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Deng R, Liu Y, Wu X, Zhao N, Deng J, Pan T, Cao L, Zhan F, Qiao X. Probing the interaction of hesperidin showing antiproliferative activity in colorectal cancer cells and human hemoglobin. Int J Biol Macromol 2024:136078. [PMID: 39341316 DOI: 10.1016/j.ijbiomac.2024.136078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Revised: 09/25/2024] [Accepted: 09/25/2024] [Indexed: 10/01/2024]
Abstract
Hesperidin, a flavanone glycoside abundant in citrus is known to possess anti-carcinogenic properties. However, its main interaction with cancer cells and blood proteins is not well-studied yet. Here we have explored the interactions of hesperidin with human colorectal cancer cells, HCT116, and human hemoglobin (HHb) with several experimental and theoretical studies. Cellular assays showed that hesperidin interacted with colorectal cancer cells and induced membrane damage, colony formation inhibition, oxidative stress, mitochondrial dysfunction, Bax/Bcl-2, caspase-9, and caspase-3 upregulation, and cytochrome c release determined by cellular, qPCR and ELISA assays. The interaction of the hesperidin with HHb indicated the formation of a static complex mainly with the assistance of hydrogen bonds which lead to partial folding of protein determined by spectroscopy, molecular docking, and molecular dynamic studies. In conclusion, these findings show that hesperidin with potential biding affinity with plasma protein model and slight induced conformational changes can also show promising anticancer activities against colorectal cancer cells.
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Affiliation(s)
- Ruiming Deng
- Department of Anesthesiology, Ganzhou People's Hospital, Ganzhou 341000, Jiangxi, China.
| | - Yanfang Liu
- The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan, China; Yunnan University, Kunming 650504, Yunnan, China
| | - Xiangyu Wu
- Department of Gastroenterology, The Affiliated Huaian Hospital of Xuzhou Medical University, Huaian 223002, Jiangsu, China
| | - Ning Zhao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Jinhai Deng
- Richard Dimbleby Department of Cancer Research, Comprehensive Cancer Centre, Kings College London, London SE1 1UL, United Kingdom
| | - Teng Pan
- Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen 518172, China
| | - Lulu Cao
- Department of Rheumatology and Immunology, Peking University People's Hospital and Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), Beijing 100044, China
| | - Fangbiao Zhan
- Department of Orthopedics, Chongqing University Three Gorges Hospital, Chongqing University, School of Medicine, Chongqing 404000, China
| | - Xiao Qiao
- Department of Gastroenterology, The Affiliated Huaian Hospital of Xuzhou Medical University, Huaian 223002, Jiangsu, China.
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Li R, Zhang Z, Zhang X, Song J, Wu Y, Wu L, Mao S, Jiang J, Zeng L. Optimizing post-craniotomy recovery: insights from symptom network analysis in primary brain tumor patients. Neurosurg Rev 2024; 47:565. [PMID: 39242405 DOI: 10.1007/s10143-024-02804-3] [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: 06/30/2024] [Revised: 08/24/2024] [Accepted: 09/01/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND Craniotomy to remove brain tumors is an intricate procedure with multiple postoperative symptoms. However, there has been limited research on the symptom networks of these patients. To this end, this study aims to explore these symptom networks, revealing their interplay to inform better symptom control, hasten the discovery of postoperative issues, and tailor Enhanced Recovery After Surgery (ERAS) protocols, all to enhance recovery and enhance patient care. METHODS From September 2023 to March 2024, 211 patients with primary brain tumors who underwent craniotomy at Shanghai Tongji Hospital were recruited. Their symptoms were assessed using the MDASI-BT (M.D. Anderson Symptom Inventory Brain Tumor Module) one day post-craniotomy. The symptom network of 22 symptoms was visualized using R, with central and bridge symptoms identified. RESULTS Sadness (rs=2.482) and difficulty in understanding (rs=1.138) have the highest strength of all symptoms, indicating they are the central symptoms. Sadness (rb=2.155) and loss of appetite (rb=1.828) have the highest value of betweenness, indicating they are the bridge symptoms. Strong correlations were found between difficulty in understanding and difficulty in speaking (r = 0.701), distress and sadness (r = 0.666), fatigue and lethargy (r = 0.632), and nausea and vomiting (r = 0.601). Subgroup analysis revealed that noninvasive tumor patients exhibited similar symptom networks to the overall cohort, whereas invasive tumor patients showed weak symptom connections, resulting in no discernible network. CONCLUSION This study underscores the importance of understanding symptom networks in brain tumor patients post-craniotomy, highlighting key symptom interrelationships. These insights can guide more effective symptom management, early complication detection, and optimization of ERAS protocols, ultimately enhancing recovery and patient care.
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Affiliation(s)
- Rongqing Li
- Department of Neurosurgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Zikai Zhang
- Department of Science Administration, Tongji Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Xin Zhang
- Department of Neurosurgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Jiefang Song
- Department of Neurosurgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
| | - Yawen Wu
- Department of Neurosurgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China
| | - Linzhi Wu
- Department of Neurosurgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China
| | - Sailu Mao
- Department of Neurosurgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China
| | - Jinxia Jiang
- Department of Neurosurgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China.
| | - Li Zeng
- Department of Nursing, Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, People's Republic of China.
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Edwards AL, Trang K, Tolstykh IV, Van Blarigan EL, Van Loon K, Laffan A, Stanfield D, Steiding P, Neuhaus J, Atreya CE, Piawah S, Venook AP, Varma MG. Association between gastrointestinal symptoms and specialty care utilization among colon cancer survivors: a cohort study. Int J Colorectal Dis 2024; 39:130. [PMID: 39138736 PMCID: PMC11322428 DOI: 10.1007/s00384-024-04685-w] [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] [Accepted: 07/08/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE Persistent gastrointestinal (GI) symptoms are frequently experienced by colon cancer survivors and may help identify patients with higher utilization of healthcare services. To assess the relationship between GI symptoms and specialty care utilization among colon cancer survivors. METHODS A prospective longitudinal cohort study at an academic medical center of 126 adults surgically treated for stage I-IV colon cancer between February 2017 and June 2022. Participants reported GI symptoms through the EORTC QLQ-C30 and QLQ-CR29 at enrollment and as frequently as every 6 months for 5 years. Main outcome measures were visits, telephone encounters, and secure messages with a medical provider within specialty oncology clinics within 6 months after each survey completion. Generalized linear mixed regression model for repeated measurements with random trajectory for each participant was performed to estimate the associations between symptoms and healthcare use. Models were adjusted for demographics, clinical and surgical factors, and timing in relation to onset of the COVID-19 pandemic. RESULTS In the 6 months after each survey time point, patients averaged 1.2 visits, 0.5 telephone encounters, and 3.2 patient-initiated messages. In adjusted models, those with any abdominal pain (RR 1.45; p = 0.002), buttock pain (RR 1.30; p = 0.050), or increased stool frequency (RR 1.26; p = 0.046) had more clinic visits in the following 6 months than those without these symptoms. Including these three symptoms in one model revealed that only abdominal pain was statistically significantly associated with increased clinic visits (RR 1.36; p = 0.016). Patients with any blood or mucus in stool (RR 2.46; p = 0.009) had significantly more telephone encounters, and those with any abdominal pain (RR 1.65; p = 0.002) had significantly more patient-initiated messages than those without these symptoms. CONCLUSIONS Our findings identify GI symptoms associated with increased use of oncologic specialty care among colon cancer survivors, with abdominal pain as an important predictor of utilization. IMPLICATIONS FOR CANCER SURVIVORS Early identification and anticipatory management of colon cancer survivors experiencing abdominal pain may decrease healthcare utilization.
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Affiliation(s)
- Anya L Edwards
- Department of Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Karen Trang
- Department of Surgery, University of California, San Francisco, San Francisco, CA, USA
| | - Irina V Tolstykh
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Erin L Van Blarigan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Department of Urology, University of California, San Francisco, San Francisco, CA, USA
| | - Katherine Van Loon
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Angela Laffan
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Dalila Stanfield
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Paige Steiding
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - John Neuhaus
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Chloe E Atreya
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Sorbarikor Piawah
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Alan P Venook
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Madhulika G Varma
- Department of Surgery, University of California, San Francisco, San Francisco, CA, USA.
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Saquetto MB, Machado RM, Bomfim I, Mathias C, Rodrigues de Castro M, Neto MG. Combined exercise on fatigue, quality of life and physical functioning in people under chemotherapy with oxaliplatin: Systematic review and meta-analysis. J Bodyw Mov Ther 2024; 39:654-665. [PMID: 38876699 DOI: 10.1016/j.jbmt.2024.02.004] [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: 04/12/2022] [Revised: 12/07/2023] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE To investigate the effects of combined exercise on fatigue, anxiety, depression, quality of life and physical functioning in gastroinstestinal neoplasm in people under chemotherapy with oxaliplatin treatment. METHODS We searched pubmed/MEDLINE, Cochrane Central Register of Controlled Trials, PEDro data base, and SciELO (until Nov 2023) for randomized controlled trials that investigated the effects of combined exercise in gastroinstestinal neoplasm people under chemotherapy with oxaliplatin treatment. Two comparisons were made: combined exercise versus usual care, combined aerobic and versus usual care (follow up). The main outcomes were muscle strength, aerobic capacity, fatigue, anxiety, depression and quality of life. Mean differences (MD) with 95% confidence interval (CI) were calculated. RESULTS Seven randomized controlled trials met the eligibility criteria, which included 464 people. Compared to usual care, combined aerobic and resistance resulted in decrease of general fatigue (-2.82; IC: 4.92 to -0.69, N = 48), physical fatigue (-5.08; IC: 8.41 to -1.74, N = 48) and improvement of domain physical functioning of quality of life (9.40; IC: 2.74 to 16.06, N = 48). Compared to usual care, combined aerobic and resistance - Follow up resulted in decrease of general fatigue (-2.32; IC: 4.41 to - 0.28, N = 48), physical fatigue (-0.92; IC: 3.31 to -1.47, N = 48) and improvement ofdomain physical functioning of (9.83; IC: 0.66 to 19.01, N = 48). CONCLUSIONS Our results demonstrate that combined exercises improves fatigue (general; physical), domain physical functioning of quality of life in gastrointestinal neoplasm people under chemotherapy treatment when compared to usual care.
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Affiliation(s)
- Micheli Bernardone Saquetto
- Departamento de Fisioterapia, Curso de Fisioterapia da Universidade Federal da Bahia - UFBA, Salvador, BA, Brazil; Grupo de Pesquisa em Fisioterapia - UFBA, Salvador, BA, Brazil; Programa de Pós-Graduação em Medicina e Saúde - UFBA, Salvador, BA, Brazil.
| | | | | | | | - Marcela Rodrigues de Castro
- Núcleo de Pesquisa em Motricidade e Saúde - Departamento de Educação Física da Universidade Federal da Bahia - UFBA, Salvador, BA, Brazil
| | - Mansueto Gomes Neto
- Departamento de Fisioterapia, Curso de Fisioterapia da Universidade Federal da Bahia - UFBA, Salvador, BA, Brazil; Grupo de Pesquisa em Fisioterapia - UFBA, Salvador, BA, Brazil; Programa de Pós-Graduação em Medicina e Saúde - UFBA, Salvador, BA, Brazil
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Kaya A, Tuzcu A. A Bibliometric Analysis of the 36-Year History of Cancer Nursing (1987-2023). Cancer Nurs 2024; 47:252-260. [PMID: 38335453 DOI: 10.1097/ncc.0000000000001324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
BACKGROUND Bibliometric analysis is an effective method for evaluating the publication characteristics and development of a journal. To our knowledge, this study is the first such analysis of the publications in Cancer Nursing . OBJECTIVE This study aimed to analyze the publication characteristics and evolution of Cancer Nursing over a period of 36 years since its inception. METHODS Bibliometric analysis was carried out on 3095 publications. Data were collected from the Web of Science Core Collection database on September 15, 2023. Data analysis was conducted with Web of Science Core Collection, VOSviewer, and Bibliometrix package in R software. RESULTS The results showed a steady increase in the citation and publication structure of Cancer Nursing . "Quality of life" was at the center of the studies, and "quality of life," "women," and "breast cancer" were identified as trend topics. The United States was both at the center of the cooperation network and was the country that contributed the most publications to the journal. CONCLUSION Cancer Nursing has had an increasing contribution to and impact on cancer nursing in terms of the quality and citations of published articles. It was noted that the journal's network of collaboration has expanded globally and that its thematic diversity is high. Although quality of life, women, and breast cancer have been reported extensively, more studies addressing the concepts of "children," "support," and "needs" are needed in the journal. IMPLICATIONS FOR PRACTICE This study not only enriches global readers in the field of cancer nursing but may also be beneficial in providing input to guide future research.
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Affiliation(s)
- Ayla Kaya
- Author Affiliations: Department of Pediatric Nursing (Dr Kaya) and Department of Public Health Nursing (Dr Tuzcu), Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Andreu Y, Soto-Rubio A, Picazo C, Gil-Juliá B, Fernández S, Chulvi R. Risk of cancer-related distress by age in colorectal cancer survivors: The modulatory role of unmet support needs. J Health Psychol 2024:13591053241253358. [PMID: 38898666 DOI: 10.1177/13591053241253358] [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: 06/21/2024] Open
Abstract
To explore the modulating role of unmet support needs on the relationship between age and the prevalence of cancer-related distress in colorectal cancer (CRC) survivors. Two hundred and forty four participants completed the questionnaires; linear regression and odd ratios were calculated. Both the prevalence of needs and their interaction with age were predictors of cancer-related distress. The risk of significant clinically distress associated with physical and socio/family needs was high in both age subgroups. Higher risk of clinical distress was associated with life perspective, sexual, occupational and health care needs in the younger subgroup and with needs for specific support resources in the older subgroup. In reducing cancer-related distress, two key issues arise: (i) the importance of managing the persistent negative symptoms following CRC treatment in survivors of any age and (ii) the need for a differentiated attention to other care needs based on the survivor's age.
