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Boelhouwer IG, van Vuuren T. Psychological capital and work functioning of workers with recurrent or metastatic cancer beyond return to work. Palliat Support Care 2024:1-7. [PMID: 38420715 DOI: 10.1017/s1478951524000233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
OBJECTIVES The existing studies among workers with a past cancer diagnosis have rarely focused on workers confronted with cancer recurrence or metastases specifically, so knowledge is lacking. The aim of this study, therefore, was to investigate the work functioning (work ability, burnout complaints, and work engagement) of workers with recurrent or metastasized cancer. Furthermore, the association of psychological capital (hope, optimism, resilience, and self-efficacy) with work functioning was studied. METHODS Data from a survey study among workers 2-10 years past cancer diagnosis were used (N = 750); 73% reported a diagnosis of breast cancer and 27% a diagnosis of cancer other than breast cancer. Analysis of variance was used to compare participants with and without cancer recurrence or metastases regarding work functioning (work ability, burnout complaints, and work engagement) and psychological capital (hope, optimism, resilience, and self-efficacy). Multivariate regression analyses were used to analyze the association of type of cancer and psychological capital with work functioning among workers with cancer recurrence or metastatic cancer (n = 54), controlling for age. RESULTS Work ability is significantly lower among workers with cancer recurrence or metastases (controlling for age); however, burnout complaints and work engagement are at comparable levels. Among workers with cancer recurrence or metastases, a higher level of hope is positively associated with work ability and work engagement, and a higher level of hope or resilience is negatively associated with burnout complaints. SIGNIFICANCE OF RESULTS Among workers with cancer recurrence or metastases, work ability needs attention. Furthermore, especially the element hope of psychological capital is important to focus on because of the association with more favorable work functioning in general. The clinical psycho-oncological practice may benefit from these insights in guiding this vulnerable group of workers who are living with active cancer and many uncertainties.
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Affiliation(s)
- Ingrid G Boelhouwer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Tinka van Vuuren
- Faculty of Management, Open Universiteit, Heerlen, The Netherlands
- Loyalis Knowledge & Consult, Heerlen, The Netherlands
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Elazzamy H, Bhatt M, Mazzara P, Barawi M, Zeni A, Aref A. Pattern of Residual Submucosal Involvement after Neoadjuvant Therapy for Rectal Cancer: A Rationale for the Utility of Endoscopic Submucosal Resection. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1807. [PMID: 37893525 PMCID: PMC10608064 DOI: 10.3390/medicina59101807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Full-thickness trans anal local excision for tumors with favorable response following neoadjuvant therapy for locally advanced rectal cancer (LARC) is a common strategy for organ preservation, but it could be associated with a high rate of postoperative complications. We describe the incidence and pattern of submucosal involvement in surgical specimens following neoadjuvant therapy for LARC and whether limiting local excision of the residual tumor bed to only mucosal/submucosal layers of the rectal wall is sufficient for accurately predicting the ypT status of residual cancer, providing a pathological rationale to replace full-thickness local excision by endoscopic submucosal resection. Materials and Methods: This was a single-institution retrospective study conducted at a teaching community hospital. We reviewed clinical and pathological findings with slides of 82 patients diagnosed with LARC treated at our center between 2006 and 2020. Eligibility criteria mirrored our current organ preservation trials. Results: No tumor was found in surgical specimens in 28 cases (34%). Additionally, 4, 22, 27, and 1 cases were staged as ypT1, ypT2, ypT3, and ypT4, respectively. Residual malignant cells were found in the submucosal layer in 98% of cases with ypT+ stage, with 'skip lesions' in only 2% of cases. Conclusions: A very high incidence of submucosal involvement is noticed in residual tumors after neoadjuvant therapy, providing pathological rationale to study the role of endoscopic submucosal resection as a restaging tool for tumors with favorable response after neoadjuvant therapy when organ preservation strategy is pursued. This study was limited by its retrospective design and relatively small number of patients.
