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Shekar N, Vuong P, Kaur P. Analysing potent biomarkers along phytochemicals for breast cancer therapy: an in silico approach. Breast Cancer Res Treat 2024; 203:29-47. [PMID: 37726449 PMCID: PMC10771382 DOI: 10.1007/s10549-023-07107-7] [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: 06/22/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE This research focused on the identification of herbal compounds as potential anti-cancer drugs, especially for breast cancer, that involved the recognition of Notch downstream targets NOTCH proteins (1-4) specifically expressed in breast tumours as biomarkers for prognosis, along with P53 tumour antigens, that were used as comparisons to check the sensitivity of the herbal bio-compounds. METHODS After investigating phytochemical candidates, we employed an approach for computer-aided drug design and analysis to find strong breast cancer inhibitors. The present study utilized in silico analyses and protein docking techniques to characterize and rank selected bio-compounds for their efficiency in oncogenic inhibition for use in precise carcinomic cell growth control. RESULTS Several of the identified phytocompounds found in herbs followed Lipinski's Rule of Five and could be further investigated as potential medicinal molecules. Based on the Vina score obtained after the docking process, the active compound Epigallocatechin gallate in green tea with NOTCH (1-4) and P53 proteins showed promising results for future drug repurposing. The stiffness and binding stability of green tea pharmacological complexes were further elucidated by the molecular dynamic simulations carried out for the highest scoring phytochemical ligand complex. CONCLUSION The target-ligand complex of green tea active compound Epigallocatechin gallate with NOTCH (1-4) had the potential to become potent anti-breast cancer therapeutic candidates following further research involving wet-lab experiments.
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Affiliation(s)
- Nivruthi Shekar
- UWA School of Agriculture and Environment, University of Western Australia, 35-Stirling Highway, Perth, WA, 6009, Australia
| | - Paton Vuong
- UWA School of Agriculture and Environment, University of Western Australia, 35-Stirling Highway, Perth, WA, 6009, Australia
| | - Parwinder Kaur
- UWA School of Agriculture and Environment, University of Western Australia, 35-Stirling Highway, Perth, WA, 6009, Australia.
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Ip EH, Levine BJ, Avis NE. A non-compensatory analysis of quality of life in breast cancer survivors using multivariate hidden Markov modeling. Qual Life Res 2020; 30:395-405. [PMID: 33011919 DOI: 10.1007/s11136-020-02648-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Health-related quality of life (HRQoL) is a multidimensional concept comprising multiple domains such as physical, emotional, and social well-being. Many analyses use a sum score to represent the construct. However, this approach implies that gain in one domain can compensate for a deficit in another, and thus such analyses may not capture HRQoL profiles. Additionally, within-individual change over time, such as improvement in one domain but deterioration in another, may not be detected. The objectives of this research are to demonstrate the utility of a non-compensatory approach by (1) evaluating this approach applied to HRQoL data, and (2) comparing the approach to a compensatory method. METHODS Data from a sample of 653 breast cancer survivors (BCS) provided five measurement time points over 18 months. We analyzed the scores from five domains on the FACT-B questionnaire (physical, functional, social, and emotional well-being and breast cancer-related concerns) using the multivariate hidden Markov model (MHMM), a non-compensatory approach that identifies different HRQoL states and associated BCS subgroups and their trajectories. RESULTS The MHMM delineated six states. States 1 and 2 had low well-being scores across all domains, with state 2 slightly better than state 1. States 3 and 4 had similar overall HRQoL scores, but different profiles with compensation occurring across the domains of both physical and social well-being. States 5 and 6 had almost identical overall scores with compensation occurring between the domains of both social and emotional well-being. Over time, states 3-6 mostly "communicated" with each other (with moderate probabilities of transitioning between states). Compensation across domains could mask subtle changes occurring in BCS. We found that a trend analysis using both compensatory and non-compensatory approaches showed improvement in the HRQoL in BCS over time. CONCLUSION The non-compensatory analysis of FACT-B shows differential profiles and trajectories in the HRQoL of BCS not captured by the sum score or one-domain-at-a-time approach.
