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Gumuchian ST, Boyle A, Hazel LH, Ellenbogen MA. Fear of depression recurrence among individuals with remitted depression: a qualitative interview study. BMC Psychiatry 2024; 24:152. [PMID: 38383311 PMCID: PMC10882790 DOI: 10.1186/s12888-024-05588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Major Depressive Disorder (MDD) is a prevalent psychiatric condition and the largest contributor to disability worldwide. MDD is highly recurrent, yet little is known about the mechanisms that occur following a Major Depressive Episode (MDE) and underlie recurrence. We explored the concept of fear of depression recurrence (FoDR) and its impact on daily functioning among individuals in remission from MDD. METHODS 30 participants (83% female; 37% White; Mage = 27.7, SD = 8.96) underwent semi-structured qualitative interviews. The interviews explored participants' experiences of FoDR including the frequency, severity, content, triggers, and impact of fears and associated coping strategies. We used content analysis to analyze the transcriptions. RESULTS Most participants (73%) reported having FoDR, with varying frequency, severity, and duration of fears. The triggers and content of participants' fears often mirrored the symptoms (e.g., low mood, anhedonia) and consequences (e.g., job loss, social withdrawal) endured during past MDEs. Some participants reported a minimal impact of FoDR on daily functioning, whereas others reported a positive (e.g., personal growth) or negative (e.g., increased anxiety) influence. LIMITATIONS Our sample size did not allow for explorations of differences in FoDR across unique MDD subtypes or sociocultural factors. CONCLUSIONS The concept of FoDR may present a window into understanding the unique cognitive and behavioural changes that occur following MDD remission and underlie depression recurrence. Future research should aim to identify underlying individual differences and characteristics of the disorder that may influence the presence and impact of FoDR. Finally, a FoDR measure should be developed so that associations between FoDR and recurrence risk, depressive symptoms, and other indices of functioning can be determined.
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Affiliation(s)
- Stephanie T Gumuchian
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, H4B 1R6, Montréal, Québec, Canada.
| | - Ariel Boyle
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, H4B 1R6, Montréal, Québec, Canada
| | - Lori H Hazel
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, H4B 1R6, Montréal, Québec, Canada
| | - Mark A Ellenbogen
- Department of Psychology, Concordia University, 7141 Sherbrooke Street West, H4B 1R6, Montréal, Québec, Canada
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Hinz A, Schulte T, Mehnert-Theuerkauf A, Richter D, Sender A, Brock H, Friedrich M, Briest S. Fear of Cancer Progression: A Comparison between the Fear of Progression Questionnaire (FoP-Q-12) and the Concerns about Recurrence Questionnaire (CARQ-4). Healthcare (Basel) 2024; 12:435. [PMID: 38391810 PMCID: PMC10888487 DOI: 10.3390/healthcare12040435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
As cancer patients often suffer from fear of cancer progression (FoP), valid screening for FoP is of high relevance. The aims of this study were to test psychometric properties of two FoP questionnaires, to determine their relationship to other anxiety-related constructs, and to analyze the impact of sociodemographic and clinical factors on the FoP. Our sample consisted of n = 1733 patients with mixed cancer diagnoses. For measuring FoP, the Fear of Progression questionnaire (FoP-Q-12) and the Concerns About Cancer Recurrence Questionnaire (CARQ-4) were used. The mean scores of the FoP-Q-12 and the CARQ-4 were 30.0 ± 10.4 and 16.1 ± 10.8, respectively, indicating relatively high levels of FoP. Both questionnaires showed excellent internal consistency coefficients, α = 0.895 and α = 0.915, respectively. The correlation between the two FoP questionnaires was r = 0.72. Female patients reported more FoP than male patients (d = 0.84 and d = 0.54, respectively). There was a nonlinear age dependency of FoP, with an increase found in the age range from 18 to 50 years and a decrease in the older age range. Radiation, chemotherapy, and antibody therapy, but not surgery, lead to an increase in FoP. Both questionnaires show good psychometric properties and can be recommended for use in an oncological routine. Female patients and patients in the middle-age range deserve special attention from healthcare providers.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Thomas Schulte
- Rehabilitation Clinic Bad Oexen, 32549 Bad Oeynhausen, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Diana Richter
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Annekathrin Sender
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Hannah Brock
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Susanne Briest
- Department of Gynecology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
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Chen F, Ou M, Xiao Z, Xu X. Trajectories of fear of cancer recurrence and its influence factors: A longitudinal study on Chinese newly diagnosed cancer patients. Psychooncology 2024; 33:e6271. [PMID: 38282228 DOI: 10.1002/pon.6271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/21/2023] [Accepted: 12/07/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE The fear of cancer recurrence (FCR) is an ongoing and common psychological problem faced by cancer patients. The objective of this study was to explore the variation trend of FCR and its influencing factors in Chinese newly diagnosed cancer patients from admission to 2 months after discharge. Demographic and tumor characteristics, as well as experiential avoidance (EA), were used as predictors. METHOD A longitudinal design and a consecutive sampling method were used to select 266 newly diagnosed cancer patients admitted to a tertiary cancer hospital in China from July to December 2022. Measurements of FCR and EA were obtained at admission (T1), 1 month after discharge (T2), and 2 months post-discharge (T3). Generalized estimating equations were used to identify factors associated with FCR for longitudinal data analysis. RESULTS A total of 266 participants completed the follow-up. Both FCR and EA scores of patients with newly diagnosed cancer showed a significant trend of first increasing and then decreasing at baseline and follow-up (p < 0.001). The junior secondary and less education level, rural residence, advanced tumor and high EA level were risk factors for higher FCR. CONCLUSIONS Our findings suggest that the FCR levels of most newly diagnosed cancer patients in China are different at the three time points and affected by different factors, with the highest level at 1 month after discharge. These results have significant implications for future identifying populations in need of targeted intervention based on their FCR trajectories.
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Affiliation(s)
- Furong Chen
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
- School of Nursing, University of South China, Hengyang, China
| | - Meijun Ou
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
| | - Zhirui Xiao
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
- School of Nursing, University of South China, Hengyang, China
| | - Xianghua Xu
- The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China
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Dax V, Ftanou M, Tran B, Lewin J, Wiley JF. Malignancy, masculinities, and psychological distress: Comparisons made between men with testicular cancer and healthy controls. Psychooncology 2024; 33:e6262. [PMID: 38102869 DOI: 10.1002/pon.6262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/14/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Psychological distress is common in men with testicular cancer (TC), and masculinities may work to explain this. This study aimed to compare masculinities and distress in TC and healthy control (HC) populations and explore relationships between correlates of distress (psychological flexibility and coping style) and masculinities in TC. METHODS A cross-sectional, online survey was completed by 92 men with TC (Mage = 34.8) and 90 HC (Mage = 30.7). Measures included psychological distress (Patient-Reported Outcomes Measurement Information System Depression/Anxiety, fear of cancer recurrence inventory-short form), masculinities (gender role conflict-short form, inventory of subjective masculinity experiences/subjective masculinity stress scale, masculinity in chronic disease inventory), coping style (mini-mental adjustment to cancer ) and psychological flexibility (comprehensive assessment of acceptance commitment therapy). Linear regressions were conducted to compare groups and analyse associations. RESULTS There were no differences in masculinities or psychological distress between populations (all p > 0.05 and all Cohen's d < 0.20), except for subjective masculine stress and restrictive affectionate behaviour between men. For men with TC, restrictive affection/emotion, conflicts between family/work and subjective masculine stress were associated with psychological distress (rs 0.21-0.58). Optimistic action was negatively associated with depression/anxiety, helplessness/hopelessness coping (rs -0.27 to -0.42) and positively associated with psychological flexibility (r = 0.35). CONCLUSIONS Masculinities are implicated in psychological distress in men with TC. Psychological flexibility as well as leveraging masculine beliefs (e.g., optimistic action) may be modifiable targets to reduce distress in men with TC.
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Affiliation(s)
- Victoria Dax
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Maria Ftanou
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Ben Tran
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Division of Personalized Medicine, Walter and Eliza Hall Institute, Melbourne, Victoria, Australia
| | - Jeremy Lewin
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Ontrac at Peter MacCallum Cancer Centre, Victorian Adolescent and Young Adult Cancer Centre, Melbourne, Victoria, Australia
| | - Joshua F Wiley
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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5
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Sun D, Zhang X, Cui M. Association between self-esteem and fear of cancer recurrence in cancer survivors: A cross-sectional study. Eur J Oncol Nurs 2023; 64:102334. [PMID: 37148748 DOI: 10.1016/j.ejon.2023.102334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/24/2023] [Accepted: 04/29/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE There may be a correlation between self-esteem as an important psychological resource for individuals and Fear of cancer recurrence (FCR), but the relationship between the two is unclear. The aim of our investigation was to evaluate the association of FCR and self-esteem in cancer survivors. METHODS Cross-sectional sampling was used to select cancer survivors. The study instruments used included: General information questionnaire, Rosenberg Self-Esteem Scale, Perceived Social Support Scale, Fear of Cancer Recurrence Inventory- Shorter Form. We used logistic regression, where models were adjusted considering confounding variables to determine odds ratios (ORs) with 95% confidence intervals (CIs) for the association of FCR with self-esteem. RESULTS Between February 2022 to July 2022, we screened 380 participants for eligibility, of whom 348 were included in the study. The percentage of cancer survivors who experienced clinical level of FCR was 73.9% and the self-esteem score was 27.73 ± 3.67 at a moderate level. The Pearson' s correlation coefficient indicated a significant inverse relationship between FCR and self-esteem (p < 0.001; r = -0.375). In a multivariable logistic regression model, FCR still has a negative correlation with self-esteem (OR, 0.812; 95%CI, 0.734-0.898). Subgroup analysis indicated that the correlation between FCR and self-esteem in cancer survivors was nearly the same in various strata, demonstrating its soundness and stability. CONCLUSIONS This study confirms that elevated self-esteem in individuals surviving cancer may be a protective factor for FCR. Improving the level of self-esteem in cancer survivors can be one of the important directions of clinical interventions for FCR.
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Affiliation(s)
- Di Sun
- School of Nursing, Liaoning University of Traditional Chinese Medicine, No.79, Chongshan East Road, Shenyang, Liaoning, 110033, China
| | - Xu Zhang
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Mengyao Cui
- Department of Breast Surgery, The First Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning, 110001, China.
