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Brown GC, Brown MM, Sharma S. Preference-based comparison of quality of life associated with vision loss in Black and White ophthalmic populations in the US. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024; 59:24-30. [PMID: 36427536 DOI: 10.1016/j.jcjo.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Utilities are preference-based estimates, typically ranging from 1.00 (normal health) to 0.00 (death), that quantify the quality-of-life improvement associated with a health care intervention. In conjunction with length-of-life gain, depending on the intervention, they measure total interventional value gain in quality-adjusted life years that can be integrated with costs in cost-utility analysis. We believed it relevant to ascertain whether race was a differentiating factor confounding utilities related to vision. METHODS An analysis of cross-sectional data obtained from consecutive Black and White ophthalmic outpatients from the Wills Eye Hospital (Philadelphia, PA.) practices who participated in a long-standing time trade-off (TTO) vision utility study from 1999 to 2016 was undertaken. Each participant was interviewed by a researcher using a previously validated and reliable TTO vision utility acquisition instrument and assigned to 1 of 5 vision categories according to acuity in the best-seeing eye. Utility outcomes were compared using both the 2-sided t test and the Mann-Whitney U test. RESULTS Eleven hundred and twenty-five consecutive patients able to successfully answer the questions were included. For vision of 20/200-20/800, White/Black mean vision utilities were, respectively, 0.58/0.59 (p = 0.84); for vision of 20/70-20/100, they were, respectively, 0.72/0.70 (p = 0.85); for vision of 20/50-20/60, they were, respectively, 0.78/0.79 (p = 0.86); for vision of 20/25-20/50, they were, respectively, 0.84/0.88 (p = 0.16); and for vision of 20/20, they were, respectively, 0.91/0.90 (p = 0.43). CONCLUSIONS TTO vision utilities in Black and White ophthalmic patient cohorts were alike at various levels of visual acuity. This suggests a similar quality of life and that TTO vision utilities used in cost-utility analysis do not require adjustment for race in Black and White ophthalmic populations in the US.
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Affiliation(s)
- Gary C Brown
- Center for Value-Based Medicine, Hilton Head, SC; Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA; Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA.
| | - Melissa M Brown
- Center for Value-Based Medicine, Hilton Head, SC; Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA; Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA
| | - Sanjay Sharma
- Department of Ophthalmology, Hotel Dieu Hospital, Kingston, ON
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Borre M, Fassov J, Poulsen JL, Christensen P, Laurberg S, Drewes AM, Krogh K. Dietary Intervention Improves Gastrointestinal Symptoms after Treatment of Cancer in the Pelvic Organs. J Clin Med 2023; 12:4766. [PMID: 37510881 PMCID: PMC10380860 DOI: 10.3390/jcm12144766] [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: 05/01/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Gastrointestinal (GI) symptoms are common in patients receiving radiotherapy, chemotherapy, and/or surgery for cancer in the pelvic organs. The aim of the present prospective cohort study was to report the efficacy of dietary intervention in patients with chronic GI sequelae to treatment of cancer in pelvic organs and insufficient symptomatic effect of medical treatment. Eighty-eight patients were offered specialist dietitian guidance. Gastrointestinal symptoms and quality of life were assessed before and after intervention by validated questionnaires. The main dietary interventions were low-fat diet (n = 44; 50%), modification of dietary fiber content (n = 19; 33%), dietary restrictions with a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet (n = 18; 20%), gluten-free diet (n = 1; 1%), and other dietary advice (n = 6; 7%). Compared to baseline, dietary intervention improved quality of life (EQ5D scale) (p < 0.01), bowel function for the last four weeks (p < 0.02), stool frequency (p < 0.03), constipation (p < 0.05), incomplete rectal emptying at defecation (p < 0.02), and performing usual activities (p < 0.0). In conclusion, this observational study using tailored dietary intervention showed that symptoms can be reduced and quality of life can be improved in patients with chronic GI sequelae following treatment of cancer in the pelvic organs not responding sufficiently to medical treatment.
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Affiliation(s)
- Mette Borre
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark; (J.F.); (K.K.)
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.L.P.); (P.C.); (S.L.); (A.M.D.)
| | - Janne Fassov
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark; (J.F.); (K.K.)
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.L.P.); (P.C.); (S.L.); (A.M.D.)
| | - Jakob Lykke Poulsen
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.L.P.); (P.C.); (S.L.); (A.M.D.)
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Peter Christensen
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.L.P.); (P.C.); (S.L.); (A.M.D.)
- Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
| | - Søren Laurberg
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.L.P.); (P.C.); (S.L.); (A.M.D.)
- Department of Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
| | - Asbjørn Mohr Drewes
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.L.P.); (P.C.); (S.L.); (A.M.D.)
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Klaus Krogh
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark; (J.F.); (K.K.)
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, 8200 Aarhus, Denmark; (J.L.P.); (P.C.); (S.L.); (A.M.D.)
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Associations of Age and Sex with the Efficacy of Inpatient Cancer Rehabilitation: Results from a Longitudinal Observational Study Using Electronic Patient-Reported Outcomes. Cancers (Basel) 2023; 15:cancers15061637. [PMID: 36980523 PMCID: PMC10046728 DOI: 10.3390/cancers15061637] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
Cancer rehabilitation is thought to increase the quality of life (QOL) and functioning of cancer survivors. It remains, however, uncertain whether subgroups benefit equally from rehabilitation. We wished to investigate the outcomes of multimodal rehabilitation according to age, sex and functioning. Patients of an Austrian rehabilitation center routinely completed the EORTC QLQ-C30 and the hospital anxiety and depression scale (HADS) questionnaires prior to (T1), and after rehabilitation (T2). To compare the outcomes between age groups (i.e., <40, 41–69, and ≥70 years), sex, and the Norton scale risk status, repeated measures of analyses of variance were calculated. A total of 5567 patients with an average age of 60.7 years were included, of which 62.7% were female. With T1 indicating the cancer survivors’ needs, older and high-risk patients reported lower functioning (all p < 0.001) and a higher symptom burden for most scales (all p < 0.05) before rehabilitation. Regardless of age, sex or risk status, the patients showed at a least small to medium improvement during rehabilitation for anxiety, depression, and most functioning and symptom scales. Some between-group differences were observed, none of which being of a relevant effect size as determined with the Cohen’s d. In conclusion, QOL is improved by rehabilitation in all patients groups, independently from age, sex, or the risk status.
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Partnership, sexuality, and fertility-related communication: findings from a register-based study among long-term hematological cancer survivors. Support Care Cancer 2023; 31:26. [PMID: 36513784 PMCID: PMC9747843 DOI: 10.1007/s00520-022-07495-4] [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: 06/07/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Even though the number of hematological cancer survivors suffering from long-term and late consequences of their disease is growing, knowledge about their situation regarding partnership, sexuality, and fertility-related communication is sparse to date. METHODS We recruited survivors of hematological malignancies (≥ 3 years after diagnosis) from two cancer registries in Germany. We applied validated instruments and study-specific items on satisfaction with partnership, sexual functioning, and fertility-related communication with physicians. We provided descriptive statistics and conducted multiple regression analyses to identify associations of the outcomes with patient factors and well-being (anxiety, depression, and quality of life). RESULTS Of 2001 eligible survivors, 922 (46%) participated. Fifty-seven percent were male, and the mean age was 64 years. Ninety percent and 60% reported to be satisfied with their partnership and sexual life, respectively. However, 81% and 86% reported being sexually impaired by physical or mental symptoms, respectively. Seventy-four percent of those with incomplete family planning had a fertility-related conversation with a physician. Female gender (p < .05, Beta = - .09), older age (p < .01, Beta = .10), and chemotherapy (p < .01, Beta = .10) were associated with less sexual pleasure caused by physical impairment. Satisfaction with partnership (p < .001, Beta = .22), satisfaction with sexual life (p < .001, Beta = .28), and conversation about fertility (p < .05, Beta = .26) were associated with better quality of life. CONCLUSION Even though long-term survivors seem to be generally satisfied with their partnership and sexual life, they may suffer from specific impairments. Our findings need to be verified in longitudinal studies.
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Borre M, Fassov J, Juul T, Laurberg S, Christensen P, Bräuner AB, Thorlacius Ussing O, Lauritzen MB, Drewes AM, Faaborg PM, Krogh K. Diet and bowel symptoms among colon cancer survivors. Acta Oncol 2022; 61:1192-1199. [DOI: 10.1080/0284186x.2022.2101901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Mette Borre
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, Aarhus, Denmark
| | - Janne Fassov
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, Aarhus, Denmark
| | - Therese Juul
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Søren Laurberg
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Christensen
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Annette Boesen Bräuner
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Surgery, Regional Hospital Viborg, Viborg, Denmark
| | - Ole Thorlacius Ussing
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Michael Bødker Lauritzen
- Department of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, Denmark
- Department of Surgery, North Denmark Regional Hospital, Hjoerring, Denmark
| | - Asbjørn Mohr Drewes
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, Aarhus, Denmark
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Pia Møller Faaborg
- Department of Surgery, Danish Colorectal Cancer Center South, Vejle, Denmark
| | - Klaus Krogh
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus University Hospital, Aarhus, Denmark
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Kim Y, Park S, Kim H, Kim SS, Lim JS, Kim S, Choi K, Seo H. A Bounding-Box Regression Model for Colorectal Tumor Detection in CT Images Via Two Contrary Networks. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:3793-3796. [PMID: 36085607 DOI: 10.1109/embc48229.2022.9871285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The field of medical image analysis has been attracted to deep learning. Various deep learning-based techniques have been introduced to aid diagnosis in the CT image of the patient. The auxiliary model for diagnosis that we proposed is to detect colorectal tumors in the CT image. The model is combined with two contrary networks of 'Detection Transformer" and 'Hourglass". Furthermore., to improve the performance of the model., we propose an efficient connection method for two contrary models by using intermediate prediction information. A total of 3.,509 patients (193.,567 CT images) were applied to the experiment and our model outperforms the conventional models in colorectal tumor detection. Clinical Relevance - The proposed model in this paper automatically detects colorectal tumors and provides the bounding box in the CT images. Colorectal tumor is one of the common diseases. In addition, the mortality rate is so high that in-time treatment is required. The model we present here has a sensitivity (or recall) of 84.73 % for tumor detection and a precision of 88.25 % in the patient CT data. The in-slice performance of the tumor detection shows an IoU of 0.56, a sensitivity of 0.67, and a precision of 0.68.
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Cunningham P, Sumal A, Patton E, Helms H, Noneman MT, Martinez-Muñiz G, Bader JE, Chatzistamou I, Aladhami A, Unger C, Enos RT, Shin HK, Velázquez KT. Ojeok-san ameliorates visceral and somatic nociception in a mouse model of colitis induced colorectal cancer. PLoS One 2022; 17:e0270338. [PMID: 35737651 PMCID: PMC9223640 DOI: 10.1371/journal.pone.0270338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/08/2022] [Indexed: 11/29/2022] Open
Abstract
Cancer patients can develop visceral, somatic, and neuropathic pain, largely due to the malignancy itself and its treatments. Often cancer patients and survivors turn to the use of complementary and alternative medicine (CAM) to alleviate pain and fatigue. Thus, it is necessary to investigate how CAM therapies work as novel analgesics to treat cancer pain. Ojeok-san (OJS) is an herbal formula consisting of seventeen herbs. This herbal formula has been shown to possess anti-inflammatory, immunoregulatory, and analgesic properties. In this study, we examined the potential beneficial effects and mechanism of action of OJS in a preclinical model of colitis-associated colorectal cancer. Male and female C57BL/6J mice were exposed to the carcinogen, azoxymethane (AOM, 10 mg/kg) and a chemical inflammatory driver, dextran sulfate sodium (DSS1-2%), to promote tumorigenesis in the colorectum. OJS was given orally (500, 1000, and 2000 mg/kg) to determine its influence on disease activity, tumor burden, nociception, sedation, Erk signaling, and behavioral and metabolic outcomes. In addition, in vitro studies were performed to assess CT-26 cell viability, dorsal root ganglia (DRG) activation, and bone-marrow-derived macrophage (BMDM) inflammatory response to lipopolysaccharide stimulation after OJS treatment. We found that administration of 2000 mg/kg of OJS was able to mitigate mechanical somatic and visceral nociception via Erk signaling without affecting symptom score and polyp number. Moreover, we discovered that OJS has sedative properties and elicits prolonged total sleeping time in AOM/DSS mice. Our in vitro experiments showed that OJS has the capacity to reduce TNFα gene expression in LPS-stimulated BMDM, but no changes were observed in DRG spike number and CT-26 cell proliferation. Taken together, these data suggest that OJS ameliorates nociception in mice and warrants further examination as a potential CAM therapy to promote analgesia.