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Affiliation(s)
| | | | | | | | | | - R Chulvi
- Medical Oncology Service, Doctor Peset University Hospital, Valencia, Spain
- FISABIO, Valencia, Spain
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7
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Zhou J, Wang Z, Chen X, Lin C, Zhao J, Loke AY, Li Q. Mutual communication intervention for colorectal cancer patient-spousal caregiver dyads: A randomized controlled trial. Br J Health Psychol 2024. [PMID: 38849210 DOI: 10.1111/bjhp.12734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVE Gender could impact the psychosocial outcomes and coping strategies of cancer patients and their spousal caregivers (SCs). This study aims to develop a gender-concerned program for colorectal cancer (CRC) couple-based mutual communication intervention (MCI) and to assess its effectiveness on the intra-couple relationship and the individual functions of the partners. DESIGN A randomized clinical trial with two study groups was utilized. METHODS A total of 144 CRC patients and their SCs were randomly assigned to either MCI or usual care (UC) groups, and all of them were required to complete the measurements at baseline and post-intervention. The primary outcome was for mutual communication, and the secondary outcomes included dyadic coping, relationship satisfaction, anxiety, depression, benefit finding and quality of life. The data were analysed by multi-level modelling. RESULTS The MCI program was feasible and acceptable for Chinese CRC couples and was effective for the improvement of the intra-couple relationship and the individual functions of each partner. CRC patients showed more improvement in mutual communication and dyadic coping than their SCs in the MCI group. Also, this intervention effectiveness was found to be independent of gender. CONCLUSIONS The MCI program is beneficial for Chinese CRC couple's adaptation outcomes. This suggests that clinical medical staff should consider the gender tendency during the implementation of interventions. More researches are needed to extend the application of the MCI program to different participants (e.g. patients with the diagnosis of other types of cancer and their SCs).
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Affiliation(s)
- Junrui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Chunyan Lin
- Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Jie Zhao
- Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon Hong Kong, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
- Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China
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Goode C, Harley J. Treatment trajectories of individuals diagnosed with rectal cancer: an interpretative phenomenological study. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:505-514. [PMID: 38850134 DOI: 10.12968/bjon.2023.0250] [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: 06/10/2024]
Abstract
Rectal cancer affects almost every aspect of an individual's daily life. However, there are gaps in understanding the complete spectrum of experiences spanning from diagnosis to recovery. Therefore, the aim of this study was to explore the treatment trajectories of individuals diagnosed with rectal cancer. Adopting an interpretative phenomenological approach, seven participants were recruited using purposive sampling. Data were collected using semi-structured, in-depth interviews that were digitally recorded, transcribed and analysed using thematic analysis. Study rigour was established following the four-dimension criteria of credibility, dependability, transferability and confirmability. Four prominent themes emerged from the participants' experiences of undergoing rectal cancer treatment: uncovering the inner battles; navigating the physical challenges; anchors of support and conquering the summit. These findings contribute to knowledge and practice by highlighting the importance of providing a comprehensive and individualised treatment plan for individuals that takes account of the physical and psycho-emotional implications of rectal cancer treatment.
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Affiliation(s)
- Catherine Goode
- Colorectal and Stoma Care Nurse Specialist, Colorectal Service, Health & Community Services, St Helier, Jersey
| | - Jacqueline Harley
- Assistant Professor in Health Systems, University College Dublin, Belfield, Dublin, Ireland
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Luo X, Xu H, Zhang Y, Liu S, Xu S, Xie Y, Xiao J, Hu T, Xiao H. Identifying the unmet needs of post-treatment colorectal cancer survivors: A critical literature review. Eur J Oncol Nurs 2024; 70:102570. [PMID: 38574419 DOI: 10.1016/j.ejon.2024.102570] [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: 11/03/2023] [Revised: 03/11/2024] [Accepted: 03/16/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE Following treatment completion, colorectal cancer (CRC) survivors experience various unmet needs. This review aims to synthesize the unmet needs of CRC survivors after treatment and to identify demographic, disease or treatment-related, healthcare-related, and psychosocial factors correlated with unmet needs. METHOD English or Chinese articles that focused on CRC survivors' post-treatment unmet needs were systematically searched from the five electronic databases, which included CINAHL, PubMed, Embase, PsycINFO, and the China Academic Journal Full-text Database, from the launch of databases to July 2023. The reference lists of the subsequent articles were further screened. RESULTS 136 individual needs extracted from 50 manuscripts were classified into nine domains based on the Supportive Care Framework. The top four unmet needs identified by CRC survivors were assistance with fears of cancer recurrence, information about managing illness and side effects at home, emotional or psychological support and reassurance, and help with sexuality problems. Following surgery, CRC survivors showed strong demand in the physical, psychological, and information domains. Survivors completed treatment within 1-year had more diverse needs than those who completed 1-3 years. Unmet needs may be greater among CRC survivors who were young, female, more educated, and unmarried. Furthermore, greater unmet needs were associated with distress, anxiety, depression, and worse quality of life. CONCLUSIONS Despite diverse needs experienced by post-treatment CRC survivors, a predominant focus on fears of cancer recurrence, information, psychological support, and sexuality needs is noted. Future studies should further explore the needs of CRC survivors after specific treatment and in different post-treatment periods.
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Affiliation(s)
- Xingjuan Luo
- School of Basic Medicine, Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Haiying Xu
- Nursing Department, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Yanting Zhang
- School of Basic Medicine, Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Sirun Liu
- School of Basic Medicine, Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Shan Xu
- School of Basic Medicine, Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Yali Xie
- Nursing Department, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Juan Xiao
- Institute of Neuroscience and Brain Diseases, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
| | - Tingting Hu
- Nursing Department, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
| | - Hong Xiao
- Nursing Department, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China.
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10
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Zhang Q, Zhang W, Zhang P, Zhao Z, Yang L, Zheng F, Zhang L, Huang G, Zhang J, Zheng W, Ma R, Yao Z, Hu B. Altered dynamic functional connectivity in rectal cancer patients with and without chemotherapy: a resting-state fMRI study. Int J Neurosci 2024; 134:584-594. [PMID: 36178032 DOI: 10.1080/00207454.2022.2130295] [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: 06/13/2022] [Revised: 08/11/2022] [Accepted: 09/01/2022] [Indexed: 10/17/2022]
Abstract
Purpose: Understanding the mechanism of brain functional alterations in rectal cancer (RC) patients is of great significance to improve the prognosis and quality of life of patients. Additionally, the influence of chemotherapy on brain function in RC patients is still unclear. In this study, we aimed to investigate the alterations of brain functional network dynamics in RC patients and explore the effects of chemotherapy on temporal dynamics of dynamic functional connectivity (DFC). Methods: The group independent component analysis (GICA) and sliding window method were applied to investigate abnormalities of DFC based on resting-state functional magnetic resonance imaging (rs-fMRI) of 18 RC patients without chemotherapy (RC_NC), 21 RC patients with chemotherapy (RC_C) and 33 healthy controls (HC). Then, the Spearman correlation between aberrant properties and clinical measures was calculated. Results: Two discrete states were identified. Compared to HC, RC_NC exhibited increased mean dwell time (MDT) and fractional windows (FW) in state 2 and decreased transition numbers between the two states. Notably, three temporal properties in RC_C showed an intermediate trend in comparison with RC_NC and HC. Furthermore, RC_C also demonstrated abnormal intra- and inter-network connections, involving the visual (VIS), default mode (DM), and cognitive control (CC) networks, and most connections related to VIS were correlated with the severity of anxiety and depression. Conclusions: Our study suggested that abnormal DFC patterns could be manifested in RC patients and chemotherapy would further correct abnormalities of network dynamics, which may provide new insights into the brain functional alterations in patients with RC from the time-varying connectivity perspective.
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Affiliation(s)
- Qin Zhang
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Wenwen Zhang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, PRChina
| | - Pengfei Zhang
- Second Clinical School, Lanzhou University, Lanzhou, PRChina
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, PRChina
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, PRChina
| | - Ziyang Zhao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Lin Yang
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Fang Zheng
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Lingyu Zhang
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Gang Huang
- Department of Radiology, Gansu Provincial Hospital, Lanzhou, PRChina
| | - Jing Zhang
- Second Clinical School, Lanzhou University, Lanzhou, PRChina
- Department of Magnetic Resonance, Lanzhou University Second Hospital, Lanzhou, PRChina
- Gansu Province Clinical Research Center for Functional and Molecular Imaging, Lanzhou, PRChina
| | - Weihao Zheng
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Rong Ma
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Zhijun Yao
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
| | - Bin Hu
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, PR China
- Joint Research Center for Cognitive Neurosensor Technology of Lanzhou University & Institute of Semiconductors, Chinese Academy of Sciences, Lanzhou, PR China
- Engineering Research Center of Open Source Software and Real-Time System (Lanzhou University), Ministry of Education, Lanzhou, PR China
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Cao F, Chen YY, Wang HC. GLI1 and PTTG1 expression in colorectal carcinoma patients undergoing radical surgery and their correlation with lymph node metastasis. World J Gastrointest Surg 2024; 16:1328-1335. [PMID: 38817299 PMCID: PMC11135310 DOI: 10.4240/wjgs.v16.i5.1328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Few studies have investigated the expression of GLI1 and PTTG1 in patients undergoing radical surgery for colorectal carcinoma (CRC) and their association with lymph node metastasis (LNM). Therefore, more relevant studies and analyses need to be conducted. AIM To explore GLI1 and PTTG1 expression in patients undergoing radical surgery for CRC and their correlation with LNM. METHODS This study selected 103 patients with CRC admitted to our hospital between April 2020 and April 2023. Sample specimens of CRC and adjacent tissues were collected to determine the positive rates and expression levels of GLI1 and PTTG1. The correlation of the two genes with patients' clinicopathological data (e.g., LNM) was explored, and differences in GLI1 and PTTG1 expression between patients with LNM and those without were analyzed. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive potential of the two genes for LNM in patients with CRC. RESULTS Significantly higher positive rates and expression levels of GLI1 and PTTG1 were observed in CRC tissue samples compared with adjacent tissues. GLI1 and PTTG1 were strongly linked to LNM in patients undergoing radical surgery for CRC, with higher GLI1 and PTTG1 levels found in patients with LNM than in those without. The areas under the ROC curve of GLI1 and PTTG1 in assessing LNM in patients with CRC were 0.824 and 0.811, respectively. CONCLUSION GLI1 and PTTG1 expression was upregulated in patients undergoing radical surgery for CRC and are significantly related to LNM in these patients. Moreover, high GLI1 and PTTG1 expression can indicate LNM in patients with CRC undergoing radical surgery. The expression of both genes has certain diagnostic and therapeutic significance.
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Affiliation(s)
- Feng Cao
- Department of Care Section, Beijing Geriatric Hospital, Beijing 100095, China
| | - Yang-Yan Chen
- Research Department, Shanghai Zhangjiang Institute of Medical Innovation, Shanghai 200000, China
| | - Hong-Cheng Wang
- Care Department, Beijing Geriatric Hospital, Beijing 100095, China
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12
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Voskanyan V, Marzorati C, Sala D, Grasso R, Pietrobon R, van der Heide I, Engelaar M, Bos N, Caraceni A, Couspel N, Ferrer M, Groenvold M, Kaasa S, Lombardo C, Sirven A, Vachon H, Velikova G, Brunelli C, Apolone G, Pravettoni G. Psychosocial factors associated with quality of life in cancer survivors: umbrella review. J Cancer Res Clin Oncol 2024; 150:249. [PMID: 38727730 PMCID: PMC11087342 DOI: 10.1007/s00432-024-05749-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/10/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Viktorya Voskanyan
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Chiara Marzorati
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - Diana Sala
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Grasso
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | | | - Iris van der Heide
- Nivel, Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Merel Engelaar
- Nivel, Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Nanne Bos
- Nivel, Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Augusto Caraceni
- Dipartimento Di Scienze Cliniche E Di Comunità, Università Degli Studi Di Milano, Milan, Italy
| | | | - Montse Ferrer
- Health Services Research Group, Hospital del Mar Research Institute, Barcelona, Spain
| | - Mogens Groenvold
- Department of Public Health, Bispebjerg Hospital and University of Copenhagen, Copenhagen, Denmark
| | - Stein Kaasa
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Claudio Lombardo
- OECI-EEIG Organisation of European Cancer Institutes-European Economic Interest Grouping, Brussels, Belgium
| | | | | | - Galina Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Cinzia Brunelli
- Scientific Directorate, Fondazione Istituto Di Ricovero E Cura a Carattere Scientifico, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Giovanni Apolone
- Scientific Directorate, Fondazione Istituto Di Ricovero E Cura a Carattere Scientifico, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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13
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Lee LJ, Han CJ, Saligan L, Wallen GR. Comparing symptom clusters in cancer survivors by cancer diagnosis: A latent class profile analysis. Support Care Cancer 2024; 32:308. [PMID: 38662054 PMCID: PMC11045444 DOI: 10.1007/s00520-024-08489-0] [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: 12/07/2023] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE Research on symptom clusters in oncology is progressing, but knowledge gaps remain. One question is whether the number and types of symptom subgroups (i.e., latent classes) differ based on cancer diagnosis. The purpose of this study was to: (1) identify and compare latent class subgroups based on four highly prevalent symptoms (pain, fatigue, sleep disturbance, and depression), and (2) examine the differences in sociodemographic and clinical factors in the identified latent classes across the seven cancer types (i.e., prostate, non-small cell lung, non-Hodgkin's lymphoma, breast, uterine, cervical, and colorectal cancer). METHODS This study is a cross-sectional secondary analysis of data obtained from the My-Health study in partnership with four Surveillance, Epidemiology, and End Results (SEER) cancer registries located in California (two), Louisiana, and New Jersey. The sample included 4,762 cancer survivors 6-13 months following diagnosis of one of the seven cancer types mentioned. Latent class profile analysis was used. RESULTS Subjects were primarily young (59% age 21-64 years), Caucasian (41%), married/cohabitating (58%) and unemployed (55%). The number and types of symptom subgroups varied across these seven cancer populations: four-subgroups were the common in prostate, lung, non-Hodgkin's lymphoma, and breast cancer survivors. Unmarried, low education, and unemployment status were associated with high risk of symptom burden across the cancer types. CONCLUSION Identifying symptom subgroups by cancer diagnosis has the potential to develop innovative and effective targeted interventions in cancer survivors. Further research is needed to establish extensive knowledge in symptom clustering between treatment regimens, and short-term and long-term cancer survivors.
