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Rodrigues B, Carraça EV, Francisco BB, Nobre I, Cortez-Pinto H, Santos I. Theory-based physical activity and/or nutrition behavior change interventions for cancer survivors: a systematic review. J Cancer Surviv 2023:10.1007/s11764-023-01390-5. [PMID: 37133640 DOI: 10.1007/s11764-023-01390-5] [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: 02/10/2023] [Accepted: 04/19/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Theory-based interventions aimed at promoting health behavior change in cancer survivors seem to be effective but remain scarce. More information on intervention features is also needed. This review aimed to synthesize the evidence from randomized controlled trials evaluating the efficacy of theory-based interventions (and its features) on physical activity (PA) and/or diet behaviors in cancer survivors. METHODS A systematic search in three databases (PubMed, PsycInfo, and Web of Science) identified studies that (i) targeted adult cancer survivors and (ii) included theory-based randomized controlled trials designed to influence PA, diet, or weight management. A qualitative synthesis of interventions' effectiveness, extensiveness of theory use, and applied intervention techniques was conducted. RESULTS Twenty-six studies were included. Socio-Cognitive Theory was the most used theory, showing promising results in PA-only trials and mixed findings in multiple-behavior interventions. Mixed findings were observed for interventions based on the Theory of Planned Behavior and Transtheoretical Model. Limited findings were found in diet-only interventions. A large variability in the extensiveness of theory use, and in intervention techniques was found. Further research is required to understand how and why these interventions offer promise for improving behavior. CONCLUSIONS Theory-based interventions seem to improve PA and diet behaviors in cancer survivors. Further studies, including thorough intervention descriptions, are needed to confirm these findings and identify the optimal features and content of lifestyle theory-based interventions for cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS This systematic review can contribute to the development of more effective interventions to promote long-term adherence to healthy lifestyle behaviors.
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Affiliation(s)
- Bruno Rodrigues
- Centro de Investigação em Atividade Física, Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Eliana V Carraça
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisboa, Portugal
| | - Beatriz B Francisco
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
| | - Inês Nobre
- Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | - Helena Cortez-Pinto
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
- Clínica Universitária de Gastrenterologia, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
- Departamento de Gastrenterologia, CHULN - Hospital de Santa Maria, Lisboa, Portugal
| | - Inês Santos
- Centro de Investigação em Desporto, Educação Física, Exercício e Saúde (CIDEFES), Universidade Lusófona, Lisboa, Portugal.
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal.
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
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Yamamoto Y, Okawa M, Suzuki K, Tateya I, Yoshimura M, Fushimi Y, Kato ET, Yoshida K, Miyamoto S. Continuous and Early Progression of Carotid Intima-Media Thickness after Radiotherapy for Head and Neck Cancer: 5-Year Prospective Observational Study. Cerebrovasc Dis 2023; 52:543-551. [PMID: 36716719 PMCID: PMC10627489 DOI: 10.1159/000528622] [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: 07/12/2022] [Accepted: 11/28/2022] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Radiation-induced carotid artery stenosis (RI-CS) is known as one of long-term side effects of radiotherapy for head and neck cancer (HNC). However, the clinical time course after irradiation has been poorly understood. We aimed to investigate the natural history of radiation-induced carotid atherosclerosis, comparing the patients who received radiotherapy for HNC with the patients who were treated without radiotherapy. METHODS The patients who received treatment of HNC at Department of Otolaryngology, Head and Neck Surgery of Kyoto University Hospital, from November 2012 to July 2015 were enrolled. The patients were assigned into the RT group and the control group, depending on whether radiotherapy was planned or not. Annual carotid ultrasound was performed from the enrollment to 5 years. The increase of mean intima-media thickness (IMT) at common carotid artery from the enrollment (Δmean IMT) was evaluated. RESULTS Fifty-six patients in the RT group and 25 patients in the control group were enrolled. From 5-year follow-up data, the significant higher increase of Δmean IMT was consistently observed in the RT group than in the control group after 2 years. The RT group presented a 7.8-fold increase of mean IMT compared to the control group (0.060 mm per year in the RT group and 0.008 mm per year in the control group). Cumulative incidence curves obtained from the analysis of all vessels revealed that the RT group presented higher incidence of Δmean IMT ≥0.25 mm than the control group (p < 0.01). In the RT group, the patients with mean IMT ≥1.0 mm at enrollment exhibited significantly higher incidence of Δmean IMT ≥0.25 mm than the patients with mean IMT <1.0 mm (p < 0.01). DISCUSSION Radiotherapy for HNC induces continuous carotid mean IMT progression. The irradiated carotid arteries with mean IMT ≥1.0 mm before radiotherapy presented earlier IMT progression than those with mean IMT <1.0 mm.
