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Nakamura ZM, Small BJ, Zhai W, Ahles TA, Ahn J, Artese AL, Bethea TN, Breen EC, Cohen HJ, Extermann M, Graham D, Irwin MR, Isaacs C, Jim HSL, Kuhlman KR, McDonald BC, Patel SK, Rentscher KE, Root JC, Saykin AJ, Tometich DB, Van Dyk K, Zhou X, Mandelblatt JS, Carroll JE. Depressive symptom trajectories in older breast cancer survivors: the Thinking and Living with Cancer Study. J Cancer Surviv 2023:10.1007/s11764-023-01490-2. [PMID: 37924476 PMCID: PMC11068856 DOI: 10.1007/s11764-023-01490-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/21/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE To identify trajectories of depressive symptoms in older breast cancer survivors and demographic, psychosocial, physical health, and cancer-related predictors of these trajectories. METHODS Recently diagnosed nonmetastatic breast cancer survivors (n = 272), ages 60-98 years, were evaluated for depressive symptoms (Center for Epidemiological Studies Depression Scale, CES-D; scores ≥16 suggestive of clinically significant depressive symptoms). CES-D scores were analyzed in growth-mixture models to determine depression trajectories from baseline (post-surgery, pre-systemic therapy) through 3-year annual follow-up. Multivariable, multinomial logistic regression was used to identify baseline predictors of depression trajectories. RESULTS Survivors had three distinct trajectories: stable (84.6%), emerging depressive symptoms (10.3%), and recovery from high depressive symptoms at baseline that improved slowly over time (5.1%). Compared to stable survivors, those in the emerging (OR = 1.16; 95% CI = 1.08-1.23) or recovery (OR = 1.26; 95% CI = 1.15-1.38) groups reported greater baseline anxiety. Greater baseline deficit accumulation (frailty composite measure) was associated with emerging depressive symptoms (OR = 3.71; 95% CI = 1.90-7.26). Less social support at baseline (OR = 0.38; 95% CI = 0.15-0.99), but greater improvement in emotional (F = 4.13; p = 0.0006) and tangible (F = 2.86; p = 0.01) social support over time, was associated with recovery from depressive symptoms. CONCLUSIONS Fifteen percent of older breast cancer survivors experienced emerging or recovery depressive symptom trajectories. Baseline anxiety, deficit accumulation, and lower social support were associated with worse outcomes. IMPLICATIONS FOR CANCER SURVIVORS Our results emphasize the importance of depression screening throughout the course of cancer care to facilitate early intervention. Factors associated with depressive symptoms, including lower levels of social support proximal to diagnosis, could serve as intervention levers.
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Affiliation(s)
- Zev M Nakamura
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, Campus Box #7160, Chapel Hill, NC, 27599, USA.
| | - Brent J Small
- School of Aging Studies, University of South Florida, and Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Wanting Zhai
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Ashley L Artese
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Traci N Bethea
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Elizabeth C Breen
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Harvey J Cohen
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Martine Extermann
- Department of Oncology, Moffitt Cancer Center, University of South Florida, Tampa, FL, USA
| | - Deena Graham
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Michael R Irwin
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Claudine Isaacs
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Kate R Kuhlman
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychological Science, University of California, Irvine, CA, USA
- Institute for Interdisciplinary Salivary Bioscience Research, School of Social Ecology, University of California, Irvine, CA, USA
| | - Brenna C McDonald
- Department of Radiology and Imaging Sciences, Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sunita K Patel
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Kelly E Rentscher
- Department of Psychiatry and Behavioral Medicine, MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Danielle B Tometich
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Kathleen Van Dyk
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Xingtao Zhou
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Jeanne S Mandelblatt
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Judith E Carroll
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
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Hossain N, Prashad M, Huszti E, Li M, Alibhai S. Age-related differences in symptom distress among patients with cancer. J Geriatr Oncol 2023; 14:101601. [PMID: 37597295 DOI: 10.1016/j.jgo.2023.101601] [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: 11/27/2022] [Revised: 06/12/2023] [Accepted: 08/01/2023] [Indexed: 08/21/2023]
Abstract
INTRODUCTION Differences in symptom distress among older (age 65-74) and very old (age 75+) patients with cancer, compared to younger patients, remain to be well explored. These differences are important to understand given the heterogeneity of older populations and may have implications for age-appropriate symptom detection and management. MATERIALS AND METHODS We examined routinely collected Edmonton Symptom Assessment System Revised (ESAS-r) scores from 9,143 patients age 40+ initiating chemotherapy for solid malignancies at a single academic cancer centre, between September 2011 and May 2019. We used multivariable logistic regression models to determine associations between the most common symptoms and age group (ages 40-64, 65-74, 75-84, and 85+), cancer site, clinical stage, sex, and income levels. We focused our findings on patients with the five most common cancers, breast (n = 1,532), prostate (n = 923), lung (n = 889), pancreatic (n = 429), and colorectal (n = 368), prior to receiving treatment. RESULTS Within our sample, 58.0% were age 40-64, 27.3% age 65-74, 11.8% age 75-84, and 2.9% age 85+. Among the nine symptoms in the ESAS-r (anxiety, depression, tiredness, wellbeing, nausea, pain, drowsiness, appetite, and shortness of breath), the most common symptoms overall were anxiety (moderate-severe scores [ESAS-r 4 or higher] were reported by 33.8% of patients), lack of well-being (38.3%), and tiredness (38.3%). Older age was associated with lower odds of moderate/severe anxiety (odds ratio [OR] 0.81, 95% confidence interval [CI] 0.73-0.90 for age 65-74; OR 0.81, 95%CI 0.70-0.93 for age 75-84; OR 0.62, 95%CI 0.47-0.82 for age 85+; referent is 40-64-year-olds for all analyses), and increased odds of tiredness (OR 1.00, 95%CI 0.90-1.11 for age 65-74; OR 1.19, 95%CI 1.04-1.37 for age 75-84; and OR 1.34, 95%CI 1.04-1.72 for age 85+). Advanced stage, female sex, and lower income levels were associated with higher odds of moderate/severe tiredness, anxiety, and lack of well-being in adjusted models. Patients with pancreatic and lung cancers reported worse scores for these three symptoms than patients with other cancers. DISCUSSION Older age was associated with differences in symptom experiences such as increased tiredness and reduced anxiety. Supportive care interventions and future research should focus on addressing these symptoms to improve patient quality of life.
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Affiliation(s)
- Nazia Hossain
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Michael Prashad
- Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Ella Huszti
- Biostatistics Research Unit, University Health Network, Toronto, Ontario, Canada
| | - Madeline Li
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Shabbir Alibhai
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University Health Network, Toronto, Ontario, Canada
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Bergerot CD, Philip EJ, Bergerot PG, Razavi M, Lee D, Clark KL, Loscalzo M, Pal SK, Dale W. Anxiety, Depression, and Coping Strategies during Chemotherapy Treatment: A Comparison of Older and Younger Adults with Advanced Cancer in Brazil. Cancer Invest 2023; 41:781-788. [PMID: 37882784 DOI: 10.1080/07357907.2023.2274033] [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: 03/08/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
We sought to examine differences in anxiety, depression and coping strategies among younger (<64-year old) and older (≥65-year old) patients. Patients were assessed at baseline (T1), mid-point (T2) and on the last day of treatment (T3) using the Hospital Anxiety and Depression Scale and the Ways of Coping. A linear mixed modeling approach was used. The study included 200 patients (gender: 70% women; diagnosis: 30% breast, 22% hematological, 18% gastrointestinal; disease stage: 60% advanced). Older patients who used an emotion-focused coping strategy had a greater decrease in anxiety at T3 compared to those that used problem-focused coping (p = .002).
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Affiliation(s)
| | - Errol J Philip
- Medical School, University of California San Francisco, San Francisco, California, USA
| | | | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - David Lee
- University of New Mexico, Albuquerque, New Mexico, USA
| | - Karen Lynn Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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Cano Garcia C, Wenzel M, Humke C, Wittler C, Dislich J, Incesu RB, Köllermann J, Steuber T, Graefen M, Tilki D, Karakiewicz PI, Kluth LA, Preisser F, Chun FKH, Mandel P, Hoeh B. Impact of Age on Long-Term Urinary Continence after Robotic-Assisted Radical Prostatectomy. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1153. [PMID: 37374357 DOI: 10.3390/medicina59061153] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
Aim and Objectives: We aimed to test the impact of age on long-term urinary continence (≥12 months) in patients undergoing robotic-assisted radical prostatectomy. Methods and Materials: We relied on an institutional tertiary-care database to identify the patients who underwent robotic-assisted radical prostatectomy between January 2014 and January 2021. Patients were divided into three age groups: age group one (≤60 years), age group two (61-69 years) and age group three (≥70 years). Multivariable logistic regression models tested the differences between the age groups in the analyses addressing long-term urinary continence after robotic-assisted radical prostatectomy. Results: Of the 201 prostate cancer patients treated with robotic-assisted radical prostatectomy, 49 (24%) were assigned to age group one (≤60 years), 93 (46%) to age group two (61-69 years) and 59 (29%) to age group three (≥70 years). The three age groups differed according to long-term urinary continence: 90% vs. 84% vs. 69% for, respectively, age group one vs. two vs. three (p = 0.018). In the multivariable logistic regression, age group one (Odds Ratio (OR) 4.73, 95% CI 1.44-18.65, p = 0.015) and 2 (OR 2.94; 95% CI 1.23-7.29; p = 0.017) were independent predictors for urinary continence, compared to age group three. Conclusion: Younger age, especially ≤60 years, was associated with better urinary continence after robotic-assisted radical prostatectomy. This observation is important at the point of patient education and should be discussed in informed consent.
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Affiliation(s)
- Cristina Cano Garcia
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 0A9, Canada
| | - Mike Wenzel
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Clara Humke
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Clarissa Wittler
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Julius Dislich
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Reha-Baris Incesu
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 0A9, Canada
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Jens Köllermann
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany
| | - Thomas Steuber
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Markus Graefen
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
- Department of Urology, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany
- Department of Urology, Koc University Hospital, 34010 Istanbul, Turkey
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 0A9, Canada
| | - Luis A Kluth
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Felix Preisser
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Felix K H Chun
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Philipp Mandel
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Benedikt Hoeh
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
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Depression and anxiety in older adults with cancer: Systematic review and meta-summary of risk, protective and exacerbating factors. Gen Hosp Psychiatry 2023; 81:32-42. [PMID: 36724695 DOI: 10.1016/j.genhosppsych.2023.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To systematically evaluate the risk factors of depression and anxiety in older adults with cancer. METHOD This PRISMA-adherent systematic review (PROSPERO CRD42022372747) involved a systematic database search for prospective and retrospective cohort studies. RESULTS We included 33 cohort studies with 31 evaluating depression and seven evaluating anxiety. Systematic synthesis yielded various protective and exacerbating factors for depression and anxiety amongst older adults with cancer. These factors span a range of domains: (1) Cancer and associated treatment-related factors; (2) Medical, physical and functional factors; (3) Demographic factors and; (4) Social and lifestyle factors. At the individual-level, the most significant factors were the presence of chronic medical comorbidities, having pre-existing psychological symptoms, and poor baseline physical and functional status. Within the social unit, the degree of social support and presence of a partner were most significant. CONCLUSION The deleterious impact comorbid psychological symptoms can have on older adults with cancer can be profound. In this review, we highlight a range of protective and exacerbating factors identified from cohort studies that may enable policymakers to tailor and individualise interventions to manage depression, anxiety and associated burden in this vulnerable population. The relative paucity of studies evaluating anxiety highlights an important research gap.
