1
|
Tao L, Xiang Y, Zeng X, Fu L, Li J, Chen H. Psychological-Distress Factors in Patients With Breast Cancer: A Qualitative Meta-Synthesis. J Clin Nurs 2024; 33:4843-4859. [PMID: 39497629 DOI: 10.1111/jocn.17532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 08/30/2024] [Accepted: 10/15/2024] [Indexed: 11/22/2024]
Abstract
AIMS To systematically review and integrate qualitative-research results pertaining to psychological distress in patients with breast cancer and to clarify its causes and drivers. BACKGROUND Patients with breast cancer experience psychological distress in the stages of diagnosis, treatment, and rehabilitation, which seriously affects their quality of life. Through comprehensive qualitative research, the study comprehensively describes the experiences of patients with breast cancer to guide medical personnel in taking better care of them. DESIGN A systematic review and synthesis of qualitative studies. METHODS Qualitative studies were included if they were related to the psychological-distress experiences of patients with breast cancer. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise study quality. Data were synthesised using the Thomas and Harden method of thematic and content analysis. DATA SOURCES Nine electronic databases (PubMed, Embase, Cochrane Library, CINAL [via EBSCO], and PsycINFO, China Knowledge Resource Integrated Database, Wanfang, Chinese Biomedical, and Weipu) were searched from inception until February 2024. RESULTS Thirteen studies were included in the meta-synthesis. Four analytical themes were identified: diagnostic and therapeutic, individual, environmental, and interpersonal factors. CONCLUSIONS Psychological distress is a subjective feeling influenced by interactions among individual, therapeutic, environmental, and interpersonal factors, and it is commonly encountered among patients with breast cancer. Therefore, to optimise the management of psychological distress, the characteristics and external environment of patients with breast cancer should be carefully considered when delivering routine nursing care. IMPACT Patients experience psychological distress at different stages of breast cancer; however, the causes of psychological distress at different stages differ. Medical staff should implement targeted psychological-distress intervention measures based on factors relevant to different stages. REPORTING METHOD The Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement. REGISTRATION The protocol of this study has been registered in the database PROSPERO (registration ID: CRD42023417364).
Collapse
Affiliation(s)
- Lin Tao
- Department of Medical Oncology, Cancer Center, Cancer Day-Care Unit, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yuping Xiang
- Department of Critical Care Medicine, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaohong Zeng
- Department of Medical Oncology, Cancer Center, Cancer Day-Care Unit, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Lan Fu
- Breast Center, West China Hospital, Sichuan University, Chengdu, China
| | - Junying Li
- Thoracic Oncology Ward, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Chen
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| |
Collapse
|
2
|
An KO, Lee KJ. Physical fitness and blood parameters outcomes of breast cancer survivor in a low-intensity circuit resistance exercise program. Open Med (Wars) 2024; 19:20241010. [PMID: 39156757 PMCID: PMC11330159 DOI: 10.1515/med-2024-1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 05/29/2024] [Accepted: 07/06/2024] [Indexed: 08/20/2024] Open
Abstract
There is limited evidence regarding the effect of circuit-type low-intensity resistance exercise on physical fitness and blood parameters in breast cancer survivors (BCSs). Therefore, this study aimed to investigate the effect of low-intensity circuit resistance exercise on changes in physical fitness and blood parameters in BCSs. A total of 16 BCSs participated in a low-intensity circuit resistance exercise group (LCREG). The exercise program in the LCREG consisted of 50-60% of one repetition maximum, two to three times weekly, for 24 weeks. The control group (CG) did not receive any interventions. All participants were measured for physical fitness and blood parameters before and after the exercise intervention. The results showed that LCREG significantly improved body mass index (BMI) (p = 0.012), grip strength (p = 0.017), back strength (p = 0.042), plank (p = 0.036), balance (p = 0.030), low-density lipoproteins (LDL) (p = 0.050), total cholesterol (p = 0.017), and natural killer cell activity (NKCA) (p = 0.035) after exercise compared to before exercise. The LCREG also significantly improved BMI (p = 0.001), grip strength (p = 0.014), plank (p = 0.018), balance (p = 0.012), LDL (p = 0.024), total cholesterol (p = 0.012), and NKCA (p = 0.036) compared to the CG. These findings suggest that low-intensity circuit resistance exercise can increase physical fitness levels and improve the blood index in BCSs.