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Affiliation(s)
- Edward H Ip
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA. .,Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA.
| | - Beverly J Levine
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA
| | - Nancy E Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, USA
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Reducing Cardiac Radiation Dose From Breast Cancer Radiation Therapy With Breath Hold Training and Cognitive Behavioral Therapy. Top Magn Reson Imaging 2020; 29:135-148. [PMID: 32568976 DOI: 10.1097/rmr.0000000000000241] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The delivery of radiation therapy shares many of the challenges encountered in imaging procedures. As in imaging, such as MRI, organ motion must be reduced to a minimum, often for lengthy time periods, to effectively target the tumor during imaging-guided therapy while reducing radiation dose to nearby normal tissues. For patients, radiation therapy is frequently a stress- and anxiety-provoking medical procedure, evoking fear from negative perceptions about irradiation, confinement from immobilization devices, claustrophobia, unease with equipment, physical discomfort, and overall cancer fear. Such stress can be a profound challenge for cancer patients' emotional coping and tolerance to treatment, and particularly interferes with advanced radiation therapy procedures where active, complex and repetitive high-level cooperation is often required from the patient.In breast cancer, the most common cancer in women worldwide, radiation therapy is an indispensable component of treatment to improve tumor control and outcome in both breast-conserving therapy for early-stage disease and in advanced-stage patients. High technological complexity and high patient cooperation is required to mitigate the known cardiac toxicity and mortality from breast cancer radiation by reducing the unintended radiation dose to the heart from left breast or left chest wall irradiation. To address this, radiation treatment in daily deep inspiration breath hold (DIBH), to create greater distance between the treatment target and the heart, is increasingly practiced. While holding the promise to decrease cardiac toxicity, DIBH procedures often augment patients' baseline stress and anxiety reaction toward radiation treatment. Patients are often overwhelmed by the physical and mental demands of daily DIBH, including the nonintuitive timed and sustained coordination of abdominal thoracic muscles for prolonged breath holding.While technologies, such as DIBH, have advanced to millimeter-precision in treatment delivery and motion tracking, the "human factor" of patients' ability to cooperate and perform has been addressed much less. Both are needed to optimally deliver advanced radiation therapy with minimized normal tissue effects, while alleviating physical and cognitive distress during this challenging phase of breast cancer therapy.This article discusses physical training and psychotherapeutic integrative health approaches, applied to radiation oncology, to leverage and augment the gains enabled by advanced technology-based high-precision radiation treatment in breast cancer. Such combinations of advanced technologies with training and cognitive integrative health interventions hold the promise to provide simple feasible and low-cost means to improve patient experience, emotional outcomes and quality of life, while optimizing patient performance for advanced imaging-guided treatment procedures - paving the way to improve cardiac outcomes in breast cancer survivors.
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Lantheaume S, Fernandez L, Moták L, Blois Da Conceição S. Cancer du sein non métastasé et dessin de l’arbre. PSYCHO-ONCOLOGIE 2020. [DOI: 10.3166/pson-2019-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cette recherche porte sur l’évolution des tracés du dessin de l’arbre (DA) au cours du temps chez 30 patientes atteintes de cancer du sein, de l’annonce diagnostique à la fin des traitements. Les patientes ont été réparties en deux groupes : le premier est composé de femmes ayant reçu de la chimiothérapie, le second de femmes n’ayant pas reçu de chimiothérapie. Les résultats mettent en évidence que les constellations de tracés au test de l’arbre n’évoluent pas au cours du temps, mais en fonction de la présence/absence de chimiothérapie. Les profils psychologiques des patientes restent stables entre l’annonce diagnostique et un délai de six mois après la fin des traitements. L’arbre dessiné semble en revanche porter les stigmates des traitements subis.
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5
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Coping with chemotherapy for breast cancer: Asking women what works. Eur J Oncol Nurs 2018; 35:85-91. [DOI: 10.1016/j.ejon.2018.06.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/11/2018] [Accepted: 06/13/2018] [Indexed: 11/24/2022]
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Gonzalez-Hernandez E, Romero R, Campos D, Burychka D, Diego-Pedro R, Baños R, Negi LT, Cebolla A. Cognitively-Based Compassion Training (CBCT ®) in Breast Cancer Survivors: A Randomized Clinical Trial Study. Integr Cancer Ther 2018; 17:684-696. [PMID: 29681185 PMCID: PMC6142100 DOI: 10.1177/1534735418772095] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Context. Breast cancer (BC) requires a significant psychological
adaptation once treatment is finished. There is growing evidence of how
compassion training enhances psychological and physical well-being, however,
there are very few studies analyzing the efficacy of compassion-based
Interventions on BC survivors. Objective. To study the efficacy
of the Cognitively-Based Compassion Training (CBCT) protocol in a BC survivor
sample on quality of life, psychological well-being, fear of cancer recurrence,
self-compassion, and compassion domains and mindfulness facets. Furthermore,
enrollment, adherence, and satisfaction with the intervention were also
analyzed. Methods. A randomized clinical trial was designed.