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Affiliation(s)
- Yu Yamamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Neurosurgery, Japanese Red Cross Fukui Hospital, Fukui, Japan
| | - Masakazu Okawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keita Suzuki
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ichiro Tateya
- Department of Otolaryngology - Head and Neck Surgery, Fujita Health University, Toyoake, Japan
| | - Michio Yoshimura
- Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Eri Toda Kato
- Department of Clinical Laboratory Medicine Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Kaur H, Hoenemeyer T, Parrish KB, Demark-Wahnefried W. Dietary Supplement Use among Older Cancer Survivors: Socio-Demographic Associations, Supplement Types, Reasons for Use, and Cost. Nutrients 2022; 14:3402. [PMID: 36014907 PMCID: PMC9414522 DOI: 10.3390/nu14163402] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 11/29/2022] Open
Abstract
Most Americans take dietary supplements (DSs) and use is even higher among cancer survivors. This secondary analysis seeks to identify types, reasons, and costs of supplements used by 367 older cancer survivors enrolled in the Harvest for Health vegetable gardening trial and evaluate associations between supplement intake and medical/socio-demographic factors. Descriptive statistics were used to identify supplement type and reasons for use. Average market price was used to estimate cost. Fifty-nine percent of the sample reported supplement use. Female (OR 2.11, 95% CI 1.35-3.30), non-Hispanic White (OR 1.77, 95% CI 1.05-3.0), and breast and gynecological survivors (OR 1.57, 1.03-2.38) were significantly more likely to report DS use compared to males, minorities, and survivors of other cancers. Use of vitamins (39%), multivitamins (23%), and minerals (12%) were the most prevalent. Commonly reported reasons for supplement use were to improve general health (47%) or treat medical conditions (39%) and cancer-related symptoms (12%). DSs daily costs ranged from USD 0.02 to 19.81, with a mean of USD 1.28 ± 1.74, a median of USD 0.78, and a mode of USD 0.34. DS use is prevalent among older cancer survivors, with overall health reported as the leading reason for use. Out-of-pocket recurrent costs can be substantial and underscore the need to promote a nutrient-rich diet whenever possible in this vulnerable population.
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Affiliation(s)
- Harleen Kaur
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA
| | - Teri Hoenemeyer
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA
| | - Kelsey B. Parrish
- Department of Health Behavior, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA
- O’Neal Comprehensive Cancer Center at University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA
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Kim H, Yoo S, Kim H, Park SG, Son M. Cancer Survivors with Low Hand Grip Strength Have Decreased Quality of Life Compared with Healthy Controls: The Korea National Health and Nutrition Examination Survey 2014-2017. Korean J Fam Med 2021; 42:204-211. [PMID: 34038988 PMCID: PMC8164921 DOI: 10.4082/kjfm.20.0060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/12/2020] [Accepted: 06/25/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Cancer survivors experience decreased physical function and reduced muscle strength, which leads to lower quality of life (QOL). The hand grip strength (HGS) can be a predictor of poor health-related QOL as a parameter of sarcopenia. The purpose of this study was to investigate the relationship between low HGS and QOL in cancer survivors and healthy controls. METHODS We analyzed 392 cancer survivors and 1,176 healthy controls from the Korea National Health and Nutrition Examination Survey, 2014-2017. We defined low HGS as 2 standard deviation values for healthy young Korean adults from a previous study. QOL was evaluated using the European Quality of Life Scale-Five Dimensions. A complex sample logistic regression model was used to assess the relationship between each dimension of low HGS and QOL. RESULTS The odds ratios (ORs) for decreased QOL were significantly higher in male cancer survivors with low HGS on self-care (OR, 8.51; 95% confidence interval [CI], 1.69-42.83) and usual activities (OR, 6.63; 95% CI, 1.22-36.03). The ORs for problems in mobility (OR, 5.87; 95% CI, 2.04-16.91), usual activities (OR, 14.46; 95% CI, 3.84-54.44), pain/discomfort (OR, 4.90; 95% CI, 2.00-12.01), and anxiety/depression (OR, 6.43; 95% CI, 2.16-19.12) were significantly high in female cancer survivors with low HGS. However, healthy controls showed no significant relationship between low HGS and QOL. CONCLUSION For cancer survivors, low HGS was associated with poor QOL in some domains. Strategies to increase muscle strength must be considered to improve the QOL of cancer survivors.
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Affiliation(s)
- Hyunji Kim
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Sunmi Yoo
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hyoeun Kim
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Seung Guk Park
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Minkyu Son
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, Korea
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Meng X, Wang X, Dong Z. Impact of non-pharmacological interventions on quality of life, anxiety, and depression scores in patients with colorectal cancer: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer 2021; 29:5635-5652. [PMID: 33786669 DOI: 10.1007/s00520-021-06185-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/24/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE Different non-pharmacological interventions have been considered and applied to patients with colorectal cancer to improve their quality of life and distress symptoms; however, there is little evidence comparing the effectiveness of these strategies. This review aimed at assessing the effect of non-pharmacological interventions on quality of life, anxiety, and depression scores among patients with colorectal cancer. METHODS A systematic search for articles published until August 1, 2020, in the English language was performed in Medline, EMBASE, Web of Science, and the Cochrane Library; the reference lists of eligible articles were scanned for other potentially eligible publications. A meta-analysis was performed using random-effects models to estimate pooled effect sizes. RESULTS Twenty studies were included, representing a total of 3438 patients with colorectal cancer. Non-pharmacological interventions were associated with a significant reduction in anxiety (standardized mean difference [SMD] = - 0.157; 95% confidence interval [CI], - 0.312-[- 0.002]) and depression (SMD = - 0.207; 95% CI, - 0.390-[- 0.024]) scores during 5-8 months of follow-up. Subgroup analyses revealed that interventions delivered face-to-face improved patients' quality of life during 1-4 months of follow-up. Moreover, interventions delivered face-to-face but without a behavioral component were associated with improved anxiety scores, whereas interventions with a behavioral component improved the depression scores during 5-8 months of follow-up. CONCLUSIONS Non-pharmacological interventions were associated with reduced anxiety and depression scores, whereas interventions delivered face-to-face were associated with improved quality of life scores in patients with colorectal cancer. Given the few studies and patients included in this meta-analysis, these conclusions should be interpreted with caution.
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Affiliation(s)
- Xinyu Meng
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Xiaodong Wang
- Gastrointestinal Surgery Center of West China Hospital, Sichuan University, Chengdu, China
| | - Zaiquan Dong
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, China.
