florida, USA
- Department of Child and Family Studies, University of South Florida, Tampa, Florida, USA
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Jess L, Bäck M, Jarfelt M. Adult childhood cancer survivors' perceptions of factors that influence their ability to be physically active. Support Care Cancer 2023; 31:409. [PMID: 37347322 DOI: 10.1007/s00520-023-07865-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/05/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE Studies indicate that adult childhood cancer survivors do not achieve recommended physical activity levels. A deeper understanding of factors that influence their ability to be physically active is essential to identify individuals in need of support. The aim was to explore factors that influence adult childhood cancer survivor's ability to be physically active. METHOD Semi-structured interviews were conducted from June to October 2020 with 20 adult childhood cancer survivors with a median age of 31 (min-max 20-47) years. Interviews were transcribed verbatim and analyzed with qualitative content analysis. RESULTS Four main categories: "The impact of environmental factors," "Personal factors of importance," "Consequences of the treatment or disease," and "The impact of support from healthcare" and 10 sub-categories, were identified. Participants described how family habits and encouragement from others influenced their present ability to be physically active. Experienced benefits of physical activity were described as a facilitator for current physical activity while suffering from late complications was identified as a barrier. Participants highlighted the importance of specific and individualized physical activity recommendations. CONCLUSION This study includes adult childhood cancer survivors several years after completion of treatment, hence highlighting the importance for support both during treatment and follow-up to sustain their physical activity. Healthcare providers need to identify individuals suffering from late complications, even several years after treatment; provide individualized physical activity recommendations; and educate families and schools about the importance of physical activity in childhood cancer survivorship. TRIAL REGISTRATION This research project was registered in the Swedish National Database of Research and Development, identifier 273320, December 6, 2019 ( https://www.researchweb.org/is/vgr/project/273320 ).
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Affiliation(s)
- Laura Jess
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Närhälsan Bollebygd Rehabilitation Center, Bollebygd, Sweden.
| | - Maria Bäck
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University, Linköping, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marianne Jarfelt
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- The Long-Term Follow-up Clinic for Adult Childhood Cancer Survivors and Cancer Rehabilitation, Sahlgrenska University Hospital, Gothenburg, Sweden
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Rodriguez-Wallberg KA, Jiang Y, Lekberg T, Nilsson HP. The Late Effects of Cancer Treatment on Female Fertility and the Current Status of Fertility Preservation-A Narrative Review. Life (Basel) 2023; 13:1195. [PMID: 37240840 PMCID: PMC10224240 DOI: 10.3390/life13051195] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Fertility counseling should be offered to all individuals of young reproductive age early in the patient's trajectory following a cancer diagnosis. Systemic cancer treatment and radiotherapy often have an inherent gonadotoxic effect with the potential to induce permanent infertility and premature ovarian failure. For the best chances to preserve a patient's fertility potential and to improve future quality of life, fertility preservation methods should be applied before cancer treatment initiation, thus multidisciplinary team-work and timely referral to reproductive medicine centers specialized in fertility preservation is recommended. We aim to review the current clinical possibilities for fertility preservation and summarize how infertility, as a late effect of gonadotoxic treatment, affects the growing population of young female cancer survivors.
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Affiliation(s)
- Kenny A. Rodriguez-Wallberg
- Department of Oncology-Pathology, Laboratory of translational Fertility Preservation, Karolinska Institutet, SE-17177 Stockholm, Sweden; (Y.J.); (T.L.); (H.P.N.)
- Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, SE-17177 Stockholm, Sweden
| | - Yanyu Jiang
- Department of Oncology-Pathology, Laboratory of translational Fertility Preservation, Karolinska Institutet, SE-17177 Stockholm, Sweden; (Y.J.); (T.L.); (H.P.N.)
| | - Tobias Lekberg
- Department of Oncology-Pathology, Laboratory of translational Fertility Preservation, Karolinska Institutet, SE-17177 Stockholm, Sweden; (Y.J.); (T.L.); (H.P.N.)
