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Wörns MA, Burns D, Paskow M, Makin H, Miller J, Turner LM, Sah J. Patient Experience of Hepatocellular Carcinoma and Their Treatment Goals: An International Qualitative Study and Patient Journey Map. Adv Ther 2024; 41:3598-3614. [PMID: 39052152 PMCID: PMC11349831 DOI: 10.1007/s12325-024-02939-1] [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: 03/14/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024]
Abstract
INTRODUCTION Understanding the patient journey of hepatocellular carcinoma (HCC) may inform future clinical decision-making and enhance the patient experience. The objectives of this study were to explore the patient experience of HCC in relation to treatment options, treatment decision-making and treatment goals throughout the disease journey. This study also aimed to determine the symptoms and impacts of HCC across early, intermediate and advanced HCC. METHODS Semi-structured 60-min interviews were conducted with n = 50 patients with HCC and n = 12 healthcare professionals (HCPs) with experience of treating patients with HCC. Interview data were analyzed using directed content analysis techniques with a hybrid inductive and deductive approach. An assessment of conceptual saturation was conducted for patients' symptom experience. RESULTS Patients described treatment decisions as mostly HCP-led. In this study, surgery/resection was the most frequently offered treatment option across the HCC journey, and most patients were satisfied with the treatment options presented to them. Overall, patients described extending their overall survival (OS) and preserving quality of life (QoL) as their most important treatment goals, with patients diagnosed with advanced/unresectable HCC prioritizing QoL. HCPs also prioritized OS and progression-free survival (PFS) though reported that QoL became more important as HCC progressed. Patients experienced various symptoms across the HCC journey including fatigue, nausea, appetite loss, diarrhea and pain. CONCLUSION Overall, HCPs and patients collaborate throughout the treatment journey regarding treatment decisions and shared treatment goals. OS is critically important to patients and HCPs, though treatment goals may change depending on various clinical factors.
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Affiliation(s)
- Marcus-Alexander Wörns
- Department of Gastroenterology, Hematology, Medical Oncology and Endocrinology, Klinikum Dortmund, Klinikum of the University Witten/Herdecke, Dortmund, Germany
| | - Danielle Burns
- Clinical Outcomes Assessment, Clarivate Analytics, London, UK
| | - Michael Paskow
- Global Medical Affairs, AstraZeneca, Gaithersburg, MD, USA
| | - Harriet Makin
- Clinical Outcomes Assessment, Clarivate Analytics, London, UK
| | - Jordan Miller
- Clinical Outcomes Assessment, Clarivate Analytics, London, UK
| | | | - Janvi Sah
- Oncology Outcomes Research, AstraZeneca, Gaithersburg, MD, USA.
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Johnson SE, Samson M. Cancer stigma: the need for policy and programmatic action. J Natl Cancer Inst Monogr 2024; 2024:45-50. [PMID: 38836525 DOI: 10.1093/jncimonographs/lgae014] [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: 10/27/2023] [Revised: 01/08/2024] [Accepted: 03/20/2024] [Indexed: 06/06/2024] Open
Abstract
Cancer is a stigmatized disease in many countries that impacts the quality of life and mental health of people affected by cancer. This commentary examines some dimensions of cancer stigma and has been developed based on insights from participants in a Union for International Cancer Control program dedicated to cancer patient organizations in low- and middle-income countries. Aimed at program managers and policy makers, this commentary highlights the importance of developing strategies to reduce cancer stigma in cancer control programs in different contexts, working closely with community-based civil society organizations and those with lived experience of cancer to understand, evaluate, and take action regarding the impact of cancer stigma on health-seeking behavior and patients' quality of life.
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Affiliation(s)
| | - Mélanie Samson
- Capacity Building, Union for International Cancer Control, Geneva, Switzerland
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Auriol C, Raynal P, Cantisano N. Stigmatization of drinking patients with liver cancer: The role of socioeconomic status. Heliyon 2024; 10:e29105. [PMID: 38623242 PMCID: PMC11016613 DOI: 10.1016/j.heliyon.2024.e29105] [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: 07/26/2023] [Revised: 03/08/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024] Open
Abstract
Patients with liver cancer may face stigmatization due to cancer, alcohol consumption, or both. This study addresses gaps in the existing literature regarding stigmatization of alcohol-related liver cancer patients, particularly its connection with socioeconomic status (SES). The study explores whether the SES of a fictional character with alcohol addiction and liver cancer influences stigma levels reported by participants. Additionally, it investigates how participants' personal characteristics, such as alcohol consumption and healthcare professional status, impact stigmatization. This study aims to provide new insights regarding the role of stigmatization in liver cancer treatment and management, emphasizing in socioeconomic determinants. The method is based on three scenarios describing a woman character with alcohol abuse and liver cancer. The scenarios depicted a woman character with either low, medium or high SES. Each participant (N = 991) was randomly assigned to one of the three scenarios. After reading it, each participant answered questionnaires assessing negative attitudes towards the character. Four scales were used: "Negative attributions about people with health problems", "Causality of cancer", "Controllability of drinking" and "Reluctance to helping behavior". Data were analyzed using ANOVA and t-tests. The scenario describing a character with a low SES significantly received more "Negative attributions about people with health problems" than the character with medium or high SES. Participants having higher alcohol consumption themselves showed lower stigma scores for three out of four scales than participants with lower consumption. In addition, participants identified as health professionals had lower stigma scores regarding the scales "Negative attributions about people with health problems" and "Controllability of drinking", and higher scores for the subscale "Reluctance to helping behavior", compared with non-professionals. A character with low SES received more negative attributions than the one with higher SES. Participants' own alcohol consumption and professional status (being health professional or not), influenced their stigmatizing attitudes.