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Affiliation(s)
- Patrice Cunningham
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Aman Sumal
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Emma Patton
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Henry Helms
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Matthew T. Noneman
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Gustavo Martinez-Muñiz
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Jackie E. Bader
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Ioulia Chatzistamou
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Ahmed Aladhami
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Christian Unger
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Reilly T. Enos
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Hyeun Kyoo Shin
- Basic Herbal Medicine Research Group, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Kandy T. Velázquez
- Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
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Body Image Issues in Patients With Colorectal Cancer: A Scoping Review. Cancer Nurs 2022; 46:233-247. [PMID: 35349543 DOI: 10.1097/ncc.0000000000001085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Stomas in colorectal cancer (CRC) survivors lead to body image problems. Advances in treatment help reduce the rate of stoma formation, but body image distress is still frequently experienced in CRC survivors. OBJECTIVES This review is aimed toward mapping and describing the state of knowledge regarding body image in patients with CRC. METHODS A systematic literature search complying with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines was conducted. Screening and data extraction were performed by 2 reviewers independently for all potentially eligible studies. RESULTS A total of 56 eligible articles were selected. The majority of these studies were quantitative studies (85%). The eligible studies were classified into 4 broad categories: instruments used to assess body image, prevalence of body image distress, factors related to body image, and impact of body image distress. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-CR38) colorectal questionnaire was the most common measurement tool found among the reviewed studies (70%), and body image distress was reported by 25.5% to 86% of participants. Excluding gender, age, type of surgery, adjuvant therapy, time from diagnosis, social support, and stoma status, changes in bowel habits was identified as affecting the body image of patients with CRC. CONCLUSION Changing bowel habits emerged as a significant factor causing body image distress for CRC survivors. IMPLICATIONS FOR PRACTICE Clinicians should raise awareness about body image distress in patients with CRC, focus on finding effective measures and interventions intended to help alleviate symptoms of bowel dysfunction, and prepare patients to adapt to altered bowel functions.
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Perrone M, Garufi C, Cosimelli M, Graziano F, Falcicchio C, Bonucci A, Fotia L, Giannarelli D, Giacomelli L, Ciliberto G, Pugliese P. A Prospective Study Evaluating Health-Related Quality of Life Following a Multimodal Treatment for Colorectal Cancer. J Gastrointest Cancer 2022; 54:117-125. [PMID: 35075581 DOI: 10.1007/s12029-022-00802-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The major improvements in the diagnosis and treatment of colorectal cancer (CRC) over the past decades increased the patients' survival rates. Despite this, patients and clinicians still need to address the long-term physical and psychosocial effects over time. This paper aims to prospectively assess CRC patients' HR-QoL psychological distress and sexual functioning and identify clinical, demographic, and psychological predictors. METHODS In total, 55 patients were evaluated from diagnosis to 5-year follow-up with the following instruments: EORTC QLQ-C30 and QLQ-C38 for QoL and sexuality; HADS for psychological distress; and specific questions to detect psychological variables. RESULTS QoL worsened after diagnosis and returned to baseline values after 5 years. Sexual function significantly deteriorated over time (with no recovery, especially in women), while borderline/severe anxiety and depression decreased. A better HR-QoL at baseline was associated with better physical, social and sexual functioning, positive body image and sexual pleasure after 5 years. CONCLUSION HR-QoL allows the early detection of patients at risk, favoring prompt patient-centered interventions.
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Affiliation(s)
- Maria Perrone
- Psychology Unit, IRCCS Regina Elena Cancer Institute, Rome, Italy.
| | - Carlo Garufi
- Medical Oncology, Azienda Ospedaliera San Camillo Forlanini Roma, Rome, Italy
| | - Maurizio Cosimelli
- Colon Rectal Surgery, Fondazione IRCCS Istituto Nazionale Dei Tumori, S.C. Oncological 2 , Milan, Italy
| | - Franco Graziano
- Department of Surgery, IRCCS Regina Elena Cancer Institute, Rome, Italy
| | | | | | - Luana Fotia
- Psychology Unit, IRCCS Regina Elena Cancer Institute, Rome, Italy
| | - Diana Giannarelli
- Biostatistics Unit, IRCCS Regina Elena Cancer Institute, Rome, Italy
| | | | - Gennaro Ciliberto
- Scientific Direction, IRCCS Regina Elena Cancer Institute, Rome, Italy
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Zhu H, Zhao N, Jiang M. Isovitexin attenuates tumor growth in human colon cancer cells through the modulation of apoptosis and epithelial-mesenchymal transition via PI3K/Akt/mTOR signaling pathway. Biochem Cell Biol 2021; 99:741-749. [PMID: 34219464 DOI: 10.1139/bcb-2021-0045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Isovitexin, a biologically active flavone C-glycosylated derivative, has a variety of biological activities. We aimed to identify the effect of isovitexin (Isov) on colon cancer. The human colonic epithelial cell (HCEC), and cancer cells were treated with Isov, Cell Counting Kit-8 (CCK8) was used to detect cell proliferation and calculate half-inhibitory concentration (IC50). The biological activity of cancer cells were assessed. The tumor size and volume were recorded. The expression levels of proteins were analyzed by western blot. Isov inhibited cancer cells proliferation, while had little cytotoxicity on HCEC. Isov significantly attenuated cell proliferation, migration, invasion and epithelial-mesenchymal transition (EMT), induced cell apoptosis, and that trends were blocked by insulin-like growth factor-1 (IGF-1) treated. The expression levels of phosphorylated phosphatidylinositol 3-kinasep (p-PI3K), phosphorylated protein kinase B (p-Akt), phosphorylated mammalian target of rapamycin (p-mTOR), and B-cell lymphoma-2 (Bcl-2) evidently decreased when treated with Isov, while the levels of Bcl2-associated X (Bax), and caspase-3 significantly increased. After Isov treatment, the tumor volume and weight were decreased, the levels of p-PI3K, p-Akt, p-mTOR, and Bcl-2 significantly decreased in tumor tissues. Our finding demonstrated that Isov could inhibit cancer cells migration, invasion and EMT. Isov maybe a new potentially treatment medicine for colon cancer.
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Affiliation(s)
- Hao Zhu
- Yantaishan Hospital, 519688, Yantai, China, 264001;
| | - Na Zhao
- Yantaishan Hospital, 519688, Yantai, Shandong, China;
| | - Maozhu Jiang
- Yantaishan Hospital, 519688, Yantai, Shandong, China;
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Redwood DG, Dinh TA, Kisiel JB, Borah BJ, Moriarty JP, Provost EM, Sacco FD, Tiesinga JJ, Ahlquist DA. Cost-Effectiveness of Multitarget Stool DNA Testing vs Colonoscopy or Fecal Immunochemical Testing for Colorectal Cancer Screening in Alaska Native People. Mayo Clin Proc 2021; 96:1203-1217. [PMID: 33840520 DOI: 10.1016/j.mayocp.2020.07.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/17/2020] [Accepted: 07/13/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To estimate the cost-effectiveness of multitarget stool DNA testing (MT-sDNA) compared with colonoscopy and fecal immunochemical testing (FIT) for Alaska Native adults. PATIENTS AND METHODS A Markov model was used to evaluate the 3 screening test effects over 40 years. Outcomes included colorectal cancer (CRC) incidence and mortality, costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). The study incorporated updated evidence on screening test performance and adherence and was conducted from December 15, 2016, through November 6, 2019. RESULTS With perfect adherence, CRC incidence was reduced by 52% (95% CI, 46% to 56%) using colonoscopy, 61% (95% CI, 57% to 64%) using annual FIT, and 66% (95% CI, 63% to 68%) using MT-sDNA. Compared with no screening, perfect adherence screening extends life by 0.15, 0.17, and 0.19 QALYs per person with colonoscopy, FIT, and MT-sDNA, respectively. Colonoscopy is the most expensive strategy: approximately $110 million more than MT-sDNA and $127 million more than FIT. With imperfect adherence (best case), MT-sDNA resulted in 0.12 QALYs per person vs 0.05 and 0.06 QALYs per person by FIT and colonoscopy, respectively. Probabilistic sensitivity analyses supported the base-case analysis. Under varied adherence scenarios, MT-sDNA either dominates or is cost-effective (ICERs, $1740-$75,868 per QALY saved) compared with FIT and colonoscopy. CONCLUSION Each strategy reduced costs and increased QALYs compared with no screening. Screening by MT-sDNA results in the largest QALY savings. In Markov model analysis, screening by MT-sDNA in the Alaska Native population was cost-effective compared with screening by colonoscopy and FIT for a wide range of adherence scenarios.
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12
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Döking S, Koulil SSV, Thewes B, Braamse AM, Custers JA, Prins JB. Combined Face-to-Face and Online Cognitive-Behavioral Therapy for High Distress of Colorectal Cancer Survivors: A Case Study. COGNITIVE AND BEHAVIORAL PRACTICE 2021. [DOI: 10.1016/j.cbpra.2020.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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13
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Larsen HM, Mekhael M, Juul T, Borre M, Christensen P, Mohr Drewes A, Thorlacius-Ussing O, Laurberg S, Krogh K, Ladefoged Fassov J. Long-term gastrointestinal sequelae in colon cancer survivors: prospective pilot study on identification, the need for clinical evaluation and effects of treatment. Colorectal Dis 2021; 23:356-366. [PMID: 33511684 DOI: 10.1111/codi.15544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/14/2021] [Accepted: 01/17/2021] [Indexed: 12/11/2022]
Abstract
AIM The aim of the present pilot study was to describe the type and frequency of long-term gastrointestinal symptoms within a well-defined cohort of colon cancer survivors, their wish for clinical evaluation and treatment outcomes. METHOD A screening survey was sent to colon cancer survivors 12, 24 and 36 months after surgery. Based on their main symptoms, patients who wished to have a consultation were referred to the gastroenterological or surgical unit of our late cancer sequelae clinic. Treatment effect was monitored by questionnaires on bowel symptoms and the EuroQol five-dimensional (EQ-5D) quality-of-life score. RESULTS Overall, 953 patients who had survived colon cancer received the screening survey and 767 replied (response rate 80.5%). Of these, 76 (9.9%; 95% CI 7.9%-12.2%) were referred for algorithm-based clinical evaluation and treatment of bowel dysfunction. The majority were women (69.7%) who had undergone a right-sided colonic resection (65.8%). Patients reported various symptoms, mainly including urgency, fragmented defaecation, loose stools and incontinence for liquid stools. Patients with emptying difficulties and low anterior resection syndrome-like symptoms were referred to the surgical unit and patients with diarrhoea were referred to the gastroenterological unit for clinical work-up. Our main endpoint, mean EQ-5D index after treatment, was improved compared with baseline (baseline 0.809, after treatment 0.846; p = 0.049). After treatment, self-rated bowel function and several bowel symptoms were improved as well. CONCLUSION This study highlights the importance of identifying colon cancer survivors in need of treatment of late gastrointestinal sequelae and clinical management in a multidisciplinary team setting.