- Breast, Endocrine tumors and Sarcoma Cancer Theme, Karolinska University Hospital, SE-17177 Stockholm, Sweden
| | - Hanna P. Nilsson
- Department of Oncology-Pathology, Laboratory of translational Fertility Preservation, Karolinska Institutet, SE-17177 Stockholm, Sweden; (Y.J.); (T.L.); (H.P.N.)
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9
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A Negative Body Image among Adolescent and Young Adult (AYA) Cancer Survivors: Results from the Population-Based SURVAYA Study. Cancers (Basel) 2022; 14:cancers14215243. [PMID: 36358662 PMCID: PMC9655157 DOI: 10.3390/cancers14215243] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 12/05/2022] Open
Abstract
Simple Summary Adolescent and young adult (AYA) cancer survivors diagnosed with cancer between ages 18–39 years often experience negative body changes, such as scars, amputation, hair loss, disfigurement, body weight changes, skin buns, and physical movement limitations. A negative body image could have negative implications for the self-esteem, self-identity, and social relationships of AYAs. Despite the possible long-term effects of cancer on body image, within the AYA literature, limited studies focus on AYA cancer survivors in a quantitative way. Therefore, the aim of our population-based cross-sectional study was to examine the prevalence, and association of a negative body image with sociodemographic, clinical, and psychosocial factors, among AYA survivors 5–20 years after diagnosis. Raising awareness and integrating supportive care for those who experience a negative body image into standard AYA survivorship care is warranted. Future longitudinal research could help to identify when and how this support for AYA survivors can be best utilized. Abstract Adolescent and young adult (AYA) cancer survivors (18–39 years at diagnosis) often experience negative body changes such as scars, amputation, and disfigurement. Understanding which factors influence body image among AYA survivors can improve age-specific care in the future. Therefore, we aim to examine the prevalence, and association of a negative body image with sociodemographic, clinical, and psychosocial factors, among AYA cancer survivors (5–20 years after diagnosis). A population-based cross-sectional cohort study was conducted among AYA survivors (5–20 years after diagnosis) registered within the Netherlands Cancer Registry (NCR) (SURVAYA-study). Body image was examined via the EORTC QLQ-C30 and QLQ-SURV100. Multivariable logistic regression models were used. Among 3735 AYA survivors who responded, 14.5% (range: 2.6–44.2%), experienced a negative body image. Specifically, AYAs who are female, have a higher Body Mass Index (BMI) or tumor stage, diagnosed with breast cancer, cancer of the female genitalia, or germ cell tumors, treated with chemotherapy, using more maladaptive coping strategies, feeling sexually unattractive, and having lower scores of health-related Quality of Life (HRQoL), were more likely to experience a negative body image. Raising awareness and integrating supportive care for those who experience a negative body image into standard AYA survivorship care is warranted. Future research could help to identify when and how this support for AYA survivors can be best utilized.
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Shrivastava SP, Elhence A, Jinwala P, Bansal S, Chitalkar P, Bhatnagar S, Patidar R, Asati V, Reddy PK. Assessment of Psychological Distress Among Indian Adolescents and Young Adults with Solid Cancer Using the National Comprehensive Cancer Network Distress Thermometer. South Asian J Cancer 2022. [DOI: 10.1055/s-0042-1756184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose The incidence of cancer has increased in India with a visible impact on the young population (aged 15–39 years). The present study aims to evaluate psychological distress among Indian adolescents and young adults (AYAs) with solid cancer using the National Comprehensive Cancer Network (NCCN) distress thermometer.
Methods The demographic and clinical characteristics of AYAs patients (age 15–39 years) with cancer were recorded. Assessment of psychological distress of patients using the NCCN distress thermometer was performed at three time points over a period of 3 months. Distress thermometer scale and a self-administered questionnaire in English and Hindi languages was handed over to participants at three time points: at treatment commencement (T1), at 1 month, and 3 months (T2 and T3, respectively) into therapy.