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Zhuang W, Wu J, Xu H, Deng C, Li S, Tian D, Ben X, Xu W, Tang Y, Qiao G. Exploring the psychological profile: a cross-sectional study of 1,185 patients with pulmonary nodules in an outpatient clinic. J Thorac Dis 2022; 14:4699-4712. [PMID: 36647497 PMCID: PMC9840009 DOI: 10.21037/jtd-22-847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/09/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND The purpose of this study was to identify the potential risk and protective factors of psychological burden in patients with pulmonary nodules (PNs) and to explore how the psychological status of the patients affects their treatment preferences. METHODS In this questionnaire-based study, 1,185 outpatients were evaluated using the Hospital Anxiety and Depression Scale (HADS), and the correlations between psychological burden and patients' sociodemographic and clinical characteristics were assessed. RESULTS Prevalence of anxiety and depression was 42.1% and 27.0%, respectively, among patients with PNs. Binary logistic regression analysis revealed that age over 60 years old [odds ratio (OR) =0.57; 95% confidence interval (CI): 0.36-0.89], computed tomography (CT) scan due to physical discomfort (OR =1.58; 95% CI: 1.11-2.24), multiple PNs (OR =1.52; 95% CI: 1.20-1.94), family history of malignancy (OR =1.28; 95% CI: 1.01-1.64), and subjective symptoms (OR =1.70; 95% CI: 1.32-2.19) were independently associated with anxiety, while multiple PNs (OR =1.51; 95% CI: 1.15-1.98), subjective symptoms (OR =1.65; 95% CI: 1.23-2.20), and indeterminate nodules (OR =1.91; 95% CI: 1.08-3.40) were independently associated with depression. There was a tendency for patients with anxiety and depression to choose more aggressive management strategies (P<0.001 and P=0.001, respectively). Univariate analysis showed that symptomatic patients (χ2=9.696; P=0.021) and those with progressive nodules (χ2=18.198, P=0.033) chose more aggressive treatment strategies. CONCLUSIONS Anxiety and depression are common in patients with PNs, which might result in nonnegligible overtreatment. Presence of subjective symptoms can significantly exacerbate psychological burden and influence treatment preference. Taking psychological factors into consideration in the outpatient clinic may facilitate patient-centered communication and promote judicious decision-making.
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Affiliation(s)
- Weitao Zhuang
- Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Junhan Wu
- Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
| | - Haijie Xu
- Shantou University Medical College, Shantou, China
- Department of Thoracic Surgery, First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Cheng Deng
- Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shaopeng Li
- Department of Cardiothoracic Surgery, Longgang Central Hospital of Shenzhen, Shenzhen, China
- Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Dan Tian
- Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaosong Ben
- Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Xu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Yong Tang
- Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guibin Qiao
- Department of Thoracic Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Shantou University Medical College, Shantou, China
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Belete AM, Alemagegn A, Mulu AT, Yazie TS, Bewket B, Asefa A, Shiferaw WS. Prevalence of depression and associated factors among adult cancer patients receiving chemotherapy during the era of COVID-19 in Ethiopia. Hospital-based cross-sectional study. PLoS One 2022; 17:e0270293. [PMID: 35749489 PMCID: PMC9232136 DOI: 10.1371/journal.pone.0270293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/08/2022] [Indexed: 01/12/2023] Open
Abstract
Background Depression is a major public health problem among cancer patients undergoing chemotherapy. It compromises patient outcomes, resulting in higher rates of mortality. Currently, there are little data on the prevalence of depression in Sub-Sharan countries. Therefore, the current study was done to assess the prevalence of depression among adult cancer patients and its associated factors in Ethiopia. Method An institutional based cross-sectional study was conducted among 420 adult cancer patients from 1st March to April 30, 2021. Systematic random sampling technique was used to recruit participants. Depression was assessed using the Patient Health Questionnaire-9. The collected data were coded and entered into Epi-data version 4.2 and exported to SPSS version 25 for analysis. Bivariate binary logistic regression was performed to select factors that will be included in multivariate analysis, and variables with a p-value < 0.05 were included in multivariate analysis. In multivariate analysis, odds ratios and their 95% confidence intervals were computed and variables with p-value < 0.05 were considered to declare a significant association. Results In this study, the prevalence of depression was 33.1% (95% CI = 0.2858, 0.3761). Minimal symptoms of depression, minor depression, moderate depression, moderate severe depression, and severe depression were found to be 272 (64.8%), 9 (2.1%), 104 (24.8%), 28 (6.7%), and 7 (1.7%), respectively. Those cancer patients who had unemployed status, sacked from jobs, and had stage IV cancer were most likely to develop depression, whereas patients who completed primary education, colon, prostate and cervical cancer were less likely to have depression. Conclusion Depression is found to be a major public health concern for adult cancer patients in Ethiopia. To reduce the occurrence of depression among cancer patients, special attention is needed.
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Affiliation(s)
- Abebe Muche Belete
- Department of Biomedical Science, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
- * E-mail:
| | - Anmut Alemagegn
- Oncology Clinic, Tikur Anbesa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anemut Tilahun Mulu
- Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Taklo Simeneh Yazie
- Pharmacology and Toxicology Unit, Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Bekalu Bewket
- Department of Nursing, College of Health Science, Injibara University, Injibara, Ethiopia
| | - Adisu Asefa
- Department of Biomedical Science, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
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8
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Popiołek A, Brzoszczyk B, Jarzemski P, Piskunowicz M, Jarzemski M, Borkowska A, Bieliński M. Quality of Life of Prostate Cancer Patients Undergoing Prostatectomy and Affective Temperament. Cancer Manag Res 2022; 14:1743-1755. [PMID: 35620062 PMCID: PMC9129097 DOI: 10.2147/cmar.s358054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/23/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Prostate cancer (PC) is one of the most common malignancies in men. The population of PC survivors is growing, and understanding the roles of different factors that affect quality of life (QoL) is important. We investigated the effects of affective temperament on the QoL of PC patients. Patients and Methods All subjects (n=100) underwent medical evaluation [including demographic data, medical history, physical examination, biochemical tests, and assessment of urinary incontinence (ICIQ-UI SF scale) and erectile dysfunction (ED) (IIEF-5 and subjective ED scale)] and psychological evaluation [including assessment of affective temperament using the TEMPS-A scale, depression and anxiety (using HADS), and QoL (EORTC-QLQ-C30 and EORTC-PR25)]. The relationships between individual variables were examined. Results Erection quality after treatment was associated with better QoL in most parameters. Similar strong relationships were observed between the urinary incontinence scale and QoL. Depressive, cyclothymic, irritable, and anxious temperaments were associated with decreased QoL. On the EORTC-PR25 scale, associations were observed between a depressive temperament and worse sexual function and urinary symptoms, between a cyclothymic temperament and worse urinary symptoms, and between an irritable temperament and worse sexual functioning. Multivariate analysis identified the severity of anxiety and depression symptoms measured by HADS as the most important psychological factors affecting QoL. Conclusion QoL in PC survivors depends on many factors, including age, interval since diagnosis, tumor stage, treatment, complications, and affective temperament profile. Depressive, cyclothymic, irritable, and anxious temperaments were associated with poorer QoL in selected domains, which was not observed for a hyperthymic temperament. The temperament profile of patients was associated with mood and anxiety level, which were important determinants of a poorer QoL.
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Affiliation(s)
- Alicja Popiołek
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
- Department of Internal Diseases, Jan Biziel University Hospital No.2 in Bydgoszcz, Bydgoszcz, Poland
| | - Bartosz Brzoszczyk
- Clinic of Urology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland
| | - Piotr Jarzemski
- Clinic of Urology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland
| | - Małgorzata Piskunowicz
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Marcin Jarzemski
- Clinic of Urology, Jan Biziel University Hospital No. 2 in Bydgoszcz, Bydgoszcz, Poland
| | - Alina Borkowska
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | - Maciej Bieliński
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
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9
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Irusen H, Fernandez P, Van der Merwe A, Suliman S, Esterhuizen T, Lazarus J, Parkes J, Seedat S. Depression, Anxiety, and Their Association to Health-Related Quality of Life in Men Commencing Prostate Cancer Treatment at Tertiary Hospitals in Cape Town, South Africa. Cancer Control 2022; 29:10732748221125561. [PMID: 36112984 PMCID: PMC9478688 DOI: 10.1177/10732748221125561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background Comorbid depression and anxiety in men with localised prostate cancer (CaP)
largely go undiagnosed and untreated and their effects on health-related
quality of life (HRQOL) in men with CaP should not be underestimated. We
examined the prevalence of depression and anxiety and its association with
HRQOL in men about to commence treatment for CaP and the differences between
treatment groups, radical prostatectomy (RP) and radiation therapy (RT). Method One hundred and seven participants from a longitudinal prospective
observational study assessing depression, anxiety and HRQOL in men with
localised CaP (DAHCaP), were used in this cross-sectional analysis. Data
were collected shortly before participants were scheduled to receive their
treatment. The Centre for Epidemiologic Studies Depression Scale (CES-D),
the State Trait Anxiety Inventory (STAI), the Memorial Anxiety Scale for
Prostate Cancer (MAX-PC), the European Organisation for Research and
Treatment in Cancer Quality of Life questionnaire (EORTC QLQ-C30) and (EORTC
QLQ-PR25) were used in this analysis. Results Symptoms of depression pre-treatment were noted in 39.3%, state anxiety 28%,
trait anxiety 31.4% and prostate cancer anxiety in 12.1% of participants.
Statistically significant correlations (P ≤ .05) with the
CES-D and a cluster of symptoms on the EORTC QLQ-C30 domains for Global
Health (rs = −.35), fatigue (rs = .38), pain
(rs = .32), dyspnoea (rs = .28), insomnia
(rs = .30) and finance (rs = .26) and EORTC
QLQ-PR25 domains for urinary symptoms (rs = .43), bowel
(rs = .43) and hormone replacement therapy (HRT)
(rs = .41) were observed. Statistically significant correlations were also noted between the STAI-S and
EORTC QLQ-C30 and EORTC QLQ-PR25. No statistically significant difference
was noted between treatments. Conclusion More men were depressed than anxious with significant associations with HRQOL
prior to commencement of treatment. CaP treatments should focus not only on
the prevailing indisposition but include a psychooncological and HRQOL
assessment at pre-treatment in high-risk individuals.
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Affiliation(s)
- Hayley Irusen
- Department of Urology, Faculty of Medicine and Health Sciences, 26697Stellenbosch University, Cape Town, South Africa
| | - Pedro Fernandez
- Department of Urology, Faculty of Medicine and Health Sciences, 26697Stellenbosch University, Cape Town, South Africa
| | - Andre Van der Merwe
- Department of Urology, Faculty of Medicine and Health Sciences, 26697Stellenbosch University, Cape Town, South Africa
| | - Sharain Suliman
- Department of Psychiatry, Stellenbosch University and SA MRC Genomics of Brain Disorders Unit, Cape Town, South Africa
| | - Tonya Esterhuizen
- Biostatistics Unit, Faculty of Medicine and Health Sciences, 26697Stellenbosch University, Cape Town, South Africa
| | - John Lazarus
- Department of Urology, Groote Schuur Hospital, 63726University of Cape Town, South Africa
| | - Jeannette Parkes
- Department of Radiation Oncology, Groote Schuur Hospital, 63726University of Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, 26697Stellenbosch University, Cape Town, South Africa
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10
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Massa E, Donisi C, Liscia N, Madeddu C, Impera V, Mariani S, Scartozzi M, Lai E. The Difficult Task of Diagnosing Depression in Elderly People with Cancer: A Systematic Review. Clin Pract Epidemiol Ment Health 2021; 17:295-306. [PMID: 35444712 PMCID: PMC8985471 DOI: 10.2174/1745017902117010295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/08/2021] [Accepted: 11/17/2021] [Indexed: 11/22/2022]
Abstract
Background:
Depression is a common psychiatric problem in the elderly and oncology patients. In elderly people with cancer, depression has a peculiar phenomenology. It has a significant impact on the quality of life. Moreover, it is associated with poor adherence to treatments, increased risk of suicide, and mortality. Nevertheless, the topic of depression in elderly people with cancer remains unexplored.