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Affiliation(s)
- Helene M Larsen
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.,Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus/Aalborg, Denmark
| | - Mira Mekhael
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.,Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus/Aalborg, Denmark
| | - Therese Juul
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.,Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus/Aalborg, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Mette Borre
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus/Aalborg, Denmark
| | - Peter Christensen
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.,Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus/Aalborg, Denmark
| | - Asbjørn Mohr Drewes
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus/Aalborg, Denmark.,Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Ole Thorlacius-Ussing
- Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus/Aalborg, Denmark.,Department of Gastrointestinal Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Søren Laurberg
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.,Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus/Aalborg, Denmark
| | - Klaus Krogh
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus/Aalborg, Denmark
| | - Janne Ladefoged Fassov
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.,Danish Cancer Society Centre for Research on Survivorship and Late Adverse Effects after Cancer in the Pelvic Organs, Aarhus/Aalborg, Denmark
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14
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Larsen HM, Elfeki H, Emmertsen KJ, Laurberg S. Long-term bowel dysfunction after right-sided hemicolectomy for cancer. Acta Oncol 2020; 59:1240-1245. [PMID: 32501750 DOI: 10.1080/0284186x.2020.1772502] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | - Hossam Elfeki
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgery, Mansoura University Hospital, Mansoura, Egypt
| | - Katrine Jøssing Emmertsen
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgery, Regional Hospital Randers, Randers, Denmark
| | - Søren Laurberg
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
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15
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Belachew AA, Reyes ME, Ye Y, Raju GS, Rodriguez MA, Wu X, Hildebrandt MAT. Patterns of racial/ethnic disparities in baseline health-related quality of life and relationship with overall survival in patients with colorectal cancer. Qual Life Res 2020; 29:2977-2986. [PMID: 32621260 DOI: 10.1007/s11136-020-02565-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Racial disparities are evident in colorectal cancer (CRC) prognosis with black patients experiencing worse outcomes than Hispanics and whites, yet mediators of these disparities are not fully known. The aim of this study is to identify variables that contribute to racial/ethnic disparities in health-related quality of life (HR-QoL) and overall survival in CRC. METHODS Using SF-12 questionnaires, we assessed HR-QoL in 1132 CRC patients by calculating their physical (PCS) and mental composite summary (MCS) scores. Associations between poor PCS/MCS and sociodemographic factors were estimated and survival differences were identified by race/ethnicity. RESULTS Hispanic patients who never married were at greater risk of poor PCS (OR 2.69; 95% CI 1.11-6.49; P = 0.028) than were currently married patients. College education was associated with a decreased risk of poor PCS in Hispanic and white, but not black, patients. Gender was significantly associated with poor MCS among white patients only. CRC patients who reported a poor PCS or MCS had poor survival, with differences in median survival times (MSTs) by race. The effect of PCS was strongest in white CRC patients with a difference in overall MST of > 116 months between those with favorable versus poor physical HR-QoL. Black patients who reported poor Physical and Mental HR-QoL showed significant risk of a poor outcome. CONCLUSION These findings suggest that racial/ethnic disparities in CRC survival may be related to differences in HR-QoL. Identified mediators of HR-QoL could supplement current CRC management strategies to improve patients' survival.
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Affiliation(s)
- Alem A Belachew
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Monica E Reyes
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yuanqing Ye
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gottumukkala S Raju
- Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M Alma Rodriguez
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Office of Cancer Survivorship, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xifeng Wu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michelle A T Hildebrandt
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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16
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Stulz A, Lamore K, Montalescot L, Favez N, Flahault C. Sexual health in colon cancer patients: A systematic review. Psychooncology 2020; 29:1095-1104. [PMID: 32281129 DOI: 10.1002/pon.5391] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 03/28/2020] [Accepted: 03/30/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Despite the impact that diagnosis and treatment can have on patients' sexual health, very little research has been conducted on the impact of colon cancer on sexual health. The aim of this systematic review was to assess the prevalence of sexual dysfunctions in colon cancer and describe the sociodemographic, clinical, and psychological correlates of sexual dysfunction. METHODS Four electronic databases (PsycINFO, PubMed, AcademicSearchPremier, Cochrane Library) were searched for studies reporting sexual adjustment outcomes for colorectal cancer patients from January 1990 to July 2019. RESULTS Of the 380 articles screened, 14 were included in this review. Sexual function is affected by colon cancer: patients' sexual satisfaction decreases significantly, as does the frequency of sexual intercourse. There is an increase in sexual problems (desire, excitement, or pleasure disorders). Male gender, advanced age, distress, and the comorbidities increase sexual disorders. In addition, it appears that partner distress negatively affects patients' sexual health. Taking such difficulties into account appears key for these patients and their partners. They could benefit from better care throughout treatment and in remission. CONCLUSION The results of this systematic review highlight the importance of taking an interest in the sexual health of patients with colon cancer.
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Affiliation(s)
- Alexandra Stulz
- LPPS, Université de Paris, France.,Oncologie, Hôpital Paris Saint Joseph, Paris, France
| | | | | | - Nicolas Favez
- Psychology/FPSE, Université de Genève, Genève, Switzerland
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17
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Firkins J, Hansen L, Driessnack M, Dieckmann N. Quality of life in "chronic" cancer survivors: a meta-analysis. J Cancer Surviv 2020; 14:504-517. [PMID: 32162194 DOI: 10.1007/s11764-020-00869-9] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/18/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Cancer survivors are now living longer giving rise to a new concept-chronic cancer as survivors continue to face long-term consequences of cancer and its treatment. For these survivors, QOL becomes a vital consideration in understanding their survivorship and the long-term impact of cancer and its treatment. The primary aim of this review is to describe QOL in cancer survivors two or more years from diagnosis. METHODS A meta-analysis was completed of relevant studies assessing QOL in long-term cancer survivorship using PubMed, CINHAL, and PsycINFO. A total of 64 articles met inclusion criteria and included in the analysis. Standardized effect sizes and errors were calculated using previously published standard QOL pass rates to compare QOL across measurement tools and calculate cumulative effect sizes (CES). Fixed-effect or random-effects models were used based on the presence of significant heterogeneity of ≤ 0.10. RESULTS Physical health (CES = - 0.894; CI, - 1.472, - 0.316), role-physical health (CES = - 2.039; CI, - 2.643, - 1.435), and mental health (CES = - 0.870; CI, - 1.447, - 0.292) had large, negative cumulative effect sizes signifying worse QOL compared with acceptable QOL rates. Tested moderators, cancer type, average age, country of origin, time since diagnosis, or decade of diagnosis, were not significant to explain heterogeneity between included studies. CONCLUSION QOL is significantly impacted 2 to 26 years after cancer diagnosis. More research is needed to determine possible moderators of QOL in long-term cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS QOL continues to be significantly impacted in long-term cancer survivorship. More research is needed to understand the impact of these findings on care needs for survivors with chronic cancer.
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Affiliation(s)
- Jenny Firkins
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA.
| | - Lissi Hansen
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
| | - Martha Driessnack
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA
| | - Nathan Dieckmann
- Oregon Health & Science University School of Nursing, 3455 SW US Veterans Hospital Road, Portland, OR, 97239, USA.,Division of Clinical Psychology, Oregon Health & Science University, 3314 SW US Veterans Hospital Road, Portland, OR, 97239, USA
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18
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Faury S, Rullier E, Denost Q, Quintard B. Quality of life and fatigue among colorectal cancer survivors according to stoma status - the national VICAN survey. J Psychosoc Oncol 2019; 38:89-102. [PMID: 31304892 DOI: 10.1080/07347332.2019.1638481] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: To assess colorectal cancer survivors' quality of life (QoL) and fatigue according to stoma status.Methods: In this large-scale national survey, we examined and compared QoL (SF-12) and fatigue (QLQ-C30) of colorectal cancer survivors according to stoma status and against population norms. Of the 487 colorectal cancer survivors who participated in the VICAN survey, 43 had a reversed stoma. We randomly selected 43 survivors without stoma as a comparison group.Findings: Colorectal cancer survivors had lower QoL scores compared to population norms. Fatigue affected survivors even two years after diagnosis. Participants with a reversed stoma scored lower on the physical QoL scale than participants without stoma.Conclusion: QoL and fatigue are impaired during a considerable period after cancer diagnosis and differ according to stoma status.Implications for psychosocial providers: Interventions aimed at improving QoL and fatigue for colorectal cancer survivors should be offered on a long-term basis, even two years after diagnosis.
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Affiliation(s)
- Stéphane Faury
- University Bordeaux, Laboratoire Handicap, Activité, Cognition, Santé, EA, Bordeaux, France
| | - Eric Rullier
- Department of Colorectal Surgery, Haut-Leveque Hospital, Bordeaux, France
| | - Quentin Denost
- Department of Colorectal Surgery, Haut-Leveque Hospital, Bordeaux, France
| | - Bruno Quintard
- University Bordeaux, Laboratoire Handicap, Activité, Cognition, Santé, EA, Bordeaux, France
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19
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Roopchand-Martin S, Rajkumar F, Creary-Yan S. Quality of life of cancer patients living in Trinidad and Tobago. Qual Life Res 2019; 28:1863-1872. [PMID: 30826980 DOI: 10.1007/s11136-019-02151-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine quality of life (QoL) of cancer patients in The Republic of Trinidad and Tobago using the European Organization for Research and Treatment of Cancer Care Quality of Life Instrument (EORTC QLQ-C30) and examine relationships between QoL and socioeconomic and medical variables. METHOD A cross-sectional study, consisting of 480 cancer patients being managed at the National Radiotherapy Centre, was conducted. One-way, multiple analysis of variance (MANOVA) with post hoc testing was used to analyze relationships between socioeconomic and medical variables and scales on the EORTC QLQ-C30. Stepwise linear regression was used to evaluate which independent variables contributed to the global QoL and function scores. RESULTS Participants were of mean age 64.1 ± 12.1 years (males) and 56.7 ± 16.6 years (females). Mean values for global QoL and function scales were below 75. Persons in younger age groups had significantly better physical and cognitive function scores (p < 0.05). Males had higher emotional function scores than females (p < 0.05). Persons with higher income and education had better scores on all function scales, except social, and less symptoms (p < 0.05). Persons receiving chemotherapy had more nausea/vomiting, appetite loss, and constipation (p < 0.05). CONCLUSION Age, income, education, and cancer treatment were factors most associated with scores on the EORTC QLQ-C30. Further research is required in this population to examine these variables in more depth and explore methods to improve QoL of cancer patients in this population.
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Affiliation(s)
- S Roopchand-Martin
- Faculty of Sport, Mona Academy of Sport, The University of the West Indies-Mona, Mona Campus, Kingston 7, Jamaica.
| | - F Rajkumar
- Physiotherapy Department, Eric Williams Medical Sciences Complex, Uriah Buttler Highway, Champs Fleurs, Trinidad
| | - S Creary-Yan
- Faculty of Sport, Mona Academy of Sport, The University of the West Indies-Mona, Mona Campus, Kingston 7, Jamaica
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20
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Harms CA, Cohen L, Pooley JA, Chambers SK, Galvão DA, Newton RU. Quality of life and psychological distress in cancer survivors: The role of psycho‐social resources for resilience. Psychooncology 2018; 28:271-277. [DOI: 10.1002/pon.4934] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/04/2018] [Accepted: 10/24/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Craig A. Harms
- School of Arts and Humanities, Psychology and CriminologyEdith Cowan University Joondalup Australia
| | - Lynne Cohen
- Faculty of Education and ArtsEdith Cowan University Joondalup Australia
| | - Julie Ann Pooley
- School of Arts and Humanities, Psychology and CriminologyEdith Cowan University Joondalup Australia
| | - Suzanne K. Chambers
- Exercise Medicine Research InstituteEdith Cowan University Joondalup Australia
- Menzies Health Institute QueenslandGriffith University Southport QLD Australia
- Cancer Council QueenslandCancer Research Centre Brisbane QLD Australia
| | - Daniel A. Galvão
- Exercise Medicine Research InstituteEdith Cowan University Joondalup Australia
| | - Robert U. Newton
- Exercise Medicine Research InstituteEdith Cowan University Joondalup Australia
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21
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Shin WJ, Zabel BA, Pachynski RK. Mechanisms and Functions of Chemerin in Cancer: Potential Roles in Therapeutic Intervention. Front Immunol 2018; 9:2772. [PMID: 30555465 PMCID: PMC6283908 DOI: 10.3389/fimmu.2018.02772] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/12/2018] [Indexed: 12/18/2022] Open
Abstract
Chemerin [RARRES2 [retinoic acid receptor responder 2], TIG2 [tazarotene induced gene 2 (TIG2)]] is a multifunctional cytokine initially described in skin cultures upon exposure to the synthetic retinoid tazarotene. Its secreted pro-form, prochemerin, is widely expressed, found systemically, and is readily converted into active chemerin by various proteases. Subsequent studies elucidated major roles of chemerin as both a leukocyte chemoattractant as well as an adipokine. Chemerin's main chemotactic receptor, the G-protein coupled receptor CMKLR1, is expressed on macrophages, dendritic, and NK cells. With respect to its role in immunology, chemerin mediates trafficking of these cells to sites of inflammation along its concentration gradient, and likely helps coordinate early responses, as it has been shown to have antimicrobial and angiogenic properties, as well. Recently, there has been mounting evidence that chemerin is an important factor in various cancers. As with its role in immune responses-where it can act as both a pro- and anti-inflammatory mediator-the potential functions or correlations chemerin has in or with cancer appears to be context dependent. Most studies, however, suggest a downregulation or loss of chemerin/RARRES2 in malignancies compared to the normal tissue counterparts. Here, we perform a comprehensive review of the literature to date and summarize relevant findings in order to better define the roles of chemerin in the setting of the tumor microenvironment and tumor immune responses, with an ultimate focus on the potential for therapeutic intervention.