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Affiliation(s)
- Camille Auriol
- Laboratoire CERPPS, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Patrick Raynal
- Laboratoire CERPPS, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Nicole Cantisano
- Laboratoire CERPPS, Université de Toulouse-Jean Jaurès, 5 allées Antonio Machado, 31058, Toulouse, France
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Wang X, Wang C, Han W, Sun J, Hui Z, Lei S, Wu H, Liu X. Global status of research on gastrointestinal cancer patients' quality of life: A bibliometric and visual analysis from 2003 to 2023. Heliyon 2024; 10:e23377. [PMID: 38148818 PMCID: PMC10750154 DOI: 10.1016/j.heliyon.2023.e23377] [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: 07/20/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 12/28/2023] Open
Abstract
Objective To analyze the current research status, hotspots, and frontiers in the field of Gastrointestinal (GI) cancer and quality of life (QoL) through the bibliometrics method, and to provide references and guidance for future research. Methods Literature related to GI cancer and QoL from April 1, 2003 to March 31, 2023 was retrieved from the Web of Science Core Collection database. CiteSpace 6.2.R1 was performed for collaboration analysis, keyword co-occurrence analysis, and document co-citation analysis. Results A total of 1224 publications were included in this study. There has been a significant increase in the number of publications in this field over the past two decades. The United States, the Karolinska Institute and the University of Amsterdam, and Pernilla Lagergren are the most prolific country, institution, and author, respectively. The links between most of the research constituents were relatively thin (centrality <0.1). The keyword analysis indicates that the benefits of physical activity on QoL, the levels of psychological distress and its relationship with QoL, as well as the development and validation of QoL measurement tools have been the research hotspots. Open-label/double-blind trials exploring therapeutic interventions and more targeted new drugs or more effective drug combinations, and longitudinal studies determining the direction of the association between psychological distress and QoL at different time points, may be emerging trends in this field. Conclusion The cooperation among countries, institutions, and authors in this field should be strengthened. In addition, the health benefits of light physical activity, interventions for QoL, trajectory and direction of the relationship between psychological distress and QoL may be the focus of future research.
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Affiliation(s)
- Xiaoqin Wang
- Department of Pediatrics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Caihua Wang
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Wenjin Han
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Jiaru Sun
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Zhaozhao Hui
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Shuangyan Lei
- Department of Radiotherapy, Shaanxi Cancer Hospital, Xi'an, China
| | - Huili Wu
- Department of Oncology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaohong Liu
- Department of Pediatrics, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Torres Velasco M, Álvarez Gallego R, Peinado P, Muñoz Gregorio C, Ugidos L, García Morillo M, Vicente E, Quijano Y, Prados S, de la Fuente E, Cubillo Gracián A. Long-Term Survival in Hepatocellular Carcinoma following Second-Line Tumor Treating Fields Therapy and Sorafenib: A Case Report. Case Rep Oncol 2024; 17:843-851. [PMID: 39144246 PMCID: PMC11324212 DOI: 10.1159/000539719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/28/2024] [Indexed: 08/16/2024] Open
Abstract
Introduction Hepatocellular carcinoma (HCC) is an aggressive solid tumor associated with high mortality. Surgery is the main treatment consideration for early disease, but patients who present with locally advanced or metastatic HCC at diagnosis have limited treatment options. There has been great progress in locoregional, immunotherapy, and targeted treatments for advanced HCC. Standard of care for HCC has changed due to results demonstrating safety and efficacy in phase 3 studies, namely, for atezolizumab concomitant with bevacizumab. Nonetheless, additional therapeutic approaches are still warranted to further increase overall survival in HCC. A first-in-class treatment option investigated in patients with HCC is Tumor Treating Fields (TTFields) therapy, which is delivered locoregionally to the tumor site from a portable medical device. TTFields are electric fields that interfere with critical cancer cell processes, hindering tumor progression. Case Presentation Here, we report on a case study of a 62-year-old male patient with HCC receiving TTFields concomitant with sorafenib as second-line therapy. Although the patient experienced adverse events with previous nivolumab, they achieved a complete response and continued on treatment for 51 months until disease progression, which led to treatment cessation. We report that during 39 months of subsequent treatment with TTFields therapy and sorafenib, the patient experienced a good quality of life, low systemic toxicity, and stable disease following a partial response. Conclusions These promising findings, along with those of the pilot phase 2 HEPANOVA clinical study, warrant further investigation of TTFields therapy in HCC.