Objective:
The main goal of this article is to review the literature from the past 20 years on the relationships between depression, cancer, and aging.
Methods:
The methods followed the Prisma model for eligibility of studies. The articles in which the keywords “depression”, “cancer”, “ elderly, aging, or geriatric” were present, either in the text or in the abstract, were selected. 8.056 articles, by matching the keywords “depression and elderly and cancer,” were identified. Only 532 papers met the eligibility criteria of search limits and selection process. Out of 532 papers, 467 were considered irrelevant, leaving 65 relevant studies. Out of 65 suitable studies, 39 (60.0%) met our quality criteria and were included.
Results:
The risk factors associated with depression in elderly people with cancer can be divided into 4 groups: 1) tumor-related; 2) anticancer treatment-related; 3) patients-related; 4) number and type of comorbidity. The main obstacles in diagnosing depression in elderly patients with cancer are the overlap of the symptoms of cancer and side effects of treatment with the symptoms of depression but also the different ways of reporting depressive symptoms of elderly people and the different clinical types of depression. There is a lack of data regarding validated scales to assess depression in geriatric patients with cancer. Any mental illness, specifically co-occurring anxiety and depression, increases the risk of diagnosis delay and anticancer treatment adherence. Cancer and the diagnosis of mental disorders prior to cancer diagnosis correlate with an increased risk for suicide. A non-pharmacological therapeutic approach, pharmacological treatment and/or a combination of both can be used to treat elderly patients with cancer, but a detailed analysis of comorbidities and the assessment of polypharmacy is mandatory in order to avoid potential side-effects and interactions between antidepressants and the other drugs taken by the patients.
Conclusion:
Future research should be conducted with the aim of developing a modified and adapted assessment method for the diagnosis and treatment of depression in elderly people with cancer in order to improve their clinical outcomes and quality of life.
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11
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Bensley JG, Dhillon HM, Evans SM, Evans M, Bolton D, Davis ID, Dodds L, Frydenberg M, Kearns P, Lawrentschuk N, Murphy DG, Millar JL, Papa N. Self-reported lack of energy or feeling depressed 12 months after treatment in men diagnosed with prostate cancer within a population-based registry. Psychooncology 2021; 31:496-503. [PMID: 34623735 DOI: 10.1002/pon.5833] [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] [Received: 08/03/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Feeling depressed and lethargic are common side effects of prostate cancer (PCa) and its treatments. We examined the incidence and severity of feeling depressed and lack of energy in patients in a population based PCa registry. METHODS We included men diagnosed with PCa between 2015 and 2019 in Victoria, Australia, and enrolled in the Prostate Cancer Outcomes Registry. The primary outcome measures were responses to two questions on the Expanded Prostate Cancer Index Composite (EPIC-26) patient reported instrument: problems with feeling depressed and problems with lack of energy 12 months following treatment. We evaluated associations between these and age, cancer risk category, treatment type, and urinary, bowel, and sexual function. RESULTS Both outcome questions were answered by 9712 out of 12,628 (77%) men. 981 patients (10%) reported at least moderate problems with feeling depressed; 1563 (16%) had at least moderate problems with lack of energy and 586 (6.0%) with both. Younger men reported feeling depressed more frequently than older men. Lack of energy was more common for treatments that included androgen deprivation therapy than not (moderate/big problems: 31% vs. 13%), irrespective of disease risk category. Both outcomes were associated with poorer urinary, bowel, and sexual functional domain scores. CONCLUSIONS Self-reported depressive feelings and lack of energy were frequent in this population-based registry. Problems with feeling depressed were more common in younger men and lack of energy more common in men having hormonal treatment. Clinicians should be aware of the incidence of these symptoms in these at-risk groups and be able to screen for them.
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Affiliation(s)
- Jonathan G Bensley
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Haryana M Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia.,Centre for Medical Psychology and Evidence-Based Decision-Making, School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Sue M Evans
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Melanie Evans
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Damien Bolton
- Department of Surgery, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia.,Olivia Newton-John Cancer and Wellness Centre, Austin Health, Melbourne, Victoria, Australia
| | - Ian D Davis
- Medical Oncology Unit, Eastern Health, Melbourne, Victoria, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Lachlan Dodds
- Ballarat Health Services, Ballarat, Victoria, Australia
| | - Mark Frydenberg
- Department of Surgery, Cabrini Institute, Cabrini Health, Monash University, Melbourne, Victoria, Australia
| | | | - Nathan Lawrentschuk
- Department of Surgery and Department of Urology, University of Melbourne at Royal Melbourne Hospital, Melbourne, Victoria, Australia.,EJ Whitten Prostate Cancer Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jeremy L Millar
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Radiation Oncology, Alfred Health, Melbourne, Victoria, Australia.,Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
| | - Nathan Papa
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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12
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Ihrig A, Hanslmeier T, Grüllich C, Zschäbitz S, Huber J, Greinacher A, Sauer C, Friederich HC, Maatouk I. Couples coping with advanced prostate cancer: An explorative study on treatment decision making, mental deterioration, partnership, and psychological burden. Urol Oncol 2021; 40:58.e17-58.e25. [PMID: 34400064 DOI: 10.1016/j.urolonc.2021.07.016] [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] [Received: 04/16/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the role of spouses and the relevance of quality of life (QoL) and life expectancy (LE) in the treatment decision-making process of patients with advanced prostate cancer (CaP). We also addressed the role of possible mental deterioration, partnership quality, QoL, distress, anxiety, and depression in patients and their spouses. METHODS AND MATERIAL This was a cross-sectional non-interventional explorative study. We administered questionnaires to 96 patients with advanced CaPand their spouses. Both patients and their spouses were asked about the influence of the spouses on treatment decision making, if they prefer quality of life or life expectancy as main goal of treatment and the perceived deterioration of the patients' mental abilities. Additional questionnaires were used to assess medical history, partnership, global quality of life, distress, depression, and anxiety. We performed statistical tests to compare patients with spouses and correlations to detect associations between variables. RESULTS The spouses (65 ± 9 years) were significantly younger than the patients (69 ± 9 years). Ninety-five percent of the patients and 91% of the spouses reported that the spouses were involved in making treatment decisions. There was a high similarity within couples with regard to their preference for QoL or LE during treatment. Between couples, this preference differed markedly. Emotional control and motivation were the areas most commonly reported to have deteriorated among patients' mental abilities. The quality of the partnership was rated as being higher than average by both partners. Among the spouses, the quality of partnership correlated significantly with the preference for LE with regard to treatment decision making. Patients and spouses reported high psychological burdens in all areas, with higher levels of distress and anxiety in spouses (P< 0.01). Reduced quality of life and greater distress, depression, and anxiety were significantly correlated with the amount of deterioration of the patients' mental abilities. CONCLUSIONS Spouses of patients with advanced CaP seem to respond to different aspects of the disease by adjusting both their involvement in treatment decision making and their preferred goal of treatment. Due to mental deterioration in the patients and pronounced anxiety in their spouses, we suggest that it is important for the attending physician to provide detailed information and support to both partners. Overall, the high-stress situation seems to affect both partners to similar degrees.
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Affiliation(s)
- Andreas Ihrig
- Division of Psycho-oncology, Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Germany.
| | - Tobias Hanslmeier
- Division of Psycho-oncology, Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Germany
| | - Carsten Grüllich
- Department of Medical Oncology, National Centre for Tumour Diseases (NCT), University Hospital Heidelberg, Germany; Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Germany
| | - Stefanie Zschäbitz
- Department of Medical Oncology, National Centre for Tumour Diseases (NCT), University Hospital Heidelberg, Germany
| | - Johannes Huber
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Germany
| | - Anja Greinacher
- Division of Psycho-oncology, Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Germany
| | - Christina Sauer
- Division of Psycho-oncology, Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Germany; Psycho-oncology Service, National Centre for Tumour Diseases (NCT), University Hospital Heidelberg, Germany
| | - Hans-Christoph Friederich
- Division of Psycho-oncology, Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Germany
| | - Imad Maatouk
- Division of Psycho-oncology, Department of General Internal and Psychosomatic Medicine, University Hospital Heidelberg, Germany; Psycho-oncology Service, National Centre for Tumour Diseases (NCT), University Hospital Heidelberg, Germany; Section of Psychosomatic Medicine, Psychotherapy and Psychooncology, Department of Internal Medicine II, Julius-Maximilian University Wuerzburg, Wuerzburg, Germany
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13
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Murray N, O’Connor C, Dempsey R, Liew S, Richards H, Brady C, Sweeney P, Hennessey D. Psychological distress in patients undergoing urological surgery: A cross-sectional study. JOURNAL OF CLINICAL UROLOGY 2021. [DOI: 10.1177/20514158211014069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The purpose of this study was to evaluate the psychological distress of urological and uro-oncological patients undergoing surgery. Methods: Patients who presented to Mercy University Hospital from October 2019–May 2020 were consecutively recruited. Demographic and clinical characteristics including age, gender, marital status, type of surgery (uro-oncology or general urology), endoscopy or open surgery were gathered. Mood was evaluated using the Hospital Anxiety and Depression Scale prior to admission, prior to discharge and 6 weeks post-surgery. Results: A total of 118 participants (79.7% male) completed the Hospital Anxiety and Depression Scale prior to admission, prior to discharge and at 6 weeks post-surgery. Forty patients (33.9%) underwent uro-oncology-related surgery. At pre-admission 39 patients (33%) fell into a possible-probable clinical category for anxiety and 15 (12.7%) for depression. Older patients had significantly lower anxiety levels than younger patients ( p⩽0.01). There were no differences between patients undergoing uro-oncology or more general urology surgery and levels of anxiety or depression. Repeated measures analysis of variance with age as a covariate indicated no significant differences in Hospital Anxiety and Depression Scale anxiety scores over time. There was a statistically significant reduction in Hospital Anxiety and Depression Scale depression scores over the three assessment time points ( p=0.004). Conclusion: Over one-third of patients were experiencing moderate to severe levels of psychological distress pre-surgery – higher than levels previously reported in uro-oncological patients. Surprisingly, there was no difference in anxiety and depression scores in uro-oncology and urology patients. Psychological distress in both uro-oncology and more general urology patients should be considered in the surgical setting. Level of evidence Moderate
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Affiliation(s)
- Nuala Murray
- Department of Urology, Mercy University Hospital, Ireland
| | | | - Rhona Dempsey
- Department of Urology, Mercy University Hospital, Ireland
| | - Sean Liew
- Department of Urology, Mercy University Hospital, Ireland
| | - Helen Richards
- Department of Clinical Psychology, Mercy University Hospital, Ireland
| | - Ciaran Brady
- Department of Urology, Mercy University Hospital, Ireland
| | - Paul Sweeney
- Department of Urology, Mercy University Hospital, Ireland
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14
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Bergerot CD, Razavi M, Clark KL, Philip EJ, Pal SK, Loscalzo M, Dale W. Emotional problem-related distress screening and its prevalence by cancer type: Assessment by patients' characteristics and level of assistance requested. Psychooncology 2021; 30:1332-1338. [PMID: 33797817 DOI: 10.1002/pon.5685] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/09/2021] [Accepted: 03/24/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Emotional problem-related distress is a common issue faced by patients with cancer. However, patients suffering with this emotional burden do not typically seek assistance. This study sought to determine the prevalence of emotional problem-related distress by cancer type, and identify factors correlated with the level of assistance requested. METHODS Using the SupportScreen®, patients were screened for emotional problem-related distress at their first or second visit to an NCI designated Comprehensive Cancer Center. General Linear Model was used to test the association between emotional problem-related distress and type of cancer, and the relationship between level of assistance requested and patients' characteristics. RESULTS A total of 2,421 patients were included in this analysis. Patients were mostly female (62%), diagnosed with breast (24%), gynecological (16%) or gastrointestinal (15%) cancers. Highest levels of emotional problem-related distress were reported by patients diagnosed with lung, gynecological, breast and gastrointestinal cancers. Level of assistance requested were significantly associated with problem-related distress scores (p < 0.001), which were higher among patients with lower household incomes (p < 0.001) and Spanish as primary language (p = 0.001). CONCLUSION Our study found an association between Level of assistance requested and emotional problem-related distress, which were heightened by lower income and Spanish-speaking. Intervention strategies should be considered to increase access to psychosocial support services.