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Anderson D, Razzak AN, McDonald M, Cao D, Hasoon J, Viswanath O, Kaye AD, Urits I. Mental Health in Urologic Oncology. Health Psychol Res 2022; 10:37518. [DOI: 10.52965/001c.37518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This article is a systematic review of mental health in urologic oncology patients with prostate cancer (PCa), bladder cancer (BC), renal cell carcinoma (RCC), testicular cancer (TC), or penile cancer (PeCa). For all pathologies, a focus on increasing quality of life post-treatment demonstrated a positive impact in reducing Mental Health Illness (MHI) prevalence. Cancer specific mental health care may be given to patients to reduce suicide risk in BC patients and sexual identify and masculinity counseling may improve mental health for TC or PeCa patients. In order to better accommodate patient’s mental health needs when undergoing GU cancer treatment, we recommend incorporation of mental health metrics such as questionnaires to assess early treatment of MHI, a greater emphasis on psychosocial support with the patient’s loved ones, peers, and healthcare team, alongside advising healthy habits such as exercise which has been shown to drastically reduce MHI incidence across all pathologies. We hope that these measures conducted by urologists and oncologists, alongside possible coordination with psychiatrists and psychologists for psychotherapy, psychopharmacology, and neuro-stimulation treatment modems may be helpful in the long term to reduce MHI incidence in urology oncology patients. Given the higher incidence of MHI in oncology patients and in the patient population after the Covid-19 pandemic, MHI awareness in the sphere of urologic oncologic treatment continues to be crucial when creating a collaborative treatment platform for patients.
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Affiliation(s)
| | | | | | | | | | - Omar Viswanath
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Valley Anesthesiology and Pain Consultants, Envision Physician Services; Department of Anesthesiology, University of Arizona College of Medicine Phoenix;Department of Anesthesiology, Creighton University School of Medicine
| | | | - Ivan Urits
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Department of Anesthesiology, Louisiana State University Health Shreveport
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Hall DL, Levine BJ, Jeter E, Chandler A, Tooze JA, Duffecy J, Victorson D, Gradishar W, Leach J, Saphner T, Smith ML, Penedo F, Mohr DC, Cella D, Wagner LI. A spotlight on avoidance coping to manage fear of recurrence among breast cancer survivors in an eHealth intervention. J Behav Med 2022; 45:771-781. [PMID: 35930212 PMCID: PMC9362703 DOI: 10.1007/s10865-022-00349-8] [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: 01/26/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022]
Abstract
Background Fear of recurrence (FoR) is prevalent among breast cancer survivors (BCS) and may be exacerbated by avoidance coping. This study examined BCS with avoidance coping and their engagement in a FoR eHealth intervention (FoRtitude). Methods BCS (N = 196) with elevated FoR participated in FoRtitude. Patient-reported measures assessed avoidance coping with FoR and baseline emotional and behavioral health. Intervention engagement was measured quantitatively (e.g., website logins, telecoaching attendance) and qualitatively (i.e., telecoaching notes). Results 38 BCS (19%) endorsed avoidance coping, which was associated with more severe post-traumatic anxiety-related symptoms and worse global mental health (ps < .05), but not anxiety (p = .19), depression (p = .11), physical health (p = .12), alcohol consumption (p = .85), or physical activity (p = .39). Avoidance coping was not associated with engagement levels (ps > .05) but did characterize engagement-related motivators and barriers. Conclusions Avoidance coping was not a barrier to FoRtitude engagement. eHealth delivery is a promising modality for engaging survivors with avoidance coping in FoR interventions.
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Affiliation(s)
- Daniel L Hall
- Harvard Medical School, Massachusetts General Hospital, 100 Cambridge St., 16th floor, Boston, MA, 02114, USA.
| | - Beverly J Levine
- Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Elizabeth Jeter
- Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Allison Chandler
- Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Janet A Tooze
- Wake Forest University School of Medicine, Winston Salem, NC, USA
| | | | | | | | | | | | | | | | | | | | - Lynne I Wagner
- Wake Forest University School of Medicine, Winston Salem, NC, USA
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Shrem NS, Wood L, Hamilton RJ, Kuhathaas K, Czaykowski P, Roberts M, Matthew A, Izard JP, Chung P, Nappi L, Jones J, Soulières D, Aprikian A, Power N, Canil C. Testicular cancer survivorship: Long-term toxicity and management. Can Urol Assoc J 2022; 16:257-272. [PMID: 35905486 PMCID: PMC9343164 DOI: 10.5489/cuaj.8009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Affiliation(s)
- Noa Shani Shrem
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Lori Wood
- Division of Medical Oncology, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Halifax, NS, Canada
| | - Robert J. Hamilton
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Kopika Kuhathaas
- Division of Urology, Department of Surgical Oncology, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Piotr Czaykowski
- Department of Medical Oncology and Hematology, CancerCare Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - Matthew Roberts
- Division of Urology, Department of Surgery, University of Ottawa, Ottawa, ON, Canada
| | - Andrew Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Jason P. Izard
- Departments of Urology and Oncology, Queen’s University, Kingston, ON, Canada
| | - Peter Chung
- Department of Radiation Oncology, Radiation Medicine Program, Princess Margaret Hospital, University of Health Network, University of Toronto, Toronto, ON, Canada
| | - Lucia Nappi
- Division of Medical Oncology, British Columbia Cancer - Vancouver Cancer Centre, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Jones
- Department of Supportive Care, Princess Margaret Cancer Centre, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Denis Soulières
- Division of Medical Oncology/Hematology, Le Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Armen Aprikian
- Division of Urology, Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Nicholas Power
- Division of Urology, Department of Surgery, Western University, London, ON, Canada
| | - Christina Canil
- Division of Medical Oncology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
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Yang Y, Sun H, Luo X, Li W, Yang F, Xu W, Ding K, Zhou J, Liu W, Garg S, Jackson T, Chen Y, Xiang YT. Network connectivity between fear of cancer recurrence, anxiety, and depression in breast cancer patients. J Affect Disord 2022; 309:358-367. [PMID: 35472477 DOI: 10.1016/j.jad.2022.04.119] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Fear of cancer recurrence (FCR), anxiety, and depression are common psychological disturbances that frequently occur together among cancer patients. This study investigated network connectivity between FCR, anxiety, and depressive symptoms in a large representative sample of breast cancer patients. METHODS This was a multicenter, cross-sectional study of 803 women with breast cancer. All participants completed the 4-item FCR scale, Generalized Anxiety Disorder Scale (GAD-7), and Patient Health Questionnaire (PHQ-9). Network analysis was conducted to investigate the network structure, central symptoms, bridge symptoms, and network stability of these disturbances. RESULTS The generated network model indicated that anxiety and depression symptom communities were well-connected with each other, while FCR emerged as a distinct cluster with only a few weak links to anxiety and depression communities. Depressive and anxiety symptoms were more central than FCR symptoms were in the model. 'Having trouble relaxing' (#GAD4, strength = 1.147) was the most central node within the whole network, and 'strong feelings about recurrence' (#FCR4, strength = 0.531) was the least central node. Several anxiety symptoms (e.g., 'feeling afraid', 'uncontrollable worry', and 'restlessness') acted as important bridging symptoms connecting FCR, depression and anxiety communities. 'Uncontrollable worry' (#GAD2) had the highest node-specific predictive betweenness value. The network stability of this model was high. CONCLUSION Depression and anxiety symptoms are highly interactive with each other among women with breast cancer. Conversely, FCR may have attenuated relations with anxiety and depression communities and emerged as a relatively independent, unique experience. Anxiety symptoms, particularly 'uncontrollable worry', acted as important trans-diagnostic symptoms that connected different communities. Findings suggested interventions to alleviate excessive worries and enhance feelings of personal control might be helpful in preventing or reducing related symptoms of FCR, anxiety and depression.
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Affiliation(s)
- Yuan Yang
- Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou 510080, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China
| | - Xian Luo
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou 510515, China
| | - Wengao Li
- Department of Psychiatry, 999 Brain Hospital, Guangzhou 510515, China
| | - Fan Yang
- Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou 510080, China
| | - Wenjing Xu
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Kairong Ding
- Guangdong Mental Health Center, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou 510080, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Jiangyan Zhou
- Department of Psychiatry, The First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - Wenting Liu
- School of Nursing, Southern Medical University, Guangzhou 510515, China
| | - Samradhvi Garg
- School of Health in Social Science, University of Edinburgh, Edinburgh EH8 9BL, UK
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou 510515, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
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10
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Zheng M, Wan H, Zhu Y, Xiang L. The Correlation Between Radiotherapy and Patients' Fear of Cancer Recurrence: A Systematic Review and Meta-analysis. J Hosp Palliat Nurs 2022; 24:186-198. [PMID: 35184117 PMCID: PMC9052863 DOI: 10.1097/njh.0000000000000848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this review was to explore the correlation between patients' fear of cancer recurrence (FCR) and radiotherapy. National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, SinoMed, PubMed, Web of Science, EBSCO-CINAHL, Cochrane Library, and Ovid Embase were searched to identify relevant studies. Thirty-five eligible studies were included in the systematic review, and 22 of them were included in further meta-analysis. The results of the meta-analysis showed that the level of patients' FCR was positively correlated with radiotherapy, but the correlation was weak (overall r = 0.075; 95% confidence interval [CI], 0.046-0.103; P = .000). In terms of subgroup analysis based on cancer site (breast cancer vs other types of cancer), the breast cancer group (r = 0.086; 95% CI, 0.027-0.143; P = .004), the mixed-type group (r = 0.073; 95% CI, 0.033-0.112; P = .000), and the other-type group (r = 0.071; 95% CI, 0.015-0.126; P = .013) have a positive correlation with radiotherapy. Patients' FCR positively correlated with the receipt of radiotherapy. However, because of the variability among the studies, the results have limitations. Therefore, longitudinal studies are needed to verify the trajectory of FCR over radiation therapy.
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11
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Pijnappel EN, Dijksterhuis WPM, Sprangers MAG, Augustinus S, de Vos-Geelen J, de Hingh IHJT, Molenaar IQ, Busch OR, Besselink MG, Wilmink JW, van Laarhoven HWM. The fear of cancer recurrence and progression in patients with pancreatic cancer. Support Care Cancer 2022; 30:4879-4887. [PMID: 35169873 PMCID: PMC9046341 DOI: 10.1007/s00520-022-06887-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/28/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE It is plausible that patients with pancreatic cancer experience fear of tumor recurrence or progression (FOP). The aim of this study was to compare FOP in patients with pancreatic cancer treated with surgical resection, palliative systemic treatment, or best supportive care (BSC) and analyze the association between quality of life (QoL) and FOP and the effect of FOP on overall survival (OS). METHODS This study included patients diagnosed with pancreatic cancer between 2015 and 2018, who participated in the Dutch Pancreatic Cancer Project (PACAP). The association between QoL and WOPS was assessed with logistic regression analyses. OS was evaluated using Kaplan-Meier curves with the log-rank tests and multivariable Cox proportional hazard analyses adjusted for clinical covariates and QoL. RESULTS Of 315 included patients, 111 patients underwent surgical resection, 138 received palliative systemic treatment, and 66 received BSC. Patients who underwent surgical resection had significantly lower WOPS scores (i.e., less FOP) at initial diagnosis compared to patients who received palliative systemic treatment or BSC only (P < 0.001). Better QoL was independently associated with the probability of having a low FOP in the BSC (OR 0.95, 95% CI 0.91-0.98) but not in the surgical resection (OR 0.97, 95% CI 0.94-1.01) and palliative systemic treatment groups (OR 0.97, 95% CI 0.94-1.00). The baseline WOPS score was not independently associated with OS in any of the subgroups. CONCLUSION Given the distress that FOP evokes, FOP should be explicitly addressed by health care providers when guiding pancreatic cancer patients through their treatment trajectory, especially those receiving palliative treatment or BSC.