Collapse
Affiliation(s)
- Keun-Ok An
- Sports Medicine Major, Division of Sports, Korea National University of Transportation, Chungju, 27469, Korea
| | - Kwang-Jin Lee
- Department of Physical Education, Chungbuk National University, Cheongju, 28644, Korea
| |
Collapse
|
3
|
Kim M, Carter J, Tadros AB, Abuhdra N, Nelson JA, Stern CS. A guide for addressing sexual health in breast cancer patients. J Surg Oncol 2024; 129:1034-1040. [PMID: 38385690 DOI: 10.1002/jso.27602] [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: 01/10/2024] [Accepted: 01/28/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE Sexual health concerns are common in breast cancer surgery but often overlooked. Yet, breast cancer patients want more sexual health information from their providers. We aimed to share ways for providers to address sexual health concerns with their breast cancer patients at different stages of the treatment process. METHODS Experts in breast cancer treatments, surgeries, and sexual health at Memorial Sloan Kettering Cancer Center assembled to review the literature and to develop the recommendations. RESULTS Providers should provide sexual health information for their breast cancer patients throughout the continuum of care. Conversations should be initiated by the providers and can be brief and informative. Whenever appropriate, patients should be referred to Sexual Medicine experts and/or psychosocial support. There are various recommendations and tools that can be utilized at diagnosis, endocrine and chemotherapy, and breast surgery to identify patients with sexual health concerns and to improve their sexual functioning. CONCLUSION In this paper, we sought to provide providers with some insights, suggestions, and tools to address sexual health concerns. We encourage healthcare providers to initiate the conversation throughout the continuum of care beginning as early as diagnosis and refer patients to additional services if available.
Collapse
Affiliation(s)
- Minji Kim
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jeanne Carter
- Gynecology Service, Department of Psychiatry, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Audree B Tadros
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nour Abuhdra
- Breast Oncology, Department of MedicineMemorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jonas A Nelson
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Carrie S Stern
- Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
4
|
Bhardwaj PV, Gupta S, Elyash A, Teplinsky E. Male Breast Cancer: a Review on Diagnosis, Treatment, and Survivorship. Curr Oncol Rep 2024; 26:34-45. [PMID: 38224426 DOI: 10.1007/s11912-023-01489-z] [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] [Accepted: 12/11/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE OF REVIEW Male breast cancer is a relatively uncommon and rare disease that is often managed based on evidence adopted from trials pertaining to female breast cancer due to low accrual rates or exclusion of males. This is despite the known differences in the biology and epidemiology of this condition. This review provides an update regarding the management and surveillance of male breast cancer. RECENT FINDINGS Men with breast cancer tend to undergo more extensive surgery in the breast and axilla. The outcomes of male breast cancer compared to a similar subtype of female breast cancer appear worse when matched for stage. Systemic therapies remain predominantly based on recommendations for female breast cancer, although tamoxifen is the more optimal endocrine therapy for men than women. Surveillance with mammograms is recommended for patients harboring a breast cancer susceptibility gene but is otherwise not advised for men who have undergone a mastectomy. Notably, the role of other imaging modalities, including ultrasound and magnetic resonance imaging, is minimal. Although the focus on survivorship care among men is low, it is abundantly clear that this is a stigmatizing diagnosis for men, and they suffer from long-term physical and psychological sequelae following a diagnosis and treatment of breast cancer. In summary, providing more gender-inclusive care and advocating for increased representation of men in prospective breast cancer studies and clinical trials may help improve outcomes and provide enhanced support for this population.