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Affiliation(s)
- Marisa Torres Velasco
- HM CIOCC MADRID (Centro Integral Oncológico Clara Campal), HM Hospitales, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Rafael Álvarez Gallego
- HM CIOCC MADRID (Centro Integral Oncológico Clara Campal), HM Hospitales, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Paloma Peinado
- HM CIOCC MADRID (Centro Integral Oncológico Clara Campal), HM Hospitales, Hospital Universitario HM Sanchinarro, Madrid, Spain
- Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain
| | - Cesar Muñoz Gregorio
- HM CIOCC MADRID (Centro Integral Oncológico Clara Campal), HM Hospitales, Hospital Universitario HM Sanchinarro, Madrid, Spain
- Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain
| | - Lisardo Ugidos
- HM CIOCC MADRID (Centro Integral Oncológico Clara Campal), HM Hospitales, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Marcial García Morillo
- HM CIOCC MADRID (Centro Integral Oncológico Clara Campal), HM Hospitales, Hospital Universitario HM Sanchinarro, Madrid, Spain
| | - Emilio Vicente
- Servicio de Cirugia General, HM Sanchinarro Hospital, Madrid, Spain
| | - Yolanda Quijano
- Servicio de Cirugia General, HM Sanchinarro Hospital, Madrid, Spain
| | - Susana Prados
- Gastroenterología – Aparato Digestivo, HM Sanchinarro Hospital, Madrid, Spain
| | | | - Antonio Cubillo Gracián
- HM CIOCC MADRID (Centro Integral Oncológico Clara Campal), HM Hospitales, Hospital Universitario HM Sanchinarro, Madrid, Spain
- Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain
- Facultad HM de Ciencias de la Salud de la Universidad Camilo José Cela, Madrid, Spain
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Liu Y, Sun M. An offline to online cognitive behavioral stress management caring program effectively improves psychological pressure, spiritual well-being, and quality of life in postoperative hepatocellular carcinoma patients. Clin Res Hepatol Gastroenterol 2023; 47:102195. [PMID: 37567466 DOI: 10.1016/j.clinre.2023.102195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/19/2023] [Accepted: 08/06/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND This study designed an offline to online cognitive behavioral stress management (OOCBSM) caring program, intending to investigate its effect on mental health and quality of life (QoL) using multiple scales in postoperative hepatocellular carcinoma (HCC) patients. METHODS 254 postoperative HCC patients were randomly (1:1) allocated into OOCBSM (included a 10-week offline CBSM and subsequent online CBSM until M6) and normal care (NC) groups (10-week NC). Hospital anxiety-and-depression scale (HADS), Zung's self-reporting anxiety (SAS) and depression scale (SDS), FACIT-SP, European quality-of-life-5 dimensions (EQ-5D), and quality-of-life questionnaire-core30 (QLQ-C30) were assessed over 6 months (M). RESULTS HADS-defined-anxiety rates at M3 (P = 0.036) and M6 (P = 0.025), SAS-defined-anxiety rate at M6 (P = 0.049), HADS-defined-depression rates at M3 (P = 0.026) and M6 (P = 0.049), and SDS-defined-depression rates at M3 (P = 0.015) and M6 (P = 0.043) were all lower in OOCBSM group compared to NC group. Furthermore, FACIT-SP scores at M1 (P = 0.004), M3 (P = 0.003), and M6 (P<0.001) were higher in OOCBSM group compared with NC group. EQ-5D scores at M1 (P = 0.025) and M3 (P = 0.030) but not M6 (P = 0.128), and QLQ-C30-symptom score at M3 (P = 0.014) but not M1 (P = 0.198) and M6 (P = 0.058) were lower in OOCBSM group versus NC group; QLQ-C30-global-health-status scores at M3 (P = 0.027) and M6 (P = 0.001) but not M1 (P = 0.312), QLQ-C30-function scores at M3 (P = 0.005) and M6 (P = 0.001) but not M1 (P = 0.084) were higher in OOCBSM group versus NC group. Patients with younger ages or higher education benefited more from OOCBSM. CONCLUSION OOCBSM improves psychological pressure, spiritual well-being, and QoL in postoperative HCC patients, especially in those with younger ages or higher education.
