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Aljawadi MH, Alkhudair N, Alrasheed M, Alsuhaibani AS, Alotaibi BJ, Almuqbil M, Alhammad AM, Arafah A, AlGahtani FH, Rehman MU. Understanding the Quality of Life Among Patients With Cancer in Saudi Arabia: Insights From a Cross-Sectional Study. Cancer Control 2024; 31:10732748241263013. [PMID: 38870396 PMCID: PMC11179550 DOI: 10.1177/10732748241263013] [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: 11/26/2023] [Revised: 04/25/2024] [Accepted: 05/21/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION Cancer patients' quality of life (QoL) significantly influences treatment response and mortality rates. Understanding QoL domains among patients with cancer and what affects it can help create interventions that improve QoL and ease patients' experience. This study measures the OoL among patients with cancer and influencing factors. METHODS A prospective cross-sectional questionnaire-based study included cancer patients aged >18 currently receiving treatment. The questionnaire collected social and economic data, followed by the validated Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30). Means and standard deviations for described numeric variables and frequencies and percentages described categorical variables. Analysis of variance, F-tests, and P-values were reported. RESULTS Among 182 cancer patients, 60% were female. Younger patients exhibited higher QoL in physical and role functioning (P = .016 and .03) and experienced more significant financial impact (P = .0144). Females reported more adverse effects from cancer symptoms, including fatigue, nausea, vomiting, and pain (36.7% vs 25.5%, P = .005; 20.6% vs 11.5%, P = .0186; 34.7% vs 25.1%, P = .0281). Single patients had superior QoL in physical functioning compared to others (P = .0127). Patients traveling long distances were more likely to face adverse financial consequences (P = .007). Asthmatic patients exhibited lower QoL in physical, role, and cognitive functioning (72.3 vs 37.8, P = .0147; 76.4 vs 22.2, P = .0024; 84.7 vs 44.4, P = .0038) and reported increased dyspnea and appetite loss (16 vs 55.6 and 26.1 vs 66.7, both P < .05). CONCLUSION Factors influencing QoL in Saudi cancer patients include age, marital status, gender, hospital distance, and chronic conditions. Thus emphasizing the necessity for personalized care strategies to enhance outcomes and alleviate the overall burden of cancer care.
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Affiliation(s)
- Mohammad H Aljawadi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Nora Alkhudair
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Marwan Alrasheed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz S Alsuhaibani
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Basil J Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mansour Almuqbil
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M Alhammad
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Azhar Arafah
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Farjah H AlGahtani
- Department of internal Medicine, King Saud University College of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Muneeb U Rehman
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Sharon CE, Wang M, Tortorello GN, Perry NJ, Ma KL, Tchou JC, Fayanju OM, Mahmoud NN, Miura JT, Karakousis GC. Impact of Patient Comorbidities on Presentation Stage of Breast and Colon Cancers. Ann Surg Oncol 2023; 30:4617-4626. [PMID: 37208570 PMCID: PMC10788153 DOI: 10.1245/s10434-023-13596-z] [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: 03/10/2023] [Accepted: 04/18/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND While patients with multiple comorbidities may have frequent contact with medical providers, it is unclear whether their healthcare visits translate into earlier detection of cancers, specifically breast and colon cancers. METHODS Patients diagnosed with stage I-IV breast ductal carcinoma and colon adenocarcinoma were identified from the National Cancer Database and stratified by comorbidity burden, dichotomized as a Charlson Comorbidity Index (CCI) Score of <2 or ≥2. Characteristics associated with comorbidities were analyzed by univariate and multivariate logistic regression. Propensity-score matching was performed to determine the impact of CCI on stage at cancer diagnosis, dichotomized as early (I-II) or late (III-IV). RESULTS A total of 672,032 patients with colon adenocarcinoma and 2,132,889 with breast ductal carcinoma were included. Patients with colon adenocarcinoma who had a CCI ≥ 2 (11%, n = 72,620) were more likely to be diagnosed with early-stage disease (53% vs. 47%; odds ratio [OR] 1.02, p = 0.017), and this finding persisted after propensity matching (CCI ≥ 2 55% vs. CCI < 2 53%, p < 0.001). Patients with breast ductal carcinoma who had a CCI ≥ 2 (4%, n = 85,069) were more likely to be diagnosed with late-stage disease (15% vs. 12%; OR 1.35, p < 0.001). This finding also persisted after propensity matching (CCI ≥ 2 14% vs. CCI < 2 10%, p < 0.001). CONCLUSIONS Patients with more comorbidities are more likely to present with early-stage colon cancers but late-stage breast cancers. This finding may reflect differences in practice patterns for routine screening in these patients. Providers should continue guideline directed screenings to detect cancers at an earlier stage and optimize outcomes.
