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Gallego A, Beato C, Brozos E, De La Cruz S, García RV. Spanish Society of Medical Oncology recommendations for comprehensive assessment and care of cancer survivors' needs. Clin Transl Oncol 2024:10.1007/s12094-024-03571-9. [PMID: 38976210 DOI: 10.1007/s12094-024-03571-9] [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: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 07/09/2024]
Abstract
This article reviews the contemporary and inclusive definition of cancer survivorship, including patients with and without disease who have completed or continue to undergo treatment. The Spanish Society of Medical Oncology (SEOM) describes in this article the needs of these patients and outlines a care model based on an estimation of cancer incidence and identification of patient needs, to enable the provision of practical actions to achieve effective care. The objectives of this review are to identify the main effects of cancer on survivors and to establish appropriate ways of measuring these effects, as well as discussing the management of physical, psychological and social, occupational, financial, and other health-related needs. We suggest a multidisciplinary care model and training programs for the different professionals involved in care, and highlight challenges and the future role of the SEOM and health-care policy in ensuring optimum care of cancer survivors.
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Affiliation(s)
- Alejandro Gallego
- Department of Medical Oncology, Cancer Center Clínica Universidad de Navarra (CCUN), Madrid and Pamplona, Calle del Marquesado de Santa Marta, 1, 28027, Madrid, Spain.
| | - Carmen Beato
- Departament of Oncology, University Hospital of Jerez de La Frontera, Cádiz, Spain
| | - Elena Brozos
- Department of Oncology, University Hospital of A Coruña, A Coruña, Spain
| | - Susana De La Cruz
- Department of Oncology, University Hospital of Navarra, Instituto de Investigación Sanitaria de Navarra, IdISNA, Pamplona, Spain
| | - Ruth Vera García
- Department of Oncology, University Hospital of Navarra, Instituto de Investigación Sanitaria de Navarra, IdISNA, Pamplona, Spain
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Wilson BE, Wright K, Koven R, Booth CM. Surveillance Imaging After Curative-Intent Treatment for Cancer: Benefits, Harms, and Evidence. J Clin Oncol 2024; 42:2245-2249. [PMID: 38805665 DOI: 10.1200/jco.23.02475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/23/2024] [Accepted: 03/29/2024] [Indexed: 05/30/2024] Open
Affiliation(s)
- Brooke E Wilson
- Department of Oncology, Queen's University, Kingston, ON, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, ON, Canada
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Kristin Wright
- Department of Oncology, Queen's University, Kingston, ON, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, ON, Canada
| | - Rachel Koven
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, ON, Canada
| | - Christopher M Booth
- Department of Oncology, Queen's University, Kingston, ON, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, ON, Canada
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3
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Hu C, Weng Y, Wang Q, Yu W, Shan S, Niu N, Chen Y. Fear of progression among colorectal cancer patients: a latent profile analysis. Support Care Cancer 2024; 32:469. [PMID: 38940963 DOI: 10.1007/s00520-024-08660-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 06/15/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE Fear of progression (FoP) leads to poor clinical outcomes in colorectal cancer patients. The study aimed to clarify the profiles and influencing factors of FoP among colorectal cancer patients. METHODS A cross-sectional study was conducted with 409 colorectal cancer patients. Convenience sampling method was used to select colorectal cancer patients hospitalized in a tertiary-level hospital in Nanjing as the survey subjects. General information questionnaire, Fear of Progression Questionnaire-Short Form, Distress Disclosure Index, and Social Support Rating Scale were used to collect the data. Latent profile analysis was used to explore the latent profiles of FoP in colorectal cancer patients. Additionally, the influencing factors of profiles were explored by Univariate Analysis and Binomial Logistic Regression Analysis. RESULTS Latent profile analysis identified two subgroups of fear of disease progression: the "fear low-risk profile (83%)", and the "severe fear profile (17%)." Patients with low age, low social support utilization, first hospital admission, severe healthcare burden, and preoperative bowel symptoms were prone to severe fear of disease progression. CONCLUSIONS There is some heterogeneity in the level of postoperative fear of disease progression in colorectal cancer patients. Doctors and nurses should focus on patients with severe fear and take targeted preventive and psychological care for patients' fear of disease progression as early as possible according to the distribution characteristics of different categories.