Participants (n = 56) were randomly assigned to CBCT (n = 28) or a
treatment-as-usual control group (TAU; n = 28). Pre-post intervention and
6-month follow-up measures took place to evaluate health-related quality of
life, psychological well-being; psychological stress, coping strategies, and
triggering cognitions; self-compassion and compassion; and mindfulness in both
intervention and wait-list groups. Results. Accrual of eligible
participants was high (77%), and the drop-out rate was 16%. Attendance to CBCT
sessions was high and practice off sessions exceeded expectations). CBCT was
effective in diminishing stress caused by FCR, fostering self-kindness and
common humanity, and increasing overall self-compassion scores, mindful
observation, and acting with awareness skillsets. Conclusion.
CBCT could be considered a promising and potentially useful intervention to
diminish stress caused by FCR and enhance self-kindness, common humanity,
overall self-compassion, mindful observation, and acting with awareness
skillsets. Nevertheless, future randomized trials are needed and a process of
deeper cultural adaptation required.
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Affiliation(s)
| | - Rocio Romero
- 2 Fundación Instituto Valenciano de Oncología, València, Spain
| | | | | | | | - Rosa Baños
- 1 Universitat de València, València, Spain.,4 CIBERObn Ciber Fisiopatologia de la obesidad y la nutrición, Madrid, Spain
| | | | - Ausiàs Cebolla
- 1 Universitat de València, València, Spain.,4 CIBERObn Ciber Fisiopatologia de la obesidad y la nutrición, Madrid, Spain
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Hess CB, Chen AM. Measuring psychosocial functioning in the radiation oncology clinic: a systematic review. Psychooncology 2014; 23:841-54. [PMID: 24846702 DOI: 10.1002/pon.3521] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 02/05/2014] [Accepted: 02/24/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND This paper aimed to systematically review the (1) prevalence, (2) risk factors, (3) interventions, and (4) measurement instruments associated with psychosocial function decline in radiation therapy (RT) patients. METHODS A MEDLINE systematic literature review was performed to identify studies monitoring psychosocial function among RT patients as a primary endpoint. RESULTS Fifty-seven and 22 risk factors for RT-related psychosocial function decline were identified and refuted, respectively, in 93 eligible studies representing 12,808 patients. Median prevalences of psychosocial function decline prior to, during, and following RT were 20%, 36%, and 25%. Prior to RT, anxiety was more prevalent than depression (20% vs 15%), but dropped following completion of RT, whereas median depression levels remained elevated (17% vs. 27%). Of the 79 identified risk factors, 17 were reported as predictive of psychosocial decline by two or more more studies, and five had robust support: (1) physical symptoms, (2) time point during RT, (3) chemotherapy reception, (4) female gender, and (5) younger age. Three interventions were consensually reported to improve psychosocial function: psychotherapy, nursing consultation/patient education, and self-management training. Eighty-six different assessment tools were used to monitor RT-related psychosocial function decline with the Hospital Anxiety and Depression Scale (25.8%) and the psychiatric interview (22.6%) being the most utilized. The distress thermometer has been used in 5 studies (5.4%) to date. CONCLUSION Psychosocial function declines in approximately one-third of RT patients. Anxiety can dissipate after initiation of RT, whereas depression can persist throughout and after RT. Severe physical symptoms and time-related factors most robustly predict psychosocial function decline, which can be improved by psychotherapy and interventions aimed to improve patient education.
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Affiliation(s)
- Clayton B Hess
- The Pennsylvania State University College of Medicine, Hershey, PA, USA; The University of Texas Southwestern-Austin Transitional Residency Program, Austin, TX, USA; Department of Radiation Oncology, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA
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Hernández M, Antonio Cruzado J. La atención psicológica a pacientes con cáncer: de la evaluación al tratamiento. CLÍNICA Y SALUD 2013. [DOI: 10.5093/cl2013a1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Güleser GN, Taşci S, Kaplan B. The experience of symptoms and information needs of cancer patients undergoing radiotherapy. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:46-53. [PMID: 21751048 DOI: 10.1007/s13187-011-0254-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The aim was to determine the symptoms and information needs of cancer patients undergoing radiotherapy (RT). The study population consisted of 345 RT patients accrued over 6 months. Patients' needs for information, sources of information, levels of satisfaction with information, symptoms and demographic factors were assessed by questionnaire and personal interview. Chi-square tests were used to test the correlation between patient variables and information needs/experiences. Most patients (80.9%) experienced RT side effects--fatigue, nausea, vomiting and loss of appetite were the most frequent. More than half of the patients had not received information about RT; however, patients (83.2%) who had problems during the treatment wanted to have information (P < 0.05). The majority of the patients receiving information identified doctors as the primary source. The patients' prioritized needs for information were all the aspects of their diagnosis and treatment and side effects of RT. Overall, the results indicate that most patients require information about their treatment and also experienced a variety of symptoms.