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Affiliation(s)
- Woo Jae Shin
- Division of Oncology, Washington University School of Medicine, St. Louis, MO, United States
| | - Brian A. Zabel
- Palo Alto Veterans Institute for Research (PAVIR), VA Palo Alto Health Care Systems (VAPAHCS), Palo Alto, CA, United States
| | - Russell K. Pachynski
- Division of Oncology, Washington University School of Medicine, St. Louis, MO, United States
- The Andrew M. and Jane M. Bursky Center for Human Immunology & Immunotherapy Programs (CHiiPs), St. Louis, MO, United States
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22
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Wu HJ, Tai CJ, Tai CJ, Chien LY. Symptom severity, symptom interference and use of complementary and alternative medicine among survivors of colorectal and breast cancer after curative treatment in Taiwan. Eur J Cancer Care (Engl) 2018; 28:e12925. [DOI: 10.1111/ecc.12925] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 03/21/2018] [Accepted: 08/22/2018] [Indexed: 01/10/2023]
Affiliation(s)
- Hsiu-Ju Wu
- Department of Oncology; Sijhih Cathay General Hospital; Taipei Taiwan
| | - Chen-Jei Tai
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine; Taipei Medical University; Taipei Taiwan
- Department of Traditional Chinese Medicine; Taipei Medical University Hospital; Taipei Taiwan
| | - Cheng-Jeng Tai
- Department of Internal Medicine, School of Medicine, College of Medicine; Taipei Medical University; Taipei Taiwan
- Division of Hematology and Oncology, Department of Internal Medicine; Taipei Medical University Hospital; Taipei Taiwan
| | - Li-Yin Chien
- Institute of Community Health Care; National Yang-Ming University; Taipei Taiwan
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23
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Soares-Miranda L, Abreu S, Ruiz-Casado A, Lucia A. Physical activity and nutritional interventions and health-related quality of life in colorectal cancer survivors: a review. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/23809000.2018.1503538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Luisa Soares-Miranda
- University of Porto, Research Center in Physical Activity Health and Leisure, Faculty of Sport, Porto, Portugal
| | - Sandra Abreu
- University of Porto, Research Center in Physical Activity Health and Leisure, Faculty of Sport, Porto, Portugal
- Faculty of Psychology, Education and Sport, Lusófona University of Porto, Porto, Portugal
| | - Ana Ruiz-Casado
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Alejandro Lucia
- Research Institute of Hospital 12 de Octubre (‘i+12ʹ), Madrid, Spain
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
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24
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Leermakers L, Döking S, Thewes B, Braamse AMJ, Gielissen MFM, de Wilt JHW, Collette EH, Dekker J, Prins JB. Study protocol of the CORRECT multicenter trial: the efficacy of blended cognitive behavioral therapy for reducing psychological distress in colorectal cancer survivors. BMC Cancer 2018; 18:748. [PMID: 30021555 PMCID: PMC6052704 DOI: 10.1186/s12885-018-4645-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 06/28/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Approximately one third of the colorectal cancer survivors (CRCS) experience high levels of psychological distress. Common concerns experienced by CRCS include distress related to physical problems, anxiety, fear of cancer recurrence (FCR) and depressive symptoms. However, psychological interventions for distressed CRCS are scarce. Therefore, a blended therapy was developed, combining face-to-face cognitive behavioral therapy (CBT) with online self-management activities and telephone consultations. The aim of the study is to evaluate the efficacy and cost-effectiveness of this blended therapy in reducing psychological distress in CRCS. METHODS/DESIGN The CORRECT study is a two-arm multicenter randomized controlled trial (RCT). A sample of 160 highly distressed CRCS (a score on the Distress Thermometer of 5 or higher) will be recruited from several hospitals in the Netherlands. CRCS will be randomized to either the intervention condition (blended CBT) or the control condition (care as usual). The blended therapy covers approximately 14 weeks and combines five face-to-face sessions and three telephone consultations with a psychologist, with access to an interactive self-management website. It includes three modules which are individually-tailored to patient concerns and aimed at decreasing: 1) distress caused by physical consequences of CRC, 2) anxiety and FCR, 3) depressive symptoms. Patients can choose between the optional modules. The primary outcome is general distress (Brief Symptom Inventory-18). Secondary outcomes are quality of life and general psychological wellbeing. Assessments will take place at baseline prior to randomization, after 4 and 7 months. DISCUSSION Blended CBT is an innovative and promising approach for providing tailored supportive care to reduce high distress in CRCS. If the intervention proves to be effective, an evidence-based intervention will become available for implementation in clinical practice. TRIAL REGISTRATION This trial is registered in the Netherlands Trial Register ( NTR6025 ) on August 3, 2016.
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Affiliation(s)
- L. Leermakers
- Radboud Institute for Health Sciences, Department of Medical Psychology Radboud University Medical Center, (840), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - S. Döking
- Radboud Institute for Health Sciences, Department of Medical Psychology Radboud University Medical Center, (840), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - B. Thewes
- Radboud Institute for Health Sciences, Department of Medical Psychology Radboud University Medical Center, (840), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - A. M. J. Braamse
- Department of Medical Psychology, Amsterdam UMC, location AMC, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - M. F. M. Gielissen
- Radboud Institute for Health Sciences, Department of primary and community care, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Siza (disability service) Arnhem, P.O. Box 532, 6800 AM Arnhem, The Netherlands
| | - J. H. W. de Wilt
- Radboud Institute for Health Sciences, Department of Surgery, Radboud university medical center, (725), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - E. H. Collette
- Department of Medical Psychology, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - J. Dekker
- Department of Rehabilitation Medicine, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - J. B. Prins
- Radboud Institute for Health Sciences, Department of Medical Psychology Radboud University Medical Center, (840), P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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25
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Lin KY, Denehy L, Frawley HC, Wilson L, Granger CL. Pelvic floor symptoms, physical, and psychological outcomes of patients following surgery for colorectal cancer. Physiother Theory Pract 2018; 34:442-452. [PMID: 29308963 DOI: 10.1080/09593985.2017.1422165] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Little has been published regarding general and pelvic floor-related health status in patients who have undergone surgery for colorectal cancer (CRC). OBJECTIVE The objective of the study was to assess changes in pelvic floor symptoms, physical activity levels, psychological status, and health-related quality of life (HRQoL) in patients with CRC from pre- to 6 months postoperatively. METHODS Pelvic floor symptoms, physical activity levels, anxiety and depression, and HRQoL of 30 participants who were undergoing surgery for stages I-III CRC were evaluated pre- and 6 months postoperatively. RESULTS Six months postoperatively, there were no significant changes in severity of pelvic floor symptoms, or other secondary outcomes (physical activity levels, depression, global HRQoL) compared to preoperative levels (p > 0.05). However, fecal incontinence (p = 0.03) and hair loss (p = 0.003) measured with the HRQoL instrument were significantly worse. Participants were engaged in low levels of physical activity before (42.3%) and after surgery (47.4%). CONCLUSION The findings of a high percentage of participants with persistent low physical activity levels and worse bowel symptoms after CRC surgery compared to preoperative levels suggest the need for health-care professionals to provide information about the benefits of physical activity and bowel management at postoperative follow-ups. Further investigation in larger studies is warranted.
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Affiliation(s)
- Kuan-Yin Lin
- a Department of Physiotherapy, School of Health Sciences , University of Melbourne , Melbourne , Australia.,b Department of Physiotherapy , Royal Melbourne Hospital , Melbourne , Australia.,c Centre for Allied Health Research and Education, Cabrini Health , Melbourne , Australia
| | - Linda Denehy
- a Department of Physiotherapy, School of Health Sciences , University of Melbourne , Melbourne , Australia.,e Institute for Breathing and Sleep , Melbourne , Victoria , Australia
| | - Helena C Frawley
- c Centre for Allied Health Research and Education, Cabrini Health , Melbourne , Australia.,d Physiotherapy, School of Allied Health , La Trobe University , Melbourne , Australia
| | - Lisa Wilson
- f Department of General Surgery , The Royal Melbourne Hospital , Melbourne , Victoria , Australia
| | - Catherine L Granger
- a Department of Physiotherapy, School of Health Sciences , University of Melbourne , Melbourne , Australia.,b Department of Physiotherapy , Royal Melbourne Hospital , Melbourne , Australia.,e Institute for Breathing and Sleep , Melbourne , Victoria , Australia
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Jefford M, Emery J, Grunfeld E, Martin A, Rodger P, Murray AM, De Abreu Lourenco R, Heriot A, Phipps-Nelson J, Guccione L, King D, Lisy K, Tebbutt N, Burgess A, Faragher I, Woods R, Schofield P. SCORE: Shared care of Colorectal cancer survivors: protocol for a randomised controlled trial. Trials 2017; 18:506. [PMID: 29084595 PMCID: PMC5663101 DOI: 10.1186/s13063-017-2245-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 10/10/2017] [Indexed: 12/20/2022] Open
Abstract
Background Colorectal cancer (CRC) is the most common cancer affecting both men and women. Survivors of CRC often experience various physical and psychological effects arising from CRC and its treatment. These effects may last for many years and adversely affect QoL, and they may not be adequately addressed by standard specialist-based follow-up. Optimal management of these effects should harness the expertise of both primary care and specialist care. Shared models of care (involving both the patient’s primary care physician [PCP] and specialist) have the potential to better support survivors and enhance health system efficiency. Methods/design SCORE (Shared care of Colorectal cancer survivors) is a multisite randomised controlled trial designed to optimise and operationalise a shared care model for survivors of CRC, to evaluate the acceptability of the intervention and study processes, and to collect preliminary data regarding the effects of shared care compared with usual care on a range of patient-reported outcomes. The primary outcome is QoL measured using the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire. Secondary outcomes are satisfaction with care, unmet needs, continuity of care and health resource use. The shared care model involves replacement of two routine specialist follow-up visits with PCP visits, as well as the provision of a tailored survivorship care plan and a survivorship booklet and DVD for CRC survivors. All consenting patients will be randomised 1:1 to either shared care or usual care and will complete questionnaires at three time points over a 12-month period (baseline and at 6 and 12 months). Health care resource use data will also be collected and used to evaluate costs. Discussion The evaluation and implementation of models of care that are responsive to the holistic needs of cancer survivors while reducing the burden on acute care settings is an international priority. Shared care between specialists and PCPs has the potential to enhance patient care and outcomes for CRC survivors while offering improvements in health care resource efficiency. If the findings of the present study show that the shared care intervention is acceptable and feasible for CRC survivors, the intervention may be readily expanded to other groups of cancer survivors. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12617000004369p. Registered on 3 January 2017; protocol version 4 approved 24 February 2017. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2245-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michael Jefford
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. .,Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia. .,Division of Cancer Medicine, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
| | - Jon Emery
- Department of General Practice and Centre for Cancer Research, University of Melbourne, Victorian Comprehensive Cancer Centre, Melbourne, VIC, Australia
| | - Eva Grunfeld
- Ontario Institute for Cancer Research, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Andrew Martin
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Paula Rodger
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Alexandra M Murray
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
| | - Alexander Heriot
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Jo Phipps-Nelson
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Lisa Guccione
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Psychology Department, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Dorothy King
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Karolina Lisy
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Niall Tebbutt
- Department of Medical Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, VIC, Australia
| | - Adele Burgess
- Colorectal Surgery Unit, Austin Health, Heidelberg, VIC, Australia
| | - Ian Faragher
- Colorectal Surgery, Western Health, Footscray, VIC, Australia
| | - Rodney Woods
- Colorectal Surgery Unit, St Vincent's Hospital, Fitzroy, VIC, Australia
| | - Penelope Schofield
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Department of Psychology, School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Heidelberg, VIC, Australia
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27
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Ahn S, Jung H, Kim S, Shin SJ, Park CG, Chu SH. Quality of life among Korean gastrointestinal cancer survivors. Eur J Oncol Nurs 2017; 30:15-21. [DOI: 10.1016/j.ejon.2017.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/22/2017] [Accepted: 07/03/2017] [Indexed: 12/30/2022]
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Drury A, Payne S, Brady AM. Cancer survivorship: Advancing the concept in the context of colorectal cancer. Eur J Oncol Nurs 2017; 29:135-147. [PMID: 28720260 DOI: 10.1016/j.ejon.2017.06.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/10/2017] [Accepted: 06/21/2017] [Indexed: 12/31/2022]
Abstract
PURPOSE Previous conceptualizations of cancer survivorship have focused on heterogeneous cancer survivors, with little consideration of the validity of conclusions for homogeneous tumour groups. This paper aims to examine the concept of cancer survivorship in the context of colorectal cancer (CRC). METHOD Rodgers' (1989) Evolutionary Method of Concept Analysis guided this study. A systematic search of PUBMED, CINAHL, PsycINFO and The Cochrane Library was conducted in November 2016 to identify studies of CRC survivorship. The Braun and Clarke (2006) framework guided the analysis and interpretation of data extracted from eighty-five publications. RESULTS Similar to general populations of cancer survivors, CRC survivors experience survivorship as an individual, life-changing process, punctuated by uncertainty and a duality of positive and negative outcomes affecting quality of life. However, CRC survivors experience specific concerns arising from the management of their disease. The concept of cancer survivorship has evolved over the past decade as the importance of navigating the healthcare system and its resources, and the constellation of met and unmet needs of cancer survivors are realised. CONCLUSIONS The results highlight core similarities between survivorship in the context of CRC and other tumour groups, but underlines issues specific to CRC survivorship. Communication and support are key issues in survivorship care which may detrimentally affect CRC survivors' well-being if they are inadequately addressed. Healthcare professionals (HCP's) therefore have a duty to ensure cancer survivors' health, information and supportive care needs are met in the aftermath of treatment.