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Affiliation(s)
- Haidy Elazzamy
- Pathology Department, Ascension St. John Hospital, Detroit, MI 48236, USA (P.M.)
| | - Monika Bhatt
- Pathology Department, Ascension St. John Hospital, Detroit, MI 48236, USA (P.M.)
| | - Paul Mazzara
- Pathology Department, Ascension St. John Hospital, Detroit, MI 48236, USA (P.M.)
| | - Mohammed Barawi
- Gastroenterology, Ascension St. John Hospital, Detroit, MI 48236, USA
| | - Amer Zeni
- Rectal Surgery, Ascension St. John Hospital, Detroit, MI 48236, USA;
| | - Amr Aref
- Radiation Oncology, Ascension St. John Hospital, Detroit, MI 48236, USA
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Vlaski T, Slavic M, Caspari R, Fischer H, Brenner H, Schöttker B. Development Trajectories of Fatigue, Quality of Life, and the Ability to Work among Colorectal Cancer Patients in the First Year after Rehabilitation-First Results of the MIRANDA Study. Cancers (Basel) 2023; 15:3168. [PMID: 37370777 DOI: 10.3390/cancers15123168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Cancer-related fatigue, low quality of life (QoL), and low ability to work are highly prevalent among colorectal cancer (CRC) patients after tumor surgery. We aimed to analyze their intercorrelations and trajectories in the first year after in-patient rehabilitation in the German multicenter MIRANDA cohort study. Recruitment is ongoing, and we included the first 147 CRC patients in this analysis. Participants filled out questionnaires at the beginning of in-patient rehabilitation (baseline) and at 3, 6, 9, and 12 months after the baseline. The EORTC-QLQ-C30-General-Health-Status (GHS)/QoL, the FACIT-F-Fatigue Scale, and the FACIT-F-FWB-ability-to-work items were used to evaluate QoL, fatigue, and ability to work, respectively. The fatigue and QoL scales were highly correlated (r = 0.606). A moderate correlation was observed between the fatigue and ability to work scales (r = 0.487) and between the QoL and ability to work scales (r = 0.455). Compared to the baseline, a statistically significant improvement in the QoL, ability to work, and fatigue scales were observed at the 3-month follow-up (Wilcoxson signed rank test, all p < 0.0001). The three scales plateaued afterward until the 12-month follow-up. In conclusion, fatigue, QoL, and ability to work were highly interrelated, improved quickly during/after in-patient rehabilitation, and did not change much afterward in German CRC patients.
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Affiliation(s)
- Tomislav Vlaski
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany
| | - Marija Slavic
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Reiner Caspari
- Clinic Niederrhein, 53474 Bad Neuenahr-Ahrweiler, Germany
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
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Sarfo MC, Bertels L, Frings-Dresen MHW, de Jong F, Blankenstein AH, van Asselt KM, de Boer AGEM. The role of general practitioners in the work guidance of cancer patients: views of general practitioners and occupational physicians. J Cancer Surviv 2023; 17:416-424. [PMID: 35469363 PMCID: PMC9038171 DOI: 10.1007/s11764-022-01211-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/10/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE To explore views of general practitioners (GPs) and occupational physicians (OPs) on the role of GPs in work guidance of cancer patients. METHODS Between 2016 and 2019, two focus groups with GPs (N = 17) and two focus groups with OPs (N = 10) were conducted. Focus group discussions were audiotaped and transcribed verbatim. Transcripts were analysed by data-driven analysis. RESULTS GPs generally indicated that they inquire about patients' occupations but do not structurally document these. GPs described offering support and advice to patients regarding their work, while other GPs stated they do not interfere with their patients' work or return to work (RTW) process. In general, GPs stated that they do not aspire a professional role in the work guidance of patients, due to lack of expertise and not having sufficient knowledge in work regulations and legislation. In contrast, OPs anticipated a proactive role from GPs concerning work guidance in cancer patients, and they expected GPs to refer cancer patients to the OP, when required. Moreover, they emphasised the importance of communication between GPs and OPs about patients' work-related problems to achieve common goals. CONCLUSIONS GPs can contribute to cancer patients' RTW process by supporting patients, giving advice and providing referral to other health professionals. Better cooperation between GPs and OPs may improve work guidance in cancer patients. IMPLICATIONS FOR CANCER SURVIVORS When cancer patients with work-related issues get appropriate advice and support from GPs and referred in time to OPs, the RTW process and staying at work of cancer patients may be positively affected.