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Affiliation(s)
- Chen Hu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yajuan Weng
- Nursing Department, Nanjing Drum Tower Hospital, Nanjing, China
| | - Qian Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenhui Yu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shihan Shan
- Department of Colorectal Surgery, Nanjing Drum Tower Hospital, Nanjing, China
| | - Niu Niu
- Department of Colorectal Surgery, Nanjing Drum Tower Hospital, Nanjing, China.
| | - Yan Chen
- Nursing Department, Nanjing Drum Tower Hospital, Nanjing, China.
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China.
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Hampton J, Alam A, Zdenkowski N, Rowe C, Fradgley E, O'Neill CJ. Fear of Cancer Recurrence in Differentiated Thyroid Cancer Survivors: A Systematic Review. Thyroid 2024; 34:541-558. [PMID: 38368547 DOI: 10.1089/thy.2023.0642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Abstract
Background: Despite excellent survival rates, health-related quality of life detriments are common in differentiated thyroid cancer survivors and can be driven by fear of cancer recurrence (FCR). This review aims to report the incidence of FCR in thyroid cancer survivors and synthesize evidence regarding contributing factors. An overview and appraisal of the range of tools used to measure FCR is presented. Methods: A systematic review of the English literature was performed. The search across six electronic databases generated 3414 studies. Two reviewers independently screened the citations and full-text articles, of which 31 were included. The data were extracted independently by two reviewers. Results: The incidence of FCR was reported in 27/31 studies and ranged from 15% to 91%. Direct comparisons regarding incidence and severity of FCR were not possible due to heterogeneity in cut-points used to define FCR. A total of eight validated tools were used to measure FCR across all studies, with five studies using self-developed nonvalidated items. There was minimal repetition of validated tools and no clear consensus as to a preferred survey tool. Factors influencing FCR were reported in 11 studies. There was minimal overlap of factors influencing FCR. Risk factors contributing to increased FCR reported in more than one study included young age and an upcoming clinical appointment. Male gender and higher education levels were reported in more than one article as protective. No literature evaluating interventions to address FCR in thyroid cancer survivors was found. Conclusion: FCR is common in thyroid cancer survivors, but significant heterogeneity in the current evidence base limits assessment of incidence, severity, or risk factors. There is a need to use validated tools to assess FCR in both research and clinical contexts. Reliable assessment of FCR may permit routine assessment of FCR in clinical practice and allow interventions to be prospectively evaluated to optimize the holistic well-being of thyroid cancer survivors.
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Affiliation(s)
- Jacob Hampton
- Surgical Services, John Hunter Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Ahmad Alam
- Surgical Services, John Hunter Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Nicholas Zdenkowski
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Christopher Rowe
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Department of Endocrinology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Elizabeth Fradgley
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Christine J O'Neill
- Surgical Services, John Hunter Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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5
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Hall DL, Wagner LI, Lebel S, Smith AB, Bergerot CD, Park ER. Guidelines needed for the management of fear of cancer recurrence in adult survivors of cancer in the United States: A consensus statement. Cancer 2024. [PMID: 38630904 DOI: 10.1002/cncr.35326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/04/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
Fear of cancer recurrence remains unaddressed in guidelines for managing anxiety and depression in adult cancer survivors in the United States. To ensure comprehensive psychosocial care, guidelines are needed for the clinical management of fear of cancer recurrence, including recommendations for screening, referral, and treatment pathways.
