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Yoshida K, Hashimoto T, Koizumi T, Suzuki N. Psychosocial experiences regarding potential fertility loss and pregnancy failure after treatment in cancer survivors of reproductive age to identify psychosocial care needs: a systematic review. Support Care Cancer 2024; 32:337. [PMID: 38727728 DOI: 10.1007/s00520-024-08544-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 05/03/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE The challenges of fertility loss owing to cancer treatment persist long after treatment. However, psychosocial care for fertility among cancer survivors who have completed cancer treatment is insufficient. This systematic review examined psychosocial experiences related to the potential loss of fertility and unsuccessful pregnancy after treatment in cancer survivors of reproductive age to identify psychosocial care needs. METHODS A systematic review was conducted using the online databases PubMed, Cochrane Library, PsycINFO, CINAHL, and Ichushi-Web between August and December 2022 to identify studies that addressed psychosocial experiences after fertility loss or failure to conceive among young cancer survivors. Study quality was assessed using the Mixed Methods Appraisal Tool. RESULTS Forty studies were included, revealing psychosocial experiences across five categories: subjective fear of (potential) fertility loss, impact on romantic relationships, alternative methods for family building, reliance on social support, and specialized care. Only one study addressed the psychosocial aspects after complete loss of fertility in young cancer survivors. CONCLUSIONS The possibility and uncertainty of fertility loss led to stress and depression, loss of identity, decreased opportunities to meet a new partner, and damaged relationships established before diagnosis. The needs encompass fertility preservation, sexuality, approaches to building a family, partner communication, and other diverse needs.
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Affiliation(s)
- Kanako Yoshida
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo, Tokyo, Japan.
| | - Tomoko Hashimoto
- Division of Integrated Medicine, IVF Namba Clinic, 1-17-28 Minamihorie Nishi-Ku, Osaka, Japan
| | - Tomoe Koizumi
- International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, Japan
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2
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Ren H, Yang T, Yin X, Tong L, Shi J, Yang J, Zhu Z, Li H. Prediction of high-level fear of cancer recurrence in breast cancer survivors: An integrative approach utilizing random forest algorithm and visual nomogram. Eur J Oncol Nurs 2024; 70:102579. [PMID: 38636114 DOI: 10.1016/j.ejon.2024.102579] [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: 08/17/2023] [Revised: 03/14/2024] [Accepted: 03/25/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE This study is the first attempt to use a combination of regression analysis and random forest algorithm to predict the risk factors for high-level fear of cancer recurrence and develop a predictive nomogram to guide clinicians and nurses in identifying high-risk populations for high-level fear of cancer recurrence. METHODS After receiving various recruitment strategies, a total of 781 survivors who had undergone breast cancer resection within 5 years in four Grade-A hospitals in China were included. Besides demographic and clinical characteristics, variables were also selected from the perspectives of somatic, cognitive, psychological, social and economic factors, all of which were measured using a scale with high reliability and validity. This study established univariate regression analysis and random forest model to screen for risk factors for high-level fear of cancer recurrence. Based on the results of the multi-variable regression model, a nomogram was constructed to visualize risk prediction. RESULTS Fatigue, social constraints, maladaptive cognitive emotion regulation strategies, meta-cognition and age were identified as risk factors. Based on the predictive model, a nomogram was constructed, and the area under the curve was 0.949, indicating strong discrimination and calibration. CONCLUSIONS The integration of two models enhances the credibility of the prediction outcomes. The nomogram effectively transformed intricate regression equations into a visual representation, enhancing the readability and accessibility of the prediction model's results. It aids clinicians and nurses in swiftly and precisely identifying high-risk individuals for high-level fear of cancer recurrence, enabling the development of timely, predictable, and personalized intervention programs for high-risk patients.