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Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Marianne Razavi
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Karen Lynn Clark
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Errol J Philip
- Medical School, University of California San Francisco, San Francisco, California, USA
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Matthew Loscalzo
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - William Dale
- Department of Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, California, USA
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15
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Psychological distress among cancer survivors during implementation of a nationwide Movement Control Order over the COVID-19 pandemic. Support Care Cancer 2021; 29:6087-6097. [PMID: 33796935 PMCID: PMC8016501 DOI: 10.1007/s00520-021-06182-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/24/2021] [Indexed: 01/17/2023]
Abstract
Objectives This study aimed to investigate the psychological distress and its associated factors among cancer survivors in Malaysia during the COVID-19 pandemic. Methods An anonymous Internet-based study was conducted between 23 April and 26 June 2020. During the study period, the country underwent phase 3 and phase 4 of the Movement Control Order (MCO), Conditional Movement Control Order (CMCO), and Recovery Movement Control Order (RMCO). Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS), which is a 14-item self-assessment scale for measuring distress (total HADS score; HADS-T) with two subscales, namely, anxiety (HADS-A) and depression (HADS-D). Perceived threat of infection was measured based on the health belief model. Results From a total of 631 responses received, the proportion of participants with anxiety and depression symptoms (above threshold score of 8 on HADS-A and HADS-D) was 29.0 and 20.9%, respectively. Psychological distress (HADS-T > 16) was reported in 22.3% of the respondents. A total of 16.5% had combined anxiety and depression symptoms. The highest HADS-A (6.10; 95% CI 5.64–6.56), HADS-D (5.61; 95% CI 5.14–6.08), and HADS-T (11.71; 95% CI 10.84–12.58) scores were reported among respondents during phase 4 of the MCO. Partial least square-based structural equation modelling (PLS-SEM) revealed that self-perceived health status, perceived susceptibility, and severity of COVID-19 have the greatest effect, leading to higher HADS-A, HADS-D, and HADS-T scores. Conclusion Heightened psychological distress was evident in cancer survivors particularly during the enforcement of the MCO over COVID-19. Providing support to address cancer survivors’ psychological and emotional needs during the COVID-19 pandemic is essential.
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16
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Distress and Quality of Life Among Patients with Advanced Genitourinary Cancers. Eur Urol Focus 2020; 6:1150-1154. [PMID: 31711933 DOI: 10.1016/j.euf.2019.10.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/20/2019] [Accepted: 10/17/2019] [Indexed: 11/21/2022]
Abstract
Patients with advanced genitourinary cancers face many challenges throughout their disease trajectory, and many will experience clinically relevant psychosocial distress. Certain groups, including female gender, younger age (and older age for suicide), unmarried status, and non-clear cell histology, remain at a higher risk, and evidence suggests that those with kidney and bladder cancers may be at an increased risk of suicide. Routine psychosocial screening, with brief validated tools, has the ability to identify patients' unmet needs, assist the health care team in addressing such symptoms, and subsequently improve quality of life, adherence, and clinical outcomes. Effective supportive care modalities are available that address common patient needs in the context of incurable disease (eg, emotional and physical symptoms); however, challenges remain in terms of patient acceptance and access through insurance coverage. As a result, remote home-based interventions have emerged with the potential to mitigate emotional symptom burden and improve disease adjustment. In this study, we highlight studies reporting on the prevalence of psychosocial distress and associated risk factors in advanced genitourinary cancers, and review evidence-based interventions for the management of distress, including distress screening and psychosocial interventions. PATIENT SUMMARY: This mini-review reports the prevalence of psychosocial distress and associated risk factors among patients with advanced kidney, bladder, or prostate cancer. We found that patients with these types of advanced genitourinary cancers are at a great risk of distress, including suicide, with consequent impairments in quality of life. We recommend that a distress screening program be incorporated as the standard of care and that referrals to appropriate psychosocial interventions be available to assist patients in greatest need.
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17
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Bergerot CD, Philip EJ, Bergerot PG, Pal SK. Distress and Quality of Life Among Patients with Advanced Genitourinary Cancers. Eur Urol Focus 2020. [DOI: 10.1016/j.euf.2019.10.014 5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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18
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Development and Initial Evaluation of a Multifaceted Intervention to Improve Mental Health and Quality of Life Among Prostate Cancer Survivors. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00108-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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19
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Esser P, Mehnert-Theuerkauf A, Friedrich M, Johansen C, Brähler E, Faller H, Härter M, Koch U, Schulz H, Wegscheider K, Weis J, Kuba K, Hinz A, Hartung T. Risk and associated factors of depression and anxiety in men with prostate cancer: Results from a German multicenter study. Psychooncology 2020; 29:1604-1612. [PMID: 32658367 DOI: 10.1002/pon.5471] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVE In order to optimize psycho-oncological care, studies that quantify the extent of distress and identify certain risk groups are needed. Among patients with prostate cancer (PCa), findings on depression and anxiety are limited. METHODS We analyzed data of PCa patients selected from a German multi-center study. Depression and anxiety were assessed with the PHQ-9 and the GAD-7 (cut-off ≥7). We provided physical symptom burden, calculated absolute and relative risk (AR and RR) of depression and anxiety across patient subsets and between patients and the general population (GP) and tested age as a moderator within the relationship of disease-specific symptoms with depression and anxiety. RESULTS Among 636 participants, the majority reported disease-specific problems (sexuality: 60%; urination: 52%). AR for depression and anxiety was 23% and 22%, respectively. Significant RR were small, with higher risks of distress in patients who are younger (eg, RRdepression = 1.15; 95%-CI: 1.06-1.26), treated with chemotherapy (RRdepression = 1.46; 95%-CI: 1.09-1.96) or having metastases (RRdepression = 1.30; 95%-CI: 1.02-1.65). Risk of distress was slightly elevated compared to GP (eg, RRdepression = 1.13; 95%-CI: 1.07-1.19). Age moderated the relationship between symptoms and anxiety (Burination = -0.10, P = .02; Bsexuality = -0.11, P = .01). CONCLUSIONS Younger patients, those with metastases or treatment with chemotherapy seem to be at elevated risk for distress and should be closely monitored. Many patients suffer from disease-specific symptom burden, by which younger patients seem to be particularly distressed. Support of coping mechanisms associated with disease-specific symptom burden seems warranted.
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Affiliation(s)
- Peter Esser
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Christoffer Johansen
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Oncology Clinic, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Unit of Survivorship, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Mainz, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Martin Härter
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Koch
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joachim Weis
- Comprehensive Cancer Center, University Medical Center Freiburg, Freiburg, Germany
| | - Katharina Kuba
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Tim Hartung
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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20
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Yang J, Liu Q, Zhao F, Feng X, Kaaya RE, Lyu J. Incidence of and sociological risk factors for suicide death in patients with leukemia: A population-based study. J Int Med Res 2020; 48:300060520922463. [PMID: 32383398 PMCID: PMC7221221 DOI: 10.1177/0300060520922463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Suicide is closely related to sociological factors, but sociological analyses of suicide risk in leukemia are lacking. This study is the first to use the Surveillance, Epidemiology, and End Results Program (SEER) database to analyze sociological risk factors for suicide death in leukemia patients. METHODS A retrospective search of the SEER database was conducted. Logistic regression was used to identify independent risk factors for suicide death. Variables significant in the univariate logistic regression models were subsequently analyzed using multivariate regression. RESULTS The death rate was highest in California (1.73%). Suicide mortality was more common during the 1970s and 1980s, after which it trended downward. Young age at diagnosis (18-34 vs. >64 years: odds ratio [OR] = 1.537, 95% confidence interval [CI] = 1.007-2.347; 35-64 vs. >64 years: OR = 1.610, 95% CI = 1.309-1.979), being male (OR = 1.518, 95% CI = 1.230-1.873), and living where a high proportion of people have at least a bachelor's degree (>50% vs. <20%: OR = 8.115, 95% CI = 5.053-13.034) significantly increased suicide death risk. CONCLUSION Our findings could increase clinician awareness of and appropriate support for leukemia patients at risk of death by suicide.
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Affiliation(s)
- Jin Yang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Qingqing Liu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Fanfan Zhao
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Xiaojie Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Rahel Elishilia Kaaya
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
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21
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Yang J, He G, Chen S, Pan Z, Zhang J, Li Y, Lyu J. Incidence and risk factors for suicide death in male patients with genital-system cancer in the United States. Eur J Surg Oncol 2019; 45:1969-1976. [PMID: 30914288 DOI: 10.1016/j.ejso.2019.03.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/18/2019] [Accepted: 03/14/2019] [Indexed: 12/21/2022] Open
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Rönningås U, Fransson P, Holm M, Wennman-Larsen A. Prostate-specific antigen (PSA) and distress: - a cross-sectional nationwide survey in men with prostate cancer in Sweden. BMC Urol 2019; 19:66. [PMID: 31299962 PMCID: PMC6626380 DOI: 10.1186/s12894-019-0493-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/02/2019] [Indexed: 02/01/2023] Open
Abstract
Background The prostate-specific antigen (PSA) -value is often used during the prostate cancer trajectory as a marker of progression or response to treatment. Concerns about PSA-values are often expressed by patients in clinical situations. Today there is a lack of larger studies that have investigated the association between PSA-value and distress. The aim was to investigate the association between PSA-values and distress adjusted for sociodemographic factors, hormonal therapy and quality of life (QoL), among men with prostate cancer. Methods In this cross-sectional survey of 3165 men with prostate cancer, members of the Swedish Prostate Cancer Federation, answered questions about sociodemographic factors, PSA, distress, QoL and treatments. Descriptive statistics, and bivariate and multivariable analyses were performed. The result was presented based on four PSA-value groups: 0–19, 20–99, 100–999, and ≥ 1000 ng/ml. Results Of the men, 53% experienced distress. An association between distress and PSA-values was found where higher PSA-values were associated with higher OR:s for experiencing distress in the different PSA-groups: 0–19 ng/ml (ref 1), 20–99 ng/ml (OR 1.25, 95% CI 1.01–1.55), 100–999 ng/ml (OR 1.47, 95% CI 1.12–1.94), ≥1000 ng/ml (OR 1.77, 95% CI 1.11–2.85). These associations were adjusted for sociodemographic factors and hormonal therapy. In the multivariable analyses, beside PSA-values, higher levels of distress were associated with being without partner or hormonal therapy. When adding QoL in the multivariable analysis, the association between PSA and distress did not remain significant. Conclusion These results indicate that the PSA-values are associated with distress, especially for those with higher values. However, to be able to support these men, continued research is needed to gain more knowledge about the mechanisms behind the association between emotional distress and PSA-values.