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Affiliation(s)
- Lena J Lee
- National Institutes of Health (NIH) Clinical Center, Bethesda, MD, USA.
| | - Claire J Han
- Ohio State University, College of Nursing, Columbus, OH, USA
| | - Leorey Saligan
- National Institute of Nursing Research (NINR), Bethesda, MD, USA
| | - Gwenyth R Wallen
- National Institutes of Health (NIH) Clinical Center, Bethesda, MD, USA
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14
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Martinez-Calderon J, García-Muñoz C, Heredia-Rizo AM, Cano-García FJ. The prevalence of anxiety and depression in cancer around the world: An overview of systematic reviews evaluating 128 meta-analyses. J Affect Disord 2024; 351:701-719. [PMID: 38311072 DOI: 10.1016/j.jad.2024.01.259] [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: 11/08/2023] [Revised: 01/25/2024] [Accepted: 01/28/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND This overview of systematic reviews with meta-analysis summarized the prevalence of anxiety and depression in different types of tumors around the world. METHODS The quality of reviews was assessed. The degree of overlap between reviews was calculated. The regional prevalence of anxiety and depression was shown in the main text based on the World Health Organization regions. RESULTS Twenty-five reviews including 128 meta-analyses of interest were selected. The pooled prevalence of anxiety in breast tumors was in Africa (19 %), the Americas (38 %), Eastern Mediterranean (56 %), Europe (38 %), South-East Asia (42 %), and Western Pacific (26 %). The pooled prevalence of depression in breast tumors was in Africa (40 %), the Americas (23-25 %), Eastern Mediterranean (49-51 %), Europe (27-29 %), South-East Asia (23-33 %), Western Pacific (29 %). The pooled prevalence of depression in digestive tumors was in the Americas (4-44 %), Eastern Mediterranean (42 %), Europe (20-27 %), South-East Asia (66 %), and Western Pacific (24-40 %). The pooled national prevalence of anxiety and depression was mainly evaluated in China and Iran. LIMITATIONS Important methodological issues were identified. For example, no reviews judged the certainty of evidence. CONCLUSIONS The Eastern Mediterranean region showed the highest prevalence of anxiety and depression for breast tumors. The South-East Asian region showed the highest prevalence of depression for digestive tumors. In these regions, many countries are considered low-income and middle-income countries. Further research funding would help increase the investigation on this topic, which may allow the development of preventive strategies that reduce the prevalence of anxiety and depression.
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Affiliation(s)
- Javier Martinez-Calderon
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain; CTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, Spain
| | - Cristina García-Muñoz
- CTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, Spain; Departamento Ciencias de la Salud y Biomédicas, Universidad Loyola de Andalucía, Sevilla, Spain.
| | - Alberto Marcos Heredia-Rizo
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain; CTS 1110: Understanding Movement and Self in health from Science (UMSS) Research Group, Andalusia, Spain
| | - Francisco Javier Cano-García
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, Universidad de Sevilla, 41018 Sevilla, Spain
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Lorca LA, Ribeiro IL, Pizarro M, Martínez M, Vivallos J. Functional results and feasibility of a teleprehabilitation program in patients who are candidates for elective colorectal cancer surgery during the COVID-19 pandemic. Asia Pac J Clin Oncol 2024; 20:251-258. [PMID: 36698248 DOI: 10.1111/ajco.13939] [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: 05/24/2022] [Revised: 10/14/2022] [Accepted: 01/07/2023] [Indexed: 01/27/2023]
Abstract
AIM To assess the value of a prehabilitation program adapted to the current COVID-19 pandemic using a teleprehabilitation modality in a public Latin American hospital. METHODS The medical records of candidates for elective colorectal cancer surgery (CRC) and who completed a teleprehabiltation program were analyzed. Sociodemographic, clinical, and functional variables were analyzed, such as cardiorespiratory capacity with the sit-to-stand test (STST), independence in activities of daily living with the Barthel index, balance with the five-times STST (FSTST) and fatigue with Brief Inventory Fatigue (BFI). The feasibility of the program was analyzed in terms of recruitment, retention, user satisfaction, and reporting of adverse events. RESULTS Of 107 people recruited, 57 completed the program (54%, 68.78 ± 12.36 years). There was a significant difference in the BFI, FSTST, and STS 1-min scores after the intervention (p < .01), with an effect size (Cliff's delta) that varied between -.13 and .21. There were no differences in the Barthel index score. In relation to the viability of the program, 99% of patients referred for surgery could be recruited into the program, with 53% retention. Regarding user satisfaction with the program, seven items (77.7%) were rated as "very satisfied," and two items (22.3%) as "satisfied." No adverse events were recorded. CONCLUSION The structured prehabilitation program adapted to teleprehabilitation for CRC candidates for surgery was effective in optimizing functional results prior to surgery and was feasible to implement in a public hospital with limited resources during the COVID-19 pandemic.
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Affiliation(s)
- Luz Alejandra Lorca
- Hospital del Salvador, Servicio de Salud Metropolitano Oriente, Santiago de, Chile
| | - Ivana Leao Ribeiro
- Departamento de Kinesiología, Facultad de Ciencias de la Salud, Universidad Católica del Maule, Talca, Chile
| | - Marta Pizarro
- Hospital del Salvador, Servicio de Salud Metropolitano Oriente, Santiago de, Chile
| | - Mónica Martínez
- Hospital del Salvador, Servicio de Salud Metropolitano Oriente, Santiago de, Chile
- Escuela de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Jessica Vivallos
- Hospital del Salvador, Servicio de Salud Metropolitano Oriente, Santiago de, Chile
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Andersen FB, Kjellberg J, Ibsen R, Sternhufvud C, Petersen B. The clinical and economic burden of illness in the first two years after ostomy creation: a nationwide Danish cohort study. Expert Rev Pharmacoecon Outcomes Res 2024; 24:567-575. [PMID: 38433657 DOI: 10.1080/14737167.2024.2324047] [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: 11/09/2023] [Accepted: 02/21/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Living with an ostomy is often associated with costly complications. This study examined the burden of illness the first two years after ostomy creation. METHODS Data from Danish national registries included all adult Danes with an ostomy created between 2002 and 2014. RESULTS Four cohorts consisted, respectively, of 11,385 subjects with a colostomy and 4,574 with an ileostomy, of which 1,663 subjects had inflammatory bowel disease (IBD) and 1,270 colorectal cancer as cause of their ileostomy. The healthcare cost was significantly higher for cases versus matched controls for all cohorts. In the first year, the total healthcare cost per person-year was €27,962 versus €4,200 for subjects with colostomy, €29,392 versus €3,308 for subjects with ileostomy, €15,947 versus €2,216 when IBD was the underlying cause, and €32,438 versus €4,196 when it was colorectal cancer. Healthcare costs decreased in the second year but remained significantly higher than controls. Hospitalization and outpatient services were primary cost drivers, with ostomy-related complications comprising 8-16% of hospitalization expenses. CONCLUSION Compared to controls, subjects with an ostomy bear a significant health and financial burden attributable to ostomy-related complications, in addition to the underlying disease, emphasizing the importance of better ostomy care to enhance well-being and reduce economic strain.
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17
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Smit KC, Derksen JWG, Stellato RK, VAN Lanen AS, Wesselink E, Belt EJT, Balen MCVAN, Coene PPLO, Dekker JWT, DE Groot JW, Haringhuizen AW, VAN Halteren HK, VAN Heek TT, Helgason HH, Hendriks MP, DE Hingh IHJT, Hoekstra R, Houtsma D, Janssen JJB, Kok N, Konsten JLM, Los M, Meijerink MR, Mekenkamp LJM, Peeters KCMJ, Polée MB, Rietbroek RC, Schiphorst AHW, Schrauwen RWM, Schreinemakers J, Sie MPS, Simkens L, Sonneveld EJA, Terheggen F, Iersel LVVAN, Vles WJ, Wasowicz-Kemps DK, DE Wilt JHW, Kok DE, Winkels RM, Kampman E, VAN Duijnhoven FJB, Koopman M, May AM. Determinants of Physical Activity among Patients with Colorectal Cancer: From Diagnosis to 5 Years after Diagnosis. Med Sci Sports Exerc 2024; 56:623-634. [PMID: 38079324 DOI: 10.1249/mss.0000000000003351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2024]
Abstract
INTRODUCTION Physical activity (PA) is associated with higher quality of life and probably better prognosis among colorectal cancer (CRC) patients. This study focuses on determinants of PA among CRC patients from diagnosis until 5 yr postdiagnosis. METHODS Sociodemographic and disease-related factors of participants of two large CRC cohort studies were combined. Moderate-to-vigorous PA during sport and leisure time (MVPA-SL) was measured at diagnosis (T0) and 6, 12, 24, and 60 months (T6 to T60) postdiagnosis, using the SQUASH questionnaire. Mixed-effects models were performed to identify sociodemographic and disease-related determinants of MVPA-SL, separately for stage I-III colon (CC), stage I-III rectal cancer (RC), and stage IV CRC (T0 and T6 only). Associations were defined as consistently present when significant at ≥4 timepoints for the stage I-III subsets. MVPA-SL levels were compared with an age- and sex-matched sample of the general Dutch population. RESULTS In total, 2905 CC, 1459 RC and 436 stage IV CRC patients were included. Patients with higher fatigue scores, and women compared with men had consistently lower MVPA-SL levels over time, regardless of tumor type and stage. At T6, having a stoma was significantly associated with lower MVPA-SL among stage I-III RC patients. Systemic therapy and radiotherapy were not significantly associated with MVPA-SL changes at T6. Compared with the general population, MVPA-SL levels of CRC patients were lower at all timepoints, most notably at T6. CONCLUSIONS Female sex and higher fatigue scores were consistent determinants of lower MVPA-SL levels among all CRC patients, and MVPA-SL levels were lowest at 6 months postdiagnosis. Our results can inform the design of intervention studies aimed at improving PA, and guide healthcare professionals in optimizing individualized support.
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Affiliation(s)
- Karel C Smit
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Jeroen W G Derksen
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Rebecca K Stellato
- Department of Data Science and Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Anne-Sophie VAN Lanen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Eric J Th Belt
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, THE NETHERLANDS
| | | | | | | | | | | | - Henk K VAN Halteren
- Department of Medical Oncology, Admiraal de Ruyter Hospital, Goes, THE NETHERLANDS
| | - Tjarda T VAN Heek
- Department of Surgery, Ziekenhuis Gelderse Vallei, Ede, THE NETHERLANDS
| | - Helgi H Helgason
- Department of Medical Oncology, Haaglanden Medical Center, Den Haag, THE NETHERLANDS
| | - Mathijs P Hendriks
- Department of Medical Oncology, Northwest Clinics, Alkmaar, THE NETHERLANDS
| | | | - Ronald Hoekstra
- Department of Medical Oncology, Ziekenhuisgroep Twente, Hengelo, THE NETHERLANDS
| | - Danny Houtsma
- Department of Medical Oncology, Haga Hospital, Den Haag, THE NETHERLANDS
| | - Johan J B Janssen
- Department of Medical Oncology, Canisius Wilhelmina Hospital, Nijmegen, THE NETHERLANDS
| | - Niels Kok
- Department of Gastrointestinal Oncology, Antoni Van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS
| | | | - Maartje Los
- Department of Medical Oncology, St. Antonius Hospital, Nieuwegein, THE NETHERLANDS
| | - Martijn R Meijerink
- Department of Radiology and Nuclear Medicine, VU Medical Center, Amsterdam, THE NETHERLANDS
| | - Leonie J M Mekenkamp
- Department of Medical Oncology, Medisch Spectrum Twente, Enschede, THE NETHERLANDS
| | - Koen C M J Peeters
- Department of Surgery, Leiden University Medical Center, University of Leiden, Leiden, THE NETHERLANDS
| | - Marco B Polée
- Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, THE NETHERLANDS
| | - Ron C Rietbroek
- Department of Medical Oncology, Rode Kruis Hospital, Beverwijk, THE NETHERLANDS
| | | | - Ruud W M Schrauwen
- Department of Gastroenterology and Hepatology, Bernhoven Hospital, Uden, THE NETHERLANDS
| | | | - Mark P S Sie
- Department of Medical Oncology, ZorgSaam Hospital, Terneuzen, THE NETHERLANDS
| | - Lieke Simkens
- Department of Medical Oncology, Maxima Medical Center, Eindhoven, THE NETHERLANDS
| | | | - Frederiek Terheggen
- Department of Medical Oncology, Bravis Hospital, Roosendaal, THE NETHERLANDS
| | - Liselot Valkenburg-VAN Iersel
- Maastricht University Medical Center, Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University, Maastricht, THE NETHERLANDS
| | - Wouter J Vles
- Department of Surgery, Ikazia Hospital, Rotterdam, THE NETHERLANDS
| | | | - Johannes H W DE Wilt
- Department of Surgery, Radboud University Medical Center, University of Nijmegen, Nijmegen, THE NETHERLANDS
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Renate M Winkels
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | | | - Miriam Koopman
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Anne M May
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
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Kiebach J, de Vries-Ten Have J, van Duijnhoven FJB, Kok DE, van Lanen AS, Kouwenhoven EA, de Wilt JHW, Schrauwen RWM, Kampman E, Winkels RM, Wesselink E. Hematocrit Is Associated with Cancer-Related Fatigue in Colorectal Cancer Survivors: A Longitudinal Analysis. Cancer Epidemiol Biomarkers Prev 2024; 33:411-418. [PMID: 38180352 DOI: 10.1158/1055-9965.epi-23-1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/03/2023] [Accepted: 01/03/2024] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a frequent symptom in colorectal cancer survivors. It is unknown to what extent anemia may contribute to CRF in colorectal cancer survivors. This study aimed to investigate the association between hematocrit, as marker for anemia, and CRF among colorectal cancer survivors from diagnosis until two years thereafter. METHODS The study population included 1,506 newly diagnosed colorectal cancer survivors at any stage of disease from a prospective cohort study. Hematocrit and CRF (EORTC QLQ-C30) were assessed at diagnosis, six months, and two years after diagnosis. Multivariable logistic regression or multivariable linear mixed models were used to assess the associations of hematocrit with CRF prevalence, or CRF severity over time, respectively. RESULTS A low hematocrit (levels <40% men/<36% women) was present in a third of the survivors at diagnosis and six months thereafter, and among 16% two years after diagnosis. The prevalence of CRF was 15% at diagnosis, peaked at 27% at six months, and was 14% two years after diagnosis. Hematocrit was associated with the prevalence of CRF at diagnosis [OR, 0.92; confidence interval (CI), 0.88-0.95], 6 months (OR, 0.89; 95% CI, 0.86-0.92), and 2 years (OR, 0.91; CI, 0.87-0.96) after diagnosis. Lower hematocrit was associated with higher severity of CRF over time (beta-coefficient = 1.3; CI, 1.5-1.1). CONCLUSIONS Lower hematocrit levels were longitudinally associated with a higher prevalence and severity of CRF in colorectal cancer. IMPACT Our findings emphasize the importance of long-term anemia monitoring and a potential role of anemia in CRF among colorectal cancer survivors.