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Affiliation(s)
- Hui Ren
- Nursing Department, The First Hospital of Jilin University, Changchun, Jilin Province, China.
| | - Tianye Yang
- Department of Plastic Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, China.
| | - Xin Yin
- Nursing Department, The First Hospital of Jilin University, Changchun, Jilin Province, China.
| | - Lingling Tong
- China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China.
| | - Jianjun Shi
- Department of Breast Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi Province, China.
| | - Jia Yang
- Changchun Central Hospital, Changchun, Jilin Province, China.
| | - Zhu Zhu
- Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, China.
| | - Hongyan Li
- The First Hospital of Jilin University, Changchun, Jilin Province, China.
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Hoffman A, Denham CJ, Fu S, Mendoza T, Nitecki R, Jorgensen KA, Garcia J, Lamiman K, Woodard TL, Rauh-Hain JA. Assessing gaps in motherhood after cancer: development and psychometric testing of the Survivorship Oncofertility Barriers Scale. Int J Gynecol Cancer 2023; 33:778-785. [PMID: 37001892 DOI: 10.1136/ijgc-2023-004302] [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: 04/03/2023] Open
Abstract
OBJECTIVE With a growing population of young cancer survivors, there is an increasing need to address the gaps in evidence regarding cancer survivors' obstetric outcomes, fertility care access, and experiences. As part of a large research program, this study engaged survivors and experts in co-developing and testing the validity, reliability, acceptability, and feasibility of a scale to assess survivor-reported barriers to motherhood after cancer. METHODS Scale items were developed based on literature and expert review of 226 reproductive health items, and six experience and focus groups with 26 survivors of breast and gynecological cancers. We then invited 128 survivors to complete the scale twice, 48 hours apart, and assessed the scale's psychometric properties using exploratory factor analyses including reliability, known-group validity, and convergent validity. RESULTS Item development identified three primary themes: multifaceted barriers for cancer survivors; challenging decisions about whether and how to pursue motherhood; and a timely need for evidence about obstetric outcomes. Retained items were developed into a 24-item prototype scale with four subscales. Prototype testing showed acceptable internal consistency (Cronbach's alpha=0.71) and test-retest reliability (intraclass correlation coefficient=0.70). Known-group validity was supported; the scale discriminated between groups by age (x=70.0 for patients ≥35 years old vs 54.5 for patients <35 years old, p=0.02) and years since diagnosis (x=71.5 for ≥6 years vs 54.3 for<6 years, p=0.01). The financial subscale was correlated with the Economic StraiN and Resilience in Cancer measure of financial toxicity (ρ=0.39, p<0.001). The scale was acceptable and feasibly delivered online. The final 22-item scale is organized in four subscales: personal, medical, relational, and financial barriers to motherhood. CONCLUSION The Survivorship Oncofertility Barriers Scale demonstrated validity, reliability, and was acceptable and feasible when delivered online. Implementing the scale can gather the data needed to inform shared decision making and to address disparities in fertility care for survivors.