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Affiliation(s)
- Gülsüm Nihal Güleser
- Erciyes University Halil Bayraktar Health Services Vocational College, Kayseri, Turkey.
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Candy B, Jones L, Drake R, Leurent B, King M. Interventions for supporting informal caregivers of patients in the terminal phase of a disease. Cochrane Database Syst Rev 2011:CD007617. [PMID: 21678368 DOI: 10.1002/14651858.cd007617.pub2] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Patients in the terminal phase of a disease may have complex needs. It is often family and friends who play a central role in providing support, despite health professional input and regardless of whether the patient is at home or elsewhere. Such informal caring may involve considerable physical, psychological, and economic stresses. A range of supportive programmes for caregivers is being developed including psychological support and practical assistance. OBJECTIVES To assess the effects of supportive interventions that aim to improve the psychological and physical health of informal caregivers of patients in the terminal phase of their illness. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2 2010); MEDLINE (1950 to May 2010); EMBASE (1980 to May 2010); PsycINFO (1872 to May 2010); CINAHL (1937 to May 2010); National Health Service Research Register (2000 to November 2008) and Dissertation Abstracts (1716 to May 2010). We searched the reference lists of relevant studies; contacted experts; and handsearched journals. SELECTION CRITERIA Randomised controlled trials (RCTs) of interventions to support adults who were caring for a friend or relative with a disease in the terminal phase. Interventions could include practical and emotional support and/or the facilitation of coping skills. Interventions could support caregivers indirectly via patient care. DATA COLLECTION AND ANALYSIS Two authors independently screened citations against the selection criteria. Data were extracted by one author and checked by another. This included extraction of any adverse effects. Risk of bias assessment was undertaken by two authors. We contacted trial authors to obtain missing information. Trial data were combined, where appropriate, on the review's primary outcomes. MAIN RESULTS We included eleven RCTs involving 1836 caregiver participants. Nine interventions were delivered directly to the caregiver. Seven of these provided support in the caring role, another involved a family life review, and one grief therapy. None provided practical support. The other two interventions aimed to support caregivers indirectly via patient care. Overall the risk of bias is unclear, as all trials under-reported methods.There is low quality evidence that interventions directly supporting the caregiver significantly reduce psychological distress in the short term (8 trials: standardised mean difference (SMD) -0.15; 95% confidence interval (CI) -0.28 to -0.02). There is also low quality evidence that these interventions in the short term may marginally improve coping skills and quality of life, but neither results were statistically significant (7 trials: SMD -0.05; 95% CI -0.24 to 0.14; 6 trials: SMD 0.08; 95% CI -0.11 to 0.26, respectively). One study assessed physical outcomes, specifically sleep improvement, and found no difference (median effect 0.00). No study measured health service use or adverse outcomes. In one study, however, a subgroup of intervention participants had higher levels of family conflict.Evidence was less clear on the indirect interventions. While both trials in this category found that supporting the patient may reduce psychological distress, none of the four assessments were statistically significant. There were no evaluations of coping with the caring role, quality of life, service use or adverse outcomes. In one trial there was no difference between trial arms in the proportion of caregivers reporting good physical health. AUTHORS' CONCLUSIONS There is evidence that supportive interventions may help reduce caregivers' psychological distress. These findings suggest that practitioners should enquire about the concerns of caregivers and should consider that they may benefit from additional support. There is, however, a need for further research to explore the benefits identified, and to assess the interventions' effects on physical health, and potential harms. Trials need to report their methods fully.