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Affiliation(s)
- Daniel L Hall
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Lynne I Wagner
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | | | - Allan Ben Smith
- The Daffodil Center, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Cristiane D Bergerot
- Oncoclinicas & Co - Medica Scientia Innovation Research (MEDSIR), Sao Paulo, Brazil
| | - Elyse R Park
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Torabi M, Yousofvand V, Mohammadi R, Karbin F, Ranjbaran H. Effectiveness of Group Spiritual Care on Leukemia Patients' Hope and Anxiety in Iran: A Randomized Controlled Trial. JOURNAL OF RELIGION AND HEALTH 2024; 63:1413-1432. [PMID: 37432586 DOI: 10.1007/s10943-023-01866-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/12/2023]
Abstract
This study examined the effectiveness of a group spiritual care program on leukemia patients' hope and anxiety. This randomized controlled trial involved 94 leukemia patients hospitalized in the two oncology departments of Shahid Beheshti Hospital, Hamadan, Iran. This study was carried out from November 2022 to April 2023. The participants were selected based on the study inclusion criteria using the convenience sampling method then they were randomized to either the experimental (N = 46) or the control group (N = 48). The participants completed the written informed consent form, the demographic information form, and Beck's anxiety and Snyder's hope questionnaires. The spiritual care program was provided in six sessions (one 45-60 min per week), including a spiritual needs assessment, religious care, spiritual care, psychological-spiritual care, supportive-spiritual care, and evaluation. The participants then completed Beck's anxiety and Snyder's hope questionnaires immediately, one and two months after the intervention. At baseline, there was no significant between-group difference in leukemia patients' mean scores of hope (P = 0.313) and anxiety (P = 0.141); however, immediately, one and two months after the intervention, a significant between-group difference in the mean scores of hope and anxiety was observed (P < 0.001). Also, from baseline to two months after the intervention, a significant decrease and increase in anxiety and hope mean scores, respectively, were observed in the experimental group (within-group difference) (P < 0.001). However, in the control group, from baseline to two months after the intervention, a significant increase and decrease in mean scores of anxiety and hope, respectively, were observed (within-group difference) (P < 0.001). As a result, it is recommended that nurses should consider providing spiritual care to leukemia patients as a part of holistic care.
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Affiliation(s)
- Mohammad Torabi
- Chronic Diseases (Home Care) Research Centre, Malayer School of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Vahid Yousofvand
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Reza Mohammadi
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Karbin
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hamid Ranjbaran
- Deputy of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Calderon C, Gustems M, Galán-Moral R, Muñoz-Sánchez MM, Ostios-García L, Jiménez-Fonseca P. Fear of Recurrence in Advanced Cancer Patients: Sociodemographic, Clinical, and Psychological Correlates. Cancers (Basel) 2024; 16:909. [PMID: 38473270 DOI: 10.3390/cancers16050909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Fear of cancer recurrence significantly impacts advanced cancer patients, prompting emotional distress and increased healthcare utilization. This present study aims to analyze the fear of recurrence among patients with advanced cancer undergoing systemic treatment and its relationship with sociodemographic, clinical, and psychological factors. A multicenter cross-sectional study was conducted in 15 oncology departments across Spain, involving patients with locally advanced, unresectable, or metastatic cancer eligible for systemic treatment. Participants provided demographic information and completed instruments such as the Cancer Worry Scale, Brief Symptom Inventory, Mishel Uncertainty in Illness Scale, and the Duke-UNC-11 Functional Social Support Questionnaire (DUFSSQ). A total of 1195 participants participated: median age 66, 56% male, mostly metastatic cancers (80%), and common tumor sites. Two fear groups emerged: 28% low and 72% high levels of fear. High fear was associated with being female, being younger, lower levels of education, and worse survival estimates. High fear correlated with more depression, anxiety, somatic symptoms, uncertainty, and stronger social support. Multivariate analyses indicated that younger patients, those with shorter survival estimates, higher depression and anxiety scores, more uncertainty, and stronger social support had a greater likelihood of experiencing fear of recurrence, while the opposite was true for older patients. This study underscores distinct fear of recurrence profiles in advanced cancer patients, emphasizing the need for targeted interventions and support. Future research should delve deeper into understanding their repercussions for improving patient care and well-being.
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Affiliation(s)
- Caterina Calderon
- Faculty of Psychology, University of Barcelona, 08007 Barcelona, Spain
| | - Marina Gustems
- Faculty of Psychology, University of Barcelona, 08007 Barcelona, Spain
| | - Rocio Galán-Moral
- Department of Medical Oncology, Hospital General Universitario de Ciudad Real, 13005 Madrid, Spain
| | - Maria M Muñoz-Sánchez
- Department of Medical Oncology, Hospital General Virgen de la Luz, 16002 Cuenca, Spain
| | | | - Paula Jiménez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Instituto de Investigación del Principado de Asturias (ISPA), 33011 Oviedo, Spain
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Nic Giolla Chomhaill C, Ward J, Dowling M. Fear of recurrence in women with ovarian cancer: A qualitative evidence synthesis. Eur J Oncol Nurs 2024; 68:102487. [PMID: 38113769 DOI: 10.1016/j.ejon.2023.102487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/16/2023] [Accepted: 12/08/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE Approximately 80% of ovarian cancers recur after first-line treatments. Women with ovarian cancer (OC) are therefore particularly vulnerable to experiencing fear of cancer recurrence (FCR). This study aimed to synthesise experiences of fear of cancer recurrence among women living with ovarian cancer. METHOD A qualitative evidence synthesis (QES) was conducted in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines. A systematic search of seven databases was undertaken to identify all available qualitative research exploring fear of cancer recurrence in women with OC. Thematic synthesis of extracted data from included studies was undertaken and managed in NVivo. RESULTS Twenty-two papers reporting on eighteen studies were included in the synthesis. Three main themes were developed (triggers, responses, and coping) and included ten subthemes. FCR was triggered by factors relating to awareness of prognosis, treatment, and negative communication. Women responded to FCR by performing body checking and protecting their families. FCR led to adverse effects on women's wellbeing as it exacerbated uncertainty about their future. Women attempted to cope with FCR through seeking support, regaining control, and redirecting negative thoughts and actions. CONCLUSIONS Women use a variety of approaches to manage their fear of recurrence. Further research on the most appropriate interventions for FCR tailored specifically to the needs of women with OC is needed.