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Affiliation(s)
- Aubri Hoffman
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Shuangshuang Fu
- Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Tito Mendoza
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Roni Nitecki
- Gynecologic Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kirsten A Jorgensen
- Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jose Garcia
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kelly Lamiman
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Terri L Woodard
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - J Alejandro Rauh-Hain
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Siegel-Ramsay JE, Sharp SJ, Ulack CJ, Chiang KS, Lanza di Scalea T, O'Hara S, Carberry K, Strakowski SM, Suarez J, Teisberg E, Wallace S, Almeida JRC. Experiences that matter in bipolar disorder: a qualitative study using the capability, comfort and calm framework. Int J Bipolar Disord 2023; 11:13. [PMID: 37079153 PMCID: PMC10119352 DOI: 10.1186/s40345-023-00293-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 03/22/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND When assessing the value of an intervention in bipolar disorder, researchers and clinicians often focus on metrics that quantify improvements to core diagnostic symptoms (e.g., mania). Providers often overlook or misunderstand the impact of treatment on life quality and function. We wanted to better characterize the shared experiences and obstacles of bipolar disorder within the United States from the patient's perspective. METHODS We recruited 24 individuals diagnosed with bipolar disorder and six caretakers supporting someone with the condition. Participants were involved in treatment or support services for bipolar disorder in central Texas. As part of this qualitative study, participants discussed their everyday successes and obstacles related to living with bipolar disorder during personalized, open-ended interviews. Audio files were transcribed, and Nvivo software processed an initial thematic analysis. We then categorized themes into bipolar disorder-related obstacles that limit the patient's capability (i.e., function), comfort (i.e., relief from suffering) and calm (i.e., life disruption) (Liu et al., FebClin Orthop 475:315-317, 2017; Teisberg et al., MayAcad Med 95:682-685, 2020). We then discuss themes and suggest practical strategies that might improve the value of care for patients and their families. RESULTS Issues regarding capability included the struggle to maintain identity, disruptions to meaningful employment, relationship loss and the unpredictable nature of bipolar disorder. Comfort related themes included the personal perception of diagnosis, social stigma and medication issues. Calm themes included managing dismissive doctors, finding the right psychotherapist and navigating financial burdens. CONCLUSIONS Qualitative data from patients with bipolar disorder helps identify gaps in care or practical limitations to treatment. When we listen to these individuals, it is clear that treatments must also address the unmet psychosocial impacts of the condition to improve patient care, capability and calm.
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Affiliation(s)
- J E Siegel-Ramsay
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - S J Sharp
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - C J Ulack
- Value Institute for Health and Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - K S Chiang
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - T Lanza di Scalea
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - S O'Hara
- Value Institute for Health and Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - K Carberry
- Value Institute for Health and Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - S M Strakowski
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - J Suarez
- Value Institute for Health and Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
- The City University of New York School of Labor and Urban Studies, New York, NY, USA
| | - E Teisberg
- Value Institute for Health and Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
- Dell Medical School and McCombs School of Business at the University of Texas, Austin, TX, USA
| | - S Wallace
- Value Institute for Health and Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
- Dell Medical School and McCombs School of Business at the University of Texas, Austin, TX, USA
| | - J R C Almeida
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
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5
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Mery CM, Well A, Taylor K, Carberry K, Colucci J, Ulack C, Zeiner A, Mizrahi M, Stewart E, Dillingham C, Cook T, Hartounian A, McCullum E, Affolter JT, Van Diest H, Lamari-Fisher A, Chang S, Wallace S, Teisberg E, Fraser CD. Examining the Real-Life Journey of Individuals and Families Affected by Single-Ventricle Congenital Heart Disease. J Am Heart Assoc 2023; 12:e027556. [PMID: 36802928 PMCID: PMC10111463 DOI: 10.1161/jaha.122.027556] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Background The lifetime journey of patients with single-ventricle congenital heart disease is characterized by long-term challenges that are incompletely understood and still unfolding. Health care redesign requires a thorough understanding of this journey to create and implement solutions that improve outcomes. This study maps the lifetime journey of individuals with single-ventricle congenital heart disease and their families, identifies the most meaningful outcomes to them, and defines significant challenges in the journey. Methods and Results This qualitative research study involved experience group sessions and 1:1 interviews of patients, parents, siblings, partners, and stakeholders. Journey maps were created. The most meaningful outcomes to patients and parents and significant gaps in care were identified across the life journey. A total of 142 participants from 79 families and 28 stakeholders were included. Lifelong and life-stage specific journey maps were created. The most meaningful outcomes to patients and parents were identified and categorized using a "capability (doing the things in life you want to), comfort (experience of physical/emotional pain/distress), and calm (experiencing health care with the least impact on daily life)" framework. Gaps in care were identified and classified into areas of ineffective communication, lack of seamless transitions, lack of comprehensive support, structural deficiencies, and insufficient education. Conclusions There are significant gaps in care during the lifelong journey of individuals with single-ventricle congenital heart disease and their families. A thorough understanding of this journey is a critical first step in developing initiatives to redesign care around their needs and priorities. This approach can be used for people with other forms of congenital heart disease and other chronic conditions. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04613934.