Results Of the 259 patients, 63% were women and 37% men; the median age was 34 years. In total, 71 (27%) were ≤ 24 years old and 188 (73%) were>24 years old. Bone sarcoma (39%) was common cancer in AYA patients aged ≤ 24 years and breast cancer (21%) in >24 years of age. The distress scores in both the groups were the highest at diagnosis (T1) followed by that measured at 1 (T2) and 3 months (T3) after diagnosis. The distress score in the age ≤ 24 years was the highest (6.7) at T1, followed by those measured at T2 (2.6) and T3 (1.1) and among age>24 years was the highest (6.6) at T1, followed by those measured at T2 (2.6) and T3 (1.2). Among AYA patients>24 years old, worry, nervousness, sadness, transportation, and sleep were the top five identified problems and in ≤ 24 years old, the top identified problems were worry, financial support, sleep, nervousness, and sadness.
Conclusion Adolescents and young adults experience some level of distress associated with the cancer diagnosis, effects of the disease, treatment regardless of the stage and various transitions throughout the trajectory of the disease. The distress thermometer is an easy and useful tool for the assessment of psychological distress in AYA cancers. Early identification of distress burden with the distress thermometer leads to effective interventions in patients with cancer which could improve outcomes including survival in AYAs with cancer in India.
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Affiliation(s)
- Shiv Prasad Shrivastava
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Aditya Elhence
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Prutha Jinwala
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Shashank Bansal
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Prakash Chitalkar
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Shweta Bhatnagar
- Department of Radiology, CHL Hospital, Indore, Madhya Pradesh, India
| | - Rajesh Patidar
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Vikas Asati
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Pradeep Kumar Reddy
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
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Gorman JR, Lyons KS, Harvey SM, Acquati C, Salsman JM, Kashy DA, Drizin JH, Smith E, Flexner LM, Hayes-Lattin B, Reese JB. Opening the Conversation: study protocol for a Phase III trial to evaluate a couple-based intervention to reduce reproductive and sexual distress among young adult breast and gynecologic cancer survivor couples. Trials 2022; 23:730. [PMID: 36056413 PMCID: PMC9438271 DOI: 10.1186/s13063-022-06665-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Reproductive and sexual health (RSH) concerns are common and distressing for young adults diagnosed with breast and gynecologic cancer and their partners. This study evaluates the efficacy of a virtual couple-based intervention called Opening the Conversation (OC). The OC intervention is grounded in theory and evidence-based practice and was adapted to improve coping and communication specifically in relation to RSH concerns after cancer. METHODS This Phase III trial is conducted in a fully remote setting and enrolls young adult couples (current age 18-44 years) with a history of breast or gynecologic cancer (stage 1-4, diagnosed under age 40) within the past 6 months to 5 years. Eligible dyads are recruited from across the USA. The target sample size is 100 couples. Dyads are randomly assigned to receive either the 5-session OC intervention or a 4-session active control intervention (Side by Side). The primary outcomes are change in reproductive distress and sexual distress. Secondary outcomes include communication about reproductive concerns, communication about sexual concerns, depressive symptoms, sexual function, relationship quality, relationship intimacy, sexual satisfaction, self-efficacy to communicate about sex and intimacy, and quality of life. An exploratory aim examines whether dyadic coping and communication quality mediate intervention effects on survivors' and partners' reproductive distress or sexual distress. Self-report outcome measures are assessed for both groups at baseline (T1), 2 weeks post-treatment (T2), and 3 months post-treatment (T3). DISCUSSION Despite the importance of RSH for quality of life for young adult cancer survivors and their partners, evidence-based interventions that help couples navigate RSH concerns are lacking. This randomized controlled trial will determine the efficacy of a novel couple-based intervention to reduce distress related to RSH concerns for younger couples after breast or gynecologic cancer, in comparison to an active control intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT04806724. Registered on Mar 19, 2021.