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Affiliation(s)
- Bridget Candy
- Marie Curie Palliative Care Research Unit, Department of Mental Health Sciences, Royal Free & University College Medical School, Hampstead Campus, Rowland Hill Street, London, UK, NW3 2PF
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Faul LA, Jim HS, Minton S, Fishman M, Tanvetyanon T, Jacobsen PB. Relationship of exercise to quality of life in cancer patients beginning chemotherapy. J Pain Symptom Manage 2011; 41:859-69. [PMID: 21330097 PMCID: PMC3779914 DOI: 10.1016/j.jpainsymman.2010.07.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 07/16/2010] [Accepted: 07/29/2010] [Indexed: 01/06/2023]
Abstract
CONTEXT Cancer diagnosis and treatment, particularly chemotherapy, has well-established adverse effects on individuals. Exercise has been found to confer benefits to patients, although the current evidence base is limited primarily to patients assessed during or after treatment. Although exercise has been a target of intervention efforts, its relationship to quality of life in patients about to begin chemotherapy has not fully been examined. OBJECTIVES To examine the relationship of pre-treatment exercise rates to patient's quality of life. METHODS One hundred ninety-two adults diagnosed with Stages I-IV cancer and Eastern Cooperative Oncology Group performance status ≤ 2, provided data on exercise, distress (anxiety and depression), and health-related quality of life prior to their initial chemotherapy infusion. RESULTS As predicted, higher rates of exercise activity were associated with lower levels of anxiety and depression, and better overall mental and physical quality of life. These relationships were independent of demographic variables (i.e., body mass index and age) also associated with quality of life in the present analyses. CONCLUSION These findings further highlight the importance of assessing exercise before the start of chemotherapy as part of broader efforts to link patients to appropriate interventions aimed at enhancing quality of life. Findings also raise the possibility that assessing exercise rates could be useful in matching patients to the type of intervention most likely to benefit them. Future research should use prospective longitudinal designs to further explore this association.
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Affiliation(s)
- Leigh Anne Faul
- Georgetown University and Lombardi Comprehensive Cancer Center, Washington, DC 20007, USA.
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Frieswijk N, Hagedoorn M. Being needy versus being needed: The role of self-regulatory focus in the experience of breast cancer. Br J Health Psychol 2011; 14:69-81. [DOI: 10.1348/135910708x299673] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Ching LC, Devi MK, Kim Emily DNurs AN. Anxiety in patients with breast cancer undergoing treatment: a systematic review. ACTA ACUST UNITED AC 2010; 8:1016-1057. [PMID: 27820329 DOI: 10.11124/01938924-201008250-00001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Breast cancer is one of the most common cancers worldwide, and anxiety is a psychological morbidity that is inevitable. Many researchers have investigated its prevalence and detrimental effects, yet little is known when comparing the different breast cancer treatments. A systematic review of all available literature was indicated to encourage better understanding of anxiety in patients undergoing treatment for breast cancer. OBJECTIVES This review aimed to determine the best available evidence on the level of anxiety among women with breast cancer undergoing/had undergone cancer treatment(s), and factor(s) contributing to anxiety in these treatment modalities. INCLUSION CRITERIA Types of participants Women with breast cancer of stage 0 to stage IIIA breast cancer, over and equal to 21 and below the age of 65 years of age.Types of intervention Women who were undergoing/had undergone cancer treatment restricted to chemotherapy, radiotherapy, surgery or combined treatments, and were without other medical co morbidities.Types of outcomes A variety of outcome measures were used to assess anxiety in the included papers. Hospital Anxiety and Depression Scale and State-Trait Anxiety Inventory were mostly used.Types of studies This review considered quantitative papers (randomized control trials, descriptive studies and systematic review) that fulfilled both requirements: SEARCH STRATEGY: The search sought to gather data from published and unpublished studies conducted between 1990 and 2010. An initial search on CINAHL and Medline was done to identify relevant search terms. A search strategy was then developed, using MeSH headings and keywords. Following databases were searched: CINAHL; PubMed; ScienceDirect; PsycINFO; Cochrane Database of Systematic Review; Scopus; Wiley Interscience and PsycARTICLES. DATA COLLECTION/EXTRACTION Two reviewers independently assessed the eligibility of the papers for inclusion. Eighteen papers were selected based on relevance, and underwent assessment for methodological quality using MAStARI. Eleven research papers that met the level of methodological standard were included into the review. Both reviewers came to the same consensus on the included and excluded papers. DATA ANALYSIS Due to the methodological heterogeneity of the included papers, a meta-analysis was not possible. The studies were hence presented in narrative summary. RESULTS Anxiety seems to be ubiquitous, presenting itself in all treatment types for breast cancer. Anxiety level in breast cancer women who underwent chemotherapy was highest before the first chemotherapy infusion, mediated by age and trait anxiety. Radiotherapy regimes did not affect anxiety level in radiotherapy-treated patients, and most research concluded that anxiety level was higher among women who underwent mastectomy than breast conservation therapy. When compared, patients who underwent chemotherapy were more anxious. CONCLUSIONS The prevalence and intensity of anxiety has been shown to be pronounced among the three treatments. Chemotherapy, as compared to other treatments, has shown to be associated with a higher anxiety level. IMPLICATIONS FOR RESEARCH With the prevalence, intensity and correlated factors of anxiety identified through this review, future research may investigate the interventions that could help alleviate anxiety among these patients. IMPLICATIONS FOR PRACTICE Anxiety is prevalent in women with breast cancer undergoing treatment, especially those undergoing chemotherapy. Healthcare professionals should pay greater attention to identify cues of anxiety in patients and prevent/alleviate it.