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Affiliation(s)
- Joann Kiebach
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Judith de Vries-Ten Have
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
- Consumption and Healthy Lifestyles Chair group, Wageningen University & Research, Wageningen, the Netherlands
| | | | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Anne-Sophie van Lanen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | | | - Johannes H W de Wilt
- Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ruud W M Schrauwen
- Department of Gastroenterology and Hepatology, Bernhoven, Uden, the Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Renate M Winkels
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
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Niu N, Huang R, Zhao J, Zeng Y. Health benefits of yoga for cancer survivors: An updated systematic review and meta-analysis. Asia Pac J Oncol Nurs 2024; 11:100316. [PMID: 38426042 PMCID: PMC10904170 DOI: 10.1016/j.apjon.2023.100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/08/2023] [Indexed: 03/02/2024] Open
Abstract
Objective To evaluate the effects of yoga on health-related outcomes [i.e., physical function, mental health, and overall quality of life (QOL)] of cancer survivors via a systematic review and meta-analysis of randomized controlled trials (RCTs) over the past 5 years across cancer types. Methods An updated systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RCTs published from January 1, 2018, to February 23, 2023, were searched in five English databases (PubMed, The Cochrane Library, ISI, PsycINFO, and CINAHL), three Chinese databases (Wan Fang, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database), and three English clinical trials registry platforms (International Clinical Trials Registry Platform, ClinicalTrials.gov, and EU Clinical Trials Register). Results A total of 34 RCTs were included in this updated review. Yoga benefited the physical function, mental health, and overall QOL of cancer survivors. The effect size of yoga for most physical and mental health-related outcomes was relatively small, but that for the QOL was generally large. The impact of yoga on the QOL of cancer survivors ranged from moderate to high. Conclusions Yoga has health benefits for cancer survivors and could therefore be used as an optional supportive intervention for cancer-related symptom management.
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Affiliation(s)
- Niu Niu
- Department of Colorectal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Ruirui Huang
- School of Nursing, Hunan University of Medicine, Huaihua, China
| | - Junwen Zhao
- Neonatal Intensive Care Unit, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yingchun Zeng
- School of Medicine, Hangzhou City University, Hangzhou, China
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Dahouri A, Sahebihagh MH, Gilani N. Factors associated with sexual dysfunction in patients with colorectal cancer in Iran: a cross-sectional study. Sci Rep 2024; 14:4915. [PMID: 38418573 PMCID: PMC10901867 DOI: 10.1038/s41598-024-55465-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] [Received: 10/06/2023] [Accepted: 02/23/2024] [Indexed: 03/01/2024] Open
Abstract
Sexual dysfunction is a prevalent issue among individuals diagnosed with colorectal cancer (CRC), significantly impacting their quality of life. However, limited research has explored the factors associated with sexual dysfunction in CRC patients in Iran. This cross-sectional study aimed to identify the demographic factors that may contribute to sexual dysfunction in this population. A cross-sectional study involving CRC patients was conducted from April 1, 2022, to May 1, 2022, in Tabriz, Iran. Ethical approvals were obtained, and convenience sampling was employed at outpatient chemotherapy centers in five Tabriz hospitals. Validated questionnaires, including participants characteristics form, the Female Sexual Function Index (FSFI) for females and International Index of Erectile Function (IIEF) for males, were utilized. Data were analyzed using IBM SPSS Statistics version 24, employing descriptive statistics and stepwise linear regression to assess association between mentioned factors and sexual function. Among 256 participants, 50.4% were males, 49.6% were females, and 80.5% were married. The predominant age range was 50-60 years. The study findings revealed a high prevalence of sexual dysfunction among both female (Mean ± SD: 10.91 ± 8.67, Min-Max: 3.20-33.00) and male (Mean ± SD: 27.64 ± 16.28, Min-Max: 11-62) CRC patients. Factors such as the presence of a colostomy for FSFI (P < 0.001), type of treatment received for both FSFI and IIEF (P < 0.001), type of housing for both FSFI and IIEF (P < 0.001), occupation for FSFI (P < 0.001), presence of other diseases for FSFI (P = 0.047), and time since the last chemotherapy session for FSFI (P = 0.018), Education for IIEF (P = 0.026), and Age for IIEF (P = 0.002) were identified as significant factors of sexual dysfunction. These demographic factors demonstrated varying effects on sexual function, underscoring the complexity of this issue. The results underscore the significance of addressing sexual health concerns in CRC patients and highlight the necessity for tailored interventions to enhance their overall well-being. Healthcare providers should recognize the influence of demographic factors on sexual function and contemplate integrating sexual health assessments and interventions into the care of CRC patients. Further research is needed to comprehend better the underlying mechanisms and devise effective strategies for managing sexual dysfunction in this population.
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Affiliation(s)
- Amirmohammad Dahouri
- Departement of Community Health Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hassan Sahebihagh
- Departement of Community Health Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Neda Gilani
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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21
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Wang S, Song Y, Zhang H, Song J, Guo X, Jiang X. Cancer-Related Fatigue and Its Influencing Factors Among Colorectal Cancer Patients: A Generalized Linear Modeling Approach. Int J Gen Med 2024; 17:579-595. [PMID: 38374816 PMCID: PMC10876184 DOI: 10.2147/ijgm.s447697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/05/2024] [Indexed: 02/21/2024] Open
Abstract
Purpose This study aimed to improve cancer-related fatigue (CRF) and health outcomes of colorectal cancer patients by understanding the status quo of CRF, exploring the relations of coping, anxiety symptoms, depressive symptoms, body image perception and CRF, and also identifying the factors affecting CRF based on a generalized linear modeling approach. Patients and Methods An exploratory cross-sectional study was conducted on 370 colorectal cancer patients at two hospitals in Anhui Province, China, from July 2020 to February 2021. The data were collected by using general information questionnaire, cancer fatigue scale, simplified coping style questionnaire, generalized anxiety disorder-7 scale, patient health questionnaire-9, and body image scale. Descriptive statistics, t-tests, one-way analysis of variance, Pearson correlation analyses, and generalized linear model analyses were applied to analyze the data. Results The average CRF score of the patients was 21.612 (SD=6.160), with a prevalence rate of 69.4% for clinically relevant fatigue. The generalized linear model revealed that: In step 1, gender (female) (B=1.799, Waldχ2=7.506, p=0.006), per capita monthly income (1001-3000 RMB) (B=-1.673, Waldχ2=5.536, p=0.019) and treatment modalities (chemotherapy+others) (B=2.425, Waldχ2=8.211, p=0.004) were related to CRF. In step 2, depressive symptoms (B=1.223, Waldχ2=129.019, p<0.001) and negative coping strategies (B=0.215, Waldχ2=11.347, p=0.001) exhibited significant positive correlations with CRF, positive coping strategies (B=-0.319, Waldχ2=59.175, p<0.001) showed significant negative correlations with CRF; While anxiety symptoms (B=0.162, Waldχ2=1.840, p=0.175) and body image perception (B=0.013, Waldχ2=0.048, p=0.826) had no correlations with CRF. Conclusion The prevalence of CRF was relatively high among colorectal cancer patients. Coping and depressive symptoms were the modifiable influencing factors of CRF. Tailored interventions dedicated to promoting positive coping behavior, diminishing negative coping behavior and reducing depressive symptoms may improve the CRF of patients with colorectal cancer. Healthcare providers working with these patients should receive corresponding education and training in these complementary treatments. Additionally, when developing non-pharmacological interventions, appropriate consideration of the patients' gender, income condition and the type of anticancer treatment is also necessary.
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Affiliation(s)
- Song Wang
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Yuanyuan Song
- Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Huaguo Zhang
- Department of Nursing, Beijing Shijitan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Jing Song
- School of Stomatology, Bengbu Medical University, Bengbu, Anhui, People's Republic of China
| | - Xiaoyan Guo
- Department of Pharmacy, Dezhou Municipal Hospital, Dezhou, Shandong, People’s Republic of China
| | - Xiaolian Jiang
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China
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22
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Rocha HB, Carneiro BC, Vasconcelos PA, Pereira R, Quinta-Gomes AL, Nobre PJ. Promoting Sexual Health in Colorectal Cancer Patients and Survivors: Results from a Systematic Review. Healthcare (Basel) 2024; 12:253. [PMID: 38275533 PMCID: PMC10815307 DOI: 10.3390/healthcare12020253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Colorectal cancer diagnosis and treatment negatively impact sexual health. However, there is still a lack of interventions targeting the sexual healthcare needs of colorectal cancer patients and survivors. This systematic review aimed to identify and summarize the efficacy of available psychological interventions aimed at improving colorectal cancer patients' and survivors' sexual health. METHODS This review followed PRISMA guidelines for systematic reviews. A database search was conducted for studies published until July 2023 on EBSCO Host, Web of Science, PubMed, and the Cochrane Library. Manuscripts were screened according to inclusion and exclusion criteria. The risk of bias was assessed using the Quality Assessment Tool for Quantitative Studies. RESULTS From the 1499 records screened, four studies describing psychological interventions to improve the sexual health of the target population were identified. All studies reported on e-health programs and showed evidence of their efficacy in the improvement of participants' sexual function. The studies presented low scores on the Quality Assessment Tool for Quantitative Studies. CONCLUSIONS Despite the evidence that tele/e-health psychological interventions have the potential to effectively promote sexual health in colorectal cancer patients and survivors, more robust research is needed to allow for generalization. Future research should further assess the efficacy of e-health interventions (eMental Health) in promoting sexual health in patients with colorectal cancer.
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23
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Storey S, Luo X, Ren J, Huang K, Von Ah D. Symptom clusters in breast cancer survivors with and without type 2 diabetes over the cancer trajectory. Asia Pac J Oncol Nurs 2024; 11:100343. [PMID: 38222966 PMCID: PMC10784674 DOI: 10.1016/j.apjon.2023.100343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/10/2023] [Indexed: 01/16/2024] Open
Abstract
Objective This study aimed to investigate symptoms and symptom clusters in breast cancer survivors (BCS) with and without type 2 diabetes across three crucial periods during the cancer trajectory (0-6 months, 12-18 months, and 24-30 months) post-initial chemotherapy. Methods Eight common symptoms in both BCS and individuals with diabetes were identified through natural language processing of electronic health records from January 2007 to December 2018. Exploratory factor analysis was employed to discern symptom clusters, evaluating their stability, consistency, and clinical relevance. Results Among the 4601 BCS in the study, 20% (n = 905) had a diabetes diagnosis. Gastrointestinal symptoms and fatigue were prevalent in both groups. While BCS in both groups exhibited an equal number of clusters, the composition of these clusters differed. Symptom clusters varied over time between BCS with and without diabetes. BCS with diabetes demonstrated less stability (repeated clusters) and consistency (same individual symptoms comprising clusters) than their counterparts without diabetes. This suggests that BCS with diabetes may experience distinct symptom clusters at pivotal points in the cancer treatment trajectory. Conclusions Healthcare providers must be attentive to BCS with diabetes throughout the cancer trajectory, considering intensified and/or unique profiles of symptoms and symptom clusters. Interdisciplinary cancer survivorship models are essential for effective diabetes management in BCS. Implementing a comprehensive diabetes management program throughout the cancer trajectory could alleviate symptoms and symptom clusters, ultimately enhancing health outcomes and potentially reducing healthcare resource utilization.
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Affiliation(s)
- Susan Storey
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Xiao Luo
- Department of Management Science and Information Systems, School of Business, Oklahoma State University, OK, USA
| | - Jie Ren
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine Indianapolis, IN, USA
| | - Kun Huang
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine; Regenstrief Institute, Indianapolis, IN, USA
| | - Diane Von Ah
- College of Nursing, Cancer Research, Center for Healthy Aging, Self-Management and Complex Care, The Ohio State University, Columbus, OH, USA
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24
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Vlaski T, Slavic M, Caspari R, Bilsing B, Fischer H, Brenner H, Schöttker B. From a Clustering of Adverse Symptoms after Colorectal Cancer Therapy to Chronic Fatigue and Low Ability to Work: A Cohort Study Analysis with 3 Months of Follow-Up. Cancers (Basel) 2024; 16:202. [PMID: 38201629 PMCID: PMC10778495 DOI: 10.3390/cancers16010202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
In colorectal cancer (CRC) patients, apart from fatigue, psychological and physical symptoms often converge, affecting their quality of life and ability to work. Our objective was to ascertain symptom clusters within a year following CRC treatment and their longitudinal association with persistent fatigue and reduced work ability at the 3-month follow-up. We used data from MIRANDA, a multicenter cohort study enrolling adult CRC patients who are starting a 3-week in-patient rehabilitation within a year post-curative CRC treatment. Participants completed questionnaires evaluating symptoms at the start of rehabilitation (baseline) and after three months. We performed an exploratory factor analysis to analyze the clustering of symptoms at baseline. Longitudinal analysis was performed using a multivariable linear regression model with dichotomized symptoms at baseline as independent variables, and the change in fatigue and ability to work from baseline to 3-month-follow-up as separate outcomes, adjusted for covariates. We identified six symptom clusters: fatigue, gastrointestinal symptoms, pain, psychosocial symptoms, urinary symptoms, and chemotherapy side effects. At least one symptom from each factor was associated with higher fatigue or reduced ability to work at the 3-month follow-up. This study highlights the interplay of multiple symptoms in influencing fatigue and work ability among CRC patients post-rehabilitation.
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Affiliation(s)
- Tomislav Vlaski
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (T.V.); (M.S.); (H.B.)
- Medical Faculty Heidelberg, Heidelberg University, 69117 Heidelberg, Germany
| | - Marija Slavic
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (T.V.); (M.S.); (H.B.)
| | - Reiner Caspari
- Clinic Niederrhein, 52474 Bad Neuenahr-Ahrweiler, Germany;
| | | | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (T.V.); (M.S.); (H.B.)
- 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; (T.V.); (M.S.); (H.B.)
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Alipourgivi F, Motolani A, Qiu AY, Qiang W, Yang GY, Chen S, Lu T. Genetic Alterations of NF-κB and Its Regulators: A Rich Platform to Advance Colorectal Cancer Diagnosis and Treatment. Int J Mol Sci 2023; 25:154. [PMID: 38203325 PMCID: PMC10779007 DOI: 10.3390/ijms25010154] [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: 10/04/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 01/12/2024] Open
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer mortality in the United States, with an estimated 52,000 deaths in 2023. Though significant progress has been made in both diagnosis and treatment of CRC in recent years, genetic heterogeneity of CRC-the culprit for possible CRC relapse and drug resistance, is still an insurmountable challenge. Thus, developing more effective therapeutics to overcome this challenge in new CRC treatment strategies is imperative. Genetic and epigenetic changes are well recognized to be responsible for the stepwise development of CRC malignancy. In this review, we focus on detailed genetic alteration information about the nuclear factor (NF)-κB signaling, including both NF-κB family members, and their regulators, such as protein arginine methyltransferase 5 (PRMT5), and outer dynein arm docking complex subunit 2 (ODAD2, also named armadillo repeat-containing 4, ARMC4), etc., in CRC patients. Moreover, we provide deep insight into different CRC research models, with a particular focus on patient-derived xenografts (PDX) and organoid models, and their potential applications in CRC research. Genetic alterations on NF-κB signaling components are estimated to be more than 50% of the overall genetic changes identified in CRC patients collected by cBioportal for Cancer Genomics; thus, emphasizing its paramount importance in CRC progression. Consequently, various genetic alterations on NF-κB signaling may hold great promise for novel therapeutic development in CRC. Future endeavors may focus on utilizing CRC models (e.g., PDX or organoids, or isogenic human embryonic stem cell (hESC)-derived colonic cells, or human pluripotent stem cells (hPSC)-derived colonic organoids, etc.) to further uncover the underpinning mechanism of these genetic alterations in NF-κB signaling in CRC progression. Moreover, establishing platforms for drug discovery in dishes, and developing Biobanks, etc., may further pave the way for the development of innovative personalized medicine to treat CRC in the future.