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Affiliation(s)
- Jessica R Gorman
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA.
| | - Karen S Lyons
- Connell School of Nursing, Boston College, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
| | - S Marie Harvey
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, 3511 Cullen Blvd, Houston, TX, 77204-4013, USA
- College of Medicine, Department of Clinical Sciences, University of Houston, 4349 Martin Luther King Blvd, Houston, TX, 77004, USA
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - John M Salsman
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27157, USA
- Wake Forest Baptist Comprehensive Cancer Center, Medical Center Blvd, Winston Salem, NC, 27157, USA
| | - Deborah A Kashy
- Department of Psychology, Michigan State University, 316 Physics Road, East Lansing, MI, 48824, USA
| | - Julia H Drizin
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA
| | - Ellie Smith
- College of Public Health & Human Sciences, School of Social & Behavioral Health Sciences, Oregon State University, 2250 SW Jefferson Way, Corvallis, OR, 97330, USA
| | - Lisa M Flexner
- Doctor of Physical Therapy Program, Oregon State University- Cascades, 1500 SW Chandler Ave, OR, 97702, Bend, USA
| | - Brandon Hayes-Lattin
- School of Medicine, Oregon Health & Sciences University, 3266 SW Research Dr, Portland, OR, 97239, USA
- OHSU Knight Cancer Institute, 3485 S Bond Ave, Portland, OR, 97239, USA
| | - Jennifer B Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
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12
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Including a discussion forum in a web-based intervention on fertility and sexuality following cancer - Usage and content. Internet Interv 2022; 29:100559. [PMID: 35845087 PMCID: PMC9284441 DOI: 10.1016/j.invent.2022.100559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/27/2022] [Accepted: 07/05/2022] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of the study was to investigate how young adult survivors of childhood cancer used an online discussion forum as part of a web-based psycho-educational intervention. Specifically, we aimed to characterize users of the discussion forum, investigate how they used the discussion forum (type of usage) and content of the posted messages. METHODS This study is a part of a randomized controlled trial, Fex-Can Childhood RCT. Participants with self-reported sexual dysfunction or fertility-related distress were drawn from a population-based national cohort. Sociodemographic and clinical characteristics of the intervention group (n = 322) and data on usage of the discussion forum were analysed with descriptive statistics and compared between subgroups. Messages posted in the online discussion forum were analysed with qualitative thematic analysis. RESULTS Approximately half (48 %) of participants in the intervention group accessed the discussion forum and most of them (76 %) without writing own posts. Users of the discussion forum did not statistically differ in sociodemographic or clinical characteristics from the rest of the intervention group. The 97 written posts, written by 38 individuals, were mainly descriptions of own experiences and thoughts and concerned three themes: A changed body, Concerns around family building and Longing for support. Peer-support and interaction between participants were seen in some forum threads and the 'like'-function was frequently used, demonstrating engagement and activity. Participants expressed that they felt affinity with and appreciated sharing own experiences and to recognize themselves in others' stories. CONCLUSIONS A discussion forum as part of a web-based intervention appears to be a valuable component by giving participants an opportunity to share intimate experiences and concerns related to surviving cancer. TRIAL REGISTRATION ISRCTN Registry, trial number: 33081791 (registered on November 27, 2019).
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13
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Adolescent and Young Adult (AYA) Cancer Survivorship Practices: An Overview. Cancers (Basel) 2021; 13:cancers13194847. [PMID: 34638332 PMCID: PMC8508173 DOI: 10.3390/cancers13194847] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/25/2021] [Accepted: 09/25/2021] [Indexed: 12/24/2022] Open
Abstract
Worldwide, more than 1.2 million adolescents and young adults (AYAs; those aged 15-39 years) are diagnosed with cancer each year. Although considerable variability exists according to cancer site and stage of disease, the 5-year relative survival at the time of diagnosis has been estimated at >80% for all AYA patients with cancer combined. Extensive survivorship research in recent decades has focused on patients diagnosed with cancer as children (<15 years) and older adults (>39 years), yet few studies to date have reported outcomes specifically for patients diagnosed as AYAs. With increasing incidence and improving survival for many tumor types, leading to the majority of AYA patients with cancer becoming long-term survivors, there is a critical need for research efforts to inform the survivorship care of this growing population. This article describes the population of AYA cancer survivors according to their epidemiology and late and long-term effects, the challenges and models of AYA survivorship care, as well as future opportunities for research and healthcare.