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Affiliation(s)
- Lim Chi Ching
- 1. The Singapore National University Hospital (NUH) Centre for Evidence Based Nursing, Alice Lee Centre for Nursing Studies, National University of Singapore (NUS) 2. Senior Lecturer, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore (NUS) 3. Deputy Director (Clinical and Oncology Nursing), National University Cancer Institute, Singapore,National University Hospital, Singapore
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Faul LA, Jim HS, Williams C, Loftus L, Jacobsen PB. Relationship of stress management skill to psychological distress and quality of life in adults with cancer. Psychooncology 2010; 19:102-9. [DOI: 10.1002/pon.1547] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Schnur JB, David D, Kangas M, Green S, Bovbjerg DH, Montgomery GH. A randomized trial of a cognitive-behavioral therapy and hypnosis intervention on positive and negative affect during breast cancer radiotherapy. J Clin Psychol 2009; 65:443-55. [PMID: 19226611 DOI: 10.1002/jclp.20559] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Breast cancer radiotherapy can be an emotionally difficult experience. Despite this, few studies have examined the effectiveness of psychological interventions to reduce negative affect, and none to date have explicitly examined interventions to improve positive affect among breast cancer radiotherapy patients. The present study examined the effectiveness of a multimodal psychotherapeutic approach, combining cognitive-behavioral therapy and hypnosis (CBTH), to reduce negative affect and increase positive affect in 40 women undergoing breast cancer radiotherapy. Participants were randomly assigned to receive either CBTH or standard care. Participants completed weekly self-report measures of positive and negative affect. Repeated and univariate analyses of variance revealed that the CBTH approach reduced levels of negative affect [F(1, 38)=13.49; p=.0007, omega(2)=.56], and increased levels of positive affect [F(1, 38)=9.67; p=.0035, omega(2)=.48], during the course of radiotherapy. Additionally, relative to the control group, the CBTH group demonstrated significantly more intense positive affect [F(1, 38)=7.09; p=.0113, d=.71] and significantly less intense negative affect [F(1, 38)=10.30; p=.0027, d=.90] during radiotherapy. The CBTH group also had a significantly higher frequency of days where positive affect was greater than negative affect (85% of days assessed for the CBTH group versus 43% of the Control group) [F(1, 38)=18.16; p=.0001, d=1.16]. Therefore, the CBTH intervention has the potential to improve the affective experience of women undergoing breast cancer radiotherapy.
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Affiliation(s)
- Julie B Schnur
- Department of Oncological Sciences, Mount Sinai School of Medicine, New York, New York 10029-6574, USA.
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Krischer MM, Xu P. Determinants of psychological functioning in patients undergoing radiotherapy: a descriptive study. J Psychosoc Oncol 2009; 26:1-13. [PMID: 19042269 DOI: 10.1080/07347330802359552] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study sought to confirm the literature reports on psychological well-being during radiotherapy treatment using a population across multiple clinical sites, resulting in a larger population (N = 156) than has typically been followed in quality of life descriptive studies of radiotherapy, and a more varied one in terms of diagnosis. This study is unique in its individual differences perspective, whereby it aimed to identify those demographic variables that predict baseline levels of psychological distress as well as changes in distress during treatment. The data used were the control data from a previous study assessing the effectiveness of a stress management intervention. Participants completed the SF-36, STAI-S, and CES-D scales at baseline and after Weeks 1, 2, and 3 of treatment. Consistent with prior studies, this study found that, on average, patients began with a low level of psychological distress, as indicated by the scale norms. However, this study found considerable variation in anxiety levels, with some patients beginning treatment with a relatively high level of anxiety. For those with relatively high levels of baseline anxiety, anxiety decreased during treatment. A patient's baseline psychological distress level was predicted by marital status, diagnosis, gender, education level, and income range. In addition, cancer type, income level, and education level predicted changes in distress levels over treatment.
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Affiliation(s)
- Mindy M Krischer
- Department of Pediatrics, University of South Florida, Tampa, FL 33612, USA.