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Affiliation(s)
- Cimarron E Sharon
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
| | - Michael Wang
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gabriella N Tortorello
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Nikhita J Perry
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kevin L Ma
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Julia C Tchou
- Division of Breast Surgery, Department of surgery, The University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Philadelphia, PA, USA
| | - Oluwadamilola M Fayanju
- Division of Breast Surgery, Department of surgery, The University of Pennsylvania, Philadelphia, PA, USA
- Abramson Cancer Center, Philadelphia, PA, USA
| | - Najjia N Mahmoud
- Abramson Cancer Center, Philadelphia, PA, USA
- Division of Colon and Rectal Surgery, Department of Surgery, The University of Pennsylvania, Philadelphia, PA, USA
| | - John T Miura
- Abramson Cancer Center, Philadelphia, PA, USA
- Division of Endocrine and Oncologic Surgery, Department of Surgery, The University of Pennsylvania, Philadelphia, PA, USA
| | - Giorgos C Karakousis
- Abramson Cancer Center, Philadelphia, PA, USA
- Division of Endocrine and Oncologic Surgery, Department of Surgery, The University of Pennsylvania, Philadelphia, PA, USA
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Omosule M, De Silva-Minor S, Coombs N. Case Report: Intraoperative radiotherapy as the new standard of care for breast cancer patients with disabling health conditions or impairments. Front Oncol 2023; 13:1156619. [PMID: 37274260 PMCID: PMC10233125 DOI: 10.3389/fonc.2023.1156619] [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: 02/01/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
In selected patients, intraoperative radiotherapy (IORT) offers an alternative to standard external beam radiotherapy (EBRT) while providing equivalent breast cancer control outcomes. After IORT, most patients do not require external beam radiotherapy and thus avoid the need to travel to and from a radiotherapy centre in the weeks after surgery. EBRT is associated with an increased risk of non-breast cancer mortality and poorer cosmetic outcomes while increasing patient travel time, emissions associated with travel and time spent in the hospital. Consequently, EBRT is associated with an overall reduction in quality of life compared to IORT. Patients with other on-going health conditions or clinical impairments are likely to be affected by the daily radiotherapy requirement. Should these patients be consulted during their pre-operative assessment as to options to undergo IORT? This paper describes a case of IORT and follow up in a functionally blind patient. Quality of life effects are elucidated and further support the use of IORT in selected breast cancer patients with health conditions or impairments.
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Affiliation(s)
- Michael Omosule
- GKT School of Medical Education, King’s College London, London, United Kingdom
| | - Shiroma De Silva-Minor
- Department of Clinical Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Nathan Coombs
- Department of Breast Surgery, Great Western Hospitals NHS Foundation Trust, Great Western Hospital, Swindon, United Kingdom
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Tsai MH, Grunert C, Vo JB, Moore JX, Guha A. Presence of Multi-Morbidities and Colorectal Cancer Screening Utilization among Breast Cancer Survivors. Cancers (Basel) 2023; 15:cancers15072077. [PMID: 37046737 PMCID: PMC10093549 DOI: 10.3390/cancers15072077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Purpose: Our study aimed to examine the association between the presence of chronic diseases with guideline-concordant colorectal cancer (CRC) screening utilization among breast cancer survivors. Methods: We analyzed data among women with a history of breast cancer from the 2016, 2018, and 2020 Behavioral Risk Factor Surveillance System. Receipt of guideline-concordant CRC screening was the outcome of interest. Diabetes, coronary heart disease/myocardial infarction, stroke, chronic obstructive pulmonary disease, emphysema/chronic bronchitis, arthritis, depressive disorder, or kidney diseases were included in chronic disease conditions. Results: Among 1324 survivors, those with multi-morbidities (3+ chronic diseases; 88.3%) had higher CRC screening use compared to those with one (84.4%) or two (85.4%) diseases (p-value < 0.05). In multivariable analysis, survivors with multi-morbidities were two times more likely to have CRC screening compared to those with only one disease (OR, 2.10; 95% CI, 1.11–3.98). Among survivors with multi-morbidities, Black women (OR, 14.07; 95% CI, 5.61–35.27), and those with frequent poor physical health (OR, 3.32; 95% CI, 1.57–7.00) were positively associated with CRC screening use. Conversely, survivors with frequent poor mental health were 67% less likely to receive CRC screening (OR, 0.33; 95% CI, 0.14–0.74). Conclusion: Among breast cancer survivors, multi-morbidities were positively associated with CRC screening.