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Affiliation(s)
- Esther N Pijnappel
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Willemieke P M Dijksterhuis
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Netherlands Cancer Registry, Netherlands Comprehensive Cancer Organization (IKNL), PO Box 19079, Utrecht, 3501 DB, The Netherlands
| | - Mirjam A G Sprangers
- Department of Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Simone Augustinus
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Judith de Vos-Geelen
- Department of Internal Medicine, Division of Medical Oncology, GROW-School for Oncology and Developmental Biology, Maastricht UMC+, P. Debyelaan 25, Maastricht, 6229 HX, The Netherlands
| | | | - Izaak Q Molenaar
- Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Olivier R Busch
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Marc G Besselink
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Johanna W Wilmink
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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12
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Conduit C, Guo C, Smith AB, Rincones O, Baenziger O, Thomas B, Goad J, Lenaghan D, Lawrentschuk N, Wong LM, Corcoran NM, Ross M, Gibbs P, O'Haire S, Anton A, Liow E, Lewin J, Tran B. Distress in People with Newly Diagnosed Testicular Cancer – Role for an Online Intervention to Alleviate Distress? (Preprint). JMIR Cancer 2022; 8:e39725. [DOI: 10.2196/39725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/24/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
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13
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Chang WH, Lai AG. Cumulative burden of psychiatric disorders and self-harm across 26 adult cancers. Nat Med 2022; 28:860-870. [PMID: 35347280 PMCID: PMC9018408 DOI: 10.1038/s41591-022-01740-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/10/2022] [Indexed: 02/06/2023]
Abstract
Cancer is a life-altering event causing considerable psychological distress. However, information on the total burden of psychiatric disorders across all common adult cancers and therapy exposures has remained scarce. Here, we estimated the risk of self-harm after incident psychiatric disorder diagnosis in patients with cancer and the risk of unnatural deaths after self-harm in 459,542 individuals. Depression was the most common psychiatric disorder in patients with cancer. Patients who received chemotherapy, radiotherapy and surgery had the highest cumulative burden of psychiatric disorders. Patients treated with alkylating agent chemotherapeutics had the highest burden of psychiatric disorders, whereas those treated with kinase inhibitors had the lowest burden. All mental illnesses were associated with an increased risk of subsequent self-harm, where the highest risk was observed within 12 months of the mental illness diagnosis. Patients who harmed themselves were 6.8 times more likely to die of unnatural causes of death compared with controls within 12 months of self-harm (hazard ratio (HR), 6.8; 95% confidence interval (CI), 4.3-10.7). The risk of unnatural death after 12 months was markedly lower (HR, 2.0; 95% CI, 1.5-2.7). We provide an extensive knowledge base to help inform collaborative cancer-psychiatric care initiatives by prioritizing patients who are most at risk.
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Affiliation(s)
- Wai Hoong Chang
- Institute of Health Informatics, University College London, London, UK
| | - Alvina G Lai
- Institute of Health Informatics, University College London, London, UK.
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14
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Testis Cancer Care in North Carolina: Implications for Real-World Evidence and Cancer Surveillance. Clin Genitourin Cancer 2022; 20:307-318. [DOI: 10.1016/j.clgc.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 11/21/2022]
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15
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James C, Brunckhorst O, Eymech O, Stewart R, Dasgupta P, Ahmed K. Fear of cancer recurrence and PSA anxiety in patients with prostate cancer: a systematic review. Support Care Cancer 2022; 30:5577-5589. [PMID: 35106656 PMCID: PMC9135793 DOI: 10.1007/s00520-022-06876-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/27/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE The impact of prostate cancer on the mental wellbeing of patients is increasingly being appreciated. Two important aspects of this include fear of cancer recurrence (FCR) and prostate-specific antigen (PSA) anxiety. However, their prevalence, severity and associating factors remain poorly understood. Therefore, this review aims to evaluate the current evidence for the prevalence, severity and associating features of PSA anxiety and FCR. METHODS A systematic search of MEDLINE, EMBASE and PsycINFO databases was conducted by two independent reviewers. Observational studies measuring FCR and PSA anxiety in prostate cancer using validated measures were included. Outcome measures were prevalence of significant levels, mean scores and significant correlations of FCR and PSA anxiety scores with patient, disease, treatment or other mental health and quality of life outcomes. RESULTS One thousand one hundred forty-eight individual records underwent screening with 32 studies included. Median prevalence of significant FCR and PSA anxiety was 16% and 22% respectively across all studies. Longitudinal studies demonstrated severity of both symptoms peaks at diagnosis, with little variability, even several years following this. Evaluating associating factors revealed younger age, generalised quality of life and mental health symptoms to be important factors for both outcomes. Few studies evaluated associations and differences between other patient, disease and treatment characteristics. CONCLUSION FCR and PSA anxiety are prominent symptoms for prostate cancer patients and importantly when present, are associated with poorer quality of life and mental health symptoms. Screening for these constructs and referral to appropriate services should form part of routine follow-up care.
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Affiliation(s)
- Callum James
- MRC Centre for Transplantation, King's College London, King's Health Partners, Guy's Hospital Campus, 5th Floor Southwark Wing, London, SE1 9RT, UK
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, King's College London, King's Health Partners, Guy's Hospital Campus, 5th Floor Southwark Wing, London, SE1 9RT, UK.
| | - Omar Eymech
- MRC Centre for Transplantation, King's College London, King's Health Partners, Guy's Hospital Campus, 5th Floor Southwark Wing, London, SE1 9RT, UK
| | - Robert Stewart
- King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Prokar Dasgupta
- MRC Centre for Transplantation, King's College London, King's Health Partners, Guy's Hospital Campus, 5th Floor Southwark Wing, London, SE1 9RT, UK.,Urology Centre, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, UK
| | - Kamran Ahmed
- MRC Centre for Transplantation, King's College London, King's Health Partners, Guy's Hospital Campus, 5th Floor Southwark Wing, London, SE1 9RT, UK.,Department of Urology, King's College Hospital, London, UK
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16
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Deuning‐Smit E, Custers JAE, Miroševič Š, Takes RP, Jansen F, Langendijk JA, Terhaard CHJ, Baatenburg de Jong RJ, Leemans CR, Smit JH, Kwakkenbos L, Verdonck‐de Leeuw IM, Prins JB. Prospective longitudinal study on fear of cancer recurrence in patients newly diagnosed with head and neck cancer: Course, trajectories, and associated factors. Head Neck 2022; 44:914-925. [PMID: 35084079 PMCID: PMC9305148 DOI: 10.1002/hed.26985] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/06/2021] [Accepted: 01/12/2022] [Indexed: 01/08/2023] Open
Abstract
Background This study assessed the course of fear of cancer recurrence (FCR) in patients newly diagnosed with head and neck cancer (HNC), identified FCR trajectories and factors associated with FCR trajectories. Methods Six hundred and seventeen HNC patients from the NET‐QUBIC cohort study completed the Cancer Worry Scale‐6 at diagnosis, 3 and 6 months post‐treatment. FCR trajectories were identified using Latent Class Growth Analysis. Associations were explored between FCR trajectories and baseline demographic and medical variables, coping and self‐efficacy. Results Overall, FCR decreased slightly between baseline and 3 months post‐treatment and remained stable up to 6 months. Two FCR trajectories were identified: “high stable” (n = 125) and “low declining” (n = 492). Patients with high stable FCR were younger, reported more negative adjustment, passive coping, and reassuring thoughts, and less avoidance. Conclusions The majority of HNC patients have low declining FCR after diagnosis, but one in five patients experience persistent high FCR up to 6 months post‐treatment.
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Affiliation(s)
- Esther Deuning‐Smit
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
| | - José A. E. Custers
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
| | - Špela Miroševič
- Department of Family Medicine Faculty of Medicine, University of Ljubljana Ljubljana Slovenia
| | - Robert P. Takes
- Department of Otorhinolaryngology—Head and Neck Surgery Radboud University Medical Center Nijmegen The Netherlands
| | - Femke Jansen
- Department of Otolaryngology—Head and Neck Surgery Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Department of Clinical, Neuro and Development Psychology Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Johannes A. Langendijk
- Department of Radiation Oncology University Medical Center Groningen, University of Groningen Groningen The Netherlands
| | | | - Robert J. Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery Erasmus Cancer Institute, ErasmusMC Rotterdam The Netherlands
| | - C. René Leemans
- Department of Otolaryngology—Head and Neck Surgery Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Johannes H. Smit
- Department of Psychiatry Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Linda Kwakkenbos
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
- Clinical Psychology, Behavioural Science Institute Radboud University Nijmegen The Netherlands
| | - Irma M. Verdonck‐de Leeuw
- Department of Otolaryngology—Head and Neck Surgery Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Department of Clinical, Neuro and Development Psychology Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Judith B. Prins
- Department of Medical Psychology Radboud Institute for Health Sciences, Radboud University Medical Center Nijmegen The Netherlands
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17
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Abstract
BACKGROUND Fear of cancer recurrence (FCR) is one of the most common and aversive psychological phenomena among cancer survivors. Understanding the independent and potentially modifiable risk factors that contribute toward FCR seen in cancer survivors would inform future interventional trials aimed at reducing this risk. OBJECTIVE The aim of this study was to provide an evidence synthesis of factors correlated with FCR to inform the development of preventive interventions. METHODS A literature search was performed of the PsycINFO, EMBASE, and MEDLINE (PubMed) databases. Reports published from inception to 2020 focusing on the correlates of FCR with physical, psychological, and social factors were identified. Authors assessed the studies' risk of bias in accordance with the Standard Quality Assessment Criteria for Quantitative Studies (QualSyst criteria) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. After extracting data and assessing the quality of the included studies, meta-analysis was conducted using RevMan 5.3 software. RESULTS Thirty-four articles were included in this study with a total sample of more than 13 000 cancer patients. Fear of cancer recurrence was positively correlated with anxiety, depression, avoidance, chemotherapy, distress, intrusive thoughts, fatigue, rumination, and neuroticism. It was negatively correlated with optimism, age, social support, quality of life, time since diagnosis, well-being, and self-efficacy. CONCLUSIONS We identified 16 factors that are correlated with FCR, 9 positively correlated with FCR and 7 negatively correlated with FCR. IMPLICATIONS FOR PRACTICE The findings of this study provide direction for the development of precise interventions for FCR in cancer survivors and lay the foundation for the further construction of an FCR-related nursing theoretical framework.