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Affiliation(s)
- Faranak Alipourgivi
- Department of Pharmacology & Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; (F.A.); (A.M.)
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN 46202, USA
| | - Aishat Motolani
- Department of Pharmacology & Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; (F.A.); (A.M.)
| | - Alice Y. Qiu
- Center for Developmental Therapeutics, Chemistry of Life Processes Institute, Northwestern University, Evanston, IL 60208, USA; (A.Y.Q.); (W.Q.)
| | - Wenan Qiang
- Center for Developmental Therapeutics, Chemistry of Life Processes Institute, Northwestern University, Evanston, IL 60208, USA; (A.Y.Q.); (W.Q.)
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA;
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Guang-Yu Yang
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL 60611, USA;
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Shuibing Chen
- Department of Surgery, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA;
| | - Tao Lu
- Department of Pharmacology & Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; (F.A.); (A.M.)
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN 46202, USA
- Department of Biochemistry & Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Department of Medical & Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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26
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Lin Y, Bailey DE, Docherty SL, Porter LS, Cooper B, Paul S, Kober K, Hammer MJ, Wright F, Conley Y, Levine J, Miaskowski C. Distinct morning and evening fatigue profiles in gastrointestinal cancer during chemotherapy. BMJ Support Palliat Care 2023; 13:e373-e381. [PMID: 34049967 PMCID: PMC8627530 DOI: 10.1136/bmjspcare-2021-002914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/08/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Purposes were to identify subgroups of patients with gastrointestinal cancers with distinct morning and evening fatigue severity profiles and evaluate for differences among these subgroups in demographic and clinical characteristics, co-occurring symptoms and quality of life (QOL) outcomes. METHODS Patients with gastrointestinal cancers (n=405) completed questionnaires six times over two cycles of chemotherapy. Latent profile analysis was used to identify distinct morning and evening fatigue profiles. Differences in demographic and clinical characteristics, co-occurring symptoms and QOL outcomes among the subgroups were evaluated using parametric and nonparametric tests. RESULTS Two distinct mornings (ie, low and very high) and three distinct evenings (ie, low, moderate and very high) fatigue classes were identified. Common risk factors for both morning and evening fatigue included younger age, lower performance status, higher comorbidity burden and self-reported depression. Higher levels of morning fatigue were associated with being unmarried, living alone, being unemployed, having a lower income, lack of regular exercise and a self-reported diagnosis of anaemia. Higher levels of evening fatigue were associated with being women, white and having childcare responsibilities. Patients in the very high morning and evening fatigue classes reported higher levels of anxiety, depressive symptoms, sleep disturbance and pain and lower levels of attentional function and poorer QOL. CONCLUSION Findings provide new insights into risk factors for and deleterious effects of morning and evening fatigue in patients with gastrointestinal cancers. Clinicians can use this information to identify high-risk patients and develop individualised interventions for morning and evening fatigue and other co-occurring symptoms.
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Affiliation(s)
- Yufen Lin
- Duke University, Durham, North Carolina, USA
| | | | | | | | - Bruce Cooper
- School of Nursing, University of California, San Francisco, California, USA
| | - Steven Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Kord Kober
- School of Nursing, University of California, San Francisco, California, USA
| | | | - Fay Wright
- New York University, New York, New York, USA
| | - Yvette Conley
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jon Levine
- School of Medicine, University of California, San Francisco, California, USA
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Lemanska A, Harkin A, Iveson T, Kelly C, Saunders M, Faithfull S. The association of clinical and patient factors with chemotherapy-induced peripheral neuropathy (CIPN) in colorectal cancer: secondary analysis of the SCOT trial. ESMO Open 2023; 8:102063. [PMID: 37988949 PMCID: PMC10774973 DOI: 10.1016/j.esmoop.2023.102063] [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: 06/22/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of oxaliplatin. CIPN can impair long-term quality of life and limit the dose of chemotherapy. We investigated the association of CIPN over time with age, sex, body mass index, baseline neuropathy, and chemotherapy regimen in people treated with adjuvant oxaliplatin-containing chemotherapy for colorectal cancer. PATIENTS AND METHODS We carried out secondary analysis of data from the SCOT randomised controlled trial. SCOT compared 3 months to 6 months of oxaliplatin-containing adjuvant chemotherapy in 6088 people with colorectal cancer recruited between March 2008 and November 2013. Two different chemotherapy regimens were used: capecitabine with oxaliplatin (CAPOX) or fluorouracil with oxaliplatin (FOLFOX). CIPN was recorded with the Functional Assessment of Cancer Therapy/Gynaecologic Oncology Group-Neurotoxicity 4 tool in 2871 participants from baseline (randomisation) for up to 8 years. Longitudinal trends in CIPN [averages with 95% confidence intervals (CIs)] were plotted stratified by the investigated factors. Analysis of covariance (ANCOVA) was used to analyse the association of factors with CIPN adjusting for the SCOT randomisation arm and oxaliplatin dose. P < 0.01 was adopted as cut-off for statistical significance to account for multiple testing. RESULTS Patients receiving CAPOX had lower CIPN scores than those receiving FOLFOX. Chemotherapy regimen was associated with CIPN from 6 months (P < 0.001) to 2 years (P = 0.001). The adjusted ANCOVA coefficient for CAPOX at 6 months was -1.6 (95% CIs -2.2 to -0.9) and at 2 years it was -1.6 (95% CIs -2.5 to -0.7). People with baseline neuropathy scores ≥1 experienced higher CIPN than people with baseline neuropathy scores of 0 (P < 0.01 for all timepoints apart from 18 months). Age, sex, and body mass index did not link with CIPN. CONCLUSIONS A neuropathy assessment before treatment with oxaliplatin can help identify people with an increased risk of CIPN. More research is needed to understand the CIPN-inducing effect of different chemotherapy regimens.
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Affiliation(s)
- A Lemanska
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
| | - A Harkin
- Cancer Research UK Glasgow Clinical Trials Unit, Glasgow, UK
| | - T Iveson
- Department of Medical Oncology, University of Southampton, Southampton, UK
| | - C Kelly
- Cancer Research UK Glasgow Clinical Trials Unit, Glasgow, UK
| | | | - S Faithfull
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK; School of Medicine, Trinity College, Dublin, Ireland
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28
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Zhou J, Chen X, Wang Z, Lin C, Zhao J, Loke AY, Li Q. Mutual communication processes within Chinese colorectal cancer patient-spousal caregiver dyads: A qualitative study of taking gender into account. Eur J Oncol Nurs 2023; 67:102427. [PMID: 37879197 DOI: 10.1016/j.ejon.2023.102427] [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: 07/22/2023] [Revised: 09/23/2023] [Accepted: 09/29/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE Mutual communication within cancer couples is a complex process. More research is needed to explore the complex process of mutual communication and its nuances presented by various factors in different culture contexts. Gender, a factor embedded in marital relationships, is an important consideration. We thus aim to explore the mutual communication process within Chinese colorectal cancer couples and take gender into account. METHODS A qualitative study was conducted by interviewing 20 colorectal cancer patients and 15 spousal caregivers. Inductive thematic analysis was used to analyze the transcripts. RESULTS Three themes (mutual communication and support interaction, communication quality, and foundation of mutual communication and collaboration) were developed. Gender was found to have specific impact on emotional disclosure and communication challenges. A preliminary framework of "smile" was constructed to demonstrate the relationship among the three themes and the relationships between the three themes and dyads' psychosocial adaptation to colorectal cancer. CONCLUSIONS Study findings demonstrate complex mutual communication processes within colorectal cancer couples and the impact of gender. The findings will contribute to developing more effective colorectal cancer couple-based mutual communication interventions. Health practitioners are suggested to improve mutual communication within colorectal cancer couples in three aspects: relational topics, emotional disclosure and communication skills. Guiding couples to deal with each theme and the relationship among the themes simultaneously is helpful for them to return and smile to their normal life.
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Affiliation(s)
- Junrui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Chunyan Lin
- Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Jie Zhao
- Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon Hong Kong, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China; Affiliated Hospital, Jiangnan University, Wuxi, Jiangsu Province, China.
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Yazdani A, Shamloo M, Khaki M, Nahvijou A. Use of sentiment analysis for capturing hospitalized cancer patients' experience from free-text comments in the Persian language. BMC Med Inform Decis Mak 2023; 23:275. [PMID: 38031102 PMCID: PMC10685532 DOI: 10.1186/s12911-023-02358-2] [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: 11/17/2022] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
PURPOSE Today, the Internet provides access to many patients' experiences, which is crucial in assessing the quality of healthcare services. This paper introduces a model for detecting cancer patients' opinions about healthcare services in the Persian language, both positive and negative. METHOD To achieve the objectives of this study, a combination of sentiment analysis (SA) and topic modeling approaches was employed. All pertinent comments made by cancer patients were collected from the patient feedback form of the Tehran University of Medical Science (TUMS) Cancer Institute (CI) in Iran, from March to October 2021. Conventional evaluation metrics such as accuracy, precision, recall, and F-measure were utilized to assess the performance of the proposed model. RESULT The experimental findings revealed that the proposed SA model achieved accuracies of 89.3%, 92.6%, and 90.8% in detecting patients' sentiments towards general services, healthcare services, and life expectancy, respectively. Based on the topic modeling results, the topic "Metastasis" exhibited lower sentiment scores compared to other topics. Additionally, cancer patients expressed dissatisfaction with the current appointment booking service, while topics such as "Good experience," "Affable staff", and "Chemotherapy" garnered higher sentiment scores. CONCLUSION The combined use of SA and topic modeling offers valuable insights into healthcare services. Policymakers can utilize the knowledge obtained from these topics and associated sentiments to enhance patient satisfaction with cancer institution services.
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Affiliation(s)
- Azita Yazdani
- Health Information Management Department, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Shamloo
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Khaki
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
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Lukkahatai N, Park J, Jia HM, Martin D, Li J, Sheng JYS, Gill J, Saligan LN, Stearns V, Carducci M. Feasibility of DNA Methylation Age as a Biomarker of Symptoms and Resilience among Cancer Survivors with Multiple Chronic Conditions. Biomedicines 2023; 11:3076. [PMID: 38002076 PMCID: PMC10669866 DOI: 10.3390/biomedicines11113076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
This study aims to examine the feasibility of DNA methylation age as a biomarker for symptoms and resilience in cancer survivors with multiple chronic conditions (MCCs). We included ten participants from our parent study, an ongoing randomized control trial study. Participants' symptoms and resilience were assessed, and peripheral blood was collected. DNA methylation age calculation was performed using DNAge® analysis. Data were analyzed using Spearman's correlation analysis and the Mann-Whitney U test. Participants in the intervention group tended to have a decrease in DNA methylation age and age acceleration after completing an exercise program (mean difference = -0.83 ± 1.26). The change in DNA methylation age was significantly correlated with the change in resilience score (r = -0.897, p = 0.015). The preliminary results suggest that DNA methylation age can be a potential biomarker for improving resilience in cancer survivors with multiple chronic conditions. This finding is limited by the small sample size, and a larger study is needed.
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Affiliation(s)
- Nada Lukkahatai
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA; (D.M.); (J.L.); (J.G.)
| | - Jongmin Park
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan-si 50612, Republic of Korea;
| | - Hejingzi Monica Jia
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Daniel Martin
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA; (D.M.); (J.L.); (J.G.)
| | - Junxin Li
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA; (D.M.); (J.L.); (J.G.)
| | - Jennifer Yeong-Shin Sheng
- Johns Hopkins School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD 21205, USA;
| | - Jessica Gill
- School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA; (D.M.); (J.L.); (J.G.)
| | - Leorey N. Saligan
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Vered Stearns
- School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA (M.C.)
| | - Michael Carducci
- School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA (M.C.)
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Arring N, Barton DL, Reese JB. Clinical Practice Strategies to Address Sexual Health in Female Cancer Survivors. J Clin Oncol 2023; 41:4927-4936. [PMID: 37535889 PMCID: PMC10617876 DOI: 10.1200/jco.23.00523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/13/2023] [Accepted: 06/30/2023] [Indexed: 08/05/2023] Open
Abstract
PURPOSE The objectives of this narrative review are to describe (1) the evidence for interventions addressing four key issues affecting female sexual health in cancer populations (ie, low sexual desire, vulvovaginal symptoms, negative body image, and sexual partner relationships) that are ready or nearly ready for integration into practice and (2) the current state of patient-provider sexual health communication related to female sexual health as these findings could have implications for integrating sexual health into practice. METHODS A narrative review of recent intervention evidence for female cancer survivors' sexual health was conducted. RESULTS Strong evidence was found for behavioral interventions, such as psychosexual counseling and psychoeducation to treat concerns related to sexual health, including desire, body image, and sexual partner relationships. For partnered female survivors, couple-based psychosexual interventions have been found to be effective. There are no proven pharmacologic treatments for sexual-related concerns other than for vulvovaginal atrophy in female cancer survivors. Vaginal nonhormonal and low-dose hormonal agents are effective remedies for vulvovaginal symptoms. Laser treatment has not yet been fully evaluated. Sexual partners are a critical context for sexual health. Despite much need, discussions around this topic continue to be relatively infrequent. Recent technology-based interventions show promise in improving discussions around sexual health. CONCLUSION Effective interventions exist for many sexual health challenges for female survivors although more high-quality intervention research, particularly multimodal interventions, is needed. Many of the effective interventions are nonpharmacologic, and thus, evaluation of the use of digital delivery to improve access to these interventions is needed. Cancer care delivery research is urgently needed to translate existing effective interventions into practice, including strategies to improve patient-provider communication around this topic.