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Elsous A, Radwan M, Najjar S, Masad A, Abu Rayya M. Unmet needs and health-related quality of life of breast cancer survivors: survey from Gaza Strip, Palestine. Acta Oncol 2023; 62:194-209. [PMID: 36802358 DOI: 10.1080/0284186x.2023.2180326] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
BACKGROUND Cancer, especially breast cancer, remains a public health problem because of its negative consequences, which require long-term programs to alleviate its devastating effects. This study aimed to examine unmet supportive care needs and health-related quality of life of females with breast cancer. METHODS A cross-sectional study with a mixed-method design was employed. A simple, randomly selected sample of 352 females attending Al-Rantisi and Al-Amal hospitals was included in this study. A validated Arabic version of the Supportive Care Needs Survey (34 items) and The European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C15-PAL) were used. Moreover, twenty-five semi-structured interviews were performed (13 females, eight husbands, and four healthcare workers). Quantitative data were analysed using descriptive and inferential analysis, whereas thematic analysis was used for qualitative data to highlight main themes. RESULTS The highest unmet need reported by females with breast cancer was psychological needs (63%), followed by health-related systems and information (62%) and physical and daily life (61%). Pain and fatigue were the most reported symptoms (65.8% and 62.5%, respectively), followed by emotional distress, physical function, and physical symptoms; 55.8%, 54.3%, and 51.5%, respectively. These unmet needs and health-related quality of life-related dimensions were highlighted and elicited by qualitative data analysis. Unmet needs are high among married females, on conservative treatments, young females (< 40 years old), and females in the first year of diagnosis. The presence of chronic diseases did not increase needs. However, health-related quality of life was affected. Six themes are subtracted: availability of anticancer therapy, affordability of healthcare, family and social support, psychological support, health education, and self-image & intimate relationship. CONCLUSION Many needs are unmet. Caring for females with breast cancer should be comprehensive to fill gaps, including psychological care, health information and education, physical care and support, and medical care.
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Affiliation(s)
- Aymen Elsous
- Faculty of Medical Sciences, Israa University -Gaza, Gaza strip, Palestine.,Department of Planning, Unit of Planning and Institutional Development Performance, Ministry of Health, Gaza strip, Palestine
| | - Mahmoud Radwan
- Department of Foreign Relations, General Directorate of International Cooperation, Ministry of Health, Gaza strip, Palestine
| | - Shahenaz Najjar
- Health Policy and Health Informatics, Arab American University of Palestine, Palestine.,Leuven Institute for Healthcare Policy, Pillar Quality and Safety, Department of Public Health and Primary Care, KU Leuven
| | - Atef Masad
- Department of Medical Laboratories, Faculty of Medical Sciences, Israa University -Gaza, Gaza strip, Palestine
| | - Mohammed Abu Rayya
- Public Health Consultant, Aid and Hope Program for Cancer Patients Care, Gaza strip, Palestine
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Frelaut M, Aupomerol M, Degousée L, Scotté F. [The place of support care]. SOINS. GERONTOLOGIE 2022; 27:21-29. [PMID: 36280368 DOI: 10.1016/j.sger.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Supportive care, in the context of breast cancer in the elderly, is part of standard oncogeriatric care. Nevertheless, the multidisciplinary reinforcement of the different transversal teams can support the global approach, that is essential to the quality of care and the life course. Evaluation is the basis of this management. As a result of this evaluation, the approach to sexual health is a novelty that is often insufficiently considered with elderly patients suffering from breast malignancy.
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Affiliation(s)
| | - Marion Aupomerol
- Service de pathologie mammaire et de gynécologie, département de médecine oncologique
| | - Lena Degousée
- Service de pathologie mammaire et de gynécologie, département de médecine oncologique
| | - Florian Scotté
- DIOPP, Gustave-Roussy, 114 rue Édouard-Vaillant, 94805 Villejuif, France.
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The association between comorbidities and stigma among breast cancer survivors. Sci Rep 2022; 12:13682. [PMID: 35953505 PMCID: PMC9368698 DOI: 10.1038/s41598-022-15460-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/23/2022] [Indexed: 01/10/2023] Open
Abstract
This study aimed to explore the association between types and numbers of comorbidities and stigma among breast cancer survivors (BCSs). A cross-sectional study was conducted among 937 BCSs in Shanghai Cancer Rehabilitation Club. All participants were asked to fill in an online questionnaire including Stigma Scale for Chronic Illnesses 8-item version (SSCI-8) and questions on sociodemographic characteristics and health status. Multivariate linear regression was used to analyze the association between comorbidities and stigma, adjusting for confounding factors. Results showed that nearly 70% of the participants had one or more comorbidities. The participants with stroke, digestive diseases or musculoskeletal diseases had significantly higher stigma than those without the above comorbidities. In addition, stigma was higher among survivors in the group with a greater number of comorbidities. Thus, it is important to strengthen the management of stigma in BCSs, especially for those with comorbidities.