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18
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Meissner VH, Olze L, Schiele S, Ankerst DP, Jahnen M, Gschwend JE, Herkommer K, Dinkel A. Fear of cancer recurrence and disease progression in long-term prostate cancer survivors after radical prostatectomy: A longitudinal study. Cancer 2021; 127:4287-4295. [PMID: 34358337 DOI: 10.1002/cncr.33836] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 04/08/2021] [Accepted: 05/03/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although fear of cancer recurrence (FCR) or disease progression is among the most endorsed unmet needs and concerns of cancer survivors, research on the course of FCR in long-term survivors is scarce. The objective of this study was to assess longitudinally the prevalence and predictors of FCR in long-term prostate cancer (PCa) survivors. METHODS In all, 2417 survivors from the multicenter German Familial Prostate Cancer Database completed the Fear of Progression Questionnaire-Short Form on average 7 years (T1 in 2010) after radical prostatectomy and at follow-up 9 years later (T2 in 2019). Hierarchical multivariable logistic regression was used to assess predictors of FCR at follow-up. RESULTS The mean age at the initial assessment was 69.5 years (standard deviation, 5.9 years); 6.5% and 8.4% of patients reported clinical FCR at the initial assessment (T1) and at the follow-up (T2), respectively. In a multivariable analysis controlling for concurrent associations, longitudinal predictors of FCR 9 years later included a lower level of education (odds ratio [OR], 4.35; 95% confidence interval [CI], 2.33-8.33), years since radical prostatectomy (OR, 1.10; 95% CI, 1.03-1.18), biochemical recurrence (OR, 1.67; 95% CI, 1.02-2.72), no current adjuvant therapy (OR, 2.38; 95% CI, 1.19-4.76), FCR (OR, 10.75; 95% CI, 6.18-18.72), and anxiety (OR, 1.35; 95% CI, 1.06-1.72). CONCLUSIONS FCR remains a burden to certain PCa survivors even many years after their diagnosis and treatment. Health care professionals should monitor for FCR and identify patients at risk to provide appropriate psychosocial care because FCR is leading to limitations in quality of life and psychological well-being.
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Affiliation(s)
- Valentin H Meissner
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Lisa Olze
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Stefan Schiele
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Donna P Ankerst
- Departments of Mathematics and Life Science Systems, Technical University of Munich, Garching, Germany
| | - Matthias Jahnen
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jürgen E Gschwend
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Kathleen Herkommer
- Department of Urology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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19
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Bisseling EM, Compen FR, Schellekens MPJ, Thewes B, Speckens AEM, van der Lee ML. Exploring Fear of Cancer Recurrence in a Sample of Heterogeneous Distressed Cancer Patients with and Without a Psychiatric Disorder. J Clin Psychol Med Settings 2021; 28:419-426. [PMID: 34138447 PMCID: PMC8458175 DOI: 10.1007/s10880-021-09776-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 11/29/2022]
Abstract
Fear of Cancer Recurrence (FCR) is a concern among cancer patients. Recent insights suggest that FCR should be viewed as a distinct syndrome. However, few studies have explored its overlap with psychiatric morbidity. We examined this overlap in a sample of distressed cancer patients. Self-referred patients (n = 245) were assessed with the Structured Clinical Interview for DSM-IV-TR Axis-I disorders and the Fear of Cancer Recurrence Inventory-Short Form. Proportions of patients with and without a psychiatric disorder meeting validated cut-offs for screening and clinically relevant FCR were compared. The prevalence of psychiatric disorders was 36%. Clinically relevant FCR was found in 198 patients (81%). Patients with a current psychiatric disorder reported clinically relevant FCR more frequently (89%) compared to those with no disorder (77%). Of patients reporting clinically relevant FCR, the majority (61%) did not additionally meet the criteria for a psychiatric disorder. These findings suggest that there should be particular attention for patients with elevated levels of FCR, warranting FCR-specific treatment. Trial registry number Clinicaltrials.gov NCT02138513
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Affiliation(s)
- Else M Bisseling
- Department of Psychiatry, Radboud University Medical Centre, 6525, EX, Nijmegen, The Netherlands. .,Department of Psychiatry, Radboud University Medical Centre for Mindfulness, Reinier Postlaan, Postbus 9101, 6500, HB, Nijmegen, The Netherlands. .,Centre for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, 3723, MB, Bilthoven, The Netherlands.
| | - Félix R Compen
- Department of Psychiatry, Radboud University Medical Centre, 6525, EX, Nijmegen, The Netherlands.,Department of Psychiatry, Radboud University Medical Centre for Mindfulness, Reinier Postlaan, Postbus 9101, 6500, HB, Nijmegen, The Netherlands
| | - Melanie P J Schellekens
- Department of Psychiatry, Radboud University Medical Centre, 6525, EX, Nijmegen, The Netherlands.,Department of Psychiatry, Radboud University Medical Centre for Mindfulness, Reinier Postlaan, Postbus 9101, 6500, HB, Nijmegen, The Netherlands.,Centre for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, 3723, MB, Bilthoven, The Netherlands
| | - Belinda Thewes
- School of Psychology, University of Sydney, Sydney, NSW, 2006, Australia
| | - Anne E M Speckens
- Department of Psychiatry, Radboud University Medical Centre, 6525, EX, Nijmegen, The Netherlands.,Department of Psychiatry, Radboud University Medical Centre for Mindfulness, Reinier Postlaan, Postbus 9101, 6500, HB, Nijmegen, The Netherlands
| | - Marije L van der Lee
- Centre for Psycho-Oncology, Scientific Research Department, Helen Dowling Institute, 3723, MB, Bilthoven, The Netherlands.,Department of Medical and Clinical Psychology, School of Social and Behavioral Sciences, Tilburg University, Warandelaan 2, 5037, AB Tilburg, The Netherlands
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20
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Ellis S, Brown RF, Thorsteinsson EB, Pakenham KI, Perrott C. Quality of life and fear of cancer recurrence in patients and survivors of non-Hodgkin lymphoma. PSYCHOL HEALTH MED 2021; 27:1649-1660. [PMID: 33928815 DOI: 10.1080/13548506.2021.1913756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Non-Hodgkin lymphoma (NHL) is a common haematological cancer that is comprised of approximately 30 subtypes, of which Waldenström Macroglobulinemia (WM) is a rare incurable form. It is typically managed using a watch-and-wait strategy that can contribute to illness uncertainty which may result in fear of cancer recurrence (FCR) and poor health-related quality of life (QOL). However, few studies have examined the correlates of FCR and QOL in NHL patients, including WM patients. One-hundred males and 92 females with a mean age of 62.7 years who were an average of 6.8 years from diagnosis completed the online questionnaire which asked about demographics, medical history, QOL, FCR, stress, anxiety and depression. Few NHL patients reported significant stress or affective distress, most had moderate-high QOL and 41% experienced recent FCR, relative to published cut-off scores. Poorer QOL was related to depression symptoms, FCR, higher illness burden (i.e. comorbidity) and fewer personal resources (i.e. unemployed), whereas FCR was related to shorter time since diagnosis and more depressive symptoms. Results suggest that FCR and depressive symptoms may adversely impact QOL, whereas a recent cancer diagnosis and depression-related pessimism may contribute to FCR.
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Affiliation(s)
- Susan Ellis
- University of Queensland, Brisbane, Australia
| | - Rhonda F Brown
- Research School of Psychology, The Australian National University, Canberra, Australia
| | | | | | - Colin Perrott
- School of Psychology, University of New England, Armidale, Australia
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21
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Petrella AR, Sabiston CM, Vani MF, Matthew A, Santa Mina D. Psychological Needs Satisfaction, Self-Rated Health and the Mediating Role of Exercise Among Testicular Cancer Survivors. Am J Mens Health 2021; 15:15579883211012601. [PMID: 33926293 PMCID: PMC8114270 DOI: 10.1177/15579883211012601] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Exploring tenets of basic psychological needs theory, the objective of this study was to examine the association between psychological needs satisfaction, exercise behavior, and physical and mental health among testicular cancer survivors. The present study investigated whether psychological needs satisfaction was directly associated with increased self-rated health, and if this relationship was mediated by engagement in exercise. Testicular cancer survivors (N = 135; Mage = 32.45; SD = 7.63) self-reported current psychological needs satisfaction, exercise behavior, and perceived global physical and mental health during routine oncology visits. Associations were examined using path analysis. Psychological needs satisfaction was a positive correlate of both self-rated physical and mental health in this sample, and exercise mediated the association between needs satisfaction and self-rated physical health. This study supports the assumptions underpinning basic psychological needs theory in this unique clinical population. Based on the findings, exercise engagement represents one mechanism associated with perceived health after cancer. Supportive care interventions should aim to enhance satisfaction of psychological needs and investigate exercise as a mechanism underpinning the relationship between needs satisfaction and perceived health in testicular cancer survivors.
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Affiliation(s)
- Anika R Petrella
- Department of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Catherine M Sabiston
- Department of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Madison F Vani
- Department of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Andrew Matthew
- Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Daniel Santa Mina
- Department of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
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22
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Examining Predictors of Fear of Cancer Recurrence Using Leventhal's Commonsense Model: Distinct Implications for Oncology Nurses. Cancer Nurs 2021; 44:3-12. [PMID: 31868820 DOI: 10.1097/ncc.0000000000000760] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is a common concern for survivors. Oncology nurses have a unique opportunity to identify survivors at increased risk of heightened FCR. Understanding predictors of FCR would be useful for this purpose; however, results about FCR predictors are inconsistent. OBJECTIVE To examine empirically inconsistent predictors of FCR as guided by Leventhal's Commonsense Model. METHODS A cross-sectional survey design was used to assess FCR, sociodemographic and clinical characteristics, and characteristics of the self (self-esteem and generalized expectancies) among cancer survivors. Structural equation modeling was used to examine predictors of FCR. RESULTS Among 1001 participants, the mean time since diagnosis was 9.07 years, and most were diagnosed with breast cancer (65.93%). The strongest predictor of higher FCR was belief that knowing someone with a recurrence affects one's own level of FCR, although knowing someone with a recurrence actually predicted lower FCR. Other significant predictors of higher FCR were having 1 or more symptoms attributed to cancer, lower self-esteem, younger age, female gender, lower pessimism, longer time since diagnosis, and active follow-up at the survivorship clinic. CONCLUSION Cancer survivors' perceptions are among an important series of variables that may predict higher levels of FCR. Oncology nurses are uniquely situated to identify the subset of cancer survivors with levels of FCR requiring professional intervention. IMPLICATIONS FOR PRACTICE Oncology nurses can use the predictors indicated in this study to identify survivors with greatest need for coping with FCR to facilitate expedient intervention and/or referral to psychosocial providers.