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Heers H, Netsch C, Wilhelm K, Secker A, Kurtz F, Spachmann P, Viniol S, Hofmann R, Hegele A. Diagnosis, Treatment, and Outcome of Arterioureteral Fistula: The Urologist's Perspective. J Endourol 2018; 32:245-251. [DOI: 10.1089/end.2017.0819] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Hendrik Heers
- Department of Urology and Paediatric Urology, Philipps-Universität Marburg, Marburg, Germany
| | | | - Konrad Wilhelm
- Department of Urology, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany
| | - Armin Secker
- Department of Urology, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Florian Kurtz
- Department of Urology, Technische Universität München, Munich, Germany
| | - Philipp Spachmann
- Department of Urology, Krankenhaus St. Josef, University of Regensburg, Regensburg, Germany
| | - Simon Viniol
- Department of Diagnostic and Interventional Radiology, Philipps-Universität Marburg, Marburg, Germany
| | - Rainer Hofmann
- Department of Urology and Paediatric Urology, Philipps-Universität Marburg, Marburg, Germany
| | - Axel Hegele
- Department of Urology and Paediatric Urology, Philipps-Universität Marburg, Marburg, Germany
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8
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Inhestern L, Geertz W, Schulz-Kindermann F, Bergelt C. Parental cancer: Characteristics of users of child-centred counselling versus individual psycho-oncological treatment. Psychooncology 2017; 27:955-961. [PMID: 29280241 DOI: 10.1002/pon.4618] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/01/2017] [Accepted: 12/12/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The aims of this study were to investigate the characteristics of users of a specific child-centred counselling service (COSIP) and to compare those to parents using an individual psycho-oncological treatment (PO). METHODS We conducted a retrospective analysis on data of users of COSIP and users of PO. Database was the routine assessment (demographic and disease-related characteristics, GAD-7, PHQ-9, EORTC QLQ-C30, and current concerns) of an outpatient psycho-oncological clinic with additional child-centred counselling. A total of 151 patients and 49 partners with children ≤21 years were included. We conducted descriptive analyses and group comparisons. RESULTS Fifty-nine patients and partners used COSIP only or additionally to individual psycho-oncological service. PO users were more depressed and were more anxious than COSIP users. Patients using PO reported worse emotional functioning than patients using COSIP. Partners using PO reported worse global quality of life and more symptoms of fatigue than partners using COSIP. With regard to current concerns, patients using COSIP reported child-related issues more frequently than PO users. PO users reported symptoms of anxiety, depressive symptoms, or exhaustion more frequently than COSIP users. CONCLUSIONS The findings demonstrate that patients and partners self-referring to PO or COSIP are highly burdened. COSIP users experience different psychosocial burden than PO users. As poor mental state of parents is a risk factor for the development of mental problems in children, parents using only PO may benefit from additional child-centred support. Accordingly, the need for COSIP should be assessed continuously during PO of patients with children ≤21 years.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wiebke Geertz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frank Schulz-Kindermann
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Duncan M, Moschopoulou E, Herrington E, Deane J, Roylance R, Jones L, Bourke L, Morgan A, Chalder T, Thaha MA, Taylor SC, Korszun A, White PD, Bhui K. Review of systematic reviews of non-pharmacological interventions to improve quality of life in cancer survivors. BMJ Open 2017; 7:e015860. [PMID: 29187408 PMCID: PMC5719270 DOI: 10.1136/bmjopen-2017-015860] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Over two million people in the UK are living with and beyond cancer. A third report diminished quality of life. DESIGN A review of published systematic reviews to identify effective non-pharmacological interventions to improve the quality of life of cancer survivors. DATA SOURCES Databases searched until May 2017 included PubMed, Cochrane Central, EMBASE, MEDLINE, Web of Science, the Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. STUDY SELECTION Published systematic reviews of randomised trials of non-pharmacological interventions for people living with and beyond cancer were included; included reviews targeted patients aged over 18. All participants had already received a cancer diagnosis. Interventions located in any healthcare setting, home or online were included. Reviews of alternative therapies or those non-English reports were excluded. Two researchers independently assessed titles, abstracts and the full text of papers, and independently extracted the data. OUTCOMES The primary outcome of interest was any measure of global (overall) quality of life. ANALYTICAL METHODS Quality assessment assessing methdological quality of systematic reviews (AMSTAR) and narrative synthesis, evaluating effectiveness of non-pharmacological interventions and their components. RESULTS Of 14 430 unique titles, 21 were included in the review of reviews. There was little overlap in the primary papers across these reviews. Thirteen reviews covered mixed tumour groups, seven focused on breast cancer and one focused on prostate cancer. Face-to-face interventions were often combined with online, telephone and paper-based reading materials. Interventions included physical, psychological or behavioural, multidimensional rehabilitation and online approaches. Yoga specifically, physical exercise more generally, cognitive behavioural therapy (CBT) and mindfulness-based stress reduction (MBSR) programmes showed benefit in terms of quality of life. CONCLUSIONS Exercise-based interventions were effective in the short (less than 3-8 months) and long term. CBT and MBSR also showed benefits, especially in the short term. The evidence for multidisciplinary, online and educational interventions was equivocal.