Collapse
Affiliation(s)
- Prarthna V Bhardwaj
- Division of Hematology-Oncology, University of Massachusetts Chan School of Medicine, Baystate, MA, USA
| | - Shilpi Gupta
- Division of Medical Oncology, Atlantic Health System, Morristown Medical Center, Morristown, NJ, USA
| | | | | |
Collapse
|
5
|
Ni Y, Lian J. Carbon dioxide laser therapy for the management of genitourinary syndrome of menopause: A meta‑analysis of randomized controlled trials. Exp Ther Med 2024; 27:10. [PMID: 38223331 PMCID: PMC10785041 DOI: 10.3892/etm.2023.12297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/21/2023] [Indexed: 01/16/2024] Open
Abstract
Genitourinary symptoms of menopause (GSM) affect ~50% of women after menopause. Recently, CO2 laser therapy has been used for managing GSM but without high quality evidence. The present review assessed the effectiveness of CO2 laser therapy in the management of GSM. PubMed, Embase, Web of Science, CENTRAL and Scopus databases were searched for randomized controlled trials (RCTs), published up to June 30, 2023, comparing CO2 laser and sham laser treatments for GSM management. The outcomes of interest included Female Sexual Function Index (FSFI), Vaginal Health Index (VHI) and visual analog scale (VAS) for dyspareunia, dryness, burning, itching and dysuria. A total of seven RCTs were included in the review and meta-analysis, with 6/7 studies using three sessions of laser therapy, 4-8 weeks apart. Meta-analysis demonstrated no statistically significant difference in FSFI [mean difference (MD), -1.48; 95% CI, -5.85, 2.89; I2=45%] and VHI scores (MD, -0.18; 95% CI, -1.66, 1.31; I2 =72%) between laser and control groups. Meta-analysis also demonstrated no statistically significant difference in VAS scores for dyspareunia (MD, -1.63; 95% CI; -4.06, 0.80; I2=91%), dryness (MD, -1.30; 95% CI, -3.14, 0.53; I2=75%), burning (MD, -0.76; 95% CI, -2.03; 0.51 I2=56%), itching (MD, -0.28; 95% CI, -0.95, 0.38; I2=0%) and dysuria (MD, 0.15; 95% CI, -0.37, 0.67; I2=23%) between the groups. The included RCTs had low risk of bias. In conclusion, meta-analyses of high-quality sham-controlled RCTs indicated that CO2 may not have any beneficial effect on GSM. Limited data and high heterogeneity in meta-analyses in this area of research are important limitations that need to be addressed by future RCTs.
Collapse
Affiliation(s)
- Yihua Ni
- Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Junyu Lian
- Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| |
Collapse
|
6
|
Yang H, Liu L, Zhang X. Exercise interventions on body composition and quality of life of overweight/obese breast cancer survivors: a meta-analysis. BMC Womens Health 2023; 23:484. [PMID: 37700300 PMCID: PMC10498647 DOI: 10.1186/s12905-023-02627-2] [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: 04/27/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND This meta-analysis aimed to assess the effects of exercise interventions on body composition and quality of life in overweight/obese breast cancer survivors. METHODS Eligible randomized controlled trials (RCTs) were searched from the Cochrane Library, PubMed, and Embase databases and assessed using the Cochrane Collaboration's assessing risk tool. The effect size was pooled as weighted mean difference (WMD) for body composition variables (i.e., body mass index [BMI], body fat, body weight, fat mass, lean mass, bone mineral density) and quality of life (i.e., physical health and mental health), and the confidence interval (CI) was set as 95%. Since heterogeneity existed, subgroup analysis was conducted to detect the source of heterogeneity. RESULTS Eight articles from six RCTs containing 548 overweight/obese breast cancer survivors (BMI ≥ 25 kg/m2) were included and analyzed. Compared to routine care, exercise intervention significantly decreased the body mass index [WMD (95% CI) = -1.37 (-2.50, -0.23) kg/m2] and body fat [WMD (95% CI) = -3.80 (-6.59, -1.01) %] of overweight/obese breast cancer survivors. Exercise intervention showed a tendency to increase physical health [WMD (95% CI) = 2.65 (-10.19, 15.48)] and mental health [WMD (95%CI) = 1.38 (-4.18, 6.95)], but no statistical significance was observed. A subgroup analysis showed the duration of intervention was a source of heterogeneity on body composition. In the 16-week subgroup, exercise intervention decreased fat mass and BMI while increased lean mass and bone mineral density. The 52-week exercise intervention was effective in increasing lean mass. A significant exercise intervention effect on reducing body fat was only detected in the 12-week subgroup. CONCLUSION Exercise intervention significantly decreased the body mass index and body fat of overweight/obese breast cancer survivors. The benefits of exercise interventions for overweight/obese breast cancer survivors need more evidence from high-quality RCTs with large sample sizes.