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Affiliation(s)
- Amanda Drury
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin 2, Ireland.
| | - Sheila Payne
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK
| | - Anne-Marie Brady
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin 2, Ireland; Centre for Practice and Healthcare Innovation, School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin 2, Ireland
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29
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Lee JY, Lee MK, Kim NK, Chu SH, Lee DC, Lee HS, Lee JW, Jeon JY. Serum chemerin levels are independently associated with quality of life in colorectal cancer survivors: A pilot study. PLoS One 2017; 12:e0176929. [PMID: 28475614 PMCID: PMC5419570 DOI: 10.1371/journal.pone.0176929] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 04/19/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) survivors are known to experience various symptoms that significantly affect their quality of life (QOL); therefore, it is important to identify clinical markers related with CRC survivor QOL. Here we investigated the relationship between serum chemerin levels, a newly identified proinflammatory adipokine, and QOL in CRC survivors. METHODS A data of total of 110 CRC survivors were analysed in the study. Serum chemerin levels were measured with an enzyme immunoassay analyser. Functional Assessment of Cancer Therapy (FACT) scores were used as an indicator of QOL in CRC survivors. RESULTS Weak but not negligible relationships were observed between serum chemerin levels and FACT-General (G) (r = -0.22, p<0.02), FACT-Colorectal cancer (C) (r = -0.23, p<0.02) and FACT-Fatigue (F) scores (r = -0.27, p<0.01) after adjusting for confounding factors. Both stepwise and enter method multiple linear regression analyses confirmed that serum chemerin levels were independently associated with FACT-G (stepwise: β = -0.15, p<0.01; enter: β = -0.12, p = 0.02), FACT-C (stepwise: β = -0.19, p<0.01; enter; β = -0.14, p = 0.02) and FACT-F scores (stepwise: β = -0.23, p<0.01; enter: β = -0.20, p<0.01). CONCLUSIONS Our results demonstrate a weak inverse relationship between serum chemerin and CRC survivor QOL. Although it is impossible to determine causality, our findings suggest that serum chemerin levels may have a significant association with CRC survivor QOL. Further prospective studies are required to confirm the clinical significance of our pilot study.
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Affiliation(s)
- Jee-Yon Lee
- Department of Family Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea
- Department of Family Medicine, CHA University College of Medicine, CHA Bundang Medical Center, Chaum Life Center, Seoul, Republic of Korea
| | - Mi-Kyung Lee
- Department of Sport and Leisure Studies, Sports Medicine Laboratory, Yonsei University, Seoul, Republic of Korea
| | - Nam-Kyu Kim
- Department of General Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-Hui Chu
- Department of Clinical Nursing Science, Yonsei University, College of Nursing, Nursing Policy Research Institute, Bio-behavioural Research Centre, Seoul, Republic of Korea
| | - Duk-Chul Lee
- Department of Family Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea
| | - Hye-Sun Lee
- Department of Biostatistics, Yonsei University, College of Medicine, Seoul, Republic of Korea
| | - Ji-Won Lee
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- * E-mail: (JWL); (JYJ)
| | - Justin Y. Jeon
- Department of Family Medicine, CHA University College of Medicine, CHA Bundang Medical Center, Chaum Life Center, Seoul, Republic of Korea
- * E-mail: (JWL); (JYJ)
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30
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Drury A, Payne S, Brady AM. The cost of survival: an exploration of colorectal cancer survivors' experiences of pain. Acta Oncol 2017; 56:205-211. [PMID: 28068155 DOI: 10.1080/0284186x.2016.1266084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The Institute of Medicine report 'From Cancer Patient to Cancer Survivor' has drawn widespread attention to the experiences of cancer survivors. Research examining the symptom experiences of survivors are proliferative within the literature but limited by samples which include multiple tumor groups and varying inclusion criteria. This cross-sectional quantitative study seeks to examine pain and quality of life (QoL) in the context of colorectal cancer (CRC) survivorship, as defined by the Institute of Medicine. MATERIAL AND METHODS A purposive sample of CRC survivors (n = 252) attending hospitals and cancer support centers in the Republic of Ireland were recruited between September 2014 and January 2016. Self-rated health (SRH), QoL and pain were assessed in the sample using the EuroQOL questionnaire, the Functional Assessment of Therapy-Colorectal (FACT-C) questionnaire, and symptom experience items. RESULTS One hundred participants (40%) indicated they had pain on the day of the survey or in the past week. Of those with pain, many also experienced a lack of energy (95%), bowel dysfunction (74%), sleep disturbance (76%) or interference with their ability to enjoy life (75%). Pain was associated with younger age, female gender, current chemotherapy treatment, and previous radiotherapy treatment. Although participants reported positive QoL scores, statistical analysis revealed pain was linked to significantly poorer SRH and overall QoL, and poorer physical, emotional, functional, social/family and CRC-specific wellbeing, compared to those who did not indicate pain. DISCUSSION Pain was experienced by almost two fifths of CRC survivors up to five years after treatment and was associated with poorer SRH and QoL. In light of these findings, healthcare professionals must endeavor to manage cancer survivors' needs in a manner which is cognizant of the burden of pain and in the context of other symptoms and morbidities experienced by long-term cancer survivors.
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Affiliation(s)
- Amanda Drury
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
| | - Sheila Payne
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Lancaster, UK
| | - Anne-Marie Brady
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
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31
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Kayser K, Acquati C, Reese JB, Mark K, Wittmann D, Karam E. A systematic review of dyadic studies examining relationship quality in couples facing colorectal cancer together. Psychooncology 2017; 27:13-21. [PMID: 27943551 DOI: 10.1002/pon.4339] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 11/13/2016] [Accepted: 12/02/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND Despite the adverse effects that treatment for colorectal cancer can have on patients' quality of life and, in particular, their intimate relationships, very little research has been conducted on the psychosocial adjustment for both patients and their partners/spouses. OBJECTIVES The aim of this systematic review was to examine dyadic studies of adjustment in couples in which one partner has been diagnosed with colorectal cancer. METHODS Pub Med, PsychINFO, MEDLINE, Social Sciences Abstracts (EBSCO), and the Cochrane Library were systematically searched for studies reporting quality of life outcomes for colorectal cancer patients and their partners/spouses. Only studies that included dyads in the sample were eligible for inclusion. The Quality Assessment Tool for Quantitative Studies was used to evaluate each study. RESULTS A total of 277 studies were identified, of which 9 studies met the inclusion criteria (N = 388 couples). The methodological quality of the studies was high in that they used standardized instruments validated with their samples, conducted dyadic data analyses (when appropriate), and used longitudinal designs. A synthesis of the studies revealed that (1) relationship factors (eg, support, communication, dyadic coping, and relationship satisfaction) affect adjustment to cancer; (2) cancer-related distress impacts each partner's adjustment or the relationship; and (3) gender, role (patient/caregiver), and clinical characteristics (treatment, mental health) can mediate adjustment to cancer. CONCLUSION The quality of the relationship can influence patients' and their partners' adjustment to colorectal cancer. Psychosocial interventions that address relationship issues may be beneficial to couples facing the challenges of colorectal cancer.
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Affiliation(s)
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Jennifer Barsky Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Kristen Mark
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
| | - Daniela Wittmann
- Urology, Taubman Center, University of Michigan, Ann Arbor, MI, USA
| | - Eli Karam
- University of Louisville, Louisville, KY, USA
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32
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Frick MA, Vachani CC, Hampshire MK, Bach C, Arnold-Korzeniowski K, Metz JM, Hill-Kayser CE. Survivorship after lower gastrointestinal cancer: Patient-reported outcomes and planning for care. Cancer 2017; 123:1860-1868. [DOI: 10.1002/cncr.30527] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/12/2016] [Accepted: 12/02/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Melissa A. Frick
- Department of Radiation Oncology; Perelman Center for Academic Medicine, University of Pennsylvania; Philadelphia Pennsylvania
| | - Carolyn C. Vachani
- Department of Radiation Oncology; Perelman Center for Academic Medicine, University of Pennsylvania; Philadelphia Pennsylvania
| | - Margaret K. Hampshire
- Department of Radiation Oncology; Perelman Center for Academic Medicine, University of Pennsylvania; Philadelphia Pennsylvania
| | - Christina Bach
- Department of Radiation Oncology; Perelman Center for Academic Medicine, University of Pennsylvania; Philadelphia Pennsylvania
| | - Karen Arnold-Korzeniowski
- Department of Radiation Oncology; Perelman Center for Academic Medicine, University of Pennsylvania; Philadelphia Pennsylvania
| | - James M. Metz
- Department of Radiation Oncology; Perelman Center for Academic Medicine, University of Pennsylvania; Philadelphia Pennsylvania
| | - Christine E. Hill-Kayser
- Department of Radiation Oncology; Perelman Center for Academic Medicine, University of Pennsylvania; Philadelphia Pennsylvania
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33
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Soares-Miranda L, Abreu S, Silva M, Peixoto A, Ramalho R, da Silva PC, Costa C, Teixeira JP, Gonçalves C, Moreira P, Mota J, Macedo G. Cancer Survivor Study (CASUS) on colorectal patients: longitudinal study on physical activity, fitness, nutrition, and its influences on quality of life, disease recurrence, and survival. Rationale and design. Int J Colorectal Dis 2017; 32:75-81. [PMID: 27730356 DOI: 10.1007/s00384-016-2671-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2016] [Indexed: 02/04/2023]
Abstract
PURPOSE Evidence suggests that being physically active in combination with a healthy diet contributes to diminish colorectal cancer risk. However, if this is true for colorectal cancer primary prevention, the same is not clear for its recurrence after colorectal cancer treatments. Data on cancer survival are scarce, and there is a need for greater attention on these survivors' lifestyle behavior. This manuscript describes rationale and design of the Cancer Survival Study (CASUS) on colorectal patients, a longitudinal observational study with the aim of investigating how physical activity, physical fitness, and dietary intake are related with their quality of life, disease recurrence, and survival. METHODS The CASUS on colorectal patients is a longitudinal cohort study on colorectal survivors, aged 18 years or older, recruited 6, 12, and 24 months after surgery. Upon recruitment, patients fill in a battery of questionnaires about physical activity, dietary intake, and quality of life, donate blood samples, do physical fitness tests, and use an accelerometer during 7 days. Repeated analyses will be performed to assess changes over time in physical activity, physical fitness, dietary intake, and other factors in relation to recurrence and survival. CONCLUSIONS Results will contribute to highlight the role of physical activity, physical fitness, and nutrition in the quality of life of colorectal cancer survivors, recurrence, and survival. This study will provide important information for policymakers on the potential benefits of future physical activity and nutritional interventions, which are inexpensive, as a way to improve general health of colorectal cancer survivors.