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14
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Vani MF, Lucibello KM, Trinh L, Santa Mina D, Sabiston CM. Body image among adolescents and young adults diagnosed with cancer: A scoping review. Psychooncology 2021; 30:1278-1293. [PMID: 33882162 DOI: 10.1002/pon.5698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cancer and treatment can produce temporary or permanent body changes, which may affect the body image (BI) of adolescents and young adults diagnosed with cancer (AYAs). This evidence has not been comprehensively summarized. A scoping review was conducted to explore the available evidence on BI among AYAs and identify the definitions, theories, models, frameworks, measures, and methods used to assess BI. METHODS Databases MEDLINE, EMBASE, PsycINFO (via Ovid) and CINAHL and Gender Studies (via EBSCO) were searched to identify published studies from 1 January 2000 to 25 November 2019. Inclusion criteria were: qualitative, quantitative, or mixed methodology; at least one BI-related measure or theme; published in English; and majority of the sample between 13 and 39 years at diagnosis and a mean age at diagnosis between 13 and 39 years. Two authors screened the titles, abstracts, and full-text articles and data were extracted and summarized. RESULTS The search yielded 11,347 articles and 82 met inclusion criteria. Articles included 45 quantitative, 33 qualitative, and four mixed-methods studies. The majority of studies used cross-sectional designs, while BI definitions, theories, models, frameworks, and measures were varied. Studies explored descriptive, psychological, physical, coping, and social factors, with BI being described most often as an outcome rather than a predictor. CONCLUSIONS Theory-based research that employs a holistic BI definition and uses longitudinal or intervention study designs or a qualitative methodology is needed to better understand the BI experience of AYAs and inform the development of strategies and programs to reduce BI concerns and increase positive body experiences.
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Affiliation(s)
- Madison F Vani
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Kristen M Lucibello
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Linda Trinh
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Santa Mina
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Catherine M Sabiston
- Department of Kinesiology, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
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15
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Miller KD, Fidler-Benaoudia M, Keegan TH, Hipp HS, Jemal A, Siegel RL. Cancer statistics for adolescents and young adults, 2020. CA Cancer J Clin 2020; 70:443-459. [PMID: 32940362 DOI: 10.3322/caac.21637] [Citation(s) in RCA: 600] [Impact Index Per Article: 150.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 02/06/2023] Open
Abstract
Cancer statistics for adolescents and young adults (AYAs) (aged 15-39 years) are often presented in aggregate, masking important heterogeneity. The authors analyzed population-based cancer incidence and mortality for AYAs in the United States by age group (ages 15-19, 20-29, and 30-39 years), sex, and race/ethnicity. In 2020, there will be approximately 89,500 new cancer cases and 9270 cancer deaths in AYAs. Overall cancer incidence increased in all AYA age groups during the most recent decade (2007-2016), largely driven by thyroid cancer, which rose by approximately 3% annually among those aged 20 to 39 years and 4% among those aged 15 to 19 years. Incidence also increased in most age groups for several cancers linked to obesity, including kidney (3% annually across all age groups), uterine corpus (3% in the group aged 20-39 years), and colorectum (0.9%-1.5% in the group aged 20-39 years). Rates declined dramatically for melanoma in the group aged 15 to 29 years (4%-6% annually) but remained stable among those aged 30 to 39 years. Overall cancer mortality declined during 2008 through 2017 by 1% annually across age and sex groups, except for women aged 30 to 39 years, among whom rates were stable because of a flattening of declines in female breast cancer. Rates increased for cancers of the colorectum and uterine corpus in the group aged 30 to 39 years, mirroring incidence trends. Five-year relative survival in AYAs is similar across age groups for all cancers combined (range, 83%-86%) but varies widely for some cancers, such as acute lymphocytic leukemia (74% in the group aged 15-19 years vs 51% in the group aged 30-39 years) and brain tumors (77% vs 66%), reflecting differences in histologic subtype distribution and treatment. Progress in reducing cancer morbidity and mortality among AYAs could be addressed through more equitable access to health care, increasing clinical trial enrollment, expanding research, and greater alertness among clinicians and patients for early symptoms and signs of cancer. Further progress could be accelerated with increased disaggregation by age in research on surveillance, etiology, basic biology, and survivorship.