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Affiliation(s)
- Noël Arring
- University of Tennessee College of Nursing, Knoxville, TN
| | | | - Jennifer B. Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA
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de Vries-Ten Have J, Winkels RM, Kampman E, Winkens LHH. Behaviour change techniques used in lifestyle interventions that aim to reduce cancer-related fatigue in cancer survivors: a systematic review. Int J Behav Nutr Phys Act 2023; 20:126. [PMID: 37833784 PMCID: PMC10576285 DOI: 10.1186/s12966-023-01524-z] [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: 07/20/2022] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Lifestyle interventions that target dietary and/or physical activity behaviours may impact cancer-related fatigue in cancer survivors. Changing lifestyle may be especially difficult for cancer survivors suffering from cancer-related fatigue. To increase effectiveness of lifestyle interventions, behaviour change techniques (BCTs) can be applied. The aim of this review is to systematically describe which BCTs are applied in lifestyle interventions targeting cancer-related fatigue among cancer survivors who finished primary treatment. METHODS PubMed, Scopus, PsycINFO, Cochrane Library and Web of Science were searched to identify randomised controlled trials (RCTs) of dietary and/or physical activity interventions targeting cancer-related fatigue in cancer survivors. The BCT taxonomy was used to code the BCTs that were applied in those interventions. BCTs that were reported in at least 25% of effective interventions were indicated as 'promising BCT', but only retained this classification when these BCTs were present in less than 25% of ineffective interventions. RESULTS Twenty-nine RCTs were identified, of which 17 were effective in reducing cancer-related fatigue. The most frequently applied BCTs were Goal setting (behaviour), Instruction on how to perform the behaviour, Demonstration of the behaviour, Behavioural practice/rehearsal, and Credible Source. The BCT 'Generalisation of the target behaviour' was identified as promising. These results should be interpreted with caution as only three studies screened their participants on level of cancer-related fatigue and most studies focused only on physical activity. Furthermore, many studies did not include a measure for actual behaviour change and had no follow-up period after the intervention ended. CONCLUSIONS There is a need for studies that screen their participants on level of cancer-related fatigue and a need for studies that focus more on dietary behaviours as a possible intervention to reduce fatigue. Also, studies should include follow-up timepoints after the interventions ends to examine long-term behaviour change. Future lifestyle interventions should describe interventions in detail to allow for easier coding of BCTs, and report on actual behaviour change following the intervention. Interventions may apply the BCT 'Generalisation of the target behaviour' to incorporate lifestyle behaviours in daily life. This may increase the chance that interventions will effectively reduce cancer-related fatigue.
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Affiliation(s)
- Judith de Vries-Ten Have
- Division of Human Nutrition and Health, Nutrition and Disease Chair Group, Wageningen University and Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands.
- Consumption and Healthy Lifestyles Chair Group, Wageningen University and Research, Hollandseweg 1, 6706 KN, Wageningen, The Netherlands.
| | - Renate M Winkels
- Division of Human Nutrition and Health, Nutrition and Disease Chair Group, Wageningen University and Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Nutrition and Disease Chair Group, Wageningen University and Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - Laura H H Winkens
- Consumption and Healthy Lifestyles Chair Group, Wageningen University and Research, Hollandseweg 1, 6706 KN, Wageningen, The Netherlands
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Ramezanzade Tabriz E, Ramezani M, Heydari A, Aledavood SA, Jamali J. Development and psychometric properties of Health-Promoting Lifestyle Scale in Colorectal Cancer Survivors (HPLS-CRCS): a mixed-method study. BMC Cancer 2023; 23:931. [PMID: 37789256 PMCID: PMC10546727 DOI: 10.1186/s12885-023-11436-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 09/22/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Detecting a health-promoting lifestyle in colorectal cancer (CRC) survivors is of paramount importance to manage disease complications, prevent their recurrence, and enhance survival; however, no specialized tool has yet been provided to measure the lifestyle of these patients. Accordingly, this study aimed to develop and determine the psychometric properties of the Health-Promoting Lifestyle Scale in CRC Survivors (HPLS-CRCS). METHODS This study was a mixed study with an exploratory sequential design in two phases. Concept analysis was performed in the first phase according to Schwartz-Barcott and Kim's (2000) hybrid model to explain the concept, identify dimensions, and generate items. In the second phase, psychometrics including validity (face, content, and construct) and reliability (internal consistency and stability) were determined. Responsiveness, interpretability, ease of use, item weighting, and scale scoring were also determined. RESULTS After explaining the concept, an initial scale encompassing 211 items was developed, content and item analyses were conducted, and the items decreased to 89 items after the face validity assessment. For construct validity, confirmatory factor analysis (CFA) was conducted with a sample size of 500 survivors, and convergent validity was performed for the Persian version of the Health-Promoting Lifestyle Profile II (HPLP-II). Accordingly, 80 items were classified into six factors: activity and rest, spiritual growth, health responsibility, nutrition, interpersonal relationships, and psychological management, with RMSEA = 0.055, χ2/df = 2.484, and χ2 = 6816.516. The reliability of the scale was confirmed, Cronbach's alpha was between 0.865 and 0.928, and the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the minimal important change (MIC), and the smallest detectable change (SDC) were 0.896, 3.36, 13.86, and 19.87, respectively. CONCLUSION The HPLS-CRCS consists of 80 items in six dimensions and is a valid and reliable scale for evaluating the health-promoting lifestyle in CRC survivors. Using this scale to evaluate the healthy lifestyle in these survivors can lead healthcare providers to detect deficiencies and plan the lifestyle of CRC survivors during the post-treatment period.
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Affiliation(s)
- Elahe Ramezanzade Tabriz
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Monir Ramezani
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- School of Nursing and Midwifery, Mashhad University of Medical Sciences, Ebne Sina St, PO Box 9137913199, Mashhad, Iran.
| | - Abbas Heydari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Jamshid Jamali
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Kim YM, Lee JE. Dyadic Effects of Psychological Health on Quality of Life in Patients with Colorectal Cancer and Caregivers: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2023; 39:151477. [PMID: 37495448 DOI: 10.1016/j.soncn.2023.151477] [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: 02/13/2023] [Revised: 05/29/2023] [Accepted: 07/03/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVES This study aimed to review dyadic research on psychological health and health-related quality of life (HRQL) in patients with colorectal cancer (CRC) and caregivers and examine the pooled partner effects and actor effects based on the Actor-Partner Interdependence Model. DATA SOURCES A systematic review and meta-analysis were conducted. We registered our review protocol with PROSPERO (CRD42021258482). Six databases were searched until June 2021 using the following keywords: colorectal neoplasms, caregivers, depression, anxiety, stress, and quality of life. Two reviewers independently screened 1,597 studies that included both CRC patients and family caregivers. Meta-analyses were performed of the partner and actor effects of psychological health on HRQL in CRC. CONCLUSION Eighteen observational studies involving 2,757 patients with CRC and 2,601 caregivers were included. Regarding partner effects, the distress of patients with CRC affected their family caregivers' distress and burden. There were three types of actor effects among patients with CRC and family caregivers: 1) the social support of patients with CRC affects their level of distress; (2) the distress of patients with CRC affects their HRQL; and (3) caregivers' social support affects their level of distress. This study provides the first comprehensive overview of the dyadic relationships between psychological health and HRQL in patients with CRC and their caregivers. IMPLICATIONS FOR NURSING PRACTICE The development of dyadic interventions for improving psychological health is warranted to help both patients with CRC and their family caregivers live with improved HRQL and well-being.
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Affiliation(s)
- Young Man Kim
- Assistant Professor, College of Nursing, Jeonbuk National University, and Reseach Institute of Nursing Science, Jeonbuk National University, Jeonju-si, Republic of Korea
| | - Jung Eun Lee
- Assistant Professor, University of Rhode Island College of Nursing, Kingston, Rhode Island, USA.
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Li X, Hoogland AI, Small BJ, Crowder SL, Gonzalez BD, Oswald LB, Sleight AG, Nguyen N, Lorona NC, Damerell V, Komrokji KR, Mooney K, Playdon MC, Ulrich CM, Li CI, Shibata D, Toriola AT, Ose J, Peoples AR, Siegel EM, Bower JE, Schneider M, Gigic B, Figueiredo JC, Jim HSL. Trajectories and risk factors of fatigue following colorectal cancer diagnosis. Colorectal Dis 2023; 25:2054-2063. [PMID: 37700526 PMCID: PMC10815933 DOI: 10.1111/codi.16746] [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: 04/18/2023] [Revised: 07/08/2023] [Accepted: 08/02/2023] [Indexed: 09/14/2023]
Abstract
AIM This study sought to identify groups of colorectal cancer patients based upon trajectories of fatigue and examine how demographic, clinical and behavioural risk factors differentiate these groups. METHOD Patients were from six cancer centres in the United States and Germany. Fatigue was measured using the fatigue subscale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) at five time points (baseline/enrolment and 3, 6, 12 and 24 months after diagnosis). Piecewise growth mixture models identified latent trajectories of fatigue. Logistic regression models examined differences in demographic, clinical and behavioural characteristics between fatigue trajectory groups. RESULTS Among 1615 participants (57% men, 86% non-Hispanic White, mean age 61 ± 13 years at diagnosis), three distinct groups were identified. In the high fatigue group (36%), fatigue significantly increased in the first 6 months after diagnosis and then showed statistically and clinically significant improvement from 6 to 24 months (P values < 0.01). Throughout the study period, average fatigue met or exceeded cutoffs for clinical significance. In the moderate (34%) and low (30%) fatigue groups, fatigue levels remained below or near population norms across the study period. Patients who were diagnosed with Stage II-IV disease and/or current smokers were more likely to be in the high fatigue than in the moderate fatigue group (P values < 0.05). CONCLUSION A large proportion of colorectal cancer patients experienced sustained fatigue after initiation of cancer treatment. Patients with high fatigue at the time of diagnosis may benefit from early supportive care.
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Affiliation(s)
- Xiaoyin Li
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Aasha I Hoogland
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Sylvia L Crowder
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Laura B Oswald
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Alix G Sleight
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nathalie Nguyen
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nicole C Lorona
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Victoria Damerell
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Khaled R Komrokji
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Kathi Mooney
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Mary C Playdon
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah, USA
| | - Cornelia M Ulrich
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
- Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Christopher I Li
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - David Shibata
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Adetunji T Toriola
- Department of Surgery, Washington University St. Louis, St. Louis, Missouri, USA
| | - Jennifer Ose
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
- Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Anita R Peoples
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
- Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Erin M Siegel
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | | | - Martin Schneider
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Biljana Gigic
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Jane C Figueiredo
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
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Yoon J, Lee H, Son H. Effects of an interactive coaching intervention on quality of life and psychological factors for colorectal cancer survivors: A single group pre and posttest design. Eur J Oncol Nurs 2023; 66:102413. [PMID: 37776600 DOI: 10.1016/j.ejon.2023.102413] [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: 05/23/2023] [Revised: 07/25/2023] [Accepted: 09/07/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE To develop and evaluate the effects of an interactive coaching intervention, using a self-management mobile application, on quality of life and physical and psychological factors for colorectal cancer survivors. METHODS We developed a self-management mobile application providing social support services for post-treatment CRC survivors and evaluated its effects through baseline and post-intervention surveys. Using the biopsychosocial holistic model as the theoretical framework, automated interactive coaching technology was applied for six weeks to provide supportive services tailored for each user. To evaluate the effects of the application, self-efficacy, health practice index, depression, fear of cancer recurrence, and quality of life measures were administered to participants. A total of 34 men and 5 women were included in the analysis. RESULTS Participants' mean age were 54.10 years and 78% of them had been diagnosed within the last five years. There were significant increases in self-efficacy (z = 2.09, p = .04), health practice index (t = 2.35, p = .02), and quality of life (t = 2.03, p = .05). More specifically, the emotional functional score increased (z = 2.23, p = .03) while both of the total symptom score (t = 2.10, p = .04) and the fatigue symptom score (z = 2.54, p = .01) decreased after six weeks of using the mobile application. CONCLUSIONS Interventions supporting colorectal cancer survivors' self-management are critical for addressing the challenges they face after treatment and improving their quality of life. Providing social support through mobile applications could be a good strategy in terms of usability and effectiveness.
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Affiliation(s)
- Jaehee Yoon
- Wolchon Elementary School, 132, Mokdongjungang-ro, Yangcheon-gu, Seoul, 07989, South Korea.
| | - HyunHae Lee
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea
| | - Heesook Son
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, South Korea.
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Choi YY, Rha SY, Park JS, Song SK, Lee J. Cancer coping self-efficacy, symptoms and their relationship with quality of life among cancer survivors. Eur J Oncol Nurs 2023; 66:102373. [PMID: 37499402 DOI: 10.1016/j.ejon.2023.102373] [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: 04/18/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE Cancer coping self-efficacy refers to an individual's confidence in dealing with challenges from cancer-related events, and a positive association with quality of life (QoL) has been demonstrated. Considering unresolved physical and psychological symptoms at the survivorship phase, which are known to worsen QoL, the association between cancer coping self-efficacy and QoL needs to be evaluated controlling for known contributing factors of QoL. This study aimed to describe cancer survivors' cancer coping self-efficacy, symptoms and their relationship with QoL. METHODS A descriptive correlational study was conducted. Participants were cancer survivors who completed intended treatment except for hormone therapy (N = 240). Cancer coping self-efficacy, symptoms, and QoL were measured. To evaluate the association of cancer survivors' cancer coping self-efficacy with QoL, correlation and multiple regression analysis were conducted. RESULTS Cancer coping self-efficacy demonstrated a significant positive association with QoL. Symptoms had a significant negative association with QoL. Fully active cancer survivors demonstrated significantly better QoL than those with functional deterioration. Self-efficacy for using spiritual coping had a significant positive association with QoL, along with symptoms and functional status, which explained 37.5% of QoL. CONCLUSIONS Cancer survivors' QoL was related to spiritual coping self-efficacy, symptoms and functional status. Improving spiritual coping self-efficacy and managing symptoms reflecting survivors' functional status need to be integrated into survivorship care.
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Affiliation(s)
- Yun Young Choi
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, South Korea
| | - Sun Young Rha
- College of Medicine and Yonsei Cancer Center, Yonsei University, Seoul, South Korea; Yonsei Cancer Center, Seoul, South Korea
| | - Ji Soo Park
- College of Medicine and Yonsei Cancer Center, Yonsei University, Seoul, South Korea; Yonsei Cancer Center, Seoul, South Korea
| | | | - Jiyeon Lee
- College of Nursing and Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea.