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23
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Chovanec M, Lauritsen J, Bandak M, Oing C, Kier GG, Kreiberg M, Rosenvilde J, Wagner T, Bokemeyer C, Daugaard G. Late adverse effects and quality of life in survivors of testicular germ cell tumour. Nat Rev Urol 2021; 18:227-245. [PMID: 33686290 DOI: 10.1038/s41585-021-00440-w] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2021] [Indexed: 02/06/2023]
Abstract
Currently, ~95% of patients with testicular germ cell tumour (TGCT) are cured, resulting in an increasing number of TGCT survivors. Although cured, these men face potential late adverse effects and reduced quality of life. Survivors face a twofold increased risk of second malignant neoplasms after chemotherapy and radiotherapy, with evidence of dose-dependent associations. For survivors managed with surveillance or treated with radiotherapy, the risk of cardiovascular disease (CVD) is comparable to the risk in the general population, whereas treatment with chemotherapy increases the risk of life-threatening CVD, especially during treatment and after 10 years of follow-up. Other adverse effects are organ-related toxicities such as neuropathy and ototoxicity. Pulmonary and renal impairment in patients with TGCT treated with chemotherapy is limited. Survivors of TGCT might experience psychosocial distress including anxiety disorders, fear of cancer recurrence and TGCT-specific issues, such as sexual dysfunction. Late adverse effects can be avoided in most patients with stage I disease if followed on a surveillance programme. However, patients with disseminated disease can experience toxicities associated with radiotherapy and chemotherapy, and/or adverse effects related to surgery for residual disease. The severity of adverse effects increases with dose of both chemotherapy and radiotherapy. This Review discusses the most recent data concerning the late adverse effects of today's standard treatments for TGCT.
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Affiliation(s)
- Michal Chovanec
- 2nd Department of Oncology, Comenius University, National Cancer Institute, Bratislava, Slovakia
| | - Jakob Lauritsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mikkel Bandak
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Christoph Oing
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gry Gundgaard Kier
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Michael Kreiberg
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Josephine Rosenvilde
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Wagner
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Carsten Bokemeyer
- Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gedske Daugaard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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24
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D'souza A, Van Veldhuizen P, Fung C. Surviving Testicular Cancer: The Role of the Contralateral Testicle. J Clin Oncol 2021; 39:265-268. [PMID: 33503392 DOI: 10.1200/jco.20.03333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Anishka D'souza
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Peter Van Veldhuizen
- Division of Hematology, Oncology Department of Medicine, University of Rochester School of Medicine and Dentistry, James P. Wilmot Cancer Institute, Rochester, NY
| | - Chunkit Fung
- Division of Hematology, Oncology Department of Medicine, University of Rochester School of Medicine and Dentistry, James P. Wilmot Cancer Institute, Rochester, NY
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Mercês CAMF, Souto JDSS, Souza PAD, Chagas MC, Weiss C, Benevides AB, Brandão MAG. Análise simultânea dos conceitos de ansiedade e medo: contribuições para os diagnósticos de enfermagem. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivos Realizar a análise simultânea dos conceitos de ansiedade e medo. Método Análise simultânea de conceitos com base nas nove etapas propostas por Haase, Leidy, Coward, Britt e Penn. Resultados 43 artigos foram incluídos a partir de uma busca em cinco bases de dados. 51 atributos, 26 antecedentes e 10 consequentes foram identificados a partir da análise destes conceitos. Esta análise revelou que a ansiedade e o medo são conceitos subjetivos, multidimensionais e com altos graus de abstração. Conclusão A análise simultânea da ansiedade e do medo possibilitou o refinamento destes diagnósticos e a proposição de modificações em seus componentes. Implicações para a prática A análise destes conceitos possibilitará a identificação precisa destes fenômenos na prática clínica, proporcionando maior acurácia diagnóstica.
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Zhu Z, Zhang D, Wang JHY, Qiao Y, Liu Y, Braithwaite D. Is education or income associated with insufficient fruit and vegetable intake among cancer survivors? A cross-sectional analysis of 2017 BRFSS data. BMJ Open 2020; 10:e041285. [PMID: 33262193 PMCID: PMC7709504 DOI: 10.1136/bmjopen-2020-041285] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Previous studies found that low education or income level was associated with insufficient fruit and vegetable consumption (IFVC) among the general population. However, cancer survivors can be heterogeneous from the general population in many aspects. Our objective was to disentangle their association among cancer survivors. DESIGN Nationwide cross-sectional survey in the USA. SETTING 2017 Behaviour Risk Factor Surveillance System. PARTICIPANTS 5409 cancer survivors. EXPOSURE AND OUTCOME Educational level (graduated from college/technical school, attended college/technical school and high school or less) and annual household income (≥US$75 000, US$35 000 to <US$75 000 and <US$35 000) were exposures of interest. IFVC, which was defined as <5 servings/day according to the American Cancer Society recommendation, was treated as the outcome. DATA ANALYSIS Multivariable logistic regression corrected for sampling weight was performed to estimate the association. Subgroup analyses and interaction tests were performed by age, gender, obesity and physical activity. RESULTS Overall, 4750 survivors (weighted percentage: 88.5%) had IFVC. Participants with lower education had a significantly higher rate of IFVC (high school or less vs college graduates: adjusted OR=2.17, 95% CI 1.45 to 3.25, p trend <0.01). The association between income and IFVC was almost null. Associations did not differ in most subgroups; however, the association of lower education appeared to be more substantial among physically inactive survivors (p interaction <0.01). CONCLUSION Low educational background, not low income, was associated with IFVC among cancer survivors. Prospective cohort studies are needed to verify the conclusion.
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Affiliation(s)
- Zhikai Zhu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Oncology, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Dongyu Zhang
- Department of Oncology, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Judy Huei-Yu Wang
- Department of Oncology, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Youlin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dejana Braithwaite
- University of Florida Health Cancer Center, Gainesville, Florida, USA
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
- Department of Aging and Geriatric Research, College of Medicine, University of Florida, Gainesville, Florida, USA
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27
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Custers JA, Kwakkenbos L, van der Graaf WT, Prins JB, Gielissen MF, Thewes B. Not as Stable as We Think: A Descriptive Study of 12 Monthly Assessments of Fear of Cancer Recurrence Among Curatively-Treated Breast Cancer Survivors 0-5 Years After Surgery. Front Psychol 2020; 11:580979. [PMID: 33224072 PMCID: PMC7667242 DOI: 10.3389/fpsyg.2020.580979] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 09/24/2020] [Indexed: 01/08/2023] Open
Abstract
Purpose: Previous studies suggest one-third of breast cancer survivors (BCS) experience elevated fear of cancer recurrence (FCR) and that it remains stable. Most studies include long assessment intervals and aggregated group data. This study aimed to describe the individual trajectories of FCR when assessed monthly using both a statistical and descriptive approach. Methods: Participants were curatively-treated BCS 0-5 years post-surgery. Questionnaire data were collected monthly for 12 months. Primary outcome was FCR [Cancer Worry Scale (CWS)]. For the descriptive approach, 218 participants were classified as low (CWS ≤ 13 at each assessment), high (CWS ≥ 14 at each assessment), or fluctuating FCR (CWS scores above and below cut-off). Latent class growth analysis (LCGA; n = 377) was conducted to identify trajectories over time. Results: Around 58% of the women reported fluctuating CWS scores, 22% reported a consistently high and 21% consistently low course. Results of the LCGA confirmed the three-class approach including a stable high FCR group (13%), a low FCR group (40%), and a moderate FCR group (47%). Both the moderate and low scoring groups reported declining scores over time. Younger patients, higher educated patients, and those less satisfied with the medical treatment were more likely to belong to the moderate or high trajectory. Conclusion: Assessed monthly, the majority of BCS report fluctuating levels of FCR. Stepped-care models should assess FCR on multiple occasions before offering tailored interventions.
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Affiliation(s)
- José Ae Custers
- Radboud Institute for Health Sciences, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Linda Kwakkenbos
- Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, Netherlands
| | - Winette Ta van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, Netherlands.,Radboud Institute for Health Sciences, Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Judith B Prins
- Radboud Institute for Health Sciences, Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marieke Fm Gielissen
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands.,Siza (disability service) Arnhem, Arnhem, Netherlands
| | - Belinda Thewes
- Psycho-Oncology Co-operative Research Group, The University of Sydney, Sydney, NSW, Australia
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Chandran EA, Chindewere A, North R, Jameson MB. Two cycles of adjuvant carboplatin for clinical stage 1 testicular seminoma in New Zealand centres: A retrospective analysis of efficacy and long-term events. Cancer Rep (Hoboken) 2020; 4:e1310. [PMID: 33103860 PMCID: PMC8451369 DOI: 10.1002/cnr2.1310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/16/2020] [Accepted: 10/05/2020] [Indexed: 01/31/2023] Open
Abstract
Background Adjuvant carboplatin reduces relapse risk in clinical stage 1 (CS1) seminoma, though there is a paucity of long‐term safety data. Aim Our objective was to report long‐term outcomes of two cycles of adjuvant carboplatin dosed at area under the time–concentration curve (AUC) of 7. Methods and results We performed a retrospective analysis on treatment and outcomes of patients with CS1 seminoma who received adjuvant carboplatin from 2000 to 2016 at our centres in the Midland Region, New Zealand. Of 159 patients, median age 39 years, 153 received two cycles of carboplatin: 147 dosed at AUC7 and 6 at AUC6. Six patients had one cycle of carboplatin AUC7. One patient relapsed at 22 months and died of bleomycin pneumonitis 2 months after achieving a complete response with BEP chemotherapy. Neither RTI (present in 21.3%) nor tumor size >4 cm (in 43.3%) was predictive of relapse. Median follow‐up was 106 months. At 15 years, outcomes were: relapse‐free survival 99.4%, overall survival 91.4%, disease‐specific survival 100%, subsequent malignant neoplasm rate 7.6%, and second testicular germ cell tumor rate 3.85%. One patient had persistent grade 1 thrombocytopenia at 46 months. Conclusions These data add to the body of evidence that two cycles of carboplatin AUC7 is safe and effective adjuvant treatment for CS1 seminoma.