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Affiliation(s)
- Ulrika Rönningås
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden. .,Department of Oncology, Sundsvall County Hospital, 851 86, Sundsvall, Sweden. .,Department of Nursing Science, Sophiahemmet University, 114 86, Stockholm, Sweden.
| | - Per Fransson
- Department of Nursing, Umeå University, 901 87, Umeå, Sweden.,Cancercentrum, Norrlands University Hospital, 901 85, Umeå, Sweden
| | - Maja Holm
- Department of Nursing Science, Sophiahemmet University, 114 86, Stockholm, Sweden
| | - Agneta Wennman-Larsen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.,Department of Nursing Science, Sophiahemmet University, 114 86, Stockholm, Sweden
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23
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Chung KJ, Shim SR, Brown S, Shim YS, Park IB, Kim KH. Does early depressive mood expire following radical retropubic prostatectomy in patients with localized prostate cancer? J Exerc Rehabil 2019; 15:264-269. [PMID: 31111011 PMCID: PMC6509445 DOI: 10.12965/jer.1938160.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 03/28/2019] [Indexed: 11/22/2022] Open
Abstract
In this study, the pattern of depressive mood in patients following radical prostatectomy (RP) for localized prostate cancer (PCa) was determined. A total of 30 patients (aged 68.03±6.1 years) who were diagnosed with localized PCa and underwent RP within 1 month entered the study. Evaluations included body mass index, prostate-specific antigen, testosterone, underlying disease, international prostate symptom score and quality of life (QoL), international index of erectile function as well as Beck depression inventory (BDI), both at the initial stage and 3 months later. Basic demographic data, laboratory results, and questionnaires were analyzed statistically. The BDI score significantly decreased 3 months after the surgery. In correlation analysis, BDI was related with the international prostate symptom score but not with the underlying disease, QoL or international index of erectile function. Body mass index was identified as one of the risk factors to decrease the probability of BDI score (≥3) significantly. Underlying disease increased the probability of BDI score. In the assessment of the correlation between BDI and each subscale, sadness, self-dislike, self-criticalness, and worth-lessness showed high correlation. In the early period, depressive mood was improved at the short-term follow-up in localized PCa patients after RP. Voiding symptoms were only related with the depressive mood, but not with other parameters, including sexual function. The depressive mood had no effect on the QoL in the early stage.
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Affiliation(s)
- Kyung Jin Chung
- Department of Urology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Sung-Ryul Shim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Suzana Brown
- Department of Technology and Society, The State University of New York (SUNY) in Korea, Incheon, Korea
| | - Young Sup Shim
- Department of Radiology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Ie Byung Park
- Department of Endocrinology and Metabolism, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Khae-Hawn Kim
- Department of Urology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
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24
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Magnuson A, Sattar S, Nightingale G, Saracino R, Skonecki E, Trevino KM. A Practical Guide to Geriatric Syndromes in Older Adults With Cancer: A Focus on Falls, Cognition, Polypharmacy, and Depression. Am Soc Clin Oncol Educ Book 2019; 39:e96-e109. [PMID: 31099668 DOI: 10.1200/edbk_237641] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Geriatric syndromes are multifactorial conditions that are prevalent in older adults. Geriatric syndromes are believed to develop when an individual experiences accumulated impairments in multiple systems that compromise their compensatory ability. In older adults with cancer, the presence of a geriatric syndrome is common and may increase the complexity of cancer treatment. In addition, the physiologic stress of cancer and cancer treatment may precipitate or exacerbate geriatric syndromes. Common geriatric syndromes include falls, cognitive syndromes and delirium, depression, and polypharmacy. In the oncology setting, the presence of geriatric syndromes is relevant; falls and cognitive problems have been shown to be predictive of chemotherapy toxicity and overall survival. Polypharmacy and depression are more common in older adults with cancer compared with the general geriatric population. Multiple screening tools exist to identify falls, cognitive problems, polypharmacy, and depression in older adults and can be applied to the oncology setting to identify patients at risk. When recognized, several interventions exist that could be considered for this vulnerable population. We review the available evidence of four geriatric syndromes in the oncology setting, including clinical implications, validated screening tools, potential supportive care, and therapeutic interventions.
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Affiliation(s)
- Allison Magnuson
- 1 Department of Medicine, Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY
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25
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Fox RS, Moreno PI, Yanez B, Estabrook R, Thomas J, Bouchard LC, McGinty HL, Mohr DC, Begale MJ, Flury SC, Perry K, Kundu SD, Penedo FJ. Integrating PROMIS® computerized adaptive tests into a web-based intervention for prostate cancer. Health Psychol 2019; 38:403-409. [PMID: 31045423 PMCID: PMC6546285 DOI: 10.1037/hea0000672] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study outlined the implementation and feasibility of delivering PROMIS® computer adaptive tests (CATs) using a web-based method to evaluate the impact of a technological adaptation of Cognitive-Behavioral Stress Management (CBSM) on the psychosocial functioning of men with advanced prostate cancer (APC) undergoing hormone therapy. METHOD Patients were randomized to a CBSM group intervention (n = 95) or a health promotion (HP) attention-matched control condition (n = 97). Participants attended all sessions via video conference using tablets, and completed PROMIS® computer adaptive tests (CATs) assessing anxiety, depression, fatigue, pain interference, and physical function weekly during the 10-week intervention. RESULTS Assessment completion rates >50% at week 1 and week 10 demonstrated moderate feasibility of repeatedly administering PROMIS® CATs using a web-based method. Multilevel modeling demonstrated no significant group-by-time interactions from week 1 to week 10 for any of the assessed PROMIS® domains adjusting for sociodemographic and medical covariates. However, simple effects demonstrated decreases in PROMIS® anxiety scores from week 1 to 10 for both groups. Results also demonstrated significant relationships of medical variables to psychosocial functioning across time points. CONCLUSIONS Results highlight the feasibility and benefits of utilizing PROMIS® CATs to repeatedly assess psychosocial functioning using a web-based method and indicate that web-based interventions may be effective for decreasing psychosocial distress and adverse symptoms among men with APC undergoing hormone therapy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Rina S. Fox
- Department of Medical Social Sciences, Northwestern
University Feinberg School of Medicine
| | - Patricia I. Moreno
- Department of Medical Social Sciences, Northwestern
University Feinberg School of Medicine
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern
University Feinberg School of Medicine
| | - Ryne Estabrook
- Department of Medical Social Sciences, Northwestern
University Feinberg School of Medicine
| | - Jessica Thomas
- Department of Medical Social Sciences, Northwestern
University Feinberg School of Medicine
| | - Laura C. Bouchard
- Department of Medical Social Sciences, Northwestern
University Feinberg School of Medicine
| | - Heather L. McGinty
- Department of Psychiatry and Behavioral Health, Ohio State
University Wexner Medical Center
| | - David C. Mohr
- Department of Preventive Medicine, Northwestern University
Feinberg School of Medicine
| | | | - Sarah C. Flury
- Department of Urology, Robert H. Lurie Comprehensive Cancer
Center, Northwestern University Feinberg School of Medicine
| | - Kent Perry
- Department of Urology, Robert H. Lurie Comprehensive Cancer
Center, Northwestern University Feinberg School of Medicine
| | - Shilajit D. Kundu
- Department of Urology, Robert H. Lurie Comprehensive Cancer
Center, Northwestern University Feinberg School of Medicine
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26
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Nguyen MH, Smets EMA, Bol N, Bronner MB, Tytgat KMAJ, Loos EF, van Weert JCM. Fear and forget: how anxiety impacts information recall in newly diagnosed cancer patients visiting a fast-track clinic. Acta Oncol 2019; 58:182-188. [PMID: 30264632 DOI: 10.1080/0284186x.2018.1512156] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION One-day fast track programs for cancer diagnostics and treatment planning are increasingly being implemented in health care. Fast-track programs are highly effective at reducing waiting times, and thus well received by patients and healthcare providers. However, these programs may also burden patients, as patients generally receive a lot of information from multiple healthcare providers within a short time span. This might increase anxiety and negatively impact recall of medical information in newly diagnosed patients. This study examines whether anxiety influences information recall at the moment of diagnosis, and whether this relation differs for younger and older patients. METHODS Data were collected from 78 colorectal cancer patients visiting a one-day fast-track multidisciplinary outpatient clinic. All consultations that took place were recorded on a video. Anxiety was measured at baseline (T1) and immediately after consultations (T2) with the STAI-6. Information recall was assessed by telephone within 36-48 hours after patients' visit (T3) using open questions. RESULTS After consultations (T2), 32% of patients experienced clinical anxiety levels. Patients recalled ∼60% of medical information (T3). Information recall was negatively impacted by anxiety (β = -.28, p = .011), and negatively related to higher age (β = -.23, p = .031), and lower education level (β = .27, p = .013). Although older patients (M = 53.99) recalled 11% less information than younger patients (M = 64.84), age was not related to anxiety and did not moderate the anxiety-recall relationship. CONCLUSION High levels of anxiety after receiving a cancer diagnosis negatively influence how much information patients remember after visiting a one-day fast-track clinic. This calls for interventions that may reduce patients' anxiety as much as reasonably possible and support patients' information recall. Researchers, practitioners, and hospitals are encouraged to continue exploring ways to optimize information provision to cancer patients in current modern healthcare.
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Affiliation(s)
- Minh Hao Nguyen
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, Netherlands
| | - Ellen M. A. Smets
- Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Nadine Bol
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, Netherlands
| | - Madelon B. Bronner
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, Netherlands
| | - Kristien M. A. J. Tytgat
- Department of Gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Eugène F. Loos
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, Netherlands
| | - Julia C. M. van Weert
- Amsterdam School of Communication Research (ASCoR), University of Amsterdam, Amsterdam, Netherlands
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27
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Is age a risk factor for depression among the oldest old with cancer? J Geriatr Oncol 2018; 9:476-481. [DOI: 10.1016/j.jgo.2018.03.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/19/2018] [Accepted: 03/20/2018] [Indexed: 11/20/2022]
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28
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Levkovich I, Cohen M, Alon S, Kuchuk I, Nissenbaum B, Evron E, Pollack S, Fried G. Symptom cluster of emotional distress, fatigue and cognitive difficulties among young and older breast cancer survivors: The mediating role of subjective stress. J Geriatr Oncol 2018; 9:469-475. [PMID: 29759914 DOI: 10.1016/j.jgo.2018.05.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 03/24/2018] [Accepted: 05/01/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To examine the nature of the symptom cluster of emotional distress, fatigue, and cognitive difficulties in young and older breast cancer survivors (BCS); To assess the mediating role of subjective stress and coping strategies (emotional control and meaning-focused coping) in the association between age and symptom cluster. MATERIALS AND METHODS Participants were 170 BCS, stages I-III, 1-12 months post-chemotherapy, filled-out the Fatigue, Emotional Control, Meaning-focused Coping, Emotional Distress and the Cognitive Difficulties Questionnaires. Statistical analyses included tests for difference between-groups Pearson correlations and Structural Equation Modeling for the assessment of the study model. RESULTS Older BCS (aged 60-82) reported lower levels of emotional distress (M = 0.87, SD = 0.87), fatigue (M = 3.85, SD = 2.38), and cognitive difficulties (M = 1.17, SD = 1.07) compared to the younger BCS (aged 24-59) (emotional distress M = 1.17, SD = 0.85, fatigue M = 5.02, SD = 2.32, and cognitive difficulties M = 1.66, SD = 1.23, p < .01-,05). The older survivors reported lower levels of subjective stress and used more emotional control strategies compared to the younger BCS. The empirical model had good fit indices (χ2 = 27.60, p = 0.20, χ2/df = 1.26; CFI = 0.98; TLI = 0.98; NFI = 0.95; RMSEA = 0.04 (90% CI = 0.00, 10) and showed that subjective stress, but not coping strategies, mediated the effect of age on symptom cluster severity. CONCLUSIONS Lower levels of subjective stress, but not coping strategies, mediated the association of age with the symptom cluster of emotional distress, fatigue and cognitive difficulties. Further research is needed to explore differences in subjective stress by age.