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Affiliation(s)
- Carlos M Mery
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX
| | - Andrew Well
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX.,Value Institute for Health and Care The University of Texas at Austin Dell Medical School and McCombs School of Business Austin TX
| | - Kate Taylor
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX
| | - Kathleen Carberry
- Value Institute for Health and Care The University of Texas at Austin Dell Medical School and McCombs School of Business Austin TX
| | - José Colucci
- Design Institute for Health The University of Texas at Austin Dell Medical School and College of Fine Arts Austin TX
| | - Christopher Ulack
- Value Institute for Health and Care The University of Texas at Austin Dell Medical School and McCombs School of Business Austin TX
| | - Adam Zeiner
- Design Institute for Health The University of Texas at Austin Dell Medical School and College of Fine Arts Austin TX
| | - Michelle Mizrahi
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX
| | - Eileen Stewart
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Pediatrics The University of Texas at Austin Dell Medical School Austin TX
| | - Christine Dillingham
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX
| | - Taylor Cook
- Design Institute for Health The University of Texas at Austin Dell Medical School and College of Fine Arts Austin TX
| | - Arotin Hartounian
- Design Institute for Health The University of Texas at Austin Dell Medical School and College of Fine Arts Austin TX
| | - Elizabeth McCullum
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX
| | - Jeremy T Affolter
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Pediatrics The University of Texas at Austin Dell Medical School Austin TX
| | - Heather Van Diest
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Health Social Work The University of Texas at Austin Dell Medical School Austin TX
| | - Alexandra Lamari-Fisher
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Psychiatry and Behavioral Sciences The University of Texas at Austin Dell Medical School Austin TX
| | - Stacey Chang
- Design Institute for Health The University of Texas at Austin Dell Medical School and College of Fine Arts Austin TX
| | - Scott Wallace
- Value Institute for Health and Care The University of Texas at Austin Dell Medical School and McCombs School of Business Austin TX
| | - Elizabeth Teisberg
- Value Institute for Health and Care The University of Texas at Austin Dell Medical School and McCombs School of Business Austin TX
| | - Charles D Fraser
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX
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Christensen ME, Haahr A, Olsen PR, Rose HK, Norlyk A. Walking a tightrope – as a next-of-kin to an adolescent or young adult with cancer facing eating difficulties. Int J Qual Stud Health Well-being 2022; 17:2121029. [PMID: 36073734 PMCID: PMC9467545 DOI: 10.1080/17482631.2022.2121029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Purpose Eating difficulties cause reduced food intake and poor quality of life among adolescents and young adults (AYAs) with cancer. Therefore, next-of-kin eating support is crucial. The purpose of this study was to explore the lived experiences of being close to AYAs with cancer in the context of eating when they are at home between high-emetogenic chemotherapy (HEC) sessions. Method In-depth interviews were conducted with 12 next-of-kin to AYAs (15–29 years old) with oncological or haematological diseases, treated with HEC. Van Manen’s hermeneutic-phenomenological approach guided the design. Results The essential meaning of the next-of-kin experiences is reflected in the overarching theme “Utilizing meals as an action-opportunity” consisting of two subthemes: ’Being on constant alert’ and “Walking a tightrope to maintain usual everyday life.” Conclusions Findings revealed that utilizing meals as an action-opportunity towards AYAs’ food intake involved existential feelings including fear of losing their loved ones. Next-of-kin experienced that providing support through and with food was their only avenue of action. However, this sparked feelings of frustration and powerlessness.