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Affiliation(s)
- Marie-Christine Sarfo
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 / K0-119, 1105 AZ, Amsterdam, The Netherlands
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Lucinda Bertels
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 / K0-119, 1105 AZ, Amsterdam, The Netherlands
| | - Femke de Jong
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Annette H Blankenstein
- Department of General Practice/Family Medicine, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Kristel M van Asselt
- Department of General Practice/Family Medicine, APH, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9 / K0-119, 1105 AZ, Amsterdam, The Netherlands.
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Work Ability in Patients With Stage I to IV Colon Cancer: Results of the Dutch Prospective Colorectal Cancer Cohort. Dis Colon Rectum 2023; 66:50-58. [PMID: 34753892 DOI: 10.1097/dcr.0000000000002075] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Colon cancer affects a patient's ability to work. Many patients who have colon cancer are employed at the time of diagnosis. OBJECTIVE We evaluated work ability during the first 2 years after colon cancer diagnosis. DESIGN This study is a national prospective study, the Prospective Dutch ColoRectal Cancer cohort, including clinical data and patient-reported outcomes. SETTINGS Data were collected in 59 medical centers in the Netherlands. PATIENTS Patients <67 years of age with stage I to IV colon cancer and who completed Work Ability Index questionnaires were selected. MAIN OUTCOME MEASURES Work ability was assessed at baseline, 3, 6, 12, 18, and 24 months. The Work Ability Index (range, 0 to 49) was evaluated using linear mixed models. Outcomes were matched to population controls without cancer. RESULTS Of 390 patients, 84% had paid employment. Work ability of patients with stage I to IV colon cancer was significantly lower at the time of diagnosis than in matched population controls (31 ± 8.2 and 41 ± 5.6). Patients with stage I to III disease receiving surgery only regained Work Ability Index scores comparable to matched population controls at 18 months. Patients receiving adjuvant systemic treatment initially demonstrated a decrease in work ability with improvements from 6 months onward and normalization at 24 months. Patients with stage IV disease did not demonstrate improvements in work ability outcomes over time. Work ability scores were negatively influenced by the administration of systemic treatment and ≥1 comorbidities. LIMITATIONS Only patients with patient-reported outcomes and work at baseline were included in this analysis. Also, questionnaire response rates decreased over time. CONCLUSIONS Work ability in patients with colon cancer is decreased for a prolonged time. Recovery depends on disease stage, type of treatment, and comorbidities. Patients with stage I to III disease treated with curative surgery alone were the first to regain work ability, followed by patients who receive adjuvant chemotherapy. Patients with stage IV disease did not regain work ability. See Video Abstract at http://links.lww.com/DCR/B759 . CAPACIDAD LABORAL EN PACIENTES CON CNCER DE COLON EN ESTADIO IIV RESULTADOS PROSPECTIVOS DE CNCER COLORECTAL EN UNA COHORTE HOLANDESA ANTECEDENTES:El cáncer de colon afecta la capacidad de trabajo en un paciente. Muchos pacientes con cáncer de colon están empleados en el momento del diagnóstico.OBJETIVO:Evaluamos la capacidad laboral durante los dos primeros años posteriores al diagnóstico de cáncer de colon.DISEÑO:Es un estudio prospectivo nacional, la cohorte de cáncer colorrectal holandés, incluye datos clínicos y resultados informados por los pacientes.ENTORNO CLINICO:Se recopilaron datos de 59 centros médicos en los Países Bajos.PACIENTES:Se seleccionaron pacientes < 67 años, con cáncer de colon en estadio I-IV, que completaron los cuestionarios de índice de capacidad para el trabajo.PRINCIPALES MEDIDAS DE VALORACIÓN:La capacidad para el trabajo se evaluó al inicio, a los 3, 6, 12, 18 y 24 meses. El índice de capacidad para el trabajo (que va de 0 a 49) se evaluó mediante modelos lineales