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Mahar KK, BrintzenhofeSzoc K, Shields JJ. The impact of changes in employment status on psychosocial well-being: a study of breast cancer survivors. J Psychosoc Oncol 2009; 26:1-17. [PMID: 19042262 DOI: 10.1080/07347330802115400] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Recent developments in the treatment of cancer have resulted in an increase in the number of cancer survivors. With this increase in the survival rate comes an increase in questions as to how a diagnosis of cancer and its treatment affects survivors and their well-being. Research has emphasized the impact that medical factors related to cancer have on the well-being of cancer survivors. However, the literature also suggests that socioeconomic factors may affect cancer survivors; well-being. This study focuses on the role that employment status plays in relationship to the levels of psychosocial well-being of women diagnosed with and treated for breast cancer. This study was a cross-sectional design utilizing secondary data analysis. The sample consisted of 369 breast cancer survivors from four cancer treatment facilities in the Mid-Atlantic region. The independent variable was employment status during and after treatment and the dependent variables were psychological distress, physical and mental functioning and quality of life. Utilizing analysis of covariance, controlling for age at diagnosis and stage of cancer it was found that there was a statistically significant difference in the dependent variables by employment status. These findings are discussed in terms of clinical and policy implications.
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Ching LC, Devi KM, Ang E. Anxiety in patients with breast cancer undergoing treatment: A systematic review. JBI LIBRARY OF SYSTEMATIC REVIEWS 2009; 7:1-25. [PMID: 27820324 DOI: 10.11124/01938924-200907341-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Lim Chi Ching
- 1 Lim Chi Ching Honours Student Alice Lee Centre for Nursing Studies National University of Singapore (NUS) Mobile: 96338590 2 M Kamala Devi MSc Adv Practice (Cancer Care), PGDipHE, BHSc(N), ONC, RN Senior Lecturer Alice Lee Centre for Nursing Studies Yong Loo Lin School of Medicine National University of Singapore (NUS) Block E3A, Level 3 7 Engineering Drive 1 Singapore 117574 Mobile: 98310611 Phone: 6516 7792 3 Dr. Emily Ang Neo Kim DNurs, MN, BNCert. Edu., ONC, CCNC, RN DNurs Candidate University of Adelaide, South Australia Deputy Director (Clinical and Oncology Nursing) National Cancer Institute Singapore (NCIS) National University Hospital, Singapore Main Building, Level 2 5 Lower Kent Ridge Road Singapore 119074 Institution mainline: 67724819 Mobile: 96539617
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Frick E, Tyroller M, Panzer M. Anxiety, depression and quality of life of cancer patients undergoing radiation therapy: a cross-sectional study in a community hospital outpatient centre. Eur J Cancer Care (Engl) 2007; 16:130-6. [PMID: 17371421 DOI: 10.1111/j.1365-2354.2006.00720.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of the present study is to determine the impact of illness characteristics and psychopathological comorbidity on the quality of life (QoL) of radio-oncological patients in health-related and individual dimensions. Sixty-three of 93 eligible patients (40 women and 23 men) were included in the study during their radiation therapy visit to an outpatient centre annexed to a community hospital in Southern Bavaria, Germany. In a semi-structured interview, we elicited individually relevant life domains rated by the patients according to the 'Schedule for the Evaluation of Individual Quality of Life - Direct Weighting'. In addition, the participants completed the 'European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire Core 30' and the 'Hospital Anxiety and Depression Scale'. We also assessed the demand for psychotherapy and utilization of psycho-oncological services. In total, 9.5% of the examined patients suffer from clinically relevant anxiety and/or depression [total Hospital Anxiety and Depression Scale (HADS) score >19]. There was a weak positive correlation between Karnofsky's Performance Status and QoL. Anxiety and depression were significantly correlated with impaired QoL, especially with impaired individual QoL. There was no association between psychopathological comorbidity and the requirement for psycho-oncological support. Conversely, patients who report difficulties in accepting help had a significantly lower QoL. Psychopathological comorbidity has a considerable influence on QoL of patients undergoing radiotherapy. Measuring the individual QoL appears as an adapted needs assessment and helps the psychotherapist in focusing on the patient's problems and desires. Furthermore, the patient's QoL is a main target in providing or planning mental health care in non-university oncological services.
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Affiliation(s)
- E Frick
- University of Munich - Psychotherapy & Psychosomatics, Nussbaumstrasse, Munich, Germany.