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Affiliation(s)
- Inbar Levkovich
- The Division of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | - Miri Cohen
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
| | - Shirly Alon
- Oncology Department, Meir Medical Center, Israel.
| | - Iryna Kuchuk
- Oncology Department, Meir Medical Center, Israel.
| | | | - Ella Evron
- Tel Aviv Sourasky Medical Center, Affiliated to Tel Aviv University, Sackler Faculty of Medicine, Israel.
| | | | - Georgeta Fried
- Oncology Unit, Rambam Health Care Campus, Haifa, Israel.
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Cockle-Hearne J, Barnett D, Hicks J, Simpson M, White I, Faithfull S. A Web-Based Intervention to Reduce Distress After Prostate Cancer Treatment: Development and Feasibility of the Getting Down to Coping Program in Two Different Clinical Settings. JMIR Cancer 2018; 4:e8. [PMID: 29712628 PMCID: PMC5952123 DOI: 10.2196/cancer.8918] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 02/12/2018] [Accepted: 02/20/2018] [Indexed: 12/25/2022] Open
Abstract
Background Distress after prostate cancer treatment is a substantial burden for up to one-third of men diagnosed. Physical and emotional symptoms and health service use can intensify, yet men are reticent to accept support. To provide accessible support that can be cost effectively integrated into care pathways, we developed a unique, Web-based, self-guided, cognitive-behavior program incorporating filmed and interactive peer support. Objective To assess feasibility of the intervention among men experiencing distress after prostate cancer treatment. Demand, acceptability, change in distress and self-efficacy, and challenges for implementation in clinical practice were measured. Methods A pre-post, within-participant comparison, mixed-methods research design was followed. Phase I and II were conducted in primary care psychological service and secondary care cancer service, respectively. Men received clinician-generated postal invitations: phase I, 432 men diagnosed <5 years; phase II, 606 men diagnosed <3.5 years. Consent was Web-based. Men with mild and moderate distress were enrolled. Web-based assessment included demographic, disease, treatment characteristics; distress (General Health Questionnaire-28); depression (Patient Health Questionnaire-9); anxiety (General Anxiety Disorder Scale-7); self-efficacy (Self-Efficacy for Symptom Control Inventory); satisfaction (author-generated, Likert-type questionnaire). Uptake and adherence were assessed with reference to the persuasive systems design model. Telephone interviews explored participant experience (phase II, n=10); interviews with health care professionals (n=3) explored implementation issues. Results A total of 135 men consented (phase I, 61/432, 14.1%; phase II, 74/606, 12.2%); from 96 eligible men screened for distress, 32% (30/96) entered the intervention (phase I, n=10; phase II, n=20). Twenty-four completed the Web-based program and assessments (phase I, n=8; phase II, n=16). Adherence for phase I and II was module completion rate 63% (mean 2.5, SD 1.9) versus 92% (mean 3.7, SD 1.0); rate of completing cognitive behavior therapy exercises 77% (mean 16.1, SD 6.2) versus 88% (mean 18.6, SD 3.9). Chat room activity occurred among 63% (5/8) and 75% (12/16) of men, respectively. In phase I, 75% (6/8) of men viewed all the films; in phase II, the total number of unique views weekly was 16, 11, 11, and 10, respectively. The phase II mood diary was completed by 100% (16/16) of men. Satisfaction was high for the program and films. Limited efficacy testing indicated improvement in distress baseline to post intervention: phase I, P=.03, r=−.55; phase II, P=.001, r=−.59. Self-efficacy improved for coping P=.02, r=−.41. Service assessment confirmed ease of assimilation into clinical practice and clarified health care practitioner roles. Conclusions The Web-based program is acceptable and innovative in clinical practice. It was endorsed by patients and has potential to positively impact the experience of men with distress after prostate cancer treatment. It can potentially be delivered in a stepped model of psychological support in primary or secondary care. Feasibility evidence is compelling, supporting further evaluative research to determine clinical and cost effectiveness.
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Affiliation(s)
- Jane Cockle-Hearne
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Deborah Barnett
- Time to Talk, Brighton General Hospital, Sussex Community NHS Foundation Trust, Brighton, United Kingdom
| | - James Hicks
- St. Richard's Hospital, Western Sussex Hospitals NHS Trust, Chichester, United Kingdom
| | - Mhairi Simpson
- Access Division - Cancer, NHS Lanarkshire, Monklands Hospital, Airdrie, United Kingdom
| | - Isabel White
- Applied Health Research Group, Department of Psychological Support and Pastoral Care, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Sara Faithfull
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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Von Visger TT, Kuntz KK, Phillips GS, Yildiz VO, Sood N. Quality of life and psychological symptoms in patients with pulmonary hypertension. Heart Lung 2018; 47:115-121. [PMID: 29361341 DOI: 10.1016/j.hrtlng.2017.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) has a delay in diagnosis that makes time since diagnosis of interest in this population. OBJECTIVES To assess psychological conditions, perceived stress, QOL, and interpersonal support and to explore whether these factors may correlate with time since diagnosis in patients with PAH. METHODS Participants at an academic medical center (n = 108) completed psychological questionnaires (Cambridge Pulmonary Hypertension Outcome Review, Patient Health Questionnaire-9, Perceived Stress Scale-10, and Interpersonal Support Evaluation List-Short Form). RESULTS Prevalence of psychiatric disorder, major depression, and "other depressive disorder" were 29.6%, 15.7%, and 9.3%, respectively. Participants reported adequate social support, high perceived stress, and average quality of life. Time since diagnosis was positively associated with greater perceived social support (ρ = 0.174, p = .075) and greater perceived stress (ρ = 0.191, p = .048), but no other psychological factor. CONCLUSIONS Routine psychological assessment and timely referral for mental health services are suggested. Social support may buffer patients from stress.
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Affiliation(s)
- Tania T Von Visger
- The Ohio State University Wexner Medical Center, Columbus, OH; The Ohio State University College of Nursing, Columbus, OH.
| | - Kristin K Kuntz
- The Ohio State University Wexner Medical Center, Columbus, OH
| | - Gary S Phillips
- The Ohio State University Wexner Medical Center, Columbus, OH
| | - Vedat O Yildiz
- The Ohio State University Wexner Medical Center, Columbus, OH; The Ohio State University College of Medicine, Columbus, OH
| | - Namita Sood
- The Ohio State University Wexner Medical Center, Columbus, OH
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31
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Bevilacqua LA, Dulak D, Schofield E, Starr TD, Nelson CJ, Roth AJ, Holland JC, Alici Y. Prevalence and predictors of depression, pain, and fatigue in older- versus younger-adult cancer survivors. Psychooncology 2018; 27:900-907. [PMID: 29239060 DOI: 10.1002/pon.4605] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND As the number of older adults in the United States continues to grow, there will be increasing demands on health care providers to address the needs of this population. Cancer is of particular importance, with over half of all cancer survivors older than 65 years. In addition, depression, pain, and fatigue are concerns for older adults with cancer and have been linked to poorer physical outcomes. METHODS For this retrospective chart review, 1012 eligible participants were identified via a query of the Electronic Medical Record for all patients referred to 1 of 4 Survivorship Clinics at Memorial Sloan Kettering Cancer Center. All patients were between the ages of 30 to 55 (younger adults) and >65 (older adults). Depression was measured using the Patient Health Questionnaire-9 (PHQ-9). RESULTS The overall rate of depression in this sample of adult cancer survivors was 9.3%. There were no differences in the rates of clinically significant depression (defined as PHQ-9 score ≥10) between younger and older adult cohorts. However, there was a small trend toward higher mean PHQ-9 scores in the younger adult cohort (3.42 vs 2.95; t = 1.763, P = .10). Women reported greater rates of depression and higher pain and fatigue scores. Hispanic/Latino patients also reported significantly greater rates of depression. CONCLUSION There were no observed differences in depression between older and younger adult cancer survivors. Gender and ethnic discrepancies in depression were observed. Future research should focus on understanding the nature of these differences and targeting interventions for the groups most vulnerable to depression after cancer treatment.
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Affiliation(s)
- Lisa A Bevilacqua
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Deirdre Dulak
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tatiana D Starr
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew J Roth
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jimmie C Holland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yesne Alici
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Lycken M, Drevin L, Garmo H, Stattin P, Adolfsson J, Lissbrant IF, Holmberg L, Bill-Axelson A. The use of palliative medications before death from prostate cancer: Swedish population-based study with a comparative overview of European data. Eur J Cancer 2018; 88:101-108. [DOI: 10.1016/j.ejca.2017.10.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 10/17/2017] [Accepted: 10/22/2017] [Indexed: 11/16/2022]
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Kinlock BL, Parker LJ, Howard DL, Bowie JV, LaVeist TA, Thorpe RJ. Prevalence and Correlates of Major Depressive Symptoms among Black Men with Prostate Cancer. Ethn Dis 2017; 27:429-436. [PMID: 29225444 DOI: 10.18865/ed.27.4.429] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives The objectives of our study were to determine the prevalence of major depressive symptoms and identify factors that are associated with major depressive symptoms among Black men with prostate cancer (PCa). Design This study consisted of 415 Black men aged 40-81 years that entered the North Carolina Central Cancer Registry during the years 2007-2008. The primary outcome variable was depressive symptoms (CES-D). Factors included age, income, education, insurance status, treatment received, time between diagnosis and treatment, Gleason score, medical mistrust and experience with racism/discrimination. Logistic regression models were used to assess factors associated with the odds of having major depressive symptoms. Results The prevalence of major depressive symptoms (≥16 on CES-D) among our sample of Black men with PCa was approximately 33%. Approximately 15% of the study participants underwent radiation beam treatment. Age was significantly associated with the odds of reporting major depressive symptoms (OR= .95, CI .91-.99) among Black men. In addition, compared with all other forms of treatment, Black men who underwent radiation beam treatment had higher odds (OR=2.38, CI 1.02- 5.51) of reporting major depressive symptoms. Conclusion Nearly one-third of Black men with PCa in this study reported major depressive symptoms. Clinicians should pay closer attention to the mental health status of Black men with PCa, especially those who are younger and those who have undergone radiation beam treatment. Cancer survivorship, particularly quality of life, may be enhanced by opportunities for assessment, evaluation and intervention of depressive symptoms among these men disproportionately affected by PCa.
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Affiliation(s)
- Ballington L Kinlock
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lauren J Parker
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Daniel L Howard
- Public Policy Research Institute and Department of Sociology, Texas A&M University, College Station, TX
| | - Janice V Bowie
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Thomas A LaVeist
- Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Roland J Thorpe
- Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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de Lima MM, Tobias-Machado M. Suicide in patients with genitourinary malignancies. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28134462 DOI: 10.1111/ecc.12635] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 09/20/2016] [Accepted: 11/20/2016] [Indexed: 12/21/2022]
Abstract
Genitourinary cancers are significant causes of morbidity and mortality around the world. The present review summarises the current literature on suicide and its risk factors among patients with genitourinary cancers. The review was based on relevant articles published in MEDLINE, ProQuest, PsycINFO, Science Direct and Scopus databases. Patients with prostate cancer represented the most important risk group for suicide, among patients with urogenital cancers. Other risk factors are male gender, older age, white race, advanced disease, living alone and co-existing psychological comorbidities. Findings from the review call for a greater caregiver awareness on psychosocial morbidity and suicidality among genitourinary cancer patients pre- and post-treatment and their early identification, adoption of risk-reduction strategies and prompt referral for expert mental health care.