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Affiliation(s)
| | - Jana Ward
- Occupational Therapy Department, Galway University Hospital, Ireland.
| | - Maura Dowling
- School of Nursing and Midwifery, University of Galway, Ireland.
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Husebø ALM, Søreide JA, Kørner H, Storm M, Wathne HB, Richardson A, Morken IM, Urstad KH, Nordfonn OK, Karlsen B. eHealth interventions to support colorectal cancer patients' self-management after discharge from surgery-an integrative literature review. Support Care Cancer 2023; 32:11. [PMID: 38055087 PMCID: PMC10700211 DOI: 10.1007/s00520-023-08191-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/16/2023] [Indexed: 12/07/2023]
Abstract
INTRODUCTION Colorectal cancer (CRC) creates elevated self-management demands and unmet support needs post-discharge. Follow-up care through eHealth post-primary surgery may be an effective means of supporting patients' needs. This integrative review describes the evidence regarding eHealth interventions post-hospital discharge focusing on delivery mode, user-interface and content, patient intervention adherence, impact on patient-reported outcomes and experiences of eHealth. METHODS A university librarian performed literature searches in 2021 using four databases. After screening 1149 records, the authors read 30 full-text papers and included and extracted data from 26 papers. Two authors analysed the extracted data using the 'framework synthesis approach'. RESULTS The 26 papers were published between 2012 and 2022. The eHealth interventions were mainly delivered by telephone with the assistance of healthcare professionals, combined with text messages or video conferencing. The user interfaces included websites, applications and physical activity (PA) trackers. The interventions comprised the monitoring of symptoms or health behaviours, patient information, education and counselling. Evidence showed a better psychological state and improved PA. Patients reported high satisfaction with eHealth. However, patient adherence was inadequately reported. CONCLUSIONS eHealth interventions may positively impact CRC patients' anxiety and PA regardless of the user interface. Patients prefer technology combined with a human element.
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Affiliation(s)
- Anne Lunde Marie Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway.
- Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway.
| | - Jon Arne Søreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Hartwig Kørner
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Hege Bjøkne Wathne
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway
| | - Alison Richardson
- NIHR CLAHRC Wessex, School of Health Sciences, University of Southampton, Building 67, Highfield Campus, University Road, Southampton, SO17 1BJ, UK
- University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Mailpoint 11, Clinical Academic Facility (Room AA102), South Academic Block, Tremona Road, Southampton, SO16 6YD, UK
| | - Ingvild Margreta Morken
- Research Group of Nursing and Health Sciences, Research Department, Stavanger University Hospital, Stavanger, Norway
- Department of Quality and Health Technologies, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
| | - Kristin Hjorthaug Urstad
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Oda Karin Nordfonn
- Department of Health and Caring Science, Western Norway University of Applied Science, Stord, Norway
| | - Bjørg Karlsen
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4036, Stavanger, Norway
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O'Neill CJ, Carlson MA, Rowe CW, Fradgley EA, Paul C. Hearing the Voices of Australian Thyroid Cancer Survivors: Qualitative Thematic Analysis of Semistructured Interviews Identifies Unmet Support Needs. Thyroid 2023; 33:1455-1464. [PMID: 37335225 PMCID: PMC10734898 DOI: 10.1089/thy.2023.0080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Background: Most thyroid cancer survivors regain their physical health-related quality of life, but psychological and social deficits persist. The nature of these detriments remains poorly understood and they are insufficiently captured by survey data alone. To address this, qualitative data exploring the breadth and depth of thyroid cancer survivors' experiences and priorities for supportive care are required. Methods: Twenty semistructured interviews were undertaken with a purposive, maximum variation sample of thyroid cancer survivors. Interviews were transcribed verbatim and coded independently by two researchers. A hybrid model of inductive and realistic