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Church AJ, Wakefield CE, Hetherington K, Shern JF. Promise and Perils of Precision Oncology for Patients With Pediatric and Young Adult Sarcomas. Am Soc Clin Oncol Educ Book 2024; 44:e432794. [PMID: 38924707 DOI: 10.1200/edbk_432794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
The completion of multiple national pediatric precision oncology platform trials and the incorporation of standardized molecular profiling into the diagnostic care of pediatric and young adult patients with sarcomas have proven the feasibility and potential of the approach. In this work, we explore the current state of the art of precision oncology for pediatric and young adults with sarcoma. We highlight important lessons learned and the challenges that should be addressed in the next generation of trials. The chapter outlines current efforts to improve standardization of molecular assays, harmonization of data collection, and novel molecular tools such as cell-free DNA analyses. Finally, we discuss the impacts and psychosocial outcomes experienced by patients and communication strategies for providers.
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Affiliation(s)
- Alanna J Church
- Department of Pathology, Boston Children's Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Claire E Wakefield
- School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, Randwick, NSW, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Kate Hetherington
- School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, Randwick, NSW, Australia
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Jack F Shern
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
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Cammas J, Tomy S, Strickland L, Mawhinney G. Oxford Spine Buddies: an acceptability and feasibility project for peer-to-peer support in a spine sarcoma service. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S16-S20. [PMID: 38780977 DOI: 10.12968/bjon.2024.33.10.s16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
BACKGROUND Primary bone and soft tissue sarcoma of the spine are rare and account for less than 0.2% of all neoplasm incidences. Following a patient and public involvement event, the need to explore patient support pathways was identified, which initiated this service evaluation project. AIM To determine the acceptability and feasibility of a peer-to-peer support project among people using the spine sarcoma service. METHODS Users were paired and introduced via Microsoft Teams. Quantitative and qualitative data both pre- and post-introduction of a buddy were collected. FINDINGS Service users felt that, although they would have preferred having a buddy at the time of their diagnosis, being allocated a buddy made them feel reassured and better supported. CONCLUSION The project was well received and preliminary data are encouraging. Therefore, due to early findings from the first participants, the service is continuing to roll out the buddy programme.
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Affiliation(s)
- Jasmine Cammas
- Specialist Nurse Practitioner, Oxford University Hospitals NHS Foundation Trust
| | - Sheto Tomy
- Specialist Research Nurse Practitioner, Oxford University Hospitals NHS Foundation Trust
| | - Louise Strickland
- Deputy Director of Nursing and Midwifery Research and Innovation, Oxford University Hospitals NHS Foundation Trust
| | - Gerard Mawhinney
- Spinal Nurse Consultant, Oxford University Hospitals NHS Foundation Trust
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Haywood D, Dauer E, Baughman FD, Lawrence BJ, Rossell SL, Hart NH, O’Connor M. "Is My Brain Ever Going to Work Fully Again?": Challenges and Needs of Cancer Survivors with Persistent Cancer-Related Cognitive Impairment. Cancers (Basel) 2023; 15:5331. [PMID: 38001592 PMCID: PMC10669848 DOI: 10.3390/cancers15225331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Many cancer survivors experience cognitive impairments that impact memory, concentration, speed of information processing, and decision making. These impairments, collectively known as cancer-related cognitive impairments (CRCIs), are a key domain of unmet needs and can significantly impact a cancer survivor's identity and quality of life. However, there are no purpose-built, multi-domain, needs assessment tools specifically for CRCI. The development of such tools requires an in-depth understanding of cancer survivors' CRCI-specific challenges and associated needs. This study explored the challenges and associated needs of cancer survivors with persistent CRCI. An in-depth qualitative design using semi-structured interviews with (a) cancer survivors with perceived CRCI (n = 32) and (b) oncology health professionals (n = 19) was utilised. A reflexive thematic analysis of the interviews resulted in five overarching themes: (1) executing regular activities, (2) relational difficulties, (3) occupational functioning, (4) psychological distress, and (5) social functioning, as well as an additional informational needs domain. Ultimately, CRCI was found to directly produce a range of challenges that negatively, and persistently, impact cancer survivors' quality of life. Cancer survivors were also found to have a range of needs associated with these challenges. This research should be used to inform future challenges and needs assessment tools as well as treatment and supportive care priority areas directly relating to CRCI.
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, NSW 2021, Australia;
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3052, Australia
| | - Evan Dauer
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
| | - Frank D. Baughman
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
| | - Blake J. Lawrence
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
| | - Susan L. Rossell
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Nicolas H. Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, NSW 2021, Australia;
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Park, SA 5042, Australia
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane City, QLD 4000, Australia
- Exercise Medicine Research Institute, School of Medical and Health Science, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Health Research, University of Notre Dame Australia, Fremantle, WA 6160, Australia
| | - Moira O’Connor
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
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"We're on a Merry-Go-Round": Reflections of Patients and Carers after Completing Treatment for Sarcoma. ACTA ACUST UNITED AC 2021; 28:3003-3014. [PMID: 34436029 PMCID: PMC8395482 DOI: 10.3390/curroncol28040263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/25/2021] [Accepted: 08/02/2021] [Indexed: 11/17/2022]
Abstract
Sarcoma is a rare cancer that has a significant impact on patients’ and carers’ quality of life. Despite this, there has been a paucity of research exploring the diverse experiences of patients and carers following sarcoma treatment. The aim of this study was to explore patients’ and carers’ reflections on life after treatment for sarcoma. A qualitative research design with a social constructionist epistemology was used. Participants included patients previously treated for sarcoma (n = 21) and family carers of patients treated for sarcoma (n = 16). Participants completed semi-structured interviews which were analysed using thematic analysis. Three primary themes were identified: “This journey is never going to be over”, “But what happens when I am better?”, and finding a silver lining. Participants represented sarcoma as having a long-term, and sometimes indefinite, threat on their life that they had limited control over. Conclusions: This study highlight the heterogeneous and ongoing needs of sarcoma survivors and their families. Patients and carers strove to translate their experiences in a meaningful way, such as by improving outcomes for other people affected by sarcoma. Parental carers in particular attempted to protect the patient from the ongoing stress of managing the disease.
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