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Affiliation(s)
| | | | - Richard North
- Department of Oncology, Tauranga Hospital, Tauranga, New Zealand
| | - Michael B Jameson
- Department of Oncology, Waikato Hospital, Hamilton, New Zealand.,Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
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29
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Brice L, McErlean G, Donovan C, Tapp C, Gilroy N, Kabir M, Greenwood M, Larsen SR, Moore J, Gottlieb D, Hertzberg M, Brown L, Hogg M, Huang G, Tan J, Ward C, Kerridge I. Fear of cancer recurrence following allogeneic haematopoietic stem cell transplantation (HSCT) for haematological malignancy: A cross-sectional study. Eur J Oncol Nurs 2020; 49:101845. [PMID: 33128994 DOI: 10.1016/j.ejon.2020.101845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/29/2020] [Accepted: 09/30/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE The aim of this study was to quantify the prevalence of Fear of Cancer Recurrence (FCR) in patients with a prior haematology malignancy surviving more than one year post allogeneic haematopoietic stem cell transplantation (HSCT), and to identify the demographic, medical and psychological factors associated with FCR occurrence. METHOD Participants were adult allogeneic HSCT recipients who had undergone the procedure for acute leukaemia or other haematological malignancy between the years 2000-2012 in Sydney, Australia. They completed a purpose designed survey and six other validated instruments which assessed FCR, psychological functioning, quality of life, demographic, social and clinical variables. RESULTS Of the 364 respondents, approximately 11% of the sample lived with severe FCR while only 5% of subjects reported having no FCR. Variables significantly associated with higher FCR included unemployment, a shorter time (years) post-transplant, not attending to health screening (PAP smear), a secondary diagnosis of skin cancer, younger age, referral to a psychiatrist and taking psychotropic medication. Higher psychological distress (depression, anxiety, stress) and lower quality of life made a significant contribution to the prediction of FCR. CONCLUSIONS Post HSCT follow-up care should include an assessment and discussion regarding FCR to balance both realistic and unrealistic cancer recurrence risks. Managing FCR is one of the most ubiquitous unmet needs of survivors of haematological disease and it is important that HSCT nurses are both aware of the fear, and are equipped with knowledge on how to help patients navigate it with realistic expectations.
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Affiliation(s)
- Lisa Brice
- Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Gemma McErlean
- Blood and Marrow Transplant Network, New South Wales Agency for Clinical Innovation, Sydney, NSW, Australia; Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia; Graduate School of Health, University of Technology, Sydney, NSW, Australia.
| | - Caroline Donovan
- School of Applied Psychology, Griffith University, QLD, Australia
| | - Caley Tapp
- School of Applied Psychology, Griffith University, QLD, Australia
| | - Nicole Gilroy
- Blood and Marrow Transplant Network, New South Wales Agency for Clinical Innovation, Sydney, NSW, Australia
| | - Masura Kabir
- Westmead Breast Cancer Institute, Sydney, NSW, Australia
| | - Matt Greenwood
- Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia; Northern Blood Research Centre, Kolling Institute, University of Sydney, NSW, Australia
| | - Stephen R Larsen
- Institute of Haematology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - John Moore
- Department of Haematology, St Vincents Hospital, Sydney, NSW, Australia
| | - David Gottlieb
- Department of Haematology, Westmead Hospital, Sydney, NSW, Australia
| | - Mark Hertzberg
- Department of Haematology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Louisa Brown
- Calvary Mater Hospital, Newcastle, NSW, Australia
| | - Megan Hogg
- Department of Haematology, Westmead Hospital, Sydney, NSW, Australia
| | - Gillian Huang
- Department of Haematology, Westmead Hospital, Sydney, NSW, Australia
| | - Jeff Tan
- Department of Haematology, St Vincents Hospital, Sydney, NSW, Australia
| | - Christopher Ward
- Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia; Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia; Westmead Breast Cancer Institute, Sydney, NSW, Australia
| | - Ian Kerridge
- Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia; Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia; Westmead Breast Cancer Institute, Sydney, NSW, Australia
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30
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Vandraas KF, Reinertsen KV, Kiserud CE, Lie HC. Fear of cancer recurrence among young adult cancer survivors-exploring long-term contributing factors in a large, population-based cohort. J Cancer Surviv 2020; 15:497-508. [PMID: 32989672 PMCID: PMC8272704 DOI: 10.1007/s11764-020-00943-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/18/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Fear of cancer recurrence (FCR) may be debilitating, yet knowledge of FCR among the growing population of long-term young adult cancer survivors (YACS) is scarce. We explored risk of FCR and associated factors in a nation-wide, population-based cohort of YACS. METHODS All 5-year survivors diagnosed at the ages of 19-39 years with breast cancer (BC), malignant melanoma (MM), colorectal cancer (CRC), leukemia (LEU), or non-Hodgkin lymphoma (NHL) between 1985 and 2009 in Norway were identified by the Cancer Registry of Norway and completed the cross-sectional comprehensive NOR-CAYACS health survey. Univariate and multivariate linear regression modeling was performed. RESULTS In total, 936 survivors were included, with an average of 16 years since diagnoses. BC was the most prevalent cancer form (38.4%), followed by MM (24.7%), NHL (15.6%), CRC (11.8%), and LEU (9.6%). Survivors worried most about getting another cancer (74%), and (20%) reported quite a bit or a lot of FCR. BC and MM survivors had the highest FCR scores. Post-traumatic stress symptoms (PTSS) had the strongest association with FCR (Std B 0.21, p < 0.01), above demographic and clinical variables. CONCLUSIONS FCR is prevalent even among long-term YACS, including survivors of MM with favorable prognoses. IMPLICATIONS FOR CANCER SURVIVORS Attention to ongoing risks of PTSS and FCR in this growing survivor population is warranted to optimize future survivorship care.
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Affiliation(s)
- Kathrine F Vandraas
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
| | - Kristin V Reinertsen
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - Hanne C Lie
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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31
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Alkan A, Yaşar A, Güç ZG, Gürbüz M, Başoğlu T, Sezgin Göksu S, Buğdaycı Başal F, Türk HM, Özdemir Ö, Yeşil Çınkır H, Güven DC, Kuş T, Türker S, Koral L, Karakaş Y, Ak N, Paydaş S, Karcı E, Demiray AG, Demir A, Alan Ö, Keskin Ö, Nayır E, Tanrıverdi Ö, Yavuzşen T, Yumuk PF, Ateş Ö, Coşkun HŞ, Turhal S, Çay Şenler F. Worse patient-physician relationship is associated with more fear of cancer recurrence (Deimos Study): A study of the Palliative Care Working Committee of the Turkish Oncology Group (TOG). Eur J Cancer Care (Engl) 2020; 29:e13296. [PMID: 32864838 DOI: 10.1111/ecc.13296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/16/2020] [Accepted: 08/07/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Fear of cancer recurrence (FCR) is an important psychological trauma associated with reduction in the quality of life, disruptions in the level of adjustment, emotional distress and anxiety. The purpose of the study was to evaluate the impact of patient-physician relationship on FCR. METHODS The study was designed as a multicentre survey study. The cancer survivors, who were under remission, were evaluated with structured questionnaires. Patient-physician relationship (PPR) scale in which higher scores indicate better relationship and FCR inventory was used. RESULTS Between January and April 2019, 1,580 patients were evaluated. The median age was 57.0 (19-88), and 66% were female. There was high level of FCR scores in 51% of participants. There was a negative correlation between PPR and FCR scores (r = -.134, p < .001). In multivariate analysis, young age, female gender, history of metastasectomy and worse PPR were associated with high levels of FCR. CONCLUSION It is the first data showing the adverse impact of worse PPR on FCR. The strategies to improve the PPR should be practised. In addition, the cancer survivors, who are under the risk of FCR, should be evaluated and managed.
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Affiliation(s)
- Ali Alkan
- Medical Oncology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Arzu Yaşar
- Medical Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Zeynep Gülsüm Güç
- Medical Oncology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Mustafa Gürbüz
- Medical Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Tuğba Başoğlu
- Medical Oncology, Marmara University School of Medicine, İstanbul, Turkey
| | - Sema Sezgin Göksu
- Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Fatma Buğdaycı Başal
- Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, Ankara, Turkey
| | - Hacı Mehmet Türk
- Medical Oncology, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey
| | - Özlem Özdemir
- Medical Oncology, İzmir Bozyaka Research and Training Hospital, İzmir, Turkey
| | - Havva Yeşil Çınkır
- Medical Oncology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Deniz Can Güven
- Medical Oncology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Tülay Kuş
- Medical Oncology, Dr Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Sema Türker
- Medical Oncology, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Lokman Koral
- Medical Oncology, Çanakkale Onsekiz Mart University School of Medicine, Çanakkale, Turkey
| | - Yusuf Karakaş
- Medical Oncology, Bodrum Acıbadem Hospital, Muğla, Turkey
| | - Naziye Ak
- Department of Medical Oncology, Institute of Oncology, Istanbul University, İstanbul, Turkey
| | - Semra Paydaş
- Medical Oncology, Çukurova University School of Medicine, Adana, Turkey
| | - Ebru Karcı
- Medical Oncology, Bağcılar Research and Training Hospital, İstanbul, Turkey
| | | | - Atakan Demir
- Medical Oncology, Acıbadem Maslak Hospital, İstanbul, Turkey
| | - Özkan Alan
- Medical Oncology, Tekirdağ Public Hospital, Tekirdağ, Turkey
| | - Özge Keskin
- Medical Oncology, Selçuk University School of Medicine, Konya, Turkey
| | - Erdinç Nayır
- Medical Oncology, VM Medical Park Mersin Hospital, Mersin, Turkey
| | - Özgür Tanrıverdi
- Medical Oncology, Muğla Sıtkı Koçman University School of Medicine, Muğla, Turkey
| | - Tuğba Yavuzşen
- Medical Oncology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | | | - Öztürk Ateş
- Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Research and Training Hospital, Ankara, Turkey
| | - Hasan Şenol Coşkun
- Medical Oncology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Serdar Turhal
- Medical Oncology, Anadolu Medical Center, Kocaeli, Turkey
| | - Filiz Çay Şenler
- Medical Oncology, Ankara University School of Medicine, Ankara, Turkey
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Reed SC, Bell JF, Miglioretti DL, Nekhlyudov L, Fairman N, Joseph JG. Relationships Between Fear of Cancer Recurrence and Lifestyle Factors Among Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:669-677. [PMID: 30879181 DOI: 10.1007/s13187-019-01509-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We examine the relationships between fear of cancer recurrence (FCR), physical activity, smoking status, and engagement in healthier habits in a US population-based sample of post-treatment cancer survivors. We used data from the 2011 Medical Expenditure Panel Survey (MEPS) Experience with Cancer Survivorship Supplement. Multivariable logistic regression was used to test the relationship of FCR to physical activity, smoking status, and engagement in healthier habits. In all analyses, MEPS survey weights were applied to account for the survey design. Compared with those reporting no FCR, survivors reporting high FCR had significantly lower odds of reporting that they were not currently smokers (odds ratio [OR] = 0.46; 95% CI 0.24, 0.91) and those with any level of FCR had significantly higher odds of reporting healthier habits since diagnosis relative to those with no FCR (low FCR OR = 1.97; 95% CI 1.36, 2.85; high FCR OR = 2.40; 95% CI 1.33, 4.32). FCR was not associated with the odds of reporting physical activity. Findings from this large population-based survey suggest that some of survivors' lifestyle factors may be related to their level of FCR. Understanding the effects of FCR on lifestyle factors may help survivors, survivorship care providers, and policy makers better understand important differences among cancer survivors and personalize interventions in clinical care.