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Affiliation(s)
| | | | - Theresa H Keegan
- Hematology and Oncology, University of California at Davis Health, Sacramento, California
| | - Heather S Hipp
- Reproductive Endocrinology and Infertility, Emory University School of Medicine, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance Research, American Cancer Society, Atlanta, Georgia
| | - Rebecca L Siegel
- Surveillance Research, American Cancer Society, Atlanta, Georgia
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16
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Lane B, Fowler K, Eaton G, Chalifour K, Garland SN. Prevalence and factors associated with high levels of distress in young adult cancer survivors compared to matched peers. Support Care Cancer 2020; 29:2653-2662. [PMID: 32970230 DOI: 10.1007/s00520-020-05785-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/16/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Young adulthood can be a difficult period of development and disruption of age-related milestones can impact psychological well-being. This study examined whether psychological distress differs in young adult (YA) cancer survivors compared to their non-cancer peers and identified factors related to high distress in YA cancer survivors. METHODS Canadian YAs (n = 448) diagnosed between the ages of 15 and 39 were compared with age-, sex-, and education-matched controls (n = 448) randomly sampled from the 2012 Canadian Community Health Survey-Mental Health. The primary measure was the Kessler Psychological Distress Scale (K10). Groups were compared using independent-samples t tests and chi-square tests of independence. Logistic regression was used to examine the factors associated with high (moderate/severe) distress for YA cancer survivors. RESULTS YA cancer survivors reported significantly higher distress than their matched peers (24.89 vs. 15.75; p < .0005). In the multivariate model, greater years of education were associated with a decreased likelihood of high distress (adjusted odds ratio (AOR) = 0.84, p = .001). Compared with those working, those in school (AOR = 6.81, p = .003) or not in school/working (AOR = 4.13, p < .0005) reported higher distress. Psychological factors associated with high distress in YA cancer survivors included body image dissatisfaction (AOR = 1.09, p < .0005), poor social support (AOR = 5.19, p = .011), and elevated fears of cancer recurrence (maladaptive: AOR = 6.39, p = .001; clinical: AOR = 12.31, p < .0005). CONCLUSIONS YA cancer survivors experience significantly greater distress than their non-cancer peers. This distress is associated with modifiable factors such as body image dissatisfaction, social support, and fear of cancer recurrence, illustrating key areas for intervention.
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Affiliation(s)
- Breanna Lane
- Department of Psychology, Faculty of Science, Memorial University, St. John's, NL, Canada
| | - Ken Fowler
- Department of Psychology, Faculty of Science, Memorial University, St. John's, NL, Canada
| | - Geoff Eaton
- Young Adult Cancer Canada, St. John's, NL, Canada
| | | | - Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, St. John's, NL, Canada. .,Discipline of Oncology, Faculty of Medicine, Memorial University, St. John's, NL, Canada.
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Shin H, Bartlett R, De Gagne JC. Integrative Literature Review on Psychological Distress and Coping Strategies Among Survivors of Adolescent Cancer. Oncol Nurs Forum 2020; 47:E131-E148. [PMID: 32830805 DOI: 10.1188/20.onf.e131-e148] [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: 11/17/2022]
Abstract
PROBLEM IDENTIFICATION Cancer survivors, particularly those diagnosed in adolescence, are faced with physical, mental, and emotional stressors associated with the disease and its treatment. These stressors add to the demand placed on survivors' already taxed coping skills. This article reviews the literature on psychological distress experienced by survivors diagnosed with cancer during adolescence and the coping strategies they employed. LITERATURE SEARCH Three electronic databases (CINAHL®, PsycINFO®, PubMed®) were searched, and 19 studies were selected. Garrard's matrix method guided this integrative review. DATA EVALUATION Gough's weight of evidence framework was used to evaluate each study. SYNTHESIS Analysis revealed important findings about the types of coping strategies used by adolescents during and after cancer treatment and the impact of each on levels of psychological distress. IMPLICATIONS FOR PRACTICE Healthcare providers, who regularly assess for negative thoughts and unmet needs among survivors, may identify symptoms of psychological distress, intervene early, and facilitate better outcomes for their patients. Patient-centered interventions aimed at coping with psychological distress are most helpful.