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Fritzsche K, Liptai C, Henke M. Psychosocial distress and need for psychotherapeutic treatment in cancer patients undergoing radiotherapy. Radiother Oncol 2004; 72:183-9. [PMID: 15297137 DOI: 10.1016/j.radonc.2004.03.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2003] [Revised: 03/12/2004] [Accepted: 03/18/2004] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Empirical investigations examining the need for psychotherapeutic treatment of inpatients in radio-oncology departments are rare. We, therefore, assessed the degree of psychosocial distress of radio-oncology inpatients and their need for psychotherapeutic interventions. PATIENTS AND METHODS Eighty-seven patients from two radio-oncology wards underwent psychodiagnostic interviews and completed self-rating instruments to determine mental disorders, psychosocial distress, coping strategies and quality of life. Need for psychotherapeutic interventions and treatment motivation were estimated by patients and by a professional. RESULTS Using ICD-10 criteria, mental and behavioral disorders were diagnosed in 51% of the patients, most of them adjustment disorders. The professional regarded 32.2% of patients as needing psychotherapeutic treatment, compared with 43% of the patients who were motivated to accept at least one of the psychotherapeutic treatments offered. There was a marked discrepancy between the points of view of the patient and the professional, in that, while the professional regarded anxiety as a highly significant predictor of the need for treatment, psychosocial distress played no role in the patients' estimation. CONCLUSIONS In determining the indication for psychotherapeutic treatment, both objectified psychosocial distress and a patients' subjective treatment expectations should be considered. There is a need to develop screening instruments that integrate both aspects.
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Affiliation(s)
- Kurt Fritzsche
- Department for Psychosomatics and Psychotherapy, University Hospital Freiburg, Hauptstr. 8, D-79114 Freiburg, Germany
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Dunn J, Steginga SK, Rose P, Scott J, Allison R. Evaluating patient education materials about radiation therapy. PATIENT EDUCATION AND COUNSELING 2004; 52:325-332. [PMID: 14998603 DOI: 10.1016/s0738-3991(03)00108-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2002] [Revised: 01/16/2003] [Accepted: 01/19/2003] [Indexed: 05/24/2023]
Abstract
Targeted treatment education for cancer patients has the potential to promote adjustment through assisting patients to participate in treatment decision making, comply with treatment regimens and cope more effectively with treatment side effects. A quasi-experimental longitudinal pre-test post-test and follow-up design was used to assess the effect of a patient education video about radiation therapy on patients' psychological distress, knowledge about radiation therapy, self-efficacy about coping with treatment and physical symptoms. Patients with head and neck (n=26) and breast cancer (n=66) were recruited into the study and allocated into control and intervention groups. No significant differences were found between the control and intervention groups on any of the outcome variables. However, patients in the intervention group reported high levels of satisfaction with the video and all reported that they would recommend the video to other patients preparing for radiation therapy. As well, 90% of patients in the intervention group reported that some or all of the information in the video was new to them. Education materials that have excellent face validity and that are well received by patients may fail to produce significant change using standard controlled study designs. Future research in this area may need to consider alternative paradigms for evaluating the helpfulness of such materials.
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Affiliation(s)
- Jeff Dunn
- Community Services, Queensland Cancer Fund, Spring Hill, Qld 4006, Australia.
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Stiegelis HE, Ranchor AV, Sanderman R. Psychological functioning in cancer patients treated with radiotherapy. PATIENT EDUCATION AND COUNSELING 2004; 52:131-141. [PMID: 15132517 DOI: 10.1016/s0738-3991(03)00021-1] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Although many side-effects of radiotherapy (RT) are physical, previous studies have shown that patients, when treated with RT, also experience psychological problems. This review describes the psychological functioning of cancer patients prior to, during, and after RT. Moreover, we examined whether medical factors are related to psychological functioning. Using Medline and Psychlit databases over the period 1980-2002, 45 articles were studied for this review. Although some global trends were found, studies revealed great variability in psychological functioning prior to, during, and after RT. Longitudinal studies should include pre-, during, and post-RT assessments of psychological functioning and also take into account the previous psychological stability of the patient.
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Affiliation(s)
- Heidi E Stiegelis
- Northern Centre for Healthcare Research, University of Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands.
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Petronis VM, Carver CS, Antoni MH, Weiss S. Investment in Body Image and Psychosocial Well-Being Among Women Treated for Early Stage Breast Cancer: Partial Replication and Extension. Psychol Health 2003. [DOI: 10.1080/0887044021000020941] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Buick DL, Petrie KJ. "I Know Just How You Feel": The Validity of Healthy Women's Perceptions of Breast-Cancer Patients Receiving Treatment. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2002. [DOI: 10.1111/j.1559-1816.2002.tb01422.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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