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Affiliation(s)
- M M de Lima
- Department of Urology, Coronel Mota Hospital, Roraima, Brazil
| | - M Tobias-Machado
- Section of Urologic Oncology, Department of Urology, ABC Medical School, São Paulo, UK
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Rosser BRS, Capistrant B, Torres B, Konety B, Merengwa E, Mitteldorf D, West W. The Effects of Radical Prostatectomy on Gay and Bisexual Men's Mental Health, Sexual Identity and Relationships: Qualitative Results from the Restore Study. SEXUAL AND RELATIONSHIP THERAPY 2016; 31:446-461. [PMID: 27942251 DOI: 10.1080/14681994.2016.1228871] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The effect of prostate cancer treatment in gay and bisexual men is an under-researched area. In 2015, we conducted in-depth telephone interviews with 19 gay and bisexual men who had undergone radical prostatectomies. Across the respondents' five emotional themes emerged: (1) shock at the diagnosis, (2) a reactive, self-reported "depression", (3) sex-specific situational anxiety, (4) a sense of grief, and, (5) an enduring loss of sexual confidence. Identity challenges included loss of a sense of maleness and manhood, changes in strength of sexual orientation, role-in-sex identity, and immersion into sexual sub-cultures. Relationship challenges identified included disclosing the sexual effects of treatment to partners, loss of partners, and re-negotiation of sexual exclusivity. Most to all of these effects stem from sexual changes. To mitigate these negative effects of radical prostatectomy, and to address health disparities n outcomes observed in gay and bisexual men, all these challenges need to be considered in any tailored rehabilitation program for gay and bisexual men.
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Affiliation(s)
- B R Simon Rosser
- Division of Epidemiology and Community Health, 1300 S. 2 St. #300, University of Minnesota, Minneapolis, MN, USA
| | - Benjamin Capistrant
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Beatriz Torres
- Department of Communication Studies, Gustavus Adolphus College, St. Peter, MN, USA
| | - Badrinath Konety
- Department of Urology, University of Minnesota, Minneapolis, MN, USA
| | - Enyinnaya Merengwa
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | | | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, USA
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Colloca G, Colloca P. The Effects of Social Support on Health-Related Quality of Life of Patients with Metastatic Prostate Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:244-252. [PMID: 26174117 DOI: 10.1007/s13187-015-0884-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Patients with metastatic prostate cancer (PC) live longer than patients with metastatic tumours of other sites. Consequently, their social network can influence their quality of life (QoL) during a remarkable life span. The aim of this article is to present the findings of a systematic review of the studies that focused on social network supporting the quality of life of these patients. A systematic review for studies meeting specific criteria was undertaken on three databases. Some level of unmet psychological needs was present in 54 % of the patients. Depression and fatigue are highly prevalent, and the dyads, patient and partner, are at higher risk for distress symptoms. The efforts of individuals to cope with metastatic PC appear influenced by adaptative skills and specific types of family support. Psychological and relational problems predominate in the hormone-sensitive stage and are increasingly replaced by physical symptoms, social and spiritual needs in the later stages. In the early castration-resistant stage, patients will discuss with their doctors information about drugs, control of side effects and treatment strategies. In metastatic PC patients, needs change during the course of the disease. Social support plays a major role in maintaining or disrupting QoL and in the efficacy of psychosocial treatments. The trajectory of disease and its effect on the reduced QoL over the entire life expectancy should be kept in mind by health system providers and social workers.
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Affiliation(s)
- Giuseppe Colloca
- Department of Oncology, G. Borea Hospital, Via G. Borea, 56, 18038, Sanremo, Imperia, Italy.
| | - Pasquale Colloca
- Department of Educational Sciences, University of Bologna, Bologna, Italy
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Quaranta L, Riva I, Gerardi C, Oddone F, Floriani I, Konstas AGP. Quality of Life in Glaucoma: A Review of the Literature. Adv Ther 2016; 33:959-81. [PMID: 27138604 PMCID: PMC4920851 DOI: 10.1007/s12325-016-0333-6] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Indexed: 11/16/2022]
Abstract
The ultimate goal of glaucoma management is the preservation of patients’ visual function and quality of life (QoL). The disease itself as well as the medical or surgical treatment can have an enormous impact on a patient’s QoL. Even the mere diagnosis of a chronic, irreversible, potentially blinding disorder can adversely affect the patient’s sense of well-being and QoL by eliciting significant anxiety. Patients with primary open-angle glaucoma rarely present with visual symptoms, at least early in the course of the disease. A better understanding of patient-reported QoL can improve patient–physician interaction and enhance treatment adherence by customizing treatment options based on individual patient profile, thus optimizing long-term prognosis. These aspects are summarized and critically appraised in this article.
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Affiliation(s)
- Luciano Quaranta
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
| | - Ivano Riva
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Chiara Gerardi
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | - Irene Floriani
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Anastasios G P Konstas
- 1st and 3rd University Departments of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Wada S, Shimizu K, Inoguchi H, Shimoda H, Yoshiuchi K, Akechi T, Uchida M, Ogawa A, Fujisawa D, Inoue S, Uchitomi Y, Matsushima E. The Association Between Depressive Symptoms and Age in Cancer Patients: A Multicenter Cross-Sectional Study. J Pain Symptom Manage 2015; 50:768-77. [PMID: 26300022 DOI: 10.1016/j.jpainsymman.2015.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 07/04/2015] [Accepted: 07/13/2015] [Indexed: 11/17/2022]
Abstract
CONTEXT There is controversy around the association between depressive symptoms and age in adult cancer patients. OBJECTIVES The aim of this study was to evaluate the following hypotheses: 1) cancer patients' depressive symptoms decrease with age, and 2) in individuals aged 65 years or older, depressive symptoms increase because of the effect of somatic symptoms. METHODS We retrospectively analyzed a database of 356 cancer patients who were consecutively recruited in a previous multicenter cross-sectional study. Depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9), and correlations with age and other factors were assessed by hierarchical multivariate regression analysis. Age was entered as the dependent variable in the first step, patient characteristics and cancer-related variables were entered in the second step, and somatic symptoms were entered in the last step. We analyzed this model for both the total sample and the subpopulation aged 65 years or older. RESULTS In the total sample, the PHQ-9 score was significantly associated with lower age, fatigue, and shortness of breath (adjusted R(2) 14.2%). In the subpopulation aged 65 years or older, no factor was associated with the PHQ-9 score (adjusted R(2) 7.3%). CONCLUSION The finding that depressive symptoms in cancer patients decreased with age was concordant with our first hypothesis, but the second hypothesis was not supported. Younger cancer patients were vulnerable to depressive symptoms and should be monitored carefully. Further studies using more representative samples are needed to examine in detail the association between depressive symptoms and age in older cancer patients.
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Affiliation(s)
- Saho Wada
- Department of Psycho-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Section of Liaison, Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Ken Shimizu
- Department of Psycho-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
| | - Hironobu Inoguchi
- Department of Psycho-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Haruki Shimoda
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira-shi, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tatsuo Akechi
- Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya-shi, Aichi, Japan; Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya-shi, Aichi, Japan
| | - Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya-shi, Aichi, Japan
| | - Asao Ogawa
- Division of Psycho-Oncology, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan; Department of Psycho-Oncology Service, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan
| | - Daisuke Fujisawa
- Division of Psycho-Oncology, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan; Department of Psycho-Oncology Service, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan
| | - Shinichirou Inoue
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama-shi, Okayama, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Eisuke Matsushima
- Section of Liaison, Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
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Nipp RD, Greer JA, El-Jawahri A, Traeger L, Gallagher ER, Park ER, Jackson VA, Pirl WF, Temel JS. Age and Gender Moderate the Impact of Early Palliative Care in Metastatic Non-Small Cell Lung Cancer. Oncologist 2015; 21:119-26. [PMID: 26621041 PMCID: PMC4709206 DOI: 10.1634/theoncologist.2015-0232] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 09/28/2015] [Indexed: 12/25/2022] Open
Abstract
This study analyzed data from a randomized controlled trial of patients with metastatic non-small cell lung cancer who received either early palliative care (EPC) integrated with oncology care or oncology care alone. Males and younger patients who received EPC had better quality of life and mood than those who received oncology care alone. However, these outcomes did not differ significantly between treatment groups for females or older patients. Background. Studies demonstrate that early palliative care (EPC) improves advanced cancer patients’ quality of life (QOL) and mood. However, it remains unclear whether the role of palliative care differs based upon patients’ demographic characteristics. We explored whether age and gender moderate the improvements in QOL and mood seen with EPC. Methods. We performed a secondary analysis of data from a randomized controlled trial of patients with metastatic non-small cell lung cancer. Patients received either EPC integrated with oncology care or oncology care alone. We assessed the degree to which QOL (Trial Outcome Index [TOI]) and mood (Hospital Anxiety and Depression Scale [HADS] and Patient Health Questionnaire 9 [PHQ-9]) outcomes at week 12 varied by patient age (<65) and gender. The week 12 data of 107 patients are included in this analysis. Results. At 12 weeks, younger patients receiving EPC reported better QOL (TOI mean = 62.04 vs. 49.43, p = .001) and lower rates of depression (HADS–Depression = 4.0% vs. 52.4%, p < .001; PHQ-9 = 0.0% vs. 28.6%, p = .006) than younger patients receiving oncology care alone. Males receiving EPC reported better QOL (TOI mean = 58.81 vs. 48.30, p = .001) and lower rates of depression (HADS–Depression = 18.5% vs. 60.9%, p = .002; PHQ-9 = 3.8% vs. 34.8%, p = .008) than males receiving oncology care alone. At 12 weeks, QOL and mood did not differ between study groups for females and older patients. Conclusion. Males and younger patients who received EPC had better QOL and mood than those who received oncology care alone. However, these outcomes did not differ significantly between treatment groups for females or older patients. Implications for Practice: This study found that early palliative care improves patients’ quality of life and mood differentially based on their age and gender. Specifically, males and younger patients receiving early palliative care experienced better quality of life and mood than those receiving oncology care alone. Conversely, females and older patients did not experience this treatment effect. Thus, palliative care interventions may need to be tailored to patients’ age- and gender-specific care needs. Studying how patients’ demographic characteristics affect their experience with palliative care will enable the development of interventions targeted to the distinct supportive care needs of patients with cancer.
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Affiliation(s)
- Ryan D Nipp
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph A Greer
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Areej El-Jawahri
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Lara Traeger
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Emily R Gallagher
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Vicki A Jackson
- Division of Palliative Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - William F Pirl
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer S Temel
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Deckx L, van den Akker M, Vergeer D, van Abbema D, van den Berkmortel F, Linsen L, de Jonge E, Houben B, van Driel M, Buntinx F. The Value of Fatigue Severity to Rule Out Depression in Older Adult Patients With Cancer. Oncol Nurs Forum 2015; 42:E302-9. [DOI: 10.1188/15.onf.e302-e309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
An aging population and advances in diagnostics and treatment have resulted in a rapidly growing population of people impacted by cancer. People live longer after a cancer diagnosis and tolerate more aggressive treatments than in the past. Younger patients struggle with diversions from the normal developmental milestones in career and relationships, while older patients deal with the dual challenges of aging and cancer. Cancer's transition from likely death to survival has increased interest in its impact on psychosocial issues and quality of life, rather than just longevity. In this article, the authors review the psychiatric diagnosis and management of the mental health issues most often encountered in oncology. Oncology treatment teams, including oncologists, nurses, social workers, and other ancillary staff, are often on the front lines of addressing psychiatric distress and clinical syndromes when psychiatrists are not easily available. The purpose of this review article is to highlight opportunities for nonpsychiatrists to improve identification and treatment of psychosocial distress and psychiatric syndromes and to request formal psychiatric consultation in appropriate situations. Psychotherapeutic, psychopharmacologic, cognitive, and behavioral-oriented interventions, as well as supportive interventions, are discussed for treating patients who are facing challenges during active cancer treatment, survivorship, and at the end of life. This review is not exhaustive but highlights the more common psychosomatic medicine and palliative care scenarios that impact cancer patient care. The importance of recognizing and addressing burnout and compassion fatigue in multidisciplinary professionals who care for those treated for cancer is also discussed given the secondary impact this can have on patient care.