mixtos. Los resultados fueron comparados con el grupo control sin cáncer.RESULTADOS:De 390 pacientes, el 84% tenía un empleo remunerado. La capacidad de trabajo de los pacientes en estadio I-IV fue significativamente menor en el momento del diagnóstico en comparación con el grupo control (31 ± 8,2 y 41 ± 5,6, respectivamente). Los pacientes con enfermedad en estadio I-III que recibieron cirugía lograron recuperar puntajes del índice de capacidad laboral comparables a los controles a los 18 meses. Los pacientes que recibieron tratamiento sistémico adyuvante inicialmente demostraron una disminución en la capacidad de trabajo con mejoras a partir de los 6 meses en adelante y una normalización a los 24 meses. Los pacientes en estadio IV no demostraron mejoras en los resultados de la capacidad laboral a lo largo del tiempo. Las puntuaciones de capacidad para el trabajo se vieron influidas negativamente por la administración del tratamiento sistémico y la existencia de ≥1 comorbilidades.LIMITACIONES:En este análisis solo se incluyeron los pacientes con resultados y trabajo desde el inicio del estudio. Además, las tasas de respuesta al cuestionario disminuyeron con el tiempo.CONCLUSIONES:La capacidad de trabajo en pacientes con cáncer de colon se reduce durante un tiempo prolongado. La recuperación depende del estadio de la enfermedad, el tipo de tratamiento y la comorbilidad. Los pacientes con enfermedad en estadio I-III tratados con cirugía curativa exclusivamente, son los primeros en recuperar la capacidad para trabajar, seguidos de los pacientes que reciben quimioterapia adyuvante. Los pacientes con enfermedad en estadio IV no recuperan la capacidad para trabajar. Consulte Video Resumen en http://links.lww.com/DCR/B759 . (Traducción- Dr. Ingrid Melo ).
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Zou W, Zhang Y, Gong L, Zhang M, Wu X, Xie J, Zhang M. Factors associated with psychosocial adjustment in working-age colorectal cancer survivors: A cross-sectional study. Asia Pac J Oncol Nurs 2022; 9:100057. [PMID: 35647223 PMCID: PMC9130516 DOI: 10.1016/j.apjon.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 03/25/2022] [Indexed: 12/05/2022] Open
Abstract
Objective This study aimed to describe the level of psychosocial adjustment and identify factors associated with psychosocial adjustment in working-age colorectal cancer survivors. Methods This cross-sectional study involved 212 colorectal cancer survivors visiting a cancer clinic at a specialized oncology hospital in China. Socio-demographic characteristics, disease-related characteristics, status of returning to work, Work Ability Index scores, M. D. Anderson Symptom Inventory for Gastrointestinal Cancer scores, and self-reported Psychological Adjustment to Illness Scale scores were collected from all participants. Data analyses included descriptive statistics, independent t-test, one-way analysis of variance, correlation analysis, and multiple linear regression analysis, which were performed using the Statistical Package for the Social Sciences version 25.0 (IBM Corporation, Armonk, NY, USA). Results Participants reported a medium level of psychosocial maladjustment (35.73 ± 19.68), with 19.3% of participants experiencing severe maladjustment, 29.7% experiencing moderate maladjustment, and 50.9% experiencing mild maladjustment, respectively. Age, gender, marital status, having a child, education level, having a stoma, comorbidities, return to work, work ability, and symptom distress were entered into a multiple linear regression analysis. The strongest factor influencing the level of psychosocial adjustment was work ability (β = −0.393, P < 0.001), followed by symptom distress (β = 0.380, P < 0.001) and an education level of college or above (β = 0.150, P = 0.027). These variables accounted for 46.1% of the variance in psychosocial adjustment. Conclusions Colorectal cancer survivors with low work ability, high symptom distress, and an education level of college or above are at a high risk for psychosocial maladjustment. Nursing interventions for psychosocial adjustment should attach increased importance to the work status and symptom distress of colorectal cancer survivors.