codebook analysis was undertaken with themes developed. Results: Patient experiences centered around three themes: (1) impact of diagnosis and treatment, (2) thyroid cancer does not happen in isolation, and (3) role of clinicians and formalized support structures. The word "cancer" had negative connotations, but for many, the reality of their experience was more positive. Despite feeling "lucky" at the relative low-risk nature of thyroid cancer, many patients reported fatigue, weight gain, and difficulty returning to usual activities; concerns that were largely dismissed or minimized by clinicians. Few were offered any support beyond their treating doctors; where patients attempted to access formalized supportive care, little was available or appropriate. Life stage and concurrent family and social stressors greatly impacted patients' ability to cope with diagnosis and treatment. Addressing thyroid cancer in isolation felt inappropriate without appreciating the broader context of their lives. Interactions with clinicians were largely positive, particularly where information was communicated as a means of empowering patients to participate in shared decision-making and where clinicians "checked in" emotionally with patients. Information about initial treatments was largely adequate but information on longer term effects and follow-up was lacking. Many patients felt that clinicians focused on physical well-being and scan results, missing opportunities to provide psychological support. Conclusions: Thyroid cancer survivors can struggle to navigate their cancer journey, particularly with regard to psychological and social functioning. There is a need to acknowledge these impacts at the time of clinical encounters, as well as develop information resources and support structures that can be individualized to optimize holistic well-being for those in need.
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Affiliation(s)
- Christine J. O'Neill
- Surgical Services, John Hunter Hospital, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Melissa A. Carlson
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Christopher W. Rowe
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Department of Endocrinology, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Elizabeth A. Fradgley
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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11
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Vyas N, Brunckhorst O, Fanshawe JB, Stewart R, Dasgupta P, Ahmed K. Prognostic factors for mental wellbeing in prostate cancer: A systematic review and meta-analysis. Psychooncology 2023; 32:1644-1659. [PMID: 37789603 PMCID: PMC10946963 DOI: 10.1002/pon.6225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/08/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVES To evaluate the evidence base for patient, oncological, and treatment prognostic factors associated with multiple mental wellbeing outcomes in prostate cancer patients. METHODS We performed a literature search of MEDLINE, EMBASE, and CINAHL databases including studies evaluating patient, oncological, or treatment factors against one of five mental wellbeing outcomes; depression, anxiety, fear of cancer recurrence, masculinity, and body image perception. Data synthesis included a random effects meta-analysis for the prognostic effect of individual factors if sufficient homogenous data was available, with a structured narrative synthesis where this was not possible. RESULTS A final 62 articles were included. Older age was associated with a reducing odds of depression (OR 0.97, p = 0.04), with little evidence of effect for other outcomes. Additionally, baseline mental health status was related to depression and increasing time since diagnosis was associated with reducing fear of recurrence, albeith with low certainty of evidence. However, few other patient or oncological factors demonstrated any coherent relationship with any wellbeing outcome. Androgen deprivation therapy was associated with increased depression (HR 1.65, 95% CI 1.41-1.92, p < 0.01) and anxiety, however, little difference was seen between other treatment options. Overall, whilst numerous factors were identified, most were evaluated by single studies with few evaluating masculinity and body image outcomes. CONCLUSION We highlight the existing evidence for prognostic factors in mental wellbeing outcomes in prostate cancer, allowing us to consider high-risk groups of patients for preventative and treatment measures. However, the current evidence is heterogenous with further work required exploring less conclusive factors and outcomes.