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Affiliation(s)
- Reema D Mehta
- Fellow, Psychosomatic Medicine Psycho-Oncology, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center/New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY
| | - Andrew J Roth
- Attending Psychiatrist, Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center/New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY
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Tavlarides AM, Ames SC, Thiel DD, Diehl NN, Parker AS. Baseline and follow-up association of the MAX-PC in Men with newly diagnosed prostate cancer. Psychooncology 2015; 24:451-7. [PMID: 24953309 PMCID: PMC4326594 DOI: 10.1002/pon.3605] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 05/20/2014] [Accepted: 05/23/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of this paper is to conduct a prospective, longitudinal study employing the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) to examine the baseline and follow-up association of prostate cancer (PCa)-specific anxiety, health-related quality of life (HRQOL), and PCa aggressiveness in men with newly-diagnosed PCa undergoing prostatectomy at our institution. METHODS From our prospective PCa registry, we identified a total of 350 men with newly-diagnosed PCa who completed the MAX-PC and the Expanded Prostate Cancer Index Composite (EPIC) at baseline and one-year following surgery. Scores on both measures were compared with clinical measure and demographics using the Wilcoxon Rank Sum, Fisher's exact, and Cochran-Armitage Trend tests. Spearman test was used to assess correlation at between the MAX-PC and EPIC at baseline and one-year. RESULTS Baseline overall MAX-PC measures were correlated with measures at one-year (r=0.5479, p<0.001). Those reporting high anxiety at one-year were more likely to have Gleason score>6 (p=0.004), T-Stage ≥ 2C disease (p=0.004), and a postoperative prostate-specific antigen (PSA)>0.1 (p=0.002); however, this did not apply to all anxious patients. Baseline EPIC sexual function scores were predictive of follow-up EPIC sexual function scores as well (r=0.5790, p<0.001). Depression was noted as a problem in 16% of patients at follow-up. CONCLUSIONS Our data suggests that the MAX-PC could be used at baseline as a tool to determine who may benefit from psychological intervention pre-PCa and post-PCa treatment. In terms of individualized medicine, behavioral therapy may be the most beneficial in improving HRQOL for younger patients, those with advanced stage disease, and more specifically those whose anxiety outweighs their actual prognosis.
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Affiliation(s)
| | - Steven C. Ames
- Division of Hematology and Oncology, Mayo Clinic, FL, USA
| | - David D. Thiel
- Department of Urology, Mayo Clinic, Jacksonville, FL, USA
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O'Donovan A, Mohile SG, Leech M. Expert consensus panel guidelines on geriatric assessment in oncology. Eur J Cancer Care (Engl) 2015; 24:574-89. [PMID: 25757457 DOI: 10.1111/ecc.12302] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2015] [Indexed: 12/27/2022]
Abstract
Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. A four-round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations to gain consensus on a given topic. Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cut-off for assessment, represented a higher degree of disagreement. The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients.
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Affiliation(s)
- A O'Donovan
- Applied Radiation Therapy Trinity (ARTT), Trinity College Dublin, Ireland
| | - S G Mohile
- James Wilmot Cancer Center, University of Rochester, Rochester, NY, USA
| | - M Leech
- Applied Radiation Therapy Trinity (ARTT), Trinity College Dublin, Ireland
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Kiffel J, Sher L. Prevention and management of depression and suicidal behavior in men with prostate cancer. Front Public Health 2015; 3:28. [PMID: 25745628 PMCID: PMC4333715 DOI: 10.3389/fpubh.2015.00028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 02/04/2015] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jeremy Kiffel
- Icahn School of Medicine at Mount Sinai , New York, NY , USA
| | - Leo Sher
- Icahn School of Medicine at Mount Sinai , New York, NY , USA ; James J. Peters Veterans' Administration Medical Center , Bronx, NY , USA
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Hamama-Raz Y, Shrira A, Ben-Ezra M, Palgi Y. The recursive effects of quality of life and functional limitation among older adult cancer patients: evidence from the Survey of Health, Ageing and Retirement in Europe. Eur J Cancer Care (Engl) 2015; 24:205-12. [PMID: 25660578 DOI: 10.1111/ecc.12300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2015] [Indexed: 11/30/2022]
Abstract
Older cancer patients need to cope with two major stressful situations simultaneously - age-related stress and illness-related stress. The current study aimed to explore whether patients' quality of life (QoL) and functional limitations have a reciprocal effect over time, and further aimed to assess whether these effects differ by age group. Data were drawn from the two first waves of the Survey of Health, Ageing and Retirement in Europe. Five hundred ninety-eight participants reported that they were diagnosed with cancer or malignant tumours. All participants completed self-report questionnaires tapping personal and medical data, QoL and functional limitations. By using a two-wave cross-lagged design, findings showed a reciprocal relationship between QoL and functional limitations among older cancer patients. This reciprocal relationship was stronger in the direction from QoL to functional limitations, especially among those 75 and older in comparison with younger patients (50-74). This suggests that assessment of QoL may be beneficial to clinicians in predicting deterioration in functional limitations among older patients receiving cancer treatment.
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Affiliation(s)
- Y Hamama-Raz
- School of Social Work, Ariel University, Ariel, Israel
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Elderly cancer patients’ psychopathology: A systematic review. Arch Gerontol Geriatr 2015; 60:9-15. [DOI: 10.1016/j.archger.2014.09.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 09/11/2014] [Accepted: 09/15/2014] [Indexed: 11/22/2022]
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Shayan Z, Shahkolahi Z, Ahmadlo N, Vafaee L, Shayan L. Prognostic Factors of Depression in Patients With Cancer Undergoing Chemotherapy and Radiotherapy. HEALTH SCOPE 2014. [DOI: 10.17795/jhealthscope-18609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Weiss Wiesel TR, Nelson CJ, Tew WP, Hardt M, Mohile SG, Owusu C, Klepin HD, Gross CP, Gajra A, Lichtman SM, Ramani R, Katheria V, Zavala L, Hurria A. The relationship between age, anxiety, and depression in older adults with cancer. Psychooncology 2014; 24:712-7. [PMID: 25099337 DOI: 10.1002/pon.3638] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 07/06/2014] [Accepted: 07/09/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE In older men with prostate cancer, aging is associated with reduced anxiety and increased depression. The purpose of this study was to examine the association among age, anxiety, and depression in a cohort of older adults receiving chemotherapy. METHODS This is a secondary analysis of a prospective longitudinal study investigating chemotherapy toxicity in older adults with cancer. Baseline data (pre-chemotherapy) included: age, sociodemographics, tumor and treatment factors, functional status, comorbidities, psychological state (measured by the Hospital Anxiety and Depression Scale), and social support. Univariate and multiple regression analyses were conducted to test the relationship between age, anxiety, and depression. RESULTS The average age of the 500 patients (56% females) was 73.1. The majority had late stage disease: 22% Stage III and 61% stage IV. Clinically significant depression was reported in 12.6%. Clinically significant anxiety was reported in 20.9%. In univariate analyses, there was no association between anxiety and age, or depression and age. In multivariable analyses, older age (p=0.05) was associated with decreased anxiety, as well as lack of social support (p<0.01) and increased number of comorbidities (p<0.01). In multivariable analysis, depression was associated with lack of social support (p<0.01), increased number of comorbidities (p<0.01), and advanced stage (p<0.01). CONCLUSIONS This study supports previous research that anxiety decreases with age in older adults with cancer. However, depression remained constant with increasing age. Greater resources and attention to identifying and treating the psychological sequelae of cancer in older adults are warranted.
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Affiliation(s)
- Talia R Weiss Wiesel
- Payne Whitney Manhattan, NewYork-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
| | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - William P Tew
- Memorial Sloan Kettering Cancer Center, Gynecologic Medical Oncology Service, New York, NY, USA
| | - Molly Hardt
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | | | - Cynthia Owusu
- Case Western Reserve University School of Medicine and Case Comprehensive Cancer Center, Cleveland, OH, USA
| | | | - Cary P Gross
- Cancer Outcomes Public Policy and Effectiveness Research (COPPER) Center, Yale University School of Medicine, New Haven, CT, USA
| | - Ajeet Gajra
- Upstate Medical University and VA Medical Center, Syracuse, NY, USA
| | | | - Rupal Ramani
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Vani Katheria
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Laura Zavala
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Arti Hurria
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
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Prasad SM, Eggener SE, Lipsitz SR, Irwin MR, Ganz PA, Hu JC. Effect of depression on diagnosis, treatment, and mortality of men with clinically localized prostate cancer. J Clin Oncol 2014; 32:2471-8. [PMID: 25002728 DOI: 10.1200/jco.2013.51.1048] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Although demographic, clinicopathologic, and socioeconomic differences may affect treatment and outcomes of prostate cancer, the effect of mental health disorders remains unclear. We assessed the effect of previously diagnosed depression on outcomes of men with newly diagnosed prostate cancer. PATIENTS AND METHODS We performed a population-based observational cohort study using Surveillance, Epidemiology, and End Results-Medicare linked data of 41,275 men diagnosed with clinically localized prostate cancer from 2004 to 2007. We identified 1,894 men with a depressive disorder in the 2 years before the prostate cancer diagnosis and determined its effect on treatment and survival. RESULTS Men with depressive disorder were older, white or Hispanic, unmarried, resided in nonmetropolitan areas and areas of lower median income, and had more comorbidities (P < .05 for all), but there was no variation in clinicopathologic characteristics. In adjusted analyses, men with depressive disorder were more likely to undergo expectant management for low-, intermediate-, and high-risk disease (P ≤ .05, respectively). Conversely, depressed men were less likely to undergo definitive therapy (surgery or radiation) across all risk strata (P < .01, respectively). Depressed men experienced worse overall mortality across risk strata (low: relative risk [RR], 1.86; 95% CI, 1.48 to 2.33; P < .001; intermediate: RR, 1.25; 95% CI, 1.06 to 1.49; P = .01; high: RR, 1.16; 95% CI, 1.03 to 1.32; P = .02). CONCLUSION Men with intermediate- or high-risk prostate cancer and a recent diagnosis of depression are less likely to undergo definitive treatment and experience worse overall survival. The effect of depression disorders on prostate cancer treatment and survivorship warrants further study, because both conditions are relatively common in men in the United States.
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Affiliation(s)
- Sandip M Prasad
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA
| | - Scott E Eggener
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA
| | - Stuart R Lipsitz
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA
| | - Michael R Irwin
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA
| | - Patricia A Ganz
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA
| | - Jim C Hu
- Sandip M. Prasad, Medical University of South Carolina, Charleston, SC; Scott E. Eggener, University of Chicago Medical Center, Chicago, IL; Stuart R. Lipsitz, Brigham and Women's Hospital, Boston, MA; Michael R. Irwin and Patricia A. Ganz, David Geffen School of Medicine at the University of California, Los Angeles; and Jim C. Hu, University of California, Los Angeles, Los Angeles, CA.
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