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Physical activity levels after low anterior resection for rectal cancer: one-year follow-up. BMC Public Health 2021; 21:2270. [PMID: 34903207 PMCID: PMC8667409 DOI: 10.1186/s12889-021-12311-5] [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] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/17/2021] [Indexed: 12/22/2022] Open
Abstract
Background Overall survival rates after rectal cancer have increased. Therefore, functional outcomes rightly deserve more interest. The aims of this study were to assess progression in total, sports, occupational and household physical activity levels of rectal cancer survivors, from preoperatively to 12 months after surgery/stoma closure and to explore predictive factors. Methods Multi-center prospective study with 125 patients who underwent low anterior resection for rectal cancer. The Flemish Physical Activity Computerized Questionnaire was completed concerning all physical activity levels at baseline (past preoperative year) and at 1, 4, 6 and 12 months after surgery/stoma closure. At these timepoints, questionnaires (LARS−/ COREFO-questionnaire) regarding bowel symptoms were also filled out. Results were analyzed using linear mixed models for repeated measures. Results Total physical activity levels up to 12 months remained significantly lower than preoperative. Occupational and sports physical activity levels remained significantly lower until 6 and 4 months postoperative, respectively. Predictive factors for decreased physical activity levels at a specific timepoint were: younger age and no stoma (total physical activity, 1 month), low/mid rectal tumor, no stoma, non-employed status (total, 4 months), higher COREFO-scores (occupational, 4 months) and non-employed status (total, 12 months). At all timepoints, lower COREFO-scores were associated with higher total physical activity levels; male gender and lower educational levels with higher occupational levels; younger age, normal BMI, employed status and adjuvant therapy with higher sports levels; and female gender, lower educational level and unemployed status with higher household levels. Conclusions One year after rectal cancer treatment, total physical activity levels were still not recovered. Rectal cancer patients, especially those at risk for decreased physical activity levels and with major bowel complaints, should be identified and guided to increase their activities. Trial registration This trial has been registered at Netherlands Trial Register (NTR6383, 23/01/2017).
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de Jong RW, Boezeman EJ, Chesnaye NC, Bemelman FJ, Massy ZA, Jager KJ, Stel VS, de Boer AGEM. Work status and work ability of patients receiving kidney replacement therapy: Results from a European survey. Nephrol Dial Transplant 2021; 37:2022-2033. [PMID: 34643706 PMCID: PMC9494090 DOI: 10.1093/ndt/gfab300] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Employment is important for the quality of life and financial security of patients of working age receiving kidney replacement therapy (KRT). We aimed to examine self-reported work status and general, physical and mental work ability, and to determine associations between demographic, disease-related, work-related, and macro-economic factors and employment. . METHODS Europeans from 37 countries, aged 19-65 years, treated with dialysis or kidney transplantation, filled out the web-based or paper-based cross-sectional EDITH kidney patient survey between November 2017 and January 2019. We performed descriptive analyses and multivariable generalized logistic mixed models. RESULTS Of the 3 544 patients, 36.5% were employed and working (25.8% of dialysis patients, 53.9% of kidney transplant recipients [KTRs]). Mean general work ability was 5.5 out of 10 (dialysis: 4.8, KTRs: 6.5). Non-working patients (all: 4.1, dialysis: 3.9, KTRs: 4.7) scored lower than working patients (all: 7.7, dialysis 7.3, KTRs: 8.0). Working dialysis patients scored lower on physical and mental work ability (7.1 and 8.1) than working KTRs (8.0 and 8.4, p < 0.001). Impaired physical work ability (42.7%) was more prevalent than impaired mental work ability (26.7%). Male sex, age 40-49 years, higher education, home dialysis or kidney transplantation as current treatment, treatment history including kidney transplantation, absence of diabetes mellitus, better general work ability, and higher country GDP were positively associated with employment (p < 0.05). CONCLUSIONS Low employment rates and impaired work ability were prevalent among European patients receiving KRT. Demographic, disease-related, work-related, and macro-economic factors were associated with employment.