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Affiliation(s)
- Morvwen Duncan
- Academic Psychological Medicine, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Elisavet Moschopoulou
- Centre for Psychiatry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Eldrid Herrington
- Blizard Institute, National Bowel Research Centre, Queen Mary University of London, London, UK
- Department of Colorectal Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Jennifer Deane
- Academic Psychological Medicine, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Rebecca Roylance
- University College Hospitals, NHS Foundation Trust and UCLH Biomedical Research Centre, London, UK
| | - Louise Jones
- Marie Curie Palliative Research Department, Division of Psychiatry, University College Medical School, London, UK
| | - Liam Bourke
- Cancer Research Group, Sheffield Hallam University, Sheffield, UK
- Health & Wellbeing, Sheffield Hallam University, Sheffield
| | - Adrienne Morgan
- Centre for Tumour Biology, Barts Cancer Institute – Queen Mary University of London, London, UK
| | - Trudie Chalder
- Department of Psychological Medicine, King’s College London, Denmark Hill, King’s College, London, UK
| | - Mohamed A Thaha
- Blizard Institute, National Bowel Research Centre, Queen Mary University of London, London, UK
- Department of Colorectal Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Stephanie C. Taylor
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK
| | - Ania Korszun
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Peter D. White
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kamaldeep Bhui
- Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Ritvo P, Obadia M, Santa Mina D, Alibhai S, Sabiston C, Oh P, Campbell K, McCready D, Auger L, Jones JM. Smartphone-Enabled Health Coaching Intervention (iMOVE) to Promote Long-Term Maintenance of Physical Activity in Breast Cancer Survivors: Protocol for a Feasibility Pilot Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e165. [PMID: 28838886 PMCID: PMC5590009 DOI: 10.2196/resprot.6615] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 12/22/2016] [Accepted: 03/25/2017] [Indexed: 12/12/2022] Open
Abstract
Background Although physical activity has been shown to contribute to long-term disease control and health in breast cancer survivors, a majority of breast cancer survivors do not meet physical activity guidelines. Past research has focused on promoting physical activity components for short-term breast cancer survivor benefits, but insufficient attention has been devoted to long-term outcomes and sustained exercise adherence. We are assessing a health coach intervention (iMOVE) that uses mobile technology to increase and sustain physical activity maintenance in initially inactive breast cancer survivors. Objective This pilot randomized controlled trial (RCT) is an initial step in evaluating the iMOVE intervention and will inform development of a full-scale pragmatic RCT. Methods We will enroll 107 physically inactive breast cancer survivors and randomly assign them to intervention or control groups at the University Health Network, a tertiary cancer care center in Toronto, Canada. Participants will be women (age 18 to 74 years) stratified by age (55 years and older/younger than 55 years) and adjuvant hormone therapy (AHT) exposure (AHT vs no AHT) following breast cancer treatment with no metastases or recurrence who report less than 60 minutes of preplanned physical activity per week. Both intervention and control groups receive the 12-week physical activity program with weekly group sessions and an individualized, progressive, home-based exercise program. The intervention group will additionally receive (1) 10 telephone-based health coaching sessions, (2) smartphone with data plan, if needed, (3) supportive health tracking software (Connected Wellness, NexJ Health Inc), and (4) a wearable step-counting device linked to a smartphone program. Results We will be assessing recruitment rates; acceptability reflected in selective, semistructured interviews; and enrollment, retention, and adherence quantitative intervention markers as pilot outcome measures. The primary clinical outcome will be directly measured peak oxygen consumption. Secondary clinical outcomes include health-related quality of life and anthropometric measures. All outcome measures are administered at baseline, after exercise program (month 3), and 6 months after program (month 9). Conclusions This pilot RCT will inform full-scale RCT planning. We will assess pilot procedures and interventions and collect preliminary effect estimates. Trial Registration ClinicalTrials.gov NCT02620735; https://clinicaltrials.gov/ct2/show/NCT02620735 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT02620735)
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Affiliation(s)
- Paul Ritvo
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Maya Obadia
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Daniel Santa Mina
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Shabbir Alibhai
- General Internal Medicine, University Health Network, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Catherine Sabiston
- Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Kristin Campbell
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - David McCready
- Surgical Oncology, University Health Network, Toronto, ON, Canada.,Division of Surgery, University of Toronto, Toronto, ON, Canada
| | - Leslie Auger
- Kinesiology Program, University of Guelph-Humber, Toronto, ON, Canada
| | - Jennifer Michelle Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Intracranial multiple myeloma may imitate subdural hemorrhage: How to overcome diagnostic limitations and avoid errors in treatment. Neurol Neurochir Pol 2017; 51:252-258. [DOI: 10.1016/j.pjnns.2017.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/23/2017] [Indexed: 10/19/2022]
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12
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Hiyoshi A, Fall K, Bergh C, Montgomery S. Comorbidity trajectories in working age cancer survivors: A national study of Swedish men. Cancer Epidemiol 2017; 48:48-55. [PMID: 28365446 DOI: 10.1016/j.canep.2017.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/09/2017] [Accepted: 03/10/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND A large proportion of cancer survivors are of working age, and maintaining health is of interest both for their working and private life. However, patterns and determinants of comorbidity over time among adult cancer survivors are incompletely described. We aimed to identify distinct comorbidity trajectories and their potential determinants. METHODS In a cohort study of Swedish men born between 1952 and 1956, men diagnosed with cancer between 2000 and 2003 (n=878) were matched with cancer-free men (n=4340) and followed over five years after their first year of survival. Comorbid diseases were identified using hospital diagnoses and included in the analysis using group-based trajectory modelling. The association of socioeconomic and developmental characteristics were assessed using multinomial logit models. RESULTS Four distinct comorbidity trajectories were identified. As many as 84% of cancer survivors remained at very low levels of comorbidity, and the distribution of trajectories was similar among the cancer survivors and the cancer-free men. Increases in comorbidity were seen among those who had comorbid disease at baseline and among those with poor summary disease scores in adolescence. Socioeconomic characteristics and physical, cognitive and psychological function were associated with types of trajectory in unadjusted models but did not retain independent relationships with them after simultaneous adjustment. CONCLUSIONS Among working-age male cancer survivors, the majority remained free or had very low levels of comorbidity. Those with poorer health in adolescence and pre-existing comorbid diseases at cancer diagnosis may, however, benefit from follow-up to prevent further increases in comorbidity.