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Affiliation(s)
- Luisa Soares-Miranda
- Research Center in Physical Activity Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal.
| | - Sandra Abreu
- Research Center in Physical Activity Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
| | - Marco Silva
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
| | - Armando Peixoto
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
| | - Rosa Ramalho
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
| | | | - Carla Costa
- Environmental Health Department, National Institute of Public Health, Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
| | - João Paulo Teixeira
- Environmental Health Department, National Institute of Public Health, Porto, Portugal.,EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Carla Gonçalves
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Pedro Moreira
- Research Center in Physical Activity Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal.,Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Jorge Mota
- Research Center in Physical Activity Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
| | - Guilherme Macedo
- Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal
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Dreidi MM, Hamdan-Mansour AM. Pain, Sleep Disturbance, and Quality of Life Among Palestinian Patients Diagnosed with Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:796-803. [PMID: 26561425 DOI: 10.1007/s13187-015-0946-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The objective of this descriptive study is to explore the relationships between pain, sleep disturbance, and quality of life among Palestinian patients diagnosed with cancer in the West Bank. A cross-sectional, descriptive-correlational design was used to collect data from 184 patients with cancer. The quality of life questionnaire, visual analogue pain scale, and physical health status were used in data collection. The results showed that the mean score for pain was 5, the best functioning was for cognitive scale (M = 75, SD = 29), the worst symptoms experienced by patients was appetite loss (M = 47, SD = 35), a moderate global health status (M = 53, SD = 27), and the mean for sleep disturbance was 43 (SD = 35). Pain and sleep disturbance showed high negative correlations with functional scales of quality of life and positive with symptom scales. The findings showed that the co-occurrence of pain and sleep disturbance was negatively correlated with quality of life (QoL) and positively with symptom scales. The regression analysis revealed that pain and sleep disturbance accounted for a significant proportion of variance in the QoL (p < 0.001), and the highest proportion was in predicting global health status (41.9 %). The findings of this study give evidence about the importance of assessing pain and sleep quality among Palestinian patients with cancer.
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Affiliation(s)
- Mu'taz M Dreidi
- Faculty of Nursing, Pharmacy and Health Professions, Birzeit University, P. O. Box 14, Birzeit, Palestine.
| | - Ayman M Hamdan-Mansour
- Department of Community Health Nursing, Faculty of Nursing, The University of Jordan, Amman, 11942, Jordan
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35
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Jefford M, Gough K, Drosdowsky A, Russell L, Aranda S, Butow P, Phipps-Nelson J, Young J, Krishnasamy M, Ugalde A, King D, Strickland A, Franco M, Blum R, Johnson C, Ganju V, Shapiro J, Chong G, Charlton J, Haydon A, Schofield P. A Randomized Controlled Trial of a Nurse-Led Supportive Care Package (SurvivorCare) for Survivors of Colorectal Cancer. Oncologist 2016; 21:1014-23. [PMID: 27306909 DOI: 10.1634/theoncologist.2015-0533] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/08/2016] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Colorectal cancer (CRC) and its treatments can cause distressing sequelae. We conducted a multicenter randomized controlled trial aiming to improve psychological distress, supportive care needs (SCNs), and quality of life (QOL) of patients with CRC. The intervention, called SurvivorCare (SC), comprised educational materials, needs assessment, survivorship care plan, end-of-treatment session, and three follow-up telephone calls. METHODS At the end of treatment for stage I-III CRC, eligible patients were randomized 1:1 to usual care (UC) or to UC plus SC. Distress (Brief Symptom Inventory 18), SCNs (Cancer Survivors' Unmet Needs measure), and QOL (European Organization for Research and Treatment of Cancer [EORTC] QOL questionnaires C30 and EORTC CRC module CR29) were assessed at baseline and at 2 and 6 months (follow-up 1 [FU1] and FU2, respectively). The primary hypothesis was that SC would have a beneficial effect on distress at FU1. The secondary hypotheses were that SC would have a beneficial effect on (a) SCN and QOL at FU1 and on (b) distress, SCNs, and QOL at FU2. A total of 15 items assessed experience of care. RESULTS Of 221 patients randomly assigned, 4 were ineligible for the study and 1 was lost to FU, leaving 110 in the UC group and 106 in the SC group. Patients' characteristics included the following: median age, 64 years; men, 52%; colon cancer, 56%; rectal cancer, 35%; overlapping sites of disease, 10%; stage I disease, 7%; stage II, 22%; stage III, 71%. Baseline distress and QOL scores were similar to population norms. Between-group differences in distress at FU1 (primary outcome) and at FU2, and SCNs and QOL at FU1 and FU2 were small and nonsignificant. Patients in the SC group were more satisfied with survivorship care than those in the UC group (significant differences on 10 of 15 items). CONCLUSION The addition of SC to UC did not have a beneficial effect on distress, SCNs, or QOL outcomes, but patients in the SC group were more satisfied with care. IMPLICATIONS FOR PRACTICE Some survivors of colorectal cancer report distressing effects after completing treatment. Strategies to identify and respond to survivors' issues are needed. In a randomized controlled trial, the addition of a nurse-led supportive care package (SurvivorCare) to usual post-treatment care did not impact survivors' distress, quality of life, or unmet needs. However, patients receiving the SurvivorCare intervention were more satisfied with survivorship care. Factors for consideration in the design of subsequent studies are discussed.
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Affiliation(s)
- Michael Jefford
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Karla Gough
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Allison Drosdowsky
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Lahiru Russell
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia Deakin University, Melbourne, Victoria, Australia
| | - Sanchia Aranda
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia Cancer Institute NSW, Sydney, New South Wales, Australia
| | - Phyllis Butow
- University of Sydney, Sydney, New South Wales, Australia
| | - Jo Phipps-Nelson
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Jane Young
- Cancer Institute NSW, Sydney, New South Wales, Australia University of Sydney, Sydney, New South Wales, Australia
| | - Mei Krishnasamy
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Anna Ugalde
- Deakin University, Melbourne, Victoria, Australia
| | - Dorothy King
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | | | | | - Robert Blum
- Bendigo Health, Bendigo, Victoria, Australia
| | | | - Vinod Ganju
- Peninsula and Southeast Oncology, Melbourne, Victoria, Australia
| | | | - Geoffrey Chong
- Ballarat Regional Integrated Cancer Centre, Ballarat, Victoria, Australia
| | - Julie Charlton
- Newcastle Private Hospital, Newcastle, New South Wales, Australia
| | | | - Penelope Schofield
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia Department of Psychology, Swinburne University of Technology, Melbourne, Victoria, Australia
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McNair AGK, Whistance RN, Forsythe RO, Rees J, Jones JE, Pullyblank AM, Avery KNL, Brookes ST, Thomas MG, Sylvester PA, Russell A, Oliver A, Morton D, Kennedy R, Jayne DG, Huxtable R, Hackett R, Dutton SJ, Coleman MG, Card M, Brown J, Blazeby JM. Synthesis and summary of patient-reported outcome measures to inform the development of a core outcome set in colorectal cancer surgery. Colorectal Dis 2015; 17:O217-29. [PMID: 26058878 PMCID: PMC4744711 DOI: 10.1111/codi.13021] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 05/05/2015] [Indexed: 12/14/2022]
Abstract
AIM Patient-reported outcome (PRO) measures (PROMs) are standard measures in the assessment of colorectal cancer (CRC) treatment, but the range and complexity of available PROMs may be hindering the synthesis of evidence. This systematic review aimed to: (i) summarize PROMs in studies of CRC surgery and (ii) categorize PRO content to inform the future development of an agreed minimum 'core' outcome set to be measured in all trials. METHOD All PROMs were identified from a systematic review of prospective CRC surgical studies. The type and frequency of PROMs in each study were summarized, and the number of items documented. All items were extracted and independently categorized by content by two researchers into 'health domains', and discrepancies were discussed with a patient and expert. Domain popularity and the distribution of items were summarized. RESULTS Fifty-eight different PROMs were identified from the 104 included studies. There were 23 generic, four cancer-specific, 11 disease-specific and 16 symptom-specific questionnaires, and three ad hoc measures. The most frequently used PROM was the EORTC QLQ-C30 (50 studies), and most PROMs (n = 40, 69%) were used in only one study. Detailed examination of the 50 available measures identified 917 items, which were categorized into 51 domains. The domains comprising the most items were 'anxiety' (n = 85, 9.2%), 'fatigue' (n = 67, 7.3%) and 'physical function' (n = 63, 6.9%). No domains were included in all PROMs. CONCLUSION There is major heterogeneity of PRO measurement and a wide variation in content assessed in the PROMs available for CRC. A core outcome set will improve PRO outcome measurement and reporting in CRC trials.
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Affiliation(s)
- A. G. K. McNair
- Centre for Surgical ResearchSchool of Social and Community MedicineUniversity of BristolBristolUK,Severn School of SurgeryUniversity Hospitals Bristol NHS Foundation TrustBristolUK
| | - R. N. Whistance
- Centre for Surgical ResearchSchool of Social and Community MedicineUniversity of BristolBristolUK,Division of Surgery Head and NeckUniversity Hospitals Bristol NHS Foundation TrustBristolUK
| | - R. O. Forsythe
- Centre for Surgical ResearchSchool of Social and Community MedicineUniversity of BristolBristolUK,Division of Surgery Head and NeckUniversity Hospitals Bristol NHS Foundation TrustBristolUK
| | - J. Rees
- Centre for Surgical ResearchSchool of Social and Community MedicineUniversity of BristolBristolUK
| | - J. E. Jones
- Colorectal Cancer Patient RepresentativeNorth Bristol NHS TrustBristolUK
| | | | - K. N. L. Avery
- Centre for Surgical ResearchSchool of Social and Community MedicineUniversity of BristolBristolUK
| | - S. T. Brookes
- Centre for Surgical ResearchSchool of Social and Community MedicineUniversity of BristolBristolUK
| | - M. G. Thomas
- Colorectal Surgery UnitUniversity Hospitals Bristol NHS Foundation TrustBristolUK
| | - P. A. Sylvester
- Colorectal Surgery UnitUniversity Hospitals Bristol NHS Foundation TrustBristolUK
| | - A. Russell
- Colorectal Consumer Liaison GroupNational Cancer Research InstituteLondonUK
| | - A. Oliver
- Colorectal Consumer Liaison GroupNational Cancer Research InstituteLondonUK
| | - D. Morton
- Academic Department of SurgeryUniversity of BirminghamBirminghamUK
| | - R. Kennedy
- Department of SurgerySt Mark's Hospital and Academic InstituteHarrowUK
| | - D. G. Jayne
- Academic Surgical UnitSt James' University Hospital NHS TrustLeedsUK
| | - R. Huxtable
- Centre for Ethics in MedicineUniversity of BristolBristolUK
| | - R. Hackett
- Colorectal Network Site Specific GroupAvon, Somerset and Wiltshire Cancer ServicesBristolUK
| | - S. J. Dutton
- Centre for Statistics in Medicine and Oxford Clinical Trials Research UnitNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal SciencesUniversity of OxfordOxfordUK
| | - M. G. Coleman
- Department of Colorectal SurgeryPlymouth Hospitals NHS TrustPlymouthUK
| | - M. Card
- Colorectal Surgery UnitUniversity Hospitals Bristol NHS Foundation TrustBristolUK
| | - J. Brown
- Clinical Trials Research UnitUniversity of LeedsLeedsUK
| | - J. M. Blazeby
- Centre for Surgical ResearchSchool of Social and Community MedicineUniversity of BristolBristolUK,Division of Surgery Head and NeckUniversity Hospitals Bristol NHS Foundation TrustBristolUK
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Spoelstra SL, Given CW, Sikorskii A, Majumder A, Schueller M, Given BA. Treatment with oral anticancer agents: symptom severity and attribution, and interference with comorbidity management. Oncol Nurs Forum 2015; 42:80-8. [PMID: 25490974 DOI: 10.1188/15.onf.42-01p] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To evaluate the prevalence, severity, and attribution of symptoms, as well as the interference with management of comorbidities, in patients who have been prescribed oral anticancer agents (OAs). DESIGN Descriptive exploratory study. SETTING A comprehensive cancer center and two community-based oncology programs in the midwestern United States. SAMPLE 30 adults undergoing OA treatment. METHODS Five phone interviews were conducted during eight weeks. Linear mixed effects and generalized estimating equations were used to examine symptoms and interference over time. MAIN RESEARCH VARIABLES Symptoms and comorbid conditions. FINDINGS The mean age of participants was 65.1 years. Fifteen participants were female, 25 were Caucasian, and 23 had comorbidities. Twenty-one patients had late-stage cancer, and rates of adherence were 90%. Fatigue, sleep disturbance, and numbness or tingling in hands and feet were highly prevalent symptoms. Younger age was associated with higher symptom severity (p < 0.01) and interference (p = 0.01). Patients with more comorbidities tended to report higher symptom severity. Simultaneous IV chemotherapy was not a predictor of symptom severity or interference over age and comorbidity. Symptoms were most frequently attributed to cancer and its treatment. Patients with a greater number of comorbidities were more likely to include comorbidities in symptom attribution and reported interference from the OA with managing comorbid conditions. CONCLUSIONS Symptoms may be more severe in patients prescribed OAs who are younger and have comorbid conditions. More comorbidities and absence of simultaneous IV chemotherapy increased the likelihood of inclusion of chronic conditions in symptom attribution. Patients reported that OA treatment interfered with comorbidity management. IMPLICATIONS FOR NURSING Nurses need to take comorbidities into account when caring for patients prescribed OAs because the chronic conditions may influence symptom severity and the ability to manage symptoms.