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Affiliation(s)
- Yueping Liu
- Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - Meiling Sun
- Department of Nursing Care, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China.
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KHAWAR MUHAMMADBABAR, WANG YAJUN, MAJEED ANEEQA, AFZAL ALI, HANEEF KABEER, SUN HAIBO. Mini-organs with big impact: Organoids in liver cancer studies. Oncol Res 2023; 31:677-688. [PMID: 37547759 PMCID: PMC10398413 DOI: 10.32604/or.2023.029718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 06/14/2023] [Indexed: 08/08/2023] Open
Abstract
Hepatocellular carcinoma, the most common primary liver cancer and a leading cause of death, is a difficult disease to treat due to its heterogeneous nature. Traditional models, such as 2D culture and patient-derived xenografts, have not proven effective. However, the development of 3D culture techniques, such as organoids, which can mimic the tumor microenvironment (TME) and preserve heterogeneity and pathophysiological properties of tumor cells, offers new opportunities for treatment and research. Organoids also have the potential for biomarker detection and personalized medication, as well as genome editing using CRISPR/Cas9 to study the behavior of certain genes and therapeutic interventions. This review explores to-the-date development of organoids with a focus on TME modeling in 3D organoid cultures. Further, it discusses gene editing using CRISPR/Cas9 in organoids, the challenges faced, and the prospects in the field of organoids.
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Affiliation(s)
- MUHAMMAD BABAR KHAWAR
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Experimental and Translational Non-Coding RNA Research, Yangzhou, China
- Applied Molecular Biology and Biomedicine Lab, Department of Zoology, University of Narowal, Narowal, Pakistan
| | - YAJUN WANG
- Department of Oncology, Haian Hospital of Traditional Chinese Medicine, Haian, China
| | - ANEEQA MAJEED
- Applied Molecular Biology and Biomedicine Lab, Department of Zoology, University of Narowal, Narowal, Pakistan
| | - ALI AFZAL
- Molecular Medicine and Cancer Therapeutics Lab, Department of Zoology, Faculty of Sciences Technology, University of Central Punjab, Lahore, Pakistan
| | - KABEER HANEEF
- Chinese Institute for Brain Research (CIBR), Beijing, China
| | - HAIBO SUN
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Experimental and Translational Non-Coding RNA Research, Yangzhou, China
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Yang L, Yan C, Wang J. Effect of multi-disciplinary team care program on quality of life, anxiety, and depression in hepatocellular carcinoma patients after surgery: A randomized, controlled study. Front Surg 2023; 9:1045003. [PMID: 36684377 PMCID: PMC9852760 DOI: 10.3389/fsurg.2022.1045003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/08/2022] [Indexed: 01/09/2023] Open
Abstract
Objective Multi-disciplinary team (MDT) collaboration enables hepatocellular carcinoma (HCC) patients to achieve better survival through precise diagnosis and individualized treatment. This study aimed to further investigate the effect of MDT care program (MDT-CP) on quality of life (QoL), anxiety and depression in HCC patients after surgery. Methods Totally, 150 postoperative HCC patients were enrolled and randomized in a 1:1 ratio into the MDT-CP group (N = 76) to receive MDT care for 6 months and the normal care program (N-CP) group (N = 74) to receive routine care for 6 months. Results Quality of Life Questionnaire-Core 30 (QLQ-C30) global health status score at 1 month (M1), M3 and M6, QLQ-C30 functions score at M3 and M6 elevated while QLQ-C30 symptom score at M1 and M3 decreased in MDT-CP group compared with N-CP group (all P < 0.05). In addition, Hospital Anxiety and Depression Scale (HADS)-Anxiety score at M3 and M6, anxiety occurrence rate at M6, anxiety degree at M6, were all reduced in MDT-CP group compared with N-CP group (all P < 0.05). HADS-Depression score at M6, and depression occurrence rate at M3, were both lessened in MDT-CP group compared to N-CP group (both P < 0.05), while there was no distinction of depression degree at any time points between groups. Conclusion MDT-CP improves QoL, relieves anxiety and depression to a certain extent in HCC patients after surgery.
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Raijmakers NJH, van Zuylen L, Fürst CJ. Timely integration of palliative care into cancer care. Eur J Cancer Care (Engl) 2022; 31:e13764. [DOI: 10.1111/ecc.13764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Natasja Johanna Helen Raijmakers
- Department of Research and Development Netherlands Comprehensive Cancer Organisation (IKNL) Utrecht The Netherlands
- Netherlands Association for Palliative Care (PZNL) Utrecht The Netherlands
| | - Lia van Zuylen
- Department of Medical Oncology Amsterdam UMC Amsterdam The Netherlands
| | - Carl Johan Fürst
- Division of Palliative Care, Department of Clinical Sciences Lund University Lund Sweden
- The Institute for Palliative Care Lund University and Region Skåne Lund Sweden
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