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Affiliation(s)
- Ayako Hiyoshi
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Cecilia Bergh
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden.
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; The Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, United Kingdom.
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McCabe MS, Pickard TA. Planning for the future: the role of nurse practitioners and physician assistants in survivorship care. Am Soc Clin Oncol Educ Book 2016:e56-61. [PMID: 24451832 DOI: 10.14694/edbook_am.2012.32.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The number of cancer survivors in the United States now approaches 12 million individuals, with an estimated 7.2% of the general population aged 18 years or older reporting a previous cancer diagnosis. These figures highlight a number of questions about the care of survivors-how patients at risk for a known set of health problems should be followed, by whom, and for how long. At the same time that oncologists are developing strategies to provide services to this growing population, there are economic and systems challenges that have relevance to the previous questions, including a predicted national shortage of physicians to provide oncology services. Nurse practitioners (NPs) and physician assistants (PAs) have been identified as members of the health care team who can help reduce the oncology supply and demand gap in a number of ways. The ASCO Study of Collaborative Practice Arrangements (SCPA) in 2011 concluded that oncology patients were aware and satisfied when their care was provided by NPs and PAs; there was an increase in productivity in practices that utilized NPs and PAs; utilizing the full scope of practice of NPs and PAs was financially advantageous; and, physicians, NPs, and PAs are highly satisfied with their collaborative practices. Increasingly, the oncology and health policy literature contains evidence supporting innovative provider models. There is still much work to be done to move beyond pilot data to establish the true value of these models.
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Affiliation(s)
- Mary S McCabe
- From the Memorial Sloan-Kettering Cancer Center and University of Texas M. D. Anderson Cancer Center
| | - Todd Alan Pickard
- From the Memorial Sloan-Kettering Cancer Center and University of Texas M. D. Anderson Cancer Center
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Westfall MY, Overholser L, Zittleman L, Westfall JM. Cancer Survivorship for Primary Care Annotated Bibliography. J Cancer Policy 2015; 4:7-12. [PMID: 26114091 DOI: 10.1016/j.jcpo.2015.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Long-term cancer survivorship care is a relatively new and rapidly advancing field of research. Increasing cancer survivorship rates have created a huge population of long-term cancer survivors whose cancer-specific needs challenge healthcare infrastructure and highlight a significant deficit of knowledge and guidelines in transitional care from treatment to normalcy/prolonged survivorship. As the paradigm of cancer care has changed from a fixation on the curative to the maintenance on long-term overall quality of life, so to, has the delineation of responsibility between oncologists and primary care physicians (PCPs). As more patients enjoy long-term survival, PCPs play a more comprehensive role in cancer care following acute treatment. To this end, this annotated bibliography was written to provide PCPs and other readers with an up-to-date and robust base of knowledge on long-term cancer survivorship, including definitions and epidemiological information as well as specific considerations and recommendations on physical, psychosocial, sexual, and comorbidity needs of survivors. Additionally, significant information is included on survivorship care, specifically Survivorship Care Plans (SPCs) and their evolution, utilization by oncologists and PCPs, and current gaps, as well as an introduction to patient navigation programs. Given rapid advancements in cancer research, this bibliography is meant to serve as current baseline reference outlining the state of the science.
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Affiliation(s)
- Matthew Y Westfall
- High Plains Research Network, University of Colorado at Denver, Aurora, CO
| | - Linda Overholser
- Department of Medicine, University of Colorado at Denver, Aurora, CO
| | - Linda Zittleman
- High Plains Research Network, University of Colorado at Denver, Aurora, CO
| | - John M Westfall
- High Plains Research Network, University of Colorado at Denver, Aurora, CO ; Colorado HealthOP, Denver, CO
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Mehnert A, Hartung T. Psychoonkologische Versorgungsforschung. DER NERVENARZT 2015; 86:258, 260-2, 264-5. [DOI: 10.1007/s00115-014-4151-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rose T, Caracciolo J, Gatenby R. Cancer survivorship, a unique and growing cohort in medical practice: radiology perspective. Am J Med 2013; 126:759-67. [PMID: 23870789 DOI: 10.1016/j.amjmed.2013.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 03/15/2013] [Accepted: 03/18/2013] [Indexed: 12/30/2022]
Abstract
The unique medical and psychologic burdens of cancer survivorship have only recently been recognized. This rapidly expanding cohort of patients will be seen increasingly by non-oncology physicians who must consider medical issues related to their cancer or its therapy for any presenting symptoms. Appropriate use of clinical imaging is essential for diagnosing treatment-related complications, recurrent tumor, or emergence of second primaries. This article will review clinical imaging in common medical problems uniquely found in cancer survivors.
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Affiliation(s)
- Trevor Rose
- Department of Radiology, Moffitt Cancer Center, Tampa, FL 33612, USA.