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Affiliation(s)
- Neel Vyas
- MRC Centre for TransplantationGuy's Hospital CampusKing's College LondonKing's Health PartnersLondonUK
| | - Oliver Brunckhorst
- MRC Centre for TransplantationGuy's Hospital CampusKing's College LondonKing's Health PartnersLondonUK
| | - Jack B. Fanshawe
- Urology CentreGuy's and St. Thomas' NHS Foundation TrustKing's Health Partners LondonLondonUK
| | - Robert Stewart
- King's College London Institute of Psychiatry, Psychology and NeuroscienceLondonUK
- South London and Maudsley NHS Foundation TrustLondonUK
| | - Prokar Dasgupta
- MRC Centre for TransplantationGuy's Hospital CampusKing's College LondonKing's Health PartnersLondonUK
- Urology CentreGuy's and St. Thomas' NHS Foundation TrustKing's Health Partners LondonLondonUK
| | - Kamran Ahmed
- MRC Centre for TransplantationGuy's Hospital CampusKing's College LondonKing's Health PartnersLondonUK
- Department of UrologySheikh Khalifa Medical CityAbu DhabiUAE
- Khalifa UniversityAbu DhabiUAE
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12
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Pereira L, Nguyen P, Benea A, Townsley C. A quality improvement project to optimize access to psychosocial care for cancer survivors who experience fear of recurrence. J Psychosoc Oncol 2023; 41:721-731. [PMID: 37702764 DOI: 10.1080/07347332.2023.2254755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
BACKGROUND The prevalence of moderate to high levels of fear of cancer recurrence (FCR) in cancer survivors may vary from 22% to 87%, although most are not usually referred to psychosocial support. The After Cancer Treatment Transition (ACTT) clinic in Women's College Hospital (Toronto) provides follow-up care to cancer survivors but in a sample of 2893 patients seen April 2019 to March 2022, only 1.5% were referred to a social worker for psychosocial needs. A single-question screening tool is currently available to screen for FCR. OBJECTIVE To evaluate the use of the single-question screening tool for FCR among cancer survivors and its impact on social work referrals. RESULTS Between July and October 2022, 788 patients were seen in the ACTT clinic. Generally, most patients in ACTT are breast cancer survivors (75%), and the remaining survivors are a mix of other cancer types (colorectal cancer, ovarian cancer, thyroid cancer, melanoma). Three hundred thirty (41.9%) ACTT patients completed the single-question screening tool for FCR. Most screened patients were female (96%), the average age was 60 years, and most were diagnosed with breast cancer (90%). Among screened patients, 37 (11%) indicated a moderately severe to high level of FCR and efforts were made to refer these 37 patients to a social worker. In the end, 22 (59.5%) patients with moderately severe/high levels of FCR were offered and accepted referral to a social worker. In comparison to the 1.5% referred to social work (among 2893 patients) prior to FCR screening, referrals increased to 6.7% (among 330 screened). CONCLUSION Use of a single-question FCR screening tool improved identifying cancer survivors in need of psychosocial support and improved access to a social worker.
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Affiliation(s)
- Luana Pereira
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, ON, Canada
| | - Patricia Nguyen
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, ON, Canada
| | - Aronela Benea
- After Cancer Treatment Transition (ACTT) Program, Women's College Hospital, Toronto, ON, Canada
| | - Carol Townsley
- After Cancer Treatment Transition (ACTT) Program, Women's College Hospital, Toronto, ON, Canada
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Chen R, Yang H, Zhang H, Chen J, Liu S, Wei L. Fear of progression among postoperative patients with newly diagnosed lung cancer: a cross-sectional survey in China. BMC Psychol 2023; 11:168. [PMID: 37217966 DOI: 10.1186/s40359-023-01211-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/17/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND More lung cancer cases are becoming diagnosed earlier in recent years. The diagnosis is often accompanied by fear of progression (FoP). There is a clear research gap in the existing literature on FoP and the most frequent concerns in newly diagnosed lung cancer patients. OBJECTIVE To identify the status and factors related to FoP in newly diagnosed Chinese lung cancer patients undergoing thoracoscopic lung cancer resection. METHODS A cross-sectional design with convenience sampling was used in this study. Participants (N = 188) with newly diagnosed lung cancer (≤ 6 months) at one hospital in Zhengzhou were recruited. A demographic questionnaire, Fear of Progression Questionnaire-Short Form, Social Support Rating Scale (SSRS), Simplified Coping Style Questionnaire, and Brief Illness Perception Questionnaire were used to assess characteristics, FoP, social support, coping style, and patient illness perceptions. Multivariable logistic regression analysis was used to identify factors associated with FoP. RESULTS The mean score of FoP was 35.39 ± 8.03. There are 56.4% of the patients (scores ≥ 34) have a clinically dysfunctional level of FoP. FoP was higher in young (18-39 years) than middle-aged patients (40-59 years) and elderly patients (≧60 years) (P = 0.004). Patients aged 40-59 years showed significantly higher fear of family-related concerns (P < 0.001), a fear of potential harm from medications (P = 0.001); Patients aged 18-39 years and 40-59 years showed significantly higher fears of work-related concerns (P = 0.012). Multiple logistic regression analyses showed that patients' age, the time from surgery and SSRS score were found to be independently associated with higher FoP. CONCLUSIONS High FoP is a frequently reported problem among newly diagnosed lung cancer patients, especially those less than 60 years old. Professional psychoeducation, psychological interventions, and personalized support are needed for patients with a high FoP.