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Affiliation(s)
- Sarah C Reed
- Betty Irene Moore School of Nursing, University of California, Davis, Betty Irene Moore Hall, 2570 48th Street, Sacramento, CA, 95817, USA.
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California, Davis, Betty Irene Moore Hall, 2570 48th Street, Sacramento, CA, 95817, USA
| | - Diana L Miglioretti
- Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of California, Davis, Medical Science 1C, Suite 145, Davis, CA, 95616, USA
| | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, 800 Huntington Avenue, Boston, MA, 02115, USA
| | - Nathan Fairman
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, Davis, 2230 Stockton Blvd., Sacramento, CA, 95817, USA
- Comprehensive Cancer Center, University of California, Davis, 2279 45th Street, Sacramento, CA, 95817, USA
| | - Jill G Joseph
- Betty Irene Moore School of Nursing, University of California, Davis, Betty Irene Moore Hall, 2570 48th Street, Sacramento, CA, 95817, USA
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Luo X, Li W, Yang Y, Humphris G, Zeng L, Zhang Z, Garg S, Zhang B, Sun H. High Fear of Cancer Recurrence in Chinese Newly Diagnosed Cancer Patients. Front Psychol 2020; 11:1287. [PMID: 32581984 PMCID: PMC7296085 DOI: 10.3389/fpsyg.2020.01287] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/15/2020] [Indexed: 01/07/2023] Open
Abstract
Background Fear of cancer recurrence (FCR) is common among cancer patients and of high clinical relevance. This study explores the prevalence and correlates of FCR in Chinese newly diagnosed cancer population. Methods This is a multicentre, cross-sectional study that includes 996 patients with mixed cancer diagnosis. All recently diagnosed patients completed a questionnaire consisting of the following: Fear of Progression Questionnaire-Short Form (FoP-Q-SF), General Anxiety Disorder Questionnaire (GAD-7), and Patient Health Questionnaire (PHQ-9). Univariate analyses, multivariate logistic regression analyses, and structural equation modeling (SEM) was performed to examine the association between tested variables and FCR. Results Of the 996 patients, 643 (64.6%) reported high FCR (scored ≥ 34 in the FoP-Q-SF). Chemotherapy (OR = 1.941), Childhood severe illness experience (OR = 2.802), depressive (OR = 1.153), and anxiety (OR = 1.249) symptoms were positively associated with high FCR, while higher monthly income (OR = 0.592) was negatively associated with high FCR. SEM indicated that emotional disturbances (anxiety and depression) directly influenced FCR, while emotional disturbances partly mediated the association between personal monthly income and FCR. Conclusion High FCR is a frequently reported problem among newly diagnosed cancer patients. Various factors increased the likelihood of the development of FCR. Flexible psychological interventions are needed for patients with high FCR.
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Affiliation(s)
- Xian Luo
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Wengao Li
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Yuan Yang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Gerald Humphris
- School of Medicine, University of St Andrews, St Andrews, United Kingdom.,Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom
| | - Lijuan Zeng
- Department of Organ Transplantation, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zijun Zhang
- CNSST Foundation New Zealand, Panmure, Auckland, New Zealand
| | - Samradhvi Garg
- School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Bin Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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Nasioudis D, Ko EM, Haggerty AF, Cory L, Giuntoli RL, Burger RA, Morgan MA, Latif NA. Performance of lymphadenectomy for apparent early stage malignant ovarian germ cell tumors in the era of platinum-based chemotherapy. Gynecol Oncol 2020; 157:613-618. [PMID: 32359845 DOI: 10.1016/j.ygyno.2020.04.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 04/03/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To investigate the patterns of use and impact of lymphadenectomy (LND) on overall survival (OS) of patients with apparent early stage malignant ovarian germ cell tumors (MOGCTs). METHODS Patients with apparent stage I MOGCT diagnosed between 2004 and 2015 were drawn from the National Cancer Database. The performance of LND was assessed from the pathology report. OS was evaluated using Kaplan-Meier curves, and compared with the log-rank test. A multivariate Cox analysis was performed to control for confounders. RESULTS A total of 2774 patients were identified; 1426 (51.4%) underwent LND. The median number of lymph nodes (LN) removed was 9 (range 1-81); 48.3% of patients had at least 10 lymph nodes removed. The rate of regional lymph node metastasis was 10.3% (147 patients). There was no difference in OS, between patients who did (n = 1287) and did not (n = 1210) undergo LND, p = 0.81; 5-yr OS rates were 96.5% and 97.6% respectively. After controlling for patient age, insurance status, histology, presence of medical comorbidities, and receipt of chemotherapy, the performance of LND was not associated with better survival (HR: 1.33, 95% CI: 0.82, 2.14). CONCLUSIONS While LN metastasis is common in apparent early stage MOGCTs, the performance of LND was not associated with a survival benefit.
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Affiliation(s)
- Dimitrios Nasioudis
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA.
| | - Emily M Ko
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Ashley F Haggerty
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Lori Cory
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Robert L Giuntoli
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Robert A Burger
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Mark A Morgan
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Nawar A Latif
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA, USA
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Ng DWL, Foo CC, Ng SSM, Kwong A, Suen D, Chan M, Or A, Chun OK, Fielding BFS, Lam WWT. The role of metacognition and its indirect effect through cognitive attentional syndrome on fear of cancer recurrence trajectories: A longitudinal study. Psychooncology 2019; 29:271-279. [PMID: 31663187 DOI: 10.1002/pon.5234] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This longitudinal study mapped distinct trajectories of fear of cancer recurrence (FCR) over 12 months among patients with breast (BC) or colorectal (CRC) cancer, and examined if metacognition, indirectly via attentional bias, intrusive thoughts and avoidance (hallmarks of cognitive attentional syndrome; CAS) predicted FCR trajectory membership. METHODS Two hundred and seventy BC (n = 163) or CRC (n = 107) patients were assessed at 8-weeks, 3-, 6-, and 12-months postsurgery on a measure of FCR (FCRI-SF). Metacognition (MCQ-30), Intrusive and Avoidant Thoughts (CIES-R) and attentional bias (dot-probe tasks) were assessed at baseline. Latent growth mixture modeling identified FCR trajectories. Fully-adjusted Multinomial Logistic Regression identified whether direct and indirect effects of metacognition through CAS determined FCR trajectory membership. RESULTS Three distinct FCR trajectories were identified, namely, low-stable (62.4%), high-stable (29.2%), and recovery (8.3%). Negative beliefs about worry, cognitive confidence, and age predicted FCR trajectories (χ2 (6) = 38.31, P<.001). Compared with Low-stable group, Recovery FCR patients held greater Negative beliefs about worry (OR = 1.13, P = .035) and High-stable FCR patients reported poorer Cognitive confidence (OR = 1.12, P = .004). The effect of Negative beliefs about worry was partially mediated by avoidance (β = .06, 95% CIs 0.03-0.12) and fully mediated by intrusive thoughts (β = .14, 95% CIs 0.08-0.20). Attentional bias did not predict FCR trajectories. CONCLUSIONS While most patients experienced low level of FCR, 3 in 10 persistently worried about cancer returning over the first 12-months postsurgery. Modifying metacognitive knowledge to interrupt maladaptive cognitive processing including intrusion and avoidance may be an effective therapeutic intervention for patients at risk of persistent FCR.
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Affiliation(s)
- Danielle W L Ng
- Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
| | - Chi-Chung Foo
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Simon S M Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ava Kwong
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Dacita Suen
- Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong
| | - Miranda Chan
- Department of Surgery, Kwong Wah Hospital, Hong Kong Hospital Authority, Hong Kong, Hong Kong
| | - Amy Or
- Department of Surgery, Kwong Wah Hospital, Hong Kong Hospital Authority, Hong Kong, Hong Kong
| | - Oi Kwan Chun
- Department of Surgery, Kwong Wah Hospital, Hong Kong Hospital Authority, Hong Kong, Hong Kong
| | - Brenna F S Fielding
- Department of Emergency Medicine, Royal Hampshire County Hospital, Winchester, Hampshire
| | - Wendy W T Lam
- Centre for Psycho-Oncological Research and Training, Division of Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
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Zhou X, Gao M, Wang W, Wu X. Patterns of posttraumatic stress disorder symptoms among cancer patients: A latent profile analysis. J Psychosom Res 2019; 125:109788. [PMID: 31421322 DOI: 10.1016/j.jpsychores.2019.109788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE It has been documented that posttraumatic stress disorder symptoms (PTSS) in traumatized individuals have naturally heterogeneous characteristics; studies have recently begun to assess the specific heterogeneous patterns of PTSS. However, most of them used the DSM-IV criteria for PTSS and focused on victims following combat, interpersonal violence, and natural disasters, with no studies focusing on cancer patients. To extend the existing literature and fill the gaps in previous studies, this study aims to examine the specific patterns of PTSS and their predictors. METHOD One hundred and ninety-one cancer patients were selected to complete self-reported questionnaires; the data analysis involved latent profile analysis and multinomial logistic regression. RESULTS Three patterns of PTSS were found: the non-symptom group (n = 29, 15.3%), the hyperarousal symptoms group (n = 84, 44.2%), and the severe PTSS group (n = 77, 40.5%). In addition, a longer elapsed time since diagnosis was related to fewer hyperarousal symptoms [OR (95%CI) = 0.98 (0.95-1.00)] and severe PTSS [OR (95%CI) = 0.98 (0.95-1.00)]; a greater fear of cancer recurrence was related to more hyperarousal symptoms [OR (95%CI) = 1.09 (1.00-1.19)] and severe PTSS [OR (95%CI) = 1.32 (1.18-1.47)]; and individuals with higher household incomes [OR (95%CI) = 1.65 (0.96-2.84)] and female patients [OR (95%CI) = 0.37 (0.16-0.87)] had more severe PTSS. CONCLUSIONS Cancer patients exhibited heterogeneous PTSS patterns.
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Affiliation(s)
- Xiao Zhou
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou 310028, China
| | - Mengqi Gao
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Wenchao Wang
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing 100875, China.