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Affiliation(s)
| | - Charles W Given
- Department of Family Medicine, Michigan State University in East Lansing
| | - Alla Sikorskii
- Department of Statistics and Probability, Michigan State University in East Lansing
| | - Atreyee Majumder
- Department of Statistics and Probability, Michigan State University in East Lansing
| | | | - Barbara A Given
- College of Nursing, Michigan State University in East Lansing
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Custers JAE, Gielissen MFM, Janssen SHV, de Wilt JHW, Prins JB. Fear of cancer recurrence in colorectal cancer survivors. Support Care Cancer 2015; 24:555-562. [PMID: 26108170 PMCID: PMC4689743 DOI: 10.1007/s00520-015-2808-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 06/08/2015] [Indexed: 01/22/2023]
Abstract
Purpose Although long-term colorectal cancer (CRC) survivors generally report a good quality of life, fear of cancer recurrence (FCR) remains an important issue. This study investigated whether the Cancer Worry Scale (CWS) can detect high FCR, the prevalence, and characteristics of FCR in CRC survivors. Methods Two hundred and eleven patients who had undergone successful CRC surgery in the period 2003–2010 in the Radboud University Medical Center in the Netherlands were asked to participate. All patients were sent an information letter plus questionnaires for collecting information on demographic and medical variables, FCR, distress, and quality of life. Results Seventy-six patients (36 %; median age of 67.7 years range 41–88 years) completed the questionnaires a median of 5.1 years after surgery. A cut-off score of 14 or higher on the CWS was optimal to detect high FCR. Twenty-nine patients (38 %) experienced high levels of FCR, characterized by higher levels of distress, post-traumatic stress symptoms, and lower quality of life. These individuals particularly reacted to disease-related triggers, felt helpless, were worried, and experienced limitations in daily functioning. High FCR was not associated with demographic or medical variables. Conclusion Long after successful CRC surgery, FCR is a serious problem that impairs the quality of life for a substantial proportion of patients. With the CWS, it is possible to detect high FCR and thereby assist survivors in receiving appropriate care.
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Affiliation(s)
- José A E Custers
- Department of Medical Psychology 840, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Marieke F M Gielissen
- Department of Medical Psychology 840, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Stephanie H V Janssen
- Department of Surgery 618, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Johannes H W de Wilt
- Department of Surgery 618, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology 840, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
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Wong EYT, Chua C, Beh SY, Koh D, Chong D, Tan IB. Addressing the needs of colorectal cancer survivors: current strategies and future directions. Expert Rev Anticancer Ther 2015; 15:639-48. [PMID: 25927672 DOI: 10.1586/14737140.2015.1038248] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Colorectal cancer (CRC) is one of the three topmost common cancers in men and the second most common cancer in women worldwide. With current advances in the medical and surgical treatment of CRC, care has slowly transformed to curative treatment. With these advances, CRC survivors are increasing in numbers and these patients have a unique range of medical, physical and psychological needs that require regular follow-up. In 2006, the Institute of Medicine recommended that cancer survivors who are completing primary treatment receive a survivorship care plan. There are many different programs of different complexity that are implemented for CRC survivors. This review outlines the needs of CRC survivors, the current surveillance techniques used in the continuing care of patients with CRC after curative treatment and the evidence behind these strategies.
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Akyol M, Ulger E, Alacacioglu A, Kucukzeybek Y, Yildiz Y, Bayoglu V, Gumus Z, Yildiz I, Salman T, Varol U, Ayakdas S, Tarhan MO. Sexual satisfaction, anxiety, depression and quality of life among Turkish colorectal cancer patients [Izmir Oncology Group (IZOG) study]. Jpn J Clin Oncol 2015; 45:657-64. [DOI: 10.1093/jjco/hyv051] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 03/17/2015] [Indexed: 01/06/2023] Open
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Lee JY, Chu SH, Jeon JY, Lee MK, Park JH, Lee DC, Lee JW, Kim NK. Effects of 12 weeks of probiotic supplementation on quality of life in colorectal cancer survivors: a double-blind, randomized, placebo-controlled trial. Dig Liver Dis 2014; 46:1126-32. [PMID: 25442120 DOI: 10.1016/j.dld.2014.09.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 09/14/2014] [Accepted: 09/14/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Probiotics may help resolve bowel symptoms and improve quality of life. We investigated the effects of 12 weeks of probiotics administration in colorectal cancer patients. METHODS We conducted a double-blind, randomized, placebo-controlled trial. The participants took probiotics (Lacidofil) or placebo twice a day for 12 weeks. The cancer-related quality of life (FACT), patient's health-9 (PHQ-9), and bowel symptom questionnaires were completed by each participant. RESULTS We obtained data for 32 participants in the placebo group and 28 participants in the probiotics group. The mean ages of total participants were 56.18 ± .86 years and 58.3% were male. Administration of probiotics significantly decreased the proportion of patients suffering from irritable bowel symptoms (0 week vs. 12 week; 67.9% vs. 45.7%, p=0.03), improved colorectal cancer-related FACT (baseline vs. 12 weeks: 19.79 ± 4.66 vs. 21.18 ± 3.67, p=0.04) and fatigue-related FACT (baseline vs. 12 weeks: 43.00 (36.50-45.50) vs. 44.50 (38.50-49.00), p=0.02) and PHQ-9 scores (0 weeks vs. 12 weeks; 3.00 (0-8.00) vs. 1.00 (0-3.00), p=0.01). We found significant differences in changes of the proportion of patients with bowel symptoms (p<0.05), functional well-being scores (p=0.04) and cancer-related FACT scores (p=0.04) between the two groups. CONCLUSION Probiotics improved bowel symptoms and quality of life in colorectal cancer survivors.
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Affiliation(s)
- Jee-Yon Lee
- Department of Family Medicine, Yonsei University, College of Medicine, Republic of Korea
| | - Sang-Hui Chu
- Department of Clinical Nursing Science, Yonsei University, College of Nursing, Nursing Policy Research Institute, Biobehavioural Research Center, Republic of Korea
| | - Justin Y Jeon
- Department of Sport and Leisure Studies, Sports Medicine Laboratory, Yonsei University, Republic of Korea
| | - Mi-Kyung Lee
- Department of Sport and Leisure Studies, Sports Medicine Laboratory, Yonsei University, Republic of Korea
| | - Ji-Hye Park
- Department of Sport and Leisure Studies, Sports Medicine Laboratory, Yonsei University, Republic of Korea
| | - Duk-Chul Lee
- Department of Family Medicine, Yonsei University, College of Medicine, Republic of Korea
| | - Ji-Won Lee
- Department of Family Medicine, Yonsei University, College of Medicine, Republic of Korea.
| | - Nam-Kyu Kim
- Department of General Surgery, Yonsei University College of Medicine, Republic of Korea.
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Thomas AA, Gallagher P, O'Céilleachair A, Pearce A, Sharp L, Molcho M. Distance from treating hospital and colorectal cancer survivors' quality of life: a gendered analysis. Support Care Cancer 2014; 23:741-51. [PMID: 25179691 DOI: 10.1007/s00520-014-2407-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 08/18/2014] [Indexed: 11/12/2022]
Abstract
PURPOSE Distance from residence to hospital has been associated with clinical outcomes for colorectal cancer patients. However, little is known about the association of remoteness with quality of life (QoL) for colorectal cancer survivors. We examined the relationship between distance from hospital and colorectal cancer survivors' QoL, with a specific focus on gender. METHODS Colorectal cancer survivors in Ireland who were more than 6-months postdiagnosis completed the European Organization for Research and Treatment of Cancer QLQ-C30, measuring global health status (GHS) and physical, role, cognitive, social, and emotional functioning. Bootstrap linear regression was used to evaluate the association between remoteness and QoL scales, controlling for demographic and clinical variables. Separate models were generated for the full sample, for women, and for men. RESULTS The final analytical sample was 496 colorectal cancer survivors; 186 women and 310 men. Living remote from the treating hospital was associated with lower physical functioning (coefficient -4.38 [95 % confidence interval -8.13, -0.91]) and role functioning (coeff. -7.78 [-12.64, -2.66]) among all colorectal cancer survivors. In the separate gender models, remoteness was significantly associated with lower physical (coeff. -7.00 [-13.47, -1.49]) and role functioning (coeff. -11.50 [-19.66, -2.65]) for women, but not for men. Remoteness had a significant negative relationship to GHS (coeff. -4.31 [-8.46, -0.27]) for men. CONCLUSIONS Aspects of QoL are lower among colorectal cancer survivors who live far from their treating hospital. There are gender differences in how remoteness is related to QoL domains. The results of this study suggest that policy makers, service providers, and health care professionals should consider the specific QoL needs of remote colorectal cancer survivors, and be attuned to and prepared to address the differing needs of men and women.
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Affiliation(s)
- Audrey Alforque Thomas
- Health Promotion Research Centre, National University of Ireland, Aras na Coiribe, Galway, Ireland,
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Khanna P, Agarwal N, Khanna D, Hays RD, Chang L, Bolus R, Melmed G, Whitman CB, Kaplan RM, Ogawa R, Snyder B, Spiegel BM. Development of an online library of patient-reported outcome measures in gastroenterology: the GI-PRO database. Am J Gastroenterol 2014; 109:234-48. [PMID: 24343547 PMCID: PMC4275098 DOI: 10.1038/ajg.2013.401] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 10/22/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Because gastrointestinal (GI) illnesses can cause physical, emotional, and social distress, patient-reported outcomes (PROs) are used to guide clinical decision making, conduct research, and seek drug approval. It is important to develop a mechanism for identifying, categorizing, and evaluating the over 100 GI PROs that exist. Here we describe a new, National Institutes of Health (NIH)-supported, online PRO clearinghouse-the GI-PRO database. METHODS Using a protocol developed by the NIH Patient-Reported Outcome Measurement Information System (PROMIS(®)), we performed a systematic review to identify English-language GI PROs. We abstracted PRO items and developed an online searchable item database. We categorized symptoms into content "bins" to evaluate a framework for GI symptom reporting. Finally, we assigned a score for the methodological quality of each PRO represented in the published literature (0-20 range; higher indicates better). RESULTS We reviewed 15,697 titles (κ>0.6 for title and abstract selection), from which we identified 126 PROs. Review of the PROs revealed eight GI symptom "bins": (i) abdominal pain, (ii) bloat/gas, (iii) diarrhea, (iv) constipation, (v) bowel incontinence/soilage, (vi) heartburn/reflux, (vii) swallowing, and (viii) nausea/vomiting. In addition to these symptoms, the PROs covered four psychosocial domains: (i) behaviors, (ii) cognitions, (iii) emotions, and (iv) psychosocial impact. The quality scores were generally low (mean 8.88 ± 4.19; 0 (min)-20 (max). In addition, 51% did not include patient input in developing the PRO, and 41% provided no information on score interpretation. CONCLUSIONS GI PROs cover a wide range of biopsychosocial symptoms. Although plentiful, GI PROs are limited by low methodological quality. Our online PRO library (www.researchcore.org/gipro/) can help in selecting PROs for clinical and research purposes.