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Affiliation(s)
- Ruiyun Chen
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
| | - Hui Yang
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China.
| | - Hongmei Zhang
- Department of Nursing, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou, 450003, Henan, People's Republic of China
| | - Jingru Chen
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
| | - Saisai Liu
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
| | - Li Wei
- Department of Thoracic Surgery, Henan Key Laboratory for Nursing, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No.7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, People's Republic of China
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14
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Lynch S, Lowry D, Finnerty C, O’Meara Y, Brennan D. The COMFORT trial: a randomised control trial comparing group-based COMpassion-FOcussed therapy and breathing pattern ReTraining with treatment as usual on the psychological functioning of patients diagnosed with cancer recurrence during COVID. Trials 2023; 24:89. [PMID: 36747246 PMCID: PMC9901386 DOI: 10.1186/s13063-023-07088-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/10/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A cancer diagnosis is a known precipitant of psychological distress, with fear of recurrence being a well-documented distressing consequence of cancer. Cancer recurrence often results in an additional psychological burden, which may exacerbate as a result of the COVID-19 pandemic. METHODS This is a single-centre, prospective, randomised controlled trial. Patients identified as having experienced cancer recurrence since March 2020 (the onset of the COVID-19 pandemic in Ireland) will be screened for participation. Eligible, consenting candidates who score 4 or higher on the Distress Thermometer will be enrolled in the study. Participants will be randomly allocated to receive either a 6-week, group-based, online, compassion-focussed therapy and breathing pattern retraining intervention or the control arm. Those in the control arm will all be offered the group intervention after the 18-week study period. The primary outcome is the Distress Thermometer score at 18 weeks post-baseline though secondary outcomes will include measures of mood, traumatic distress and mental adjustment to cancer. DISCUSSION To our knowledge, this protocol describes the first RCT which directly examines the effect of a group-based psychological intervention on Irish patients experiencing cancer recurrence in the context of COVID-19. The outcome of this trial is likely to be twofold: It will determine if the psychological intervention achieves its primary objective of distress amelioration 3 months post-intervention and to establish the feasibility of delivering this intervention in a virtual format. TRIAL REGISTRATION ClinicalTrials.gov NCT05518591. Registered on 25 August 2022. All items from the World Health Organization Trial Registration Data set have been included.
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Affiliation(s)
- Sinead Lynch
- grid.411596.e0000 0004 0488 8430Department of Psychology, Mater Misericordiae University Hospital, Dublin, Ireland ,grid.411596.e0000 0004 0488 8430Department of Psycho-Oncology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Damien Lowry
- grid.411596.e0000 0004 0488 8430Department of Psychology, Mater Misericordiae University Hospital, Dublin, Ireland ,grid.411596.e0000 0004 0488 8430Department of Pain Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Clodagh Finnerty
- grid.7886.10000 0001 0768 2743COMFORT Trial, University College Dublin, Dublin, Ireland
| | - Yvonne O’Meara
- grid.7886.10000 0001 0768 2743Women’s Cancer Survivorship Research Coordinator, School of Medicine, University College Dublin, Dublin, Ireland
| | - Donal Brennan
- grid.411596.e0000 0004 0488 8430Mater Misericordiae University Hospital, Dublin, Ireland ,grid.7886.10000 0001 0768 2743School of Medicine, University College Dublin, Dublin, Ireland
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The Juggernaut of Adaptive Metabolism in Cancers: Implications and Therapeutic Targets. Cancers (Basel) 2022; 14:cancers14215202. [DOI: 10.3390/cancers14215202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
The disease of cancer instills a sense of fear and dread among patients and the next of kin who are indirectly affected by the deteriorating quality of life of their loved ones [...]
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