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Tortosa-Martínez J, Beltrán-Carrillo VJ, Romero-Elías M, Ruiz-Casado A, Jiménez-Loaisa A, González-Cutre D. "To be myself again": Perceived benefits of group-based exercise for colorectal cancer patients. Eur J Oncol Nurs 2023; 66:102405. [PMID: 37708625 DOI: 10.1016/j.ejon.2023.102405] [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: 01/10/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE To explore the perceived benefits of a group-based exercise program for patients with colorectal cancer (CRC) undergoing chemotherapy treatment. METHODS In-depth semi-structured interviews were conducted with all participants (n = 27) at the end of the exercise program (patients, relatives and healthcare professionals). The exercise instructor in charge of the exercise program with CRC patients also collected observational field notes throughout a research diary. RESULTS Three main themes related to exercise as a coping strategy were obtained: (a) physical recovery; (b) psychosocial well-being, and (c) reconnection with their embodied selves and normal lives. Physical recovery included a perceived increase in fitness and a reduction in physical side-effects. Psychosocial well-being included perceived benefits in self-confidence, sense of control, reduced fear, feeling of being useful, sense of achievement, positive thinking and avoiding depression. All the physical and psychosocial benefits helped patients reconnect with their embodied selves, engage in activities practised before the diagnoses, improve their body image, avoid stigma, and increase their social life beyond cancer diagnoses. In this sense, some patients held on to their past selves, trying to keep or recover normality in their lives, while others acknowledged that they might not be the same person anymore, with exercise being part of this new identity. CONCLUSIONS This study shows that exercise is a coping strategy that benefitted CRC patients in several ways related to their physical and psychosocial quality of life.
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Affiliation(s)
- Juan Tortosa-Martínez
- Department of General and Specific Didactics, Area of Physical Education and Sport, Faculty of Education, University of Alicante, Spain
| | | | - María Romero-Elías
- Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Ana Ruiz-Casado
- Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Department of Medical Oncology, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Alejandro Jiménez-Loaisa
- Department of Didactics of Physical Education, Artistic and Music, Faculty of Education of Toledo, University of Castilla-La Mancha, Spain
| | - David González-Cutre
- Department of Sport Sciences, Sports Research Centre, Miguel Hernandez University of Elche, Spain
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Zhou J, Wang Z, Chen X, Li Q. Gender Differences in Psychosocial Outcomes and Coping Strategies of Patients with Colorectal Cancer: A Systematic Review. Healthcare (Basel) 2023; 11:2591. [PMID: 37761788 PMCID: PMC10530630 DOI: 10.3390/healthcare11182591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: Gender is an important factor impacting cancer experience. This review mainly aimed to summarize colorectal cancer (CRC) patients' gender differences in psychosocial outcomes and coping strategies. (2) Methods: Relevant studies were searched for in four electronic databases from 2007 to July 2023. And manual searching was performed on the included studies' reference lists to identify additional eligible studies. (3) Results: A total of 37 eligible articles were included in this review. These studies were conducted in 19 countries, and they targeted CRC patients at various treatment stages. Significant results showed that female patients tended to have more psychological distress, complex social functioning, and less sexual distress and to choose more positive coping strategies than male patients. But there was no gender difference in psychosocial outcomes and/or coping strategies in some studies, which implied that gender similarity also existed. (4) Conclusions: The findings support the fact that there are both gender differences and similarities in CRC patients' psychosocial outcomes and coping strategies. A perspective beyond the simple masculine-feminine binary improved our in-depth understanding of gender tendency. Importantly, taking gender tendency into account is critical for medical staff to provide more personalized support and communication interventions.
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Affiliation(s)
| | | | | | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (J.Z.); (Z.W.); (X.C.)
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Han CJ, Saligan L, Crouch A, Kalady MF, Noonan AM, Lee LJ, Von Ah D. Latent class symptom profiles of colorectal cancer survivors with cancer-related cognitive impairment. Support Care Cancer 2023; 31:559. [PMID: 37668747 DOI: 10.1007/s00520-023-08031-8] [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: 04/06/2023] [Accepted: 08/30/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE Colorectal cancer (CRC) survivors experience cancer-related cognitive impairment and co-occurring symptoms after cancer treatments. There has been little data to inform the risk factors of complex symptom phenotypes in CRC survivors. OBJECTIVES To determine if subgroups of CRC survivors after cancer treatments could be identified based on the cognitive impairment and common co-occurring symptoms (depression, anxiety, sleep disturbance, fatigue, and pain); and to explore risk factors (sociodemographic and clinical characteristics, perceived stress, and social support) of these subgroups. METHODS Latent class profile analysis (LCPA) was used to identify subgroups based on self-reported symptoms in 64 CRC survivors. Cognitive impairment was measured by assessing subjective cognitive function using the Patient-Reported Outcome Measurement Information System (PROMIS) measure. The Kruskal-Wallis test and regression analyses were performed. RESULTS Three distinct latent classes were identified (Class 1: All Low '28.1%'; Class 2: High Psychological Symptoms (depression/anxiety) '25%'; Class 3: High Somatic Symptoms (fatigue, sleep disturbance, and pain) with High Cognitive Impairment'46.9%'). The pain was the most distinguishable symptom across the latent classes. The high symptom burden group was associated with less time since cancer diagnosis, higher perceived stress levels, and poor emotional social support. CONCLUSION Our study adds to the information on interindividual variability in symptom experience of CRC survivors with cognitive impairment. Findings suggest a need for increased attention to screening for co-occurring symptoms (e.g., high pain) and future interventions focused on stress management and social support.
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Affiliation(s)
- Claire J Han
- Center for Healthy Aging, Self-Management and Complex Care, Ohio State University, College of Nursing, Columbus, OH, USA
- Department of Cancer Control Survivorship, Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA
| | - Leorey Saligan
- Symptoms Biology Unit, Division of Intramural Research, National Institute of Nursing Research, National Institutes of Health, 3 Center Drive, Building 3, Room 5E14, Bethesda, MD, 20892, USA
| | - Adele Crouch
- University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
| | - Matthew F Kalady
- Division of Colon and Rectal Surgery, Columbus, OH, USA
- Clinical Cancer Genetics Program, Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA
| | - Anne M Noonan
- GI Medical Oncology Section, GI Oncology Disease Specific Research Group Leader, Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA
| | - Lena J Lee
- Translational Biobehavioral and Health Disparities (TBHD), National Institutes of Health (NIH) Clinical Center, Bethesda, MD, USA
| | - Diane Von Ah
- Center for Healthy Aging, Self-Management and Complex Care, Ohio State University, College of Nursing, Columbus, OH, USA.
- Cancer Survivorship and Control Group, Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, 43210, USA.
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Yang HY, Chang YL, Lin BR, Chou YJ, Shun SC. Cognitive Function in Patients at Different Stages of Treatment for Colorectal Cancer: A Comparative Cross-Sectional Study. Semin Oncol Nurs 2023; 39:151446. [PMID: 37183103 DOI: 10.1016/j.soncn.2023.151446] [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: 10/31/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVES To compare subjective and objective cognitive functions among patients at the following three stages of treatment for colorectal cancer (CRC): new diagnosis (Group A), ≤2 years since chemotherapy completion (Group B), and >2 years since chemotherapy completion (Group C). DATA SOURCES A comparative cross-sectional approach was used in this study. The Functional Assessment of Cancer Therapy-Cognitive Function questionnaire and neuropsychological assessments were used to assess patients' subjective cognitive function, attention, memory, and executive functions. A total of 63 patients with stage I to III CRC were recruited from a medical center in northern Taiwan. We performed one-to-one-to-one propensity score matching to identify 36 individuals as eligible for this study. A generalized estimating equation was used to compare subjective and objective cognitive functions. CONCLUSION We observed no significant between-group differences in subjective cognitive function and objective performance in overall cognition and memory. Group B had significantly longer reaction time in attention and processing speed than did Group A. Adjuvant chemotherapy had significantly deleterious effects on attention and processing speed in patients with CRC. These cognitive symptoms last for approximately 2 years after the completion of chemotherapy. IMPLICATIONS FOR NURSING PRACTICE The early detection of cancer-related cognitive impairment is necessary for managing symptom distress. Future studies with a large sample size and longitudinal design may elucidate the trajectory of specific cognitive functions. Developing nursing interventions aimed at improving attention and executive function in patients with CRC are needed.
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Affiliation(s)
- Hui-Ying Yang
- PhD Candidate, School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Ling Chang
- Professor, Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Been-Ren Lin
- Attending Physician, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; Attending Physician, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yun-Jen Chou
- Assistant Professor, School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shiow-Ching Shun
- Professor, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Lin Y, Porter LS, Chee W, Alese OB, Curseen KA, Higgins MK, Northouse L, Xiao C. A Web-Based Dyadic Intervention to Manage Psychoneurological Symptoms for Patients With Colorectal Cancer and Their Caregivers: Protocol for a Mixed Methods Study. JMIR Res Protoc 2023; 12:e48499. [PMID: 37379055 PMCID: PMC10365620 DOI: 10.2196/48499] [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: 05/05/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Patients with colorectal cancer (CRC) receiving chemotherapy often experience psychoneurological symptoms (PNS; ie, fatigue, depression, anxiety, sleep disturbance, pain, and cognitive dysfunction) that negatively impact both patients' and their caregivers' health outcomes. Limited information is available on PNS management for CRC patient and caregiver dyads. OBJECTIVE The purposes of this study are to (1) develop a web-based dyadic intervention for patients with CRC receiving chemotherapy and their caregivers (CRCweb) and (2) evaluate the feasibility, acceptability, and preliminary effects of CRCweb among patient-caregiver dyads in a cancer clinic. METHODS A mixed methods approach will be used. Semistructured interviews among 8 dyads will be conducted to develop CRCweb. A single-group pre- and posttest clinical trial will be used to examine the feasibility, acceptability, and preliminary effects of the intervention (CRCweb) among 20 dyads. Study assessments will be conducted before (T1) and after intervention (T2). Content analysis will be performed for semistructured interviews. Descriptive statistics will be calculated separately for patients and caregivers, and pre-post paired t tests will be used to evaluate treatment effects. RESULTS This study was funded in November 2022. As of April 2023, we have obtained institutional review board approval and completed clinical trial registration and are currently recruiting patient-caregiver dyads in a cancer clinic. The study is expected to be completed in October 2024. CONCLUSIONS Developing a web-based dyadic intervention holds great promise to reduce the PNS burden in patients with CRC receiving chemotherapy and their caregivers. The findings from this study will advance intervention development and implementation of symptom management and palliative care for patients with cancer and their caregivers. TRIAL REGISTRATION ClinicalTrials.gov NCT05663203; https://clinicaltrials.gov/ct2/show/NCT05663203. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/48499.
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Affiliation(s)
- Yufen Lin
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Laura S Porter
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, NC, United States
| | - Wonshik Chee
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Olatunji B Alese
- Winship Cancer Institute, Emory University, Atlanta, GA, United States
| | | | - Melinda K Higgins
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Laurel Northouse
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Canhua Xiao
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
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Dars S, Buckley E, Beckmann K, Roder D, Banwell H. Development of the consensus-based recommendations for Podiatry care of Neuropathy In Cancer Survivors (PodNICS): a Delphi consensus study of Australian podiatrists. J Foot Ankle Res 2023; 16:33. [PMID: 37291602 PMCID: PMC10251566 DOI: 10.1186/s13047-023-00632-0] [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: 03/13/2023] [Accepted: 05/22/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Chemotherapy Induced Peripheral Neuropathy (CIPN) is the most common presenting side effect of chemotherapy. As a sensory based neuropathy, this condition can persist for a long time after cessation of chemotherapy and impact the quality of life of cancer survivors. Podiatrists in Australia have been managing people with CIPN related lower limb complications, however guidelines on management of CIPN do not exist. The aim of this study was to achieve consensus and agreement of Australian podiatrists on strategies to best manage people presenting with symptoms of CIPN. METHODS An online three-round modified Delphi survey of Australian podiatrists with expertise in CIPN was conducted in line with recommendations for conducting and reporting of Delphi studies (CREDES). Panellists responded to open-ended questions in Round 1, whereupon their responses were themed into statements and analysed for existing consensus. Statements not reaching consensus were returned during Round 2 to seek agreement from responders using a five-point Likert scale and to allow responders to make further comments. For a statement to reach consensus or agreement, 70% or more of panellists needed to make the same comment or agree or strongly agree with the same themed statement. Statements reaching 50 to 69% consensus or agreement were returned to panellists in Round 3 for them to consider their responses in the light of group outcomes. RESULTS Round one resulted in 229 comments from 21 of 26 podiatrists who agreed to participate. These comments were themed into 53 statements with 11 consensus statements accepted. Round 2 resulted in 22 statements reaching agreement, and 15 new statements being generated from 18 comments made by 17 respondents. Round 3 resulted in 11 statements reaching agreement. Outcomes were developed into a set of clinical recommendations for diagnosis and management of people presenting with CIPN. These recommendations provide guidance on 1) identifying common signs and symptoms of CIPN including sensory, motor and autonomic symptoms; 2) diagnosis and assessment of CIPN including neurological, motor and dermatological assessment modalities; and 3) best clinical practice and management strategies for CIPN identified by podiatrists including both podiatry and non-podiatry specific care. CONCLUSIONS This is the first study in podiatry literature to develop expert-informed consensus-based recommendations for clinical presentation, diagnosis and assessment and management of people with CIPN. These recommendations aim to help guide podiatrists in the consistent care of people with CIPN.
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Affiliation(s)
- Sindhrani Dars
- Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, 5001, Australia.
| | - Elizabeth Buckley
- Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, 5001, Australia
| | - Kerri Beckmann
- Cancer Epidemiology and Population Health Research Group and Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, 5001, Australia
| | - David Roder
- Cancer Epidemiology and Population Health Research Group and Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, 5001, Australia
| | - Helen Banwell
- Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, 5001, Australia
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Avisar A, Cohen M, Aharon A, Katz R, Bar-Sela G. Positive affect and fatigue as predictors of anti-inflammatory IL-10 concentrations among colorectal cancer patients during adjuvant chemotherapy. J Psychosom Res 2023; 167:111162. [PMID: 36796157 DOI: 10.1016/j.jpsychores.2023.111162] [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] [Received: 06/25/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/30/2023]
Abstract
OBJECTIVES (1) To examine the relationships of positive and negative affect and symptoms of depression, anxiety, and fatigue at baseline with the anti-inflammatory cytokine IL-10 concentrations in serum at three points in colorectal cancer patients; and (2) to assess the relationship between these factors and disease recurrence or mortality after a median follow-up of 24 months. METHODS In a prospective trial, 92 stage II or III colorectal cancer patients scheduled to receive standard chemotherapy were enrolled. Blood samples were collected prior to start of chemotherapy onset (T0), 3 months later (T1), and upon chemotherapy completion (T2). RESULTS IL-10 concentrations were similar across the time points. Linear mixed-effects model analysis showed that controlling for confounders, higher positive affect and lower fatigue pretreatment (T0) predicted IL-10 concentrations across the time points (estimate = 0.18, SE = 0.08, 95% CI = 0.03, 0.34, p < .04 and estimate = -0.25, SE = 0.12, 95% CI = -0.50, 0.01, p < .04, respectively). Depression at T0 significantly predicted higher disease recurrence and mortality (estimate = 0.17, SE = 0.08, adjusted OR = 1.18, 95% CI = 1.02, 1.38, p = .03). CONCLUSIONS We report on associations not previously assessed between positive affect and fatigue and the anti-inflammatory cytokine IL-10. Results add to previous findings suggesting that positive affect and fatigue could have a role in anti-inflammatory cytokine dysregulation.