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Affiliation(s)
- Puja Khanna
- Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Nikhil Agarwal
- Department of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA,Department of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Dinesh Khanna
- Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ron D. Hays
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, and Department of Health Services, UCLA School of Public Health, Los Angeles, California, USA
| | - Lin Chang
- Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA,Center for Neurobiology of Stress, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Roger Bolus
- Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA,UCLA/VA Center for Outcomes Research and Education, Los Angeles, California, USA
| | - Gil Melmed
- Department of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Cynthia B. Whitman
- UCLA/VA Center for Outcomes Research and Education, Los Angeles, California, USA
| | - Robert M. Kaplan
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, and Department of Health Services, UCLA School of Public Health, Los Angeles, California, USA
| | - Rikke Ogawa
- Biomedical Library of the Health Sciences, University of California at Los Angeles, Los Angeles, California, USA
| | - Bradley Snyder
- UCLA/VA Center for Outcomes Research and Education, Los Angeles, California, USA
| | - Brennan M.R. Spiegel
- Department of Gastroenterology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA,Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, and Department of Health Services, UCLA School of Public Health, Los Angeles, California, USA,Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California, USA,UCLA/VA Center for Outcomes Research and Education, Los Angeles, California, USA
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Lowery AE, Starr T, Dhingra LK, Rogak L, Hamrick-Price JR, Farberov M, Kirsh KL, Saltz LB, Breitbart WS, Passik SD. Frequency, characteristics, and correlates of pain in a pilot study of colorectal cancer survivors 1-10 years post-treatment. PAIN MEDICINE (MALDEN, MASS.) 2013; 14:1673-80. [PMID: 24010414 PMCID: PMC3971863 DOI: 10.1111/pme.12223] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The long-term effects of disease and treatment in colorectal cancer (CRC) survivors are poorly understood. This study examined the prevalence and characteristics of pain in a sample of CRC survivors up to 10 years post-treatment. DESIGN One hundred cancer-free CRC survivors were randomly chosen from an institutional database and completed a telephone survey using the Brief Pain Inventory, Neuropathic Pain Questionnaire-Short Form, Quality of Life Cancer Survivor Summary, Brief Zung Self-Rating Depression Scale, Zung Self-Rating Anxiety Scale, and Fear of Recurrence Questionnaire. RESULTS Participants were primarily Caucasian (90%) married (69%) males (53.5%) with a mean age of 64.7 years. Chronic pain was reported in 23% of CRC survivors, with a mean moderate intensity rating (mean = 6.05, standard deviation = 2.66) on a 0-10 rating scale. Over one-third (39%) of those with pain attributed it to their cancer or treatment. Chi-square and t-test analyses showed that survivors with pain were more likely to be female, have lower income, be more depressed and more anxious, and show a higher endorsement of suicidal ideation than CRC survivors without chronic pain. On average, pain moderately interfered with daily activity. CONCLUSIONS Chronic pain is likely a burdensome problem for a small but not inconsequential minority of CRC survivors requiring a biopsychosocial treatment approach to improve recognition and treatment. Open dialogue between clinicians and survivors about physical and emotional symptoms in long-term follow-up is highly recommended.
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Affiliation(s)
- Amy E. Lowery
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Tatiana Starr
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Lara K. Dhingra
- Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, New York
| | - Lauren Rogak
- Department of Epidemiology-Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York
| | | | - Maria Farberov
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York
| | | | - Leonard B. Saltz
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - William S. Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Steven D. Passik
- Clinical Addiction Education and Research, Millennium Laboratories, San Diego, CA, USA
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Marventano S, Forjaz M, Grosso G, Mistretta A, Giorgianni G, Platania A, Gangi S, Basile F, Biondi A. Health related quality of life in colorectal cancer patients: state of the art. BMC Surg 2013; 13 Suppl 2:S15. [PMID: 24267735 PMCID: PMC3851259 DOI: 10.1186/1471-2482-13-s2-s15] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females with a progressive increase in prevalence in industrialized countries. The loss of health due to the cancer and/or the consequence of the treatment may result in psychophysical, functional and social impairment; all of these affect health-related quality of life (QoL). Description The most frequently CRC-specific QoL questionnaires is the FACT-C. QoL is not only important for the well-being of cancer patient but it also influences survival and response to therapy. Many studies investigated various determinants involved in the assessment of QoL in CRC, suggesting that symptoms, surgical procedures and the number of comorbidity significantly affected QoL. Conclusion Despite that CRC patients have a relatively good QoL compared with the general population, a wide range of intervention could be undertaken to improve their QoL. The finding of this review may be useful for cancer clinicians in taking therapy and surveillance-related decisions. However, future research should be directed to large-scale prospective studies using well validated QoL instruments to facilitate comparison of results.
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Appleton L, Goodlad S, Irvine F, Poole H, Wall C. Patients' experiences of living beyond colorectal cancer: A qualitative study. Eur J Oncol Nurs 2013; 17:610-7. [DOI: 10.1016/j.ejon.2013.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 12/20/2012] [Accepted: 01/05/2013] [Indexed: 01/11/2023]
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LeMasters T, Madhavan S, Sambamoorthi U, Kurian S. A population-based study comparing HRQoL among breast, prostate, and colorectal cancer survivors to propensity score matched controls, by cancer type, and gender. Psychooncology 2013; 22:2270-82. [PMID: 23606210 PMCID: PMC4892175 DOI: 10.1002/pon.3288] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 02/21/2013] [Accepted: 03/04/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Objectives were to compare health-related quality of life (HRQoL) between breast cancer survivors, prostate cancer survivors (PCS), and colorectal cancer survivors (CCS) to matched controls, stratified by short and long-term survivors, by cancer type, and gender. METHODS By using the 2009 Behavioral Risk Factor Surveillance System, propensity scores matched three controls to adult survivors >1 year past diagnosis (N = 11,964) on age, gender, race/ethnicity, income, insurance status, and region of the USA Chi-square tests and logistic regression models compared HRQoL outcomes (life satisfaction, activity limitations, sleep quality, emotional support, general, physical, and mental health). RESULTS Although all cancer survivors reported worse general health (p < 0.000) and more activity limitations (p < 0.004) than controls, these disparities decreased among long-term survivors. Short-term PCS and male CCS were more likely to report worse outcomes across additional domains of HRQoL than controls, but PCS were 0.61, 0.63, and 0.70 times less likely to report activity limitations, fair/poor general health, and 1-15 bad physical health days in the past month than male CCS. Breast cancer survivors and female CCS were 2.12 and 3.17, 1.58 and 1.86, and 1.49 and 153, respectively, times more likely to report rarely/never receiving needed emotional support, 1-15 bad mental health days in the past month, and not receiving enough sleep 1-15 days in the past month than PCS and male CCS. CONCLUSIONS Cancer survivors experience worse HRQoL than similar individuals without a history of cancer and the severity of affected HRQoL domains differ by time since diagnosis, cancer type, and gender.
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Affiliation(s)
- Traci LeMasters
- West Virginia University, School of Pharmacy, Department of Pharmaceutical Systems and Policy, Morgantown, WV, USA
| | - Suresh Madhavan
- West Virginia University, School of Pharmacy, Department of Pharmaceutical Systems and Policy, Morgantown, WV, USA
| | - Usha Sambamoorthi
- West Virginia University, School of Pharmacy, Department of Pharmaceutical Systems and Policy, Morgantown, WV, USA
| | - Sobha Kurian
- West Virginia University, Mary Babb Randolph Cancer Center, Morgantown, WV, USA
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48
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Gray NM, Hall SJ, Browne S, Johnston M, Lee AJ, Macleod U, Mitchell ED, Samuel L, Campbell NC. Predictors of anxiety and depression in people with colorectal cancer. Support Care Cancer 2013; 22:307-14. [DOI: 10.1007/s00520-013-1963-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 08/27/2013] [Indexed: 01/06/2023]
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49
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Pita-Fernández S, Pértega-Díaz S, López-Calviño B, Seoane-Pillado T, Gago-García E, Seijo-Bestilleiro R, González-Santamaría P, Pazos-Sierra A. Diagnostic and treatment delay, quality of life and satisfaction with care in colorectal cancer patients: a study protocol. Health Qual Life Outcomes 2013; 11:117. [PMID: 23845102 PMCID: PMC3710493 DOI: 10.1186/1477-7525-11-117] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 07/09/2013] [Indexed: 01/12/2023] Open
Abstract
Background Due to recent improvements in colorectal cancer survival, patient-reported outcomes, including health-related quality of life and satisfaction with care, have become well-established endpoints to determine the impact of the disease on the lives of patients. The aim of this study is to determine prospectively, in a cohort of colorectal cancer incident cases: a) health-related quality of life, b) satisfaction with hospital-based care, and c) functional status. A secondary objective is to determine whether diagnostic/therapeutic delay influence quality of life or patients’ satisfaction levels. Methods/design Single-centre prospective follow-up study of colorectal cancer patients diagnosed during the period 2011–2012 (n = 375). This project was approved by the corresponding ethics review board, and informed consent is obtained from each patient. After diagnosis, patients are interviewed by a trained nurse, obtaining information on sociodemographic characteristics, family history of cancer, first symptoms, symptom perception and reaction to early symptoms. Quality of life is assessed with the EORTC QLQ-C30 and QLQ-CR29 questionnaires, and patients’ satisfaction with care is determined using the EORTC IN-PATSAT32. Functional status is measured with the Karnofsky Performance Status Scale. Clinical records are also reviewed to collect information on comorbidity, tumour characteristics, treatment, hospital consultations and exploratory procedures. Symptoms-to-diagnosis interval is defined as the time from the date of first symptoms until the cytohistological confirmation of cancer. Treatment delay is defined as the time between diagnosis and surgical treatment. All the patients will be followed-up for a maximum of 2 years. For survivors, assessments will be re-evaluated at one and two years after the diagnosis. Multiple linear/logistic regression models will be used to identify variables associated with the patients’ functional status, quality of life and satisfaction with care score. Changes in quality of life over time will be analysed with linear mixed-effects regression models. Discussion The results will provide a deeper understanding of the impact of colorectal cancer from a more patient-centred approach, allowing us to identify groups of patients in need of additional attention, as well as areas for improvement. Special attention will be given to the relationship between diagnostic/therapeutic delay and patients’ quality of life and satisfaction with the care received.
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Affiliation(s)
- Salvador Pita-Fernández
- Clinical Epidemiology and Biostatistics Unit, Complexo Hospitalario Universitario A Coruña, Universidade de A Coruña, Hotel de Pacientes 7a Planta, As Xubias 84, A Coruña, Spain.
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50
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Spiegel BMR. Patient-reported outcomes in gastroenterology: clinical and research applications. J Neurogastroenterol Motil 2013; 19:137-48. [PMID: 23667745 PMCID: PMC3644650 DOI: 10.5056/jnm.2013.19.2.137] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 02/25/2013] [Accepted: 02/26/2013] [Indexed: 12/11/2022] Open
Abstract
Patient-generated reports, also known as Patient-Reported Outcomes (PROs), capture the patients' illness experience in a structured format and may help bridge the gap between patients and providers. PROs measure any aspect of patient-reported health (e.g., physical, emotional or social symptoms) and can help to direct care and improve clinical outcomes. When clinicians systematically collect patient-reported data in the right place at the right time, PRO measurement can effectively aid in detection and management of conditions, improve satisfaction with care and enhance the patient-provider relationship. This review article summarizes the latest approaches to PRO measuring for clinical trials and clinical practice, with a focus on use of PROs in gastroenterology.
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Affiliation(s)
- Brennan M R Spiegel
- Department of Gastroenterology, VA Greater Los Angeles Healthcare System; Division of Digestive Diseases, David Geffen School of Medicine at UCLA; Department of Health Services, UCLA School of Public Health; and UCLA/VA Center for Outcomes Research and Education, Los Angeles, California, USA
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