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Aguilar-Company J, Lopez-Olivo MA, Ruiz-Camps I. Multidisciplinary approach to treatment with immune checkpoint inhibitors in patients with HIV, tuberculosis, or underlying autoimmune diseases. Front Med (Lausanne) 2022; 9:875910. [PMID: 35911382 PMCID: PMC9334667 DOI: 10.3389/fmed.2022.875910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/27/2022] [Indexed: 12/24/2022] Open
Abstract
We reviewed the available information on the use of immune checkpoint inhibitors (ICIs) in populations with special conditions, namely, patients with HIV, tuberculosis, or underlying autoimmune disease. Available data show that treatment with ICIs is safe in patients with HIV; it is advisable, however, that these patients receive adequate antiretroviral therapy and have an undetectable viral load before ICIs are initiated. Tuberculosis reactivation has been reported with the use of ICIs, possibly due to immune dysregulation. Tuberculosis has also been associated with the use of immunosuppressors to treat immune-related adverse events (irAEs). Active tuberculosis must be ruled out in patients with symptoms or signs, and selected patients may benefit from screening for latent tuberculosis infection, although more data are required. Limited data exist regarding the safety of ICIs in patients with cancer and autoimmune disease. Data from observational studies suggest that up to 29% of patients with a preexisting autoimmune disease treated with an ICI present with an autoimmune disease flare, and 30% present with a de novo irAE of any type. The frequency of flares appears to differ according to the type of ICI received, with higher rates associated with PD-1/PD-L1 inhibitors. The most common autoimmune diseases for which patients reported flares with ICI therapy are rheumatoid arthritis, other inflammatory arthritis, and psoriasis. Most studies have reported flares or de novo irAEs associated with ICIs that were mild to moderate, with low rates of discontinuation and no deaths due to flares. Therefore, the use of ICIs in these patients is possible, but careful monitoring is required.
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Affiliation(s)
- Juan Aguilar-Company
- Medical Oncology Department, Vall d'Hebron Hospital Universitari and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain,Infectious Diseases Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Maria A. Lopez-Olivo
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States,*Correspondence: Maria A. Lopez-Olivo
| | - Isabel Ruiz-Camps
- Infectious Diseases Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain,Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain,Centro de Investigación en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Dai D, Coetzer H, Zion SR, Malecki MJ. Multimorbidity and Its Associations With Anxiety and Depression Among Newly Diagnosed Patients With Breast Cancer: A Retrospective Observational Cohort Study in a US Commercially Insured and Medicare Advantage Population. Cancer Control 2022; 29:10732748221140691. [DOI: 10.1177/10732748221140691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Multimorbidity is common in patients with breast cancer, thus increasing the complexity of cancer care and economic burden, worsening their prognosis and quality of life. The prevalence of multimorbidity and its influence on psychological distress among patients with breast cancer have not been well characterized. Objectives To examine the prevalence of multimorbidity and its associations with anxiety and depression among newly diagnosed patients with breast cancer. Methods We conducted a retrospective observational cohort study using a large administrative claims database. Patients with breast cancer (ICD-10-CM: C50.x) were identified during the study period (1/1/2017-12/31/2020). The index date was defined as the diagnosis date of breast cancer. Demographics and comorbid conditions were assessed using data within 12 months prior to the index date. Multimorbidity was defined as the presence of ≥2 comorbid conditions. Anxiety and depression were examined using data within 12 months after the index date. Multivariable logistic regressions were performed to examine the associations between multimorbidity and anxiety and depression, adjusting for sociodemographic factors. Results Of the 6392 patients with newly diagnosed breast cancer, 86.9% had multimorbidity at the time of breast cancer diagnosis. The median number of comorbid conditions was 5. Overall, 27.7% experienced anxiety, and 21.9% experienced depression in the first year following breast cancer diagnosis. An increased number of comorbid conditions was associated with elevated prevalence of both anxiety and depression. After adjusting for possible confounding factors, number of comorbid conditions was significantly associated with risk of anxiety (adjusted odds ratio [95% confidence interval (CI)]: 1.17 [1.15-1.19]), and depression (1.24 [1.21-1.26]); all P < .0001. Conclusions Multimorbidity was highly prevalent among patients with breast cancer and was strongly associated with increased risk of anxiety and depression in the first year following breast cancer diagnosis. The presence of multimorbidity, anxiety, and depression should be considered in the context of clinical decision making to optimize cancer care and improve mental health and quality of life.
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Affiliation(s)
- Dingwei Dai
- CVS Health Clinical Trial Services, LLC, Woonsocket, RI, USA
| | | | - Sean R. Zion
- Blue Note Therapeutics, Inc., San Francisco, CA, USA
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