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Kjær T, Bøje CR, Olsen MH, Overgaard J, Johansen J, Ibfelt E, Steding-Jessen M, Johansen C, Dalton SO. Affiliation to the work market after curative treatment of head-and-neck cancer: a population-based study from the DAHANCA database. Acta Oncol 2013; 52:430-9. [PMID: 23282115 DOI: 10.3109/0284186x.2012.746469] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Survivors of squamous cell carcinoma of the head and neck (HNSCC) are more severely affected in regard to affiliation to the work market than other cancer survivors. Few studies have investigated associations between socioeconomic and disease-related factors and work market affiliation after curative treatment of HNSCC. We investigated the factors for early retirement pension due to disability and unemployment in patients who had been available for work one year before diagnosis. METHODS In a nationwide, population-based cohort study, data on 2436 HNSCC patients treated curatively in 1992-2008 were obtained from the Danish Head and Neck Cancer Group database and linked to Danish administrative population-based registries to obtain demographic and socioeconomic variables. We used multivariate logistic regression models to assess associations between socioeconomic factors (education, income and cohabitating status), cancer-specific variables such as tumour site and stage, comorbidity, early retirement pension and unemployment, with adjustment for age, gender and year of diagnosis. RESULTS Short education [odds ratio (OR) 4.8; 95% confidence interval (CI) 2.2-10.4], low income (OR 3.2; 95% CI 1.8-5.8), living alone (OR 3.0; 95% CI 2.1-4.4) and having a Charlson comorbidity index score of 3 or more (OR 5.9; 95% CI 3.1-11) were significantly associated with early retirement overall and in all site groups. For the subgroup of patients who were employed before diagnosis, the risk pattern was similar. Tumour stage was not associated with early retirement or unemployment. CONCLUSIONS Cancer-related factors were less strongly associated with early retirement and unemployment than socioeconomic factors and comorbidity. Clinicians treating HNSCC patients should be aware of the socioeconomic factors related to work market affiliation in order to provide more intensive social support or targeted rehabilitation for this patient group.
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Affiliation(s)
- Trille Kjær
- Survivorship, Danish Cancer Society Research Center, Denmark.
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Mehnert A, Koch U, Schulz H, Wegscheider K, Weis J, Faller H, Keller M, Brähler E, Härter M. Prevalence of mental disorders, psychosocial distress and need for psychosocial support in cancer patients - study protocol of an epidemiological multi-center study. BMC Psychiatry 2012; 12:70. [PMID: 22747671 PMCID: PMC3434016 DOI: 10.1186/1471-244x-12-70] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 07/02/2012] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Empirical studies investigating the prevalence of mental disorders and psychological distress in cancer patients have gained increasing importance during recent years, particularly with the objective to develop and implement psychosocial interventions within the cancer care system. Primary purpose of this epidemiological cross-sectional multi-center study is to detect the 4-week-, 12-month-, and lifetime prevalence rates of comorbid mental disorders and to further assess psychological distress and psychosocial support needs in cancer patients across all major tumor entities within the in- and outpatient oncological health care and rehabilitation settings in Germany. METHODS/DESIGN In this multicenter, epidemiological cross-sectional study, cancer patients across all major tumor entities will be enrolled from acute care hospitals, outpatient cancer care facilities, and rehabilitation centers in five major study centers in Germany: Freiburg, Hamburg, Heidelberg, Leipzig and Würzburg. A proportional stratified random sample based on the nationwide incidence of all cancer diagnoses in Germany is used. Patients are consecutively recruited in all centers. On the basis of a depression screener (PHQ-9) 50% of the participants that score below the cutoff point of 9 and all patients scoring above are assessed using the Composite International Diagnostic Interview for Oncology (CIDI-O). In addition, all patients complete validated questionnaires measuring emotional distress, information and psychosocial support needs as well as quality of life. DISCUSSION Epidemiological data on the prevalence of mental disorders and distress provide detailed and valid information for the estimation of the demands for the type and extent of psychosocial support interventions. The data will provide information about specific demographic, functional, cancer- and treatment-related risk factors for mental comorbidity and psychosocial distress, specific supportive care needs and use of psychosocial support offers.
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Affiliation(s)
- Anja Mehnert
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
| | - Uwe Koch
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Holger Schulz
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Joachim Weis
- Department of Psychooncology, Tumor Biology Center, University of Freiburg, Breisacher Str. 117, 79106, Freiburg, Germany
| | - Hermann Faller
- Institute of Psychotherapy and Medical Psychology, University of Würzburg, Klinikstr. 3, 97070, Würzburg, Germany
| | - Monika Keller
- Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 155, 69120, Heidelberg, Germany
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Martin Härter
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Grant M, Economou D, Ferrell B, Uman G. Educating health care professionals to provide institutional changes in cancer survivorship care. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:226-232. [PMID: 22271583 PMCID: PMC3724461 DOI: 10.1007/s13187-012-0314-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The Institute of Medicine (IOM) 2006 report, From Cancer Patient to Cancer Survivor: Lost in Transition (In M. Hewitt, S. Greenfield and E. Stovall (Eds.), (pp. 9-186). Washington DC: The National Academies Press, 2006) identifies the key components of care that contribute to quality of life for the cancer survivor. As cancer survivorship care becomes an important part of quality cancer care oncology professionals need education to prepare themselves to provide this care. Survivorship care requires a varied approach depending on the survivor population, treatment regimens and care settings. The goal of this program was to encourage institutional changes that would integrate survivorship care into participating centers. An NCI-funded educational program: Survivorship Education for Quality Cancer Care provided multidiscipline two-person teams an opportunity to gain this important knowledge using a goal-directed, team approach. Educational programs were funded for yearly courses from 2006 to 2009. Survivorship care curriculum was developed using the Quality of Life Model as the core around the IOM recommendations. Baseline data was collected for all participants. Teams were followed-up at 6, 12 and 18 months postcourse for goal achievement and institutional evaluations. Comparison data from baseline to 18 months provided information on the 204 multidiscipline teams that participated over 4 years. Teams attended including administrators, social workers, nurse practitioners, registered nurses, physicians and others. Participating centers included primarily community cancer centers and academic centers followed by pediatric centers, ambulatory/physician offices and free standing cancer centers. Statistically significant changes at p = <0.05 levels were seen by 12 months postcourse related to the effectiveness, receptiveness and comfort of survivorship care in participant settings. Institutional assessments found improvement in seven domains of care that related to institutional change. This course provided education to participants that led to significant changes in survivorship care in their settings.