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18
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Rossi AM, Hibler BP, Navarrete-Dechent C, Lacouture ME. Restorative oncodermatology: Diagnosis and management of dermatologic sequelae from cancer therapies. J Am Acad Dermatol 2020; 85:693-707. [PMID: 32781177 DOI: 10.1016/j.jaad.2020.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/13/2020] [Accepted: 08/01/2020] [Indexed: 12/19/2022]
Abstract
The long-term survival of patients with cancer has risen dramatically during the last few decades. Despite this remarkable success, the same treatments that have enabled cure or remission often secondarily affect the skin, hair, and nails. Conditions including scarring, striae distensae, persistent alopecia, pigmentary changes, nail alterations, chronic radiation dermatitis, and radiation fibrosis have been associated with anxiety, depression, decreased quality of life, and impaired function. These dermatologic changes are cosmetically disfiguring, may limit activities, and are a visual reminder of past illness. Interventions toward improving these untoward sequelae and restoring the appearance and function of skin and appendages are critical for normalization and may contribute to improved quality of life in cancer survivors. Here, we outline dermatologic sequelae of cancer therapies with a review of medical and procedural treatment strategies to restore dermatologic health in the survivorship population.
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Affiliation(s)
- Anthony M Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Weill Cornell Medicine, New York, New York.
| | - Brian P Hibler
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mario E Lacouture
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Dermatology, Weill Cornell Medicine, New York, New York
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Akbarbegloo M, Zamanzadeh V, Ghahramanian A, Valizadeh L, Matin H. Health and Psychosocial Self-Care Needs in Off-Therapy Childhood Cancer: Hybrid Model Concept Analysis. Patient Prefer Adherence 2020; 14:803-815. [PMID: 32494126 PMCID: PMC7225174 DOI: 10.2147/ppa.s246558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 04/19/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The self-care concept is a complicated and multi-dimensional phenomenon. There are different opinions about self-care needs; therefore, this study was conducted to clarify the self-care needs of the off-therapy childhood cancer survivors based on the hybrid model. PATIENTS AND METHODS There are three phases in the hybrid model including literature review, fieldwork, and final analysis. At the theoretical phase, 119 articles in databases were evaluated without time limits up to August 2019. At the fieldwork phase, 19 participants were selected with purposive sampling and interviewed through unstructured interviews. Then, the data were analyzed by qualitative content analysis approach. In the final phase, the overall analysis of the two previous phases was carried out and the ultimate definition of self-care needs was presented with the integration of the results of two previous phases. RESULTS Theoretical results showed that self-care needs are those that need to be performed by off therapy childhood cancer in everyday life in order to maintain health and well-being through the practice of healthy behaviors and activities. Also, fieldwork results indicated that self-care needs are increased due to the physical, mental, and social vulnerability of the disease. Following that, the need for protective self-care behaviors to prevent against physical and psychosocial side effects arises. If the patients are unable to implement protective behaviors, the need for support from others is created. Therefore, by synthesizing the findings of literature review and fieldwork, self-care needs are two-dimensional concept: (1) need for changing in behavior to protect themselves against physical and psychosocial distress and (2) need for supporting to implement care. CONCLUSION Taking into account the self-care needs, healthcare providers can support childhood cancer survivors in gaining and maintaining independency in self-care. On the other hand, the results of this study by creating a basic knowledge in the field of self-care needs can be used in the development of policy and standards of care to meet the needs of this group.