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Affiliation(s)
- Marie Ernst Christensen
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus, Denmark
- Research Centre for Health and Welfare Technology, Program for Rehabilitation, via University College, Aarhus, Denmark
| | - Anita Haahr
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus, Denmark
- Research Centre for Health and Welfare Technology, Program for Rehabilitation, via University College, Aarhus, Denmark
| | - Pia Riis Olsen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Hanne Krogh Rose
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Annelise Norlyk
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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7
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Christian N, McFall C, Suarez J, Ulack C, Wagen B, Williams W, Teisberg E. Achieving Calm: A Study on the Health Care Experiences of People With Lived Experience of Homelessness in Central Texas. QUALITATIVE HEALTH RESEARCH 2022; 32:2118-2125. [PMID: 36356263 DOI: 10.1177/10497323221135795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The experiences of care of people with lived experience of homelessness are rarely embraced to change care delivery. We conducted qualitative group and one-on-one interviews utilizing experience group methodology with 27 people with lived experience of homelessness currently housed in one permanent housing community in central Texas. We analyzed data using an inductive thematic approach to identify shared obstacles and barriers to receiving health care. We then analyzed findings with the capability, comfort, and calm value framework to identify health outcomes that matter most to study participants. Poor access to care, discontinuities in care, distrust in providers, and confusing terminology were identified as the biggest barriers to health. The overwhelming majority of experiences reflected poor health outcomes of calm, the outcome of a health care experience that adds ease to one's life rather than logistical and administrative chaos. We propose three practical approaches to achieve calm for this population as follows: systems-level embracement of compassionate care, integration of relationship-based care navigation into all levels of care, and building efficient transportation into care design. We conclude that designing health care that works in the lives of people with lived experience of homelessness is critical to address the gaps in care that fuel the health disparity these individuals face compared to people without this lived experience.
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Affiliation(s)
- Nicholaus Christian
- Yale Program in Addiction, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | | | - Joel Suarez
- 116372The CUNY School of Labor and Urban Studies, New York, NY, USA
- Edmond J. Safra Center for Ethics at Harvard University, Cambridge, MA, USA
| | - Chris Ulack
- Value Institute for Health and Care, Austin, TX, USA
- 377659The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Brooke Wagen
- 377659The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Whitney Williams
- 377659The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Elizabeth Teisberg
- Value Institute for Health and Care, Austin, TX, USA
- 377659The University of Texas at Austin Dell Medical School, Austin, TX, USA
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8
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Hamilton AC, Donnelly DW, Fitzpatrick D, Coleman HG. Early-Onset Cancers in Adults: A Review of Epidemiology, Supportive Care Needs and Future Research Priorities. Cancers (Basel) 2022; 14:4021. [PMID: 36011014 PMCID: PMC9406462 DOI: 10.3390/cancers14164021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 12/03/2022] Open
Abstract
Rising incidence of specific types of early-age onset cancers in adults aged 18-49 years has been reported in high-income countries. In this review, we summarise the epidemiology of early-onset cancers using exemplar data from a high-income UK region, discuss supportive care needs for young patients and outline future research directions. The incidence rate of early-onset cancers increased by 20.5% from 1993 to 2019 in Northern Ireland. Differences in types of cancer were observed between sexes and across age groups of 18-29, 30-39 and 40-49 years. One and five-year net survival was mostly better in 18-29-year-olds for all cancers combined compared to older age groups for both sexes, but there were variations in specific cancer types. Poorer survival was observed for patients with brain/central nervous system, connective and soft tissue or lung cancers. Patients with early-onset cancers face unique supportive care needs and require holistic care. The impact of cancer treatment on fertility and fertility preservation treatments is an important consideration. Social media can be used for patient support, information, fundraising, advocacy work and recruitment to research studies. We also outline suggested future research priorities for early-onset cancers, spanning prevention, diagnosis, treatment and supportive care needs.