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Affiliation(s)
- Rianne W de Jong
- ERA Registry, Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Edwin J Boezeman
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nicholas C Chesnaye
- ERA Registry, Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Frederike J Bemelman
- Department of Nephrology, Division of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ziad A Massy
- Division of Nephrology, Amboise Paré University Hospital, APHP, Boulogne-Billancourt, Paris, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) Unit 1018 Team 5, Research Centre in Epidemiology and Population Health (CESP), University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France
| | - Kitty J Jager
- ERA Registry, Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Vianda S Stel
- ERA Registry, Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Clinical Effect of Radiotherapy Combined with Capecitabine after Neoadjuvant Therapy for Rectal Cancer. JOURNAL OF ONCOLOGY 2021; 2021:9972051. [PMID: 34194503 PMCID: PMC8203376 DOI: 10.1155/2021/9972051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/25/2021] [Indexed: 11/17/2022]
Abstract
Objective The purpose of the study was to investigate the clinical effect of radiotherapy combined with capecitabine in rectal cancer patients after neoadjuvant therapy. Methods 80 rectal cancer patients who underwent neoadjuvant therapy in our hospital from February 2016 to February 2018 were selected as the study subjects and divided into the control group (n = 40) and experimental group (n = 40) according to the order of admission. Among them, the control group was treated with radiotherapy, while the experimental group was treated with radiotherapy combined with capecitabine. The therapeutic efficacy, CEA levels, the incidence and recurrence rate of adverse reactions, as well as the progression-free survival and survival rate after 2-year treatment were analyzed in the two groups. Results The effective rate of treatment in the experimental group of 87.5% (35/40) was significantly higher than 50% (20/40) in the control group, with statistical significance (X2 = 13.09, P < 0.001). After treatment, the CEA levels in the two groups both decreased significantly, and the CEA level in the experimental group of 3.75 ± 1.76 ng/ml was significantly lower than 7.35 ± 2.11 ng/ml in the control group, with statistical significance (T = 8.29, P < 0.001). The incidence and the recurrence rate of adverse reactions of 5% (2/40) and 10% (4/40), respectively, in the experimental group were significantly lower than those of 40% (16/40) and 30% (12/40) in the control group, with statistical significance (X2 = 14.05, 5.00, P < 0.001, 0.05). After the 2-year follow-up, it was found that the progression-free survival of 21.53 ± 6.23 months in the experimental group was significantly longer than that of 18.18 ± 5.41 months in the control group, with statistical significance (T = 2.57, P < 0.05), and the 2-year survival rate of 97.5% (39/40) in the experimental group was significantly higher than 80% (32/40) in the control group, with statistical significance (T = 6.13, P < 0.05). Conclusion Radiotherapy combined with capecitabine in rectal cancer patients after neoadjuvant therapy can improve the therapeutic efficacy with fewer adverse reactions and longer patients' survival, which is worthy of popularization and application after neoadjuvant therapy for rectal cancer.
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The associations between late effects of cancer treatment, work ability and job resources: a systematic review. Int Arch Occup Environ Health 2020; 94:147-189. [PMID: 32929528 PMCID: PMC7873002 DOI: 10.1007/s00420-020-01567-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/25/2020] [Indexed: 01/11/2023]
Abstract
Objective The aim of this review is to evaluate associations between possible late effects of cancer treatment (i.e. physical complaints, fatigue, or cognitive complaints) and work ability among workers beyond 2 years after cancer diagnosis who returned to work. The role of job resources (social support, autonomy, leadership style, coaching, and organizational culture) is also evaluated. Methods The search for studies was conducted in PsycINFO, Medline, Business Source Premier, ABI/Inform, CINAHL, Cochrane Library and Web of Science. A quality assessment was used to clarify the quality across studies. Results The searches included 2303 records. Finally, 36 studies were included. Work ability seemed to decline shortly after cancer treatment and recover in the first 2 years after diagnosis, although it might still be lower than among healthy workers. No data were available on the course of work ability beyond the first 2 years. Late physical complaints, fatigue and cognitive complaints were negatively related with work ability across all relevant studies. Furthermore, social support and autonomy were associated with higher work ability, but no data were available on a possible buffering effect of these job resources on the relationship between late effects and work ability. As far as reported, most research was carried out among salaried workers. Conclusion It is unknown if late effects of cancer treatment diminish work ability beyond two years after being diagnosed with cancer. Therefore, more longitudinal research into the associations between possible late effects of cancer treatment and work ability needs to be carried out. Moreover, research is needed on the buffering effect of job resources, both for salaried and self-employed workers. Electronic supplementary material The online version of this article (10.1007/s00420-020-01567-w) contains supplementary material, which is available to authorized users.
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