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Affiliation(s)
- Adva Avisar
- The Graduate Studies Authority, University of Haifa, Haifa, Israel
| | - Miri Cohen
- School of Social Work, University of Haifa, Haifa, Israel
| | - Anat Aharon
- Hematology Research Laboratory, Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rina Katz
- Clinical Immunology and Tissue Typing Lab, Rambam Health Care Campus, Haifa, Israel
| | - Gil Bar-Sela
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Cancer Center, Emek Medical Center, Afula, Israel.
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Melhem SJ, Nabhani-Gebara S, Kayyali R. Cancer literacy among Jordanian colorectal cancer survivors and informal carers: Qualitative explorations. Front Public Health 2023; 11:1116882. [PMID: 37020817 PMCID: PMC10067669 DOI: 10.3389/fpubh.2023.1116882] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/01/2023] [Indexed: 03/22/2023] Open
Abstract
IntroductionCancer patients face a variety of challenges in understanding their diagnosis and treatment options. Making informed decisions requires health literacy. There is scant research on how colorectal cancer (CRC) survivors and their caregivers engage with healthcare systems and obtain cancer-related knowledge to maintain proper health literacy, which is crucial for enhancing their outcomes.Materials and methodsIn-depth semi-structured interviews (IDIs) with CRC survivors (n = 15) and online focus groups (FG) with informal caregivers (ICs) were held in Amman between Jan-June 2020. In-depth interviews were conducted using semi-structured interview protocol that addressed the healthcare experience of CRC cancer survivors. FGs evaluated ICs' perspectives of e-health for cancer care support. IDIs and FGs were done in the local Jordanian Arabic dialect, which was then translated into English. Transcribed audio-recordings were thematically coded and framework analysis was used.ResultsThe findings are organized around a central concept of “exploring the level of literacy and its impact.” From the overarching theme, three themes and subthemes emerged, including: (1) The current state of counseling and information provision, (2) The impact of lack of information, awareness, and literacy and (3) The health system's influence on literacy.ConclusionsPoor cancer literacy hinders patients throughout their cancer journey. Empowering cancer patients is crucial for a more timely and positive patient experience. Increased cancer literacy together with the creation of health-literate organizations and systems have the potential to improve patients' treatment throughout the continuum of care.
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46
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Chou YJ, Wang YC, Lin BR, Shun SC. Resilience process in individuals with colorectal cancer: a qualitative study. Qual Life Res 2023; 32:681-690. [PMID: 36050622 DOI: 10.1007/s11136-022-03242-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Resilience is a positive outcome in giving individuals strength to adapt to cancer and have better various aspects of health-related quality of life. However, research focusing on resilience in relation to colorectal cancer (CRC) is limited. Therefore, the aim of this study was to explore the process of resilience in individuals with CRC. METHOD Sixteen individuals diagnosed with stage Ι to III CRC within the last five years were recruited from a CRC surgical outpatient department in a medical center in Northern Taiwan. Semi-structured interviews were used to explore the resilience process of living with CRC. Recorded interviews were transcribed verbatim and were analyzed using modified grounded theory. FINDINGS Resilience is a dynamic three-phase process, including impact of CRC, adaptation or maladaptation following CRC, and growth from CRC experience. Resilience strategies (i.e., attitude adjustment, developing personal strategies to conquer CRC and side effects, setting new goals in life, and viewing death as a normal process), avoidance behaviors, and passive waiting strategy were shown across the resilience process. CONCLUSIONS All individuals showed negative impacts during CRC diagnosis and treatments, but some individuals used the resilience strategies in helping to promote positive adjustment and redirect to develop their resilience process. Furthermore, resilient and maladaptive individuals may change the situation depending on which strategies are used and on the progression of CRC because resilience is dynamic. Oncology clinicians should help individuals use resilience strategies to smoothly go through the resilience process.
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Affiliation(s)
- Yun-Jen Chou
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ya-Ching Wang
- School on Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Been-Ren Lin
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.,College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shiow-Ching Shun
- School of Nursing, Institute of Clinical Nursing, National Yang Ming Chiao Tung University, No.155, Sec.2, Li-Nong Street, Taipei, 112, Taiwan.
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Haas S, Mikkelsen AH, Kronborg CJS, Oggesen BT, Møller PF, Fassov J, Frederiksen NA, Krogsgaard M, Graugaard-Jensen C, Ventzel L, Christensen P, Emmertsen KJ. Management of treatment-related sequelae following colorectal cancer. Colorectal Dis 2023; 25:458-488. [PMID: 35969031 DOI: 10.1111/codi.16299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 02/08/2023]
Abstract
AIM Colorectal cancer survivors are one of the most rapidly growing groups of patients living with and beyond cancer. In a national multidisciplinary setting, we have examined the extent of late treatment-related sequelae in colorectal cancer survivors and present the scientific evidence for management of these conditions in this patient category with the aim of facilitating identification and treatment. METHOD A systematic search for existing guidelines and relevant studies was performed across 16 and 4 databases, respectively, from inception to 2021. This yielded 13 guidelines and 886 abstracts, of which 188 were included in the finalized guideline (231 included for full text review). Secondarily, bibliographies were cross-referenced and 53 additional articles were included. RESULTS Symptoms have been divided into overall categories including psychosocial, bowel-related, urinary, sexual (male and female), pain/neuropathy and fatigue symptoms or complaints that are examined individually. Merging and grading of data resulted in 22 recommendations and 42 management strategies across categories. Recommendations are of a more general character, whereas management strategies provide more practical advice suited for initiation on site before referral to specialized units. CONCLUSION Treatment-related sequelae in colorectal cancer survivors are common and attention needs to be focused on identifying patients with unmet treatment needs and the development of evidence-based treatment algorithms.
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Affiliation(s)
- Susanne Haas
- Department of Surgery, Danish Cancer Society National Research Center for Survivorship and Late Adverse Effects Following Pelvic Organ Cancer, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgery, Randers Regional Hospital, Randers, Denmark
| | | | | | | | - Pia F Møller
- Department of Surgery, Vejle Hospital, Vejle, Denmark
| | - Janne Fassov
- Department of Surgery, Danish Cancer Society National Research Center for Survivorship and Late Adverse Effects Following Pelvic Organ Cancer, Aarhus University Hospital, Aarhus, Denmark
- Department of Gastroenterology and Hepatology, Aarhus University Hospital, Aarhus, Denmark
| | | | | | | | - Lise Ventzel
- Department of Oncology, University Hospital of Southern Denmark, Vejle, Denmark
| | - Peter Christensen
- Department of Surgery, Danish Cancer Society National Research Center for Survivorship and Late Adverse Effects Following Pelvic Organ Cancer, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Katrine Jøssing Emmertsen
- Department of Surgery, Danish Cancer Society National Research Center for Survivorship and Late Adverse Effects Following Pelvic Organ Cancer, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgery, Randers Regional Hospital, Randers, Denmark
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Wang L, Langlais C, Kenfield SA, Van Loon K, Laffan A, Atreya CE, Chan JM, Zhang L, Allen IE, Miaskowski C, Fukuoka Y, Meyerhardt JA, Venook AP, Van Blarigan EL. Quality of life among colorectal cancer survivors participating in a pilot randomized controlled trial of a web-based dietary intervention with text messages. Support Care Cancer 2023; 31:155. [PMID: 36763183 PMCID: PMC9918568 DOI: 10.1007/s00520-023-07620-x] [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: 09/13/2022] [Accepted: 01/29/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE We aimed to estimate the effect of a 12-week web-based dietary intervention with text messages on quality of life (QoL) among colorectal cancer (CRC) survivors. METHODS Between 2017 and 2018, 50 CRC survivors were randomized (1:1) to receive a 12-week web-based dietary intervention with daily text messages or wait-list control. Health-related QoL was assessed using the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and colorectal quality of life module (QLQ-CR29) at baseline, 12, and 24 weeks. Within- and between-group mean changes in health-related QoL with 95% confidence intervals (CI) were calculated for both arms. RESULTS Compared to the controls, participants receiving the intervention had an improvement in emotional functioning (mean change: 14.3; 95% CI: 3.0, 25.6) at 12 weeks and social functioning (mean change: 13.8; 95% CI: 2.1, 25.5) at 24 weeks. A decrease of fatigue from baseline was also observed in the intervention arm (mean change: - 9.1; 95% CI: - 17.1, - 1.1) at 24 weeks. No other changes in QoL scores were associated with the intervention. CONCLUSION CRC survivors randomized to receive a web-based dietary intervention with text messages experienced higher emotional and social functioning. Further study with a larger population may be warranted. TRIAL REGISTRATION clinicaltrials.gov, NCT02965521. Registered 16 November 2016, https://clinicaltrials.gov/ct2/keydates/NCT02965521.
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Affiliation(s)
- Lufan Wang
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Crystal Langlais
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- IQVIA, Durham, NC, USA
| | - Stacey A Kenfield
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Department of Urology, University of California, San Francisco, UCSF, San Francisco, CA, USA
| | - Katherine Van Loon
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Angela Laffan
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
| | - Chloe E Atreya
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - June M Chan
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Department of Urology, University of California, San Francisco, UCSF, San Francisco, CA, USA
| | - Li Zhang
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Isabel E Allen
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Christine Miaskowski
- Department of Physiologic Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Yoshimi Fukuoka
- Department of Physiologic Nursing, University of California, San Francisco, San Francisco, CA, USA
| | | | - Alan P Venook
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Erin L Van Blarigan
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
- Department of Urology, University of California, San Francisco, UCSF, San Francisco, CA, USA.
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Kriel SA, Paterson C. Providing Leadership Through Patients as Partners: Improving Australian Colorectal Survivorship Care Through Perspectives from a Nurse Who Became a Cancer Patient. Semin Oncol Nurs 2023; 39:151360. [PMID: 36424249 DOI: 10.1016/j.soncn.2022.151360] [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] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To provide contemporary real-world, real-life insights into gaps in supportive care experiences for people affected by colorectal cancer. For the first time, this article includes a patient as a coauthor, with the aim to identify future priorities to improve care and recovery in colorectal cancer survivorship. DATA SOURCES Electronic databases, peer-reviewed literature, and real-life professional and personal experiences were used. CONCLUSION There are several problematic areas in providing supportive care for people affected by colorectal cancer that could be improved by wider access to colorectal specialist nurses, coordinated multidisciplinary teams, patient collaboration, linking survivorship care outcomes to national standards, and developing supported self-management care plans. IMPLICATIONS FOR NURSING PRACTICE A patient-led insight has underscored some fundamental failings in current service delivery among people affected by colorectal cancer. Partnering with consumers in research and service redesign is essential to stratify future priorities to optimize care and person-centered recovery.
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Affiliation(s)
- Sally-Anne Kriel
- Founder, Awakened Mumma Wellness; Clinical Nurse Consultant, Moderator of 'The Movement' for Bowel Cancer Australia.
| | - Catherine Paterson
- Faculty of Health, School of Nursing, Midwifery & Public Health, University of Canberra, ACT, Australia; SYNERGY Nursing & Midwifery Research Centre, ACT Health Directorate, Garran, ACT, Australia; School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Garthdee, Aberdeen, Scotland; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research group, University of Canberra, Canberra ACT, Australia
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50
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Han CJ, Reding KW, Kalady MF, Yung R, Greenlee H, Paskett ED. Factors associated with long-term gastrointestinal symptoms in colorectal cancer survivors in the women's health initiatives (WHI study). PLoS One 2023; 18:e0286058. [PMID: 37205667 DOI: 10.1371/journal.pone.0286058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/08/2023] [Indexed: 05/21/2023] Open
Abstract
PURPOSE Colorectal cancer (CRC) survivors often experience long-term symptoms after cancer treatments. But gastrointestinal (GI) symptom experiences are under-investigated in CRC survivors. We described persistent GI symptoms after cancer treatments in female CRC survivors and assessed GI symptoms' risk and life-impact factors. METHODS A cross-sectional study utilized data from the Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study that recruited postmenopausal women. Correlation analyses and multivariable linear regression models were used. RESULTS CRC survivors after cancer treatments were included (N = 413, mean age 71.2 years old, mean time since diagnosis = 8.1 years). 81% of CRC survivors experienced persistent GI symptoms. Bloating/gas was the most prevalent (54.2%± 0.88) and severe GI symptom, followed by constipation (44.1%±1.06), diarrhea (33.4%±0.76), and abdominal/pelvic pain (28.6%±0.62). Significant risk factors for GI symptoms include time since cancer diagnosis (<5 years), advanced cancer stage, high psychological distress, poor dietary habits, and low physical activity. Fatigue and sleep disturbance were the most significant risk factors for long-term GI symptoms (β = 0.21, t = 3.557; β = 0.20, t = 3.336, respectively, Ps < .001). High severity of GI symptoms was positively associated with poor quality of life (QOL), increased daily life interferences (social and physical functions), and low body image satisfaction (Ps < .001). CONCLUSIONS Women CRC survivors experience a high GI symptom burden, highlighting the need to inform policy and improve the QOL of cancer survivors. Our findings will aid in identifying those more vulnerable to symptoms, and inform future survivorship care interventions (i.e., community-based cancer symptom management) by considering multiple risk factors (e.g., psychological distress).
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Affiliation(s)
- Claire J Han
- Center for Healthy Aging, Self-Management and Complex Care, Ohio State University, College of Nursing, Columbus, OH, United States of America
- Department of Cancer Control Survivorship, Ohio State University Comprehensive Cancer Center, Columbus, OH, United States of America
| | - Kerryn W Reding
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle, WA, United States of America
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Matthew F Kalady
- Division of Colon and Rectal Surgery, Clinical Cancer Genetics Program, Ohio State University Comprehensive Cancer Center, Columbus, OH, United States of America
| | - Rachel Yung
- Fred Hutchinson Cancer Research Center, Clinical Research Division, University of Washington School of Medicine, Medical Oncology, Seattle, WA, United States of America
| | - Heather Greenlee
- Cancer Prevention Program, Public Health Sciences and Clinical Research Divisions, Fred Hutchinson Cancer Center, Seattle, WA, United States of America
- Department of Medical Oncology, University of Washington School of Medicine, Seattle, WA, United States of America
| | - Electra D Paskett
- Department of Internal Medicine in the College of Medicine, Ohio State University, Columbus, OH, United States of America
- Division of Epidemiology in the College of Public Health, Ohio State University, Columbus, OH, United States of America
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