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Affiliation(s)
- M Akbarbegloo
- Department of Pediatric Nursing, Faculty of Nursing, Khoy University of Medical Sciences, Khoy, Iran
| | - V Zamanzadeh
- Department of Medical- Surgical Nursing, Faculty of Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - A Ghahramanian
- Department of Medical- Surgical Nursing, Faculty of Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - L Valizadeh
- Department of Pediatric Nursing, Faculty of Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
- Correspondence: L Valizadeh Tabriz, East Azerbaijan Province, IranTel +98 41 3479 6770Fax +98 4133340634 Email
| | - H Matin
- Department of Health Education and Promotion, Faculty of Health, Khoy University of Medical Sciences, Khoy, Iran
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Comparing the Impact of Cancer and Treatment-Related Effects on Psychological Well-being and Quality of Life Between Hong Kong Survivors of Childhood Solid Tumors and Leukemia. Cancer Nurs 2019; 43:446-454. [PMID: 31361673 DOI: 10.1097/ncc.0000000000000736] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Evidence shows that survivors of solid tumors have a lower survival rate and shorter disease-free survival time than survivors of leukemia. However, the psychological well-being and health-related quality of life (HRQOL) of these 2 groups of cancer survivors have not been compared. OBJECTIVE To examine and compare the impact of cancer and treatment-related effects on psychological well-being and HRQOL between survivors of childhood solid tumors and leukemia. METHODS We conducted a cross-sectional study involving 65 Hong Kong survivors of solid tumors and 70 survivors of leukemia aged 8 to 18 years who had their medical follow-up in a pediatric outpatient clinic. Participants' depressive symptoms, self-esteem, and HRQOL were assessed. Twenty-two survivors of childhood solid tumors and 15 survivors of childhood leukemia were then selected for semistructured interviews. RESULTS Survivors of childhood solid tumors reported significantly higher mean scores for depressive symptoms, and lower mean self-esteem and HRQOL scores than survivors of childhood leukemia. Qualitative data revealed that survivors of childhood solid tumors faced more challenges in their daily life than survivors of childhood leukemia. CONCLUSIONS Survivors of childhood solid tumors reported poorer psychological well-being and HRQOL than survivors of childhood leukemia. This vulnerable group warrants more attention and support. IMPLICATIONS FOR PRACTICE It is vital for healthcare professionals to understand the impact of cancer and treatment-related effects in the context of different types of cancer. This will facilitate development and evaluation of appropriate psychological interventions to promote psychological well-being and HRQOL among childhood cancer survivors.
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21
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Brierley ME, Sansom‐Daly UM, Baenziger J, McGill B, Wakefield CE. Impact of physical appearance changes reported by adolescent and young adult cancer survivors: A qualitative analysis. Eur J Cancer Care (Engl) 2019; 28:e13052. [DOI: 10.1111/ecc.13052] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/31/2019] [Accepted: 03/25/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Mary‐Ellen E. Brierley
- Behavioural Sciences Unit, Kids Cancer Centre Sydney Children's Hospital Sydney New South Wales Australia
- School of Women's and Children's Health UNSW Sydney Kensington New South Wales Australia
| | - Ursula M. Sansom‐Daly
- Behavioural Sciences Unit, Kids Cancer Centre Sydney Children's Hospital Sydney New South Wales Australia
- School of Women's and Children's Health UNSW Sydney Kensington New South Wales Australia
| | - Julia Baenziger
- Behavioural Sciences Unit, Kids Cancer Centre Sydney Children's Hospital Sydney New South Wales Australia
- School of Women's and Children's Health UNSW Sydney Kensington New South Wales Australia
- Department of Health Sciences & Health Policy University of Lucerne Lucerne Switzerland
| | - Brittany McGill
- Behavioural Sciences Unit, Kids Cancer Centre Sydney Children's Hospital Sydney New South Wales Australia
- School of Women's and Children's Health UNSW Sydney Kensington New South Wales Australia
| | - Claire E. Wakefield
- Behavioural Sciences Unit, Kids Cancer Centre Sydney Children's Hospital Sydney New South Wales Australia
- School of Women's and Children's Health UNSW Sydney Kensington New South Wales Australia
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Adolescent and young adult cancer survivors' perceptions of participating in a survey – Ethical and methodological considerations. Eur J Oncol Nurs 2019; 39:55-61. [DOI: 10.1016/j.ejon.2019.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 11/20/2022]
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