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Affiliation(s)
| | - David W. Donnelly
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
- Northern Ireland Cancer Registry, Queen’s University Belfast, Belfast BT12 6DP, UK
| | - Deirdre Fitzpatrick
- Northern Ireland Cancer Registry, Queen’s University Belfast, Belfast BT12 6DP, UK
| | - Helen G. Coleman
- Centre for Public Health, Queen’s University Belfast, Belfast BT12 6BA, UK
- Northern Ireland Cancer Registry, Queen’s University Belfast, Belfast BT12 6DP, UK
- Patrick G. Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast BT9 7AE, UK
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9
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Christensen ME, Olsen PR, Haahr A, Rose HK, Norlyk A. Struggling to Eat to Survive Cancer-Lived Experiences of Eating Among Adolescents and Young Adults Undergoing High-Emetogenic Chemotherapy. J Adolesc Young Adult Oncol 2021; 11:268-274. [PMID: 34424776 DOI: 10.1089/jayao.2021.0062] [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: 01/07/2023] Open
Abstract
Purpose: The purpose of this study was to provide in-depth understanding of adolescents' and young adults' (AYAs') lived experiences of eating when they are at home between high-emetogenic chemotherapy sessions. Methods: The study was guided by van Manen's hermeneutic-phenomenological methodology. Eligible AYAs were 15-29 years old, diagnosed with either oncological or hematological cancer, treated with high-emetogenic chemotherapy, and Danish speaking. AYAs were recruited from three university hospital departments. Data were collected using semi-structured in-depth interviews. Results: Thirteen AYAs, aged 17-29 years, participated in the interviews via telephone or face-to-face in their homes. The essential meaning of the phenomenon of eating can be characterized by the overarching theme "Struggling to eat to survive" and unfolded through the following three themes: "Cooperating with a deceiving body", "Capturing moments of eating opportunities", and "Being loved and cared for at home". Conclusions: Struggling to eat was essential for survival and a fundamental existential challenge that required reflection and consciousness. AYAs experienced their deceiving bodies as a major concern, which challenged their ability to eat and forced them to develop strategies to capture moments of eating opportunities. AYAs kept hold of doing "something" themselves to maintain the slightest control of their own lives and thereby assist clinical outcomes and cure. However, AYAs had to struggle with food and start viewing food as a friend, not an enemy.
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Affiliation(s)
- Marie Ernst Christensen
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus C, Denmark.,Research Centre for Health and Welfare Technology, Program for Rehabilitation, VIA University College, Aarhus N, Denmark
| | - Pia Riis Olsen
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
| | - Anita Haahr
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus C, Denmark.,Research Centre for Health and Welfare Technology, Program for Rehabilitation, VIA University College, Aarhus N, Denmark
| | - Hanne Krogh Rose
- Department of Oncology, Aarhus University Hospital, Aarhus N, Denmark
| | - Annelise Norlyk
- Research Unit for Nursing and Health Care, Department of Public Health, Aarhus University, Aarhus C, Denmark
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10
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Brumback AC, Wilson RB, Augustine EF, Bass NE, Bassuk AG, Cejas DM, Shellhaas RA, Strober JB, Tilton AC, Pearl PL. Introducing the Child Neurology Society Leadership, Diversity, Equity, and Inclusion Task Force. Ann Neurol 2021; 90:537-538. [PMID: 34288089 DOI: 10.1002/ana.26176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 07/19/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Audrey C Brumback
- Dell Medical School and The Center for Learning and Memory at The University of Texas at Austin, Austin, TX
| | - Rujuta B Wilson
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA
| | | | - Nancy E Bass
- University Hospital Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH
| | - Alexander G Bassuk
- University of Iowa Healthcare and Carver College of Medicine, Iowa City, IA
| | - Diana M Cejas
- The University of North Carolina School of Medicine and The Carolina Institute for Developmental Disabilities, Chapel Hill, NC
| | - Renée A Shellhaas
- Mott Children's Hospital and University of Michigan Health, Ann Arbor, MI
| | - Jonathan B Strober
- Benioff Children's Hospital at The University of California, San Francisco, CA
| | - Ann C Tilton
- Louisiana State University New Orleans School of Medicine, New Orleans, LA
| | - Phillip L Pearl
- Boston Children's Hospital, Harvard Medical School, Boston, MA
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