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Affiliation(s)
- Marcia Grant
- City of Hope, Division of Nursing Research and Education, Duarte, CA 91010, USA.
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Mehnert A, Härter M, Koch U. Langzeitfolgen einer Krebserkrankung. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:509-15. [DOI: 10.1007/s00103-012-1447-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Romito F, Cormio C, Giotta F, Colucci G, Mattioli V. Quality of life, fatigue and depression in Italian long-term breast cancer survivors. Support Care Cancer 2012; 20:2941-8. [PMID: 22399132 DOI: 10.1007/s00520-012-1424-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 02/21/2012] [Indexed: 12/24/2022]
Affiliation(s)
- Francesca Romito
- Experimental Unit of Psychological Oncology, Department of Critical Area and Surgery, National Cancer Center Giovanni Paolo II, Via O. Flacco 65, 70126, Bari, Italy.
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Chubak J, Tuzzio L, Hsu C, Alfano CM, Rabin BA, Hornbrook MC, Spegman A, Von Worley A, Williams A, Nekhlyudov L. Providing care for cancer survivors in integrated health care delivery systems: practices, challenges, and research opportunities. J Oncol Pract 2012; 8:184-9. [PMID: 22942814 DOI: 10.1200/jop.2011.000312] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2011] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Optimal approaches to cancer survivorship care are needed. This study sought to identify practices, barriers, and research opportunities in meeting the care needs of cancer survivors in integrated health care delivery systems. METHODS This study was conducted at 10 sites within the Cancer Research Network, a National Cancer Institute-funded consortium of integrated health care delivery systems providing care for nearly 11 million enrollees. We identified 48 clinical leaders, administrators, and providers in oncology, primary care, nursing administration, and specialty care. Forty (83%) completed semi-structured, audio-recorded, transcribed telephone interviews, which we analyzed using an immersion-crystallization approach. RESULTS Respondents were aware of the needs of cancer survivors and the difficulties they face in transitioning from treatment to follow-up care. Respondents from all sites reported that oncology and primary care are jointly responsible for the care of cancer survivors, often through the use of electronic medical records. Many respondents were not familiar with standardized survivorship care plans. Only two sites had formal cancer survivorship programs in place, and two were developing such programs. Respondents at sites with and without programs acknowledged existing gaps in evidence on the effectiveness of formal survivorship care and expressed a desire for additional research. CONCLUSION Our exploratory study suggests an awareness of cancer survivorship care in integrated health care delivery systems, although approaches to providing such care vary across systems. These settings may offer a unique opportunity to develop, test, and implement innovative models of care, which can be systematically evaluated to inform and enhance cancer survivorship care in diverse health care settings.
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Affiliation(s)
- Jessica Chubak
- Group Health Research Institute; University of Washington School of Public Health, Seattle, WA; National Cancer Institute, Bethesda, MD; Kaiser Permanente, Denver, CO, Portland, OR, and Honolulu, HI; Geisinger Health System, Danville, PA; Health Services Research Division, LCF Research, Albuquerque, NM; Harvard Medical School and Harvard Pilgrim HealthCare Institute; and Harvard Vanguard Medical Associates, Boston, MA
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El seguimiento en los supervivientes de cáncer: una responsabilidad compartida. Med Clin (Barc) 2011; 137:163-5. [DOI: 10.1016/j.medcli.2011.03.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 03/08/2011] [Indexed: 11/22/2022]
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Baade PD, Youlden DR, Chambers SK. When do I know I am cured? Using conditional estimates to provide better information about cancer survival prospects. Med J Aust 2011; 194:73-7. [PMID: 21241220 DOI: 10.5694/j.1326-5377.2011.tb04171.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Accepted: 10/07/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To report the latest conditional survival estimates for patients with cancer in Queensland, Australia. DESIGN, SETTING AND PARTICIPANTS Descriptive study of state-wide population-based data from the Queensland Cancer Registry on patients aged 15-89 years who were diagnosed with invasive cancer between 1982 and 2007. MAIN OUTCOME MEASURE Conditional 5-year relative survival for the 13 most common types of invasive cancer, and all cancers combined. RESULTS The prognosis for patients with cancer generally improves with each additional year that they survive. A significant excess in mortality compared with the general population ceases to occur within 10 years after diagnosis for survivors of stomach, colorectal, cervical and thyroid cancer and melanoma, with these groups having a conditional 5-year relative survival of at least 95% after 10 years. For the remaining cancers we studied (pancreatic, lung, breast, prostate, kidney, and bladder cancer, non-Hodgkin lymphoma, and leukaemia), conditional 5-year relative survival estimates (at 10 years after diagnosis) ranged from 82% to 94%, suggesting that patients in these cohorts continue to have poorer survival compared with the age-matched general population. CONCLUSIONS Estimates of conditional survival have the potential to provide useful information for cancer clinicians, patients and their carers as they are confronted by personal and surveillance-related decisions. This knowledge may be effective in building realistic hope and helping people manage uncertainty about the future. We suggest that measures of conditional survival be incorporated into routine statistical reporting in Australia.