Collapse
Affiliation(s)
- Hongchang Yang
- Physical Education Department, Hohai University, Nanjing, Jiangsu, China
| | - Li Liu
- Department of Rehabilitation, Brain Hospital Affiliated to Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, Jiangsu, China.
| | - Xiaoxia Zhang
- Department of Kinesiology, Centenary College of Louisiana, 2911 Centenary Blvd, Shreveport, LA, USA.
| |
Collapse
|
7
|
Cucinella L, Tiranini L, Cassani C, Martella S, Nappi RE. Genitourinary Syndrome of Menopause in Breast Cancer Survivors: Current Perspectives on the Role of Laser Therapy. Int J Womens Health 2023; 15:1261-1282. [PMID: 37576184 PMCID: PMC10422970 DOI: 10.2147/ijwh.s414509] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/03/2023] [Indexed: 08/15/2023] Open
Abstract
Genitourinary syndrome of menopause (GSM) is a frequent consequence of iatrogenic menopause or anti-estrogenic adjuvant therapies in breast cancer survivors (BCSs). GSM may profoundly affect sexual health and quality of life, and a multidimensional unique model of care is needed to address the burden of this chronic heterogeneous condition. Severe symptoms may be insufficiently managed with non-hormonal traditional treatments, such as moisturizers and lubricants, recommended as the first-line approach by current guidelines, because concerns exist around the use of vaginal estrogens, particularly in women on aromatase inhibitors (AIs). Vaginal laser therapy has emerged as a promising alternative in women with GSM who are not suitable or do not respond to hormonal management, or are not willing to use pharmacological strategies. We aim to systematically review current evidence about vaginal laser efficacy and safety in BCSs and to highlight gaps in the literature. We analyzed results from 20 studies, including over 700 BCSs treated with either CO2 or erbium laser, with quite heterogeneous primary outcomes and duration of follow up (4 weeks-24 months). Although evidence for laser efficacy in BCSs comes mostly from single-arm prospective studies, with only one randomized double-blind sham-controlled trial for CO2 laser and one randomized comparative trial of erbium laser and hyaluronic acid, available data are reassuring in the short term and indicate effectiveness of both CO2 and erbium lasers on the most common GSM symptoms. However, further studies are mandatory to establish long-term efficacy and safety in menopausal women, including BCSs.
Collapse
Affiliation(s)
- Laura Cucinella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy
| | - Lara Tiranini
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy
| | - Chiara Cassani
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Unit of Obstetrics and Gynecology, IRCCS San Matteo Foundation, Pavia, Italy
| | - Silvia Martella
- Unit of Preventive Gynecology, IRCCS European Institute of Oncology, Milan, Italy
| | - Rossella E Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Research Centre for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy
| |
Collapse
|
8
|
Yan Y, Guo T, Zhang M, Cui G. Vaginal metastasis from breast cancer: A case report. Open Life Sci 2023; 18:20220623. [PMID: 37360785 PMCID: PMC10290277 DOI: 10.1515/biol-2022-0623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 06/28/2023] Open
Abstract
Breast cancer is one of the most common malignancies in women. However, cases of vaginal metastases of breast cancer are rarely reported in China and abroad. The main clinical symptom of vaginal metastases of breast cancer is vaginal bleeding. This article aims to provide a reference for the diagnosis and clinical management of vaginal metastases from breast cancer. This article describes in detail the management of a 50-year-old woman with vaginal metastases from breast cancer, who was admitted to the hospital with persistent vaginal bleeding without apparent causes. Persistent vaginal bleeding was found after two and a half years when her breast cancer surgery was performed. After comprehensive evaluation, vaginal mass resection was performed. Postoperative histopathology confirmed that the vaginal mass was breast cancer metastasis. The patient was treated with local radiotherapy and three cycles of eribulin and bevacizumab after the vaginal mass was removed. A reexamination of computed tomography showed that the chest wall metastases were less extensive than before. Orbital metastases were also reduced in size, which was revealed by the physical examination. The patient had since failed to return to hospital on time for a regular treatment due to personal reasons. After 9 months of follow-up, the patient died of multiple metastases. The diagnosis of vaginal masses is based on pathological examination, and systemic treatment should be the mainstay when extensive metastases are presented.
Collapse
Affiliation(s)
- Yunbo Yan
- Hebei Medical University, Shijiazhuang, China
- Second Department of Thyroid and Breast Surgery, Cangzhou Central Hospital, No. 16 of Xinhua West Road, Yunhe District, Cangzhou, Hebei Province, 061000, China
| | - Tianjiao Guo
- Hebei Medical University, Shijiazhuang, China
- Department of Diagnostic Computed Tomography, Cangzhou Central Hospital, Cangzhou, China
| | - Minmei Zhang
- Vascular Surgery Department, TCM Hospital of Shijiazhuang City, Shijiiazhuang, China
| | - Guozhong Cui
- Second Department of Thyroid and Breast Surgery, Cangzhou Central Hospital, No. 16 of Xinhua West Road, Yunhe District, Cangzhou, Hebei Province, 061000, China
| |
Collapse
|