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Affiliation(s)
- Peter D Baade
- Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, QLD, Australia.
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Vistad I, Cvancarova M, Kristensen GB, Fosså SD. A study of chronic pelvic pain after radiotherapy in survivors of locally advanced cervical cancer. J Cancer Surviv 2011; 5:208-16. [PMID: 21259075 PMCID: PMC3096775 DOI: 10.1007/s11764-011-0172-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 01/09/2011] [Indexed: 12/14/2022]
Abstract
Introduction Chronic pelvic pain (persisting pain in hips, groins or lower back) is poorly described in studies of cervical cancer survivors (CCSs). The aims of this study were to describe chronic pelvic pain and associated variables in CCSs surveyed >5 years post-radiotherapy, and to compare the presence of pain in hips and lower back in CCSs with findings in the general female population. Methods Ninety-one CCSs treated with radiotherapy between 1994 and 1999 were in 2005 included in a cross-sectional questionnaire-based study. They were asked about demographic variables, clinical symptoms, mental distress, and quality of life (QOL). Normative data (NORM) were collected from a population-study of Norwegian females. Results Pain in lower back and hips was significantly more prevalent (p < .001) in CCSs compared to NORMs. 35/92 (38%) of the CCSs had chronic pelvic pain. These women had significantly lower QOL, higher levels of anxiety and depression and more bladder and intestinal problems than those without chronic pelvic pain. In a multivariable regression model, use of analgesics and intestinal and bladder problems were significantly associated with chronic pelvic pain in the CCSs. Conclusions CCSs have a higher prevalence of pain in lower back and hips than women in the general population, which might be due to late effects of radiation. 35/92 (38%) of the CCSs suffer from chronic pelvic pain, shown to be associated with high overall mental and somatic morbidity. Implications for Cancer Survivors Evaluation and management of pelvic pain is important in follow-up of CCSs treated with radiotherapy.
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Affiliation(s)
- Ingvild Vistad
- Department of Gynaecology, Sorlandet Hospital HF, Kristiansand, Norway.
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The Italian response to cancer survivorship research and practice: developing an evidence base for reform. J Cancer Surviv 2010; 4:284-9. [PMID: 20652433 DOI: 10.1007/s11764-010-0143-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 06/29/2010] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Improvement in cancer survival rates have increased longevity but have also revealed physical and psycho-social sequelae of long-term survivorship and raised many questions regarding how to assess, treat, and prevent these survival-related problems. The United States, Australia, and some northern European Union countries have already started to address these issues. Italy still needs to take up this challenge, taking into account its specific social and cultural background that shapes a different survivorship scenario. METHODS This brief report summarizes the concept of cancer survivorship and the response to this emerging public health issue in Italy. Two current nationwide research programs on long-term cancer survivorship and post-cancer pain are described to provide readers with a perspective of how Italy is seeking to increase the understanding of the needs and problems of cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS The results of these nationwide research programs will provide an evidence base for reforming the national care plans to address the needs of the growing number of Italian people with a history of cancer. It is hoped that this description of Italy's response to this public health challenge will offer some insight into how Italy is responding to the health and psychosocial needs of cancer survivors.
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Glendenning JL, Barbachano Y, Norman AR, Dearnaley DP, Horwich A, Huddart RA. Long-term neurologic and peripheral vascular toxicity after chemotherapy treatment of testicular cancer. Cancer 2010; 116:2322-31. [PMID: 20225230 DOI: 10.1002/cncr.24981] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Testicular cancer is curable in the majority of men, and persisting treatment toxicity is a concern. The authors report a cross-sectional study of the long-term effects of chemotherapy (C) on neurologic function and development of Raynaud phenomenon. METHODS Seven hundred thirty-nine patients who were treated between 1982 and 1992 gave consent to enter the study. Patients were classified according to the receipt of C (n = 384) or no C (n = 355). Patients completed a general health questionnaire and a quality-of-life form (the European Organization for Research and Treatment of Cancer Quality-of-Life C30 questionnaire with testicular module). Symptom scores of 3 or 4 were considered clinically significant. Patients were assessed in the clinic, and clinical history was used to diagnose Raynaud phenomenon (RP) and tinnitus. Examinations included peripheral nerve function testing for light touch and vibration sense. Five hundred seventy-seven patients underwent audiometry. RESULTS On physician assessment, peripheral neuropathy and RP were more common after C (21.7% vs 9.1% [P<.001] and 20.3% vs 1.7% [P<.001], respectively). Similar results were obtained for symptom scores (12.5% vs 5.5% [P = .002] and 9.7% vs 3.7% [P<.001], respectively). On multivariate analysis, for peripheral neuropathy, the significant predictors were cisplatin dose, carboplatin dose, and age. For RP, the significant predictor was bleomycin. Significant differences in hearing thresholds were noted at 8000 hertz only and, on multivariate analysis, were related to age, cisplatin dose, and vincristine dose. Auditory symptom scores did not differ between groups. CONCLUSIONS With long-term follow-up, peripheral neuropathy and RP remained detectable in approximately 20% of patients and caused significant symptoms in 10% of patients. Detectable effects on high frequency remained but caused little symptomatic problem. These effects persisted and were related to the cumulative chemotherapy dose.
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Affiliation(s)
- Jennifer L Glendenning
- Urology Unit, The Royal Marsden National Health Service Foundation Trust, Sutton, Surrey, United Kingdom
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