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Reed SC, Bell JF, Miglioretti DL, Nekhlyudov L, Fairman N, Joseph JG. Fear of cancer recurrence and associations with mental health status and individual characteristics among cancer survivors: Findings from a nationally representative sample. J Psychosoc Oncol 2019; 38:125-142. [PMID: 31510882 DOI: 10.1080/07347332.2019.1649338] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Purpose: To describe the prevalence of fear of cancer recurrence (FCR) and test its associations with validated mental health status measures.Design: Cross-sectional survey using the Medical Expenditure Panel Survey Experiences with Cancer Survivorship Supplement.Sample: Post-treatment cancer survivors (n = 1032).Methods: Survey-weighted U.S. population-based estimates describe the prevalence of sociodemographic, health and mental health characteristics of cancer survivors by their level of FCR. Multinomial logistic regression was used to test associations of validated measures of mental health status and individual characteristics on levels of FCR in unadjusted models and those controlling for sociodemographic and health characteristics.Findings: Overall, 34.3% of cancer survivors reported no FCR, 54.4% reported low FCR, and 11.3% reported high FCR. Cancer survivors were at increased risk of reporting high FCR relative to no FCR if they had a low 12-item Short Form Health Survey Mental Component Summary score (≤48) compared to high scores (odds ratio = 2.88; 95% confidence interval = 1.57, 5.29). Reporting depressive symptoms or psychological distress did not significantly increase the risk of reporting high or low FCR relative to no FCR.Conclusions: To our knowledge, this study is the first to provide U.S. population-based estimates of associations between FCR and individual and health characteristics.Implications for Psychosocial Providers or Policy: Our results provide valuable information about which survivors are most at-risk for FCR. Future research is needed to more clearly differentiate FCR from other constructs.
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Affiliation(s)
- Sarah C Reed
- Betty Irene Moore School of Nursing, University of California, Sacramento, CA, USA
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California, Sacramento, CA, USA
| | - Diana L Miglioretti
- Division of Biostatistics, Department of Public Health Sciences, School of Medicine, University of California, Davis, CA, USA
| | - Larissa Nekhlyudov
- Harvard Medical School, Department of Medicine, Brigham and Women's Hospital, Boston, CA, USA
| | - Nathan Fairman
- UC Davis Comprehensive Cancer Center, Psychiatry and Behavioral Sciences, UC Davis School of Medicine, Davis, CA, USA
| | - Jill G Joseph
- Betty Irene Moore School of Nursing, University of California, Sacramento, CA, USA
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Westmaas JL, Thewes B, Séguin Leclair C, Lebel S. Smoking versus quitting and fear of cancer recurrence 9 years after diagnosis in the American Cancer Society's Longitudinal Study of Cancer Survivors-I (SCS-I). Cancer 2019; 125:4260-4268. [PMID: 31390060 DOI: 10.1002/cncr.32431] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/08/2019] [Accepted: 06/10/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Fear of cancer recurrence (FCR) adversely affects quality of life. Cigarette smoking increases the risk of recurrence and may exacerbate FCR among survivors who smoke. FCR also may motivate quitting, but research on whether quitting reduces long-term survivors' FCR is lacking. Among long-term survivors of various cancers, the authors investigated relationships between quitting (vs smoking) and FCR, controlling for sociodemographic, cancer-related, and health-related variables. METHODS Data from the American Cancer Society's Longitudinal Study of Cancer Survivors-I were used in generalized estimating equations to compare FCR at 3 waves (T1-T3) after diagnosis between 2 groups; survivors who reported current smoking (n = 196) approximately 9 years after diagnosis (at T3) or who, based on T3 recall of quitting age, had quit smoking after diagnosis (n = 97). T3 cross-sectional analyses among current smokers examined associations of FCR with smoking level and intentions of quitting. RESULTS A significant smoking status × time interaction (P = .003) indicated that only quitters experienced decreases in FCR from T1 to T3 (P = .007). At T3, FCR was significantly lower among quitters than among current smokers (P = .05), and current smokers reported that FCR caused more functioning impairments (eg, disruption of relationships, everyday activities, mood) than quitters (P = .001). Cross-sectional analyses (T3) among smokers found that heavier smoking predicted less attempts to cope with FCR (P = .04) and that reassurance behaviors (eg, self-examination for cancer) predicted stronger quitting intentions (P = .02). CONCLUSIONS Quitting smoking lowers FCR, and FCR may disrupt functioning among continuing smokers. Interventions for FCR should be multimodal and should treat both psychological distress and health-related behaviors such as smoking.
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Affiliation(s)
- J Lee Westmaas
- Behavioral and Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | - Belinda Thewes
- The Health Psychology Clinic, Moruya, New South Wales, Australia
| | | | - Sophie Lebel
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
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Hall DL, Jimenez RB, Perez GK, Rabin J, Quain K, Yeh GY, Park ER, Peppercorn JM. Fear of Cancer Recurrence: A Model Examination of Physical Symptoms, Emotional Distress, and Health Behavior Change. J Oncol Pract 2019; 15:e787-e797. [PMID: 31298966 DOI: 10.1200/jop.18.00787] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
PURPOSE Fear of cancer recurrence is highly prevalent among adult survivors of cancer. The role of fear of recurrence in the emotional distress of survivors of cancer, as well as health behaviors that may directly affect their health, remains unclear. To advance oncology practice, this study sought to examine the extent to which fear of recurrence stemming from physical symptoms accounts for emotional distress in a large sample of adult survivors of cancer and to extend the model to explain postdiagnosis self-reported health behavior change. METHODS In 2016, 258 survivors of cancer at an academic hospital completed a survey of psychosocial needs. Items assessed physical symptoms (checklist), fear of cancer recurrence (Assessment of Survivor Concerns), emotional distress (anxiety and depressed mood), and health behaviors (current alcohol use, physical activity, diet, and sunscreen use, as well as changes after cancer diagnosis) informed by National Comprehensive Cancer Network survivorship guidelines. Indirect effects regression models accounting for relevant covariates (age and treatment history) used 5,000-iteration bootstrapping. RESULTS Higher fear of cancer recurrence was associated with greater number of physical symptoms (P < .001), greater emotional distress (P < .05), lower moderate or vigorous physical activity (P < .05), higher sunscreen use (P < .05), and postdiagnosis increases in alcohol use (P < .01) and reductions in physical activity (P < .01). Fear of cancer recurrence models accounted for almost half of the variance in distress of survivors of cancer (R2 = 0.44, P < .001) and, to a lesser yet significant extent, changes in alcohol consumption (R2 = 0.09, P < .001) and physical activity (R2 = 0.06, P = .003). CONCLUSION Fear of cancer recurrence plays a central role in the emotional distress and key health behaviors of survivors of cancer. These findings support fear of cancer recurrence as a potential target for emotional health and health behavior change interventions.
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Affiliation(s)
- Daniel L Hall
- Harvard Medical School/Massachusetts General Hospital, Boston, MA.,Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, MA
| | - Rachel B Jimenez
- Harvard Medical School/Massachusetts General Hospital, Boston, MA
| | - Giselle K Perez
- Harvard Medical School/Massachusetts General Hospital, Boston, MA.,Mongan Health Policy Research Center, Massachusetts General Hospital, Boston, MA
| | - Julia Rabin
- Harvard Medical School/Massachusetts General Hospital, Boston, MA
| | - Katharine Quain
- Harvard Medical School/Massachusetts General Hospital, Boston, MA
| | - Gloria Y Yeh
- Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, MA
| | - Elyse R Park
- Harvard Medical School/Massachusetts General Hospital, Boston, MA.,Mongan Health Policy Research Center, Massachusetts General Hospital, Boston, MA
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Mirosevic S, Thewes B, van Herpen C, Kaanders J, Merkx T, Humphris G, Baatenburg de Jong RJ, Langendijk JA, Leemans CR, Terhaard CHJ, Verdonck-de Leeuw IM, Takes R, Prins J. Prevalence and clinical and psychological correlates of high fear of cancer recurrence in patients newly diagnosed with head and neck cancer. Head Neck 2019; 41:3187-3200. [PMID: 31173429 PMCID: PMC6771492 DOI: 10.1002/hed.25812] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 05/02/2019] [Accepted: 05/13/2019] [Indexed: 01/04/2023] Open
Abstract
Background Patients with head and neck cancer (HNC) are vulnerable to fear of cancer recurrence (FCR) and psychiatric morbidity. We investigated the prevalence of high FCR and demographic, clinical, psychological, and psychiatric factors associated with high FCR prior to the start of the treatment. Methods In a cross‐sectional substudy of the large ongoing prospective NET‐QUBIC study questionnaires and psychiatric interviews of 216 patients newly diagnosed with HNC were analyzed. Results High FCR was observed in 52.8% of patients and among those 21.1% also had a lifetime history of selected anxiety or major depressive disorder. FCR was not related to any clinical characteristics; however, younger age, higher anxiety symptoms, introversion, greater needs for support regarding sexuality, and being an exsmoker were significantly associated with higher FCR. Conclusion Factors associated with high FCR provide us with a better conceptual understanding of FCR in patients newly diagnosed with HNC.
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Affiliation(s)
- Spela Mirosevic
- Department of Family Medicine, Medical Faculty Ljubljana, Ljubljana, Slovenia
| | - Belinda Thewes
- Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carla van Herpen
- Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Johannes Kaanders
- Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Thijs Merkx
- Department Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Gerry Humphris
- School of Medicine, University of St. Andrews, St. Andrews, Scotland, UK
| | - Robert J Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, Erasmus Cancer Institute, Erasmus MC, Rotterdam, The Netherlands
| | - Johannes A Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - C René Leemans
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
| | - Chris H J Terhaard
- Department of Radiotherapy, University Medical Center, Utrecht, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.,Department of Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands
| | - Robert Takes
- Department of Head and Neck Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Judith Prins
- Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands
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- Project Kubus, Vumc, Afdeling KNO, Amsterdam, The Netherlands
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Ng DWL, Kwong A, Suen D, Chan M, Or A, Ng SS, Foo CC, Fielding BF, Lam WW. Fear of cancer recurrence among Chinese cancer survivors: Prevalence and associations with metacognition and neuroticism. Psychooncology 2019; 28:1243-1251. [DOI: 10.1002/pon.5073] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 03/06/2019] [Accepted: 03/26/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Danielle Wing Lam Ng
- Centre for Psycho‐Oncological Research and Training, Division of Behavioural Sciences, School of Public HealthThe University of Hong Kong Hong Kong
| | - Ava Kwong
- Department of SurgeryThe University of Hong Kong Hong Kong
| | - Dacita Suen
- Department of SurgeryThe University of Hong Kong Hong Kong
| | - Miranda Chan
- Department of SurgeryKwong Wah Hospital, Hong Kong Hospital Authority Hong Kong
| | - Amy Or
- Department of SurgeryKwong Wah Hospital, Hong Kong Hospital Authority Hong Kong
| | - Siuman Simon Ng
- Department of SurgeryThe Chinese University of Hong Kong Hong Kong
| | - Chi Chung Foo
- Department of SurgeryThe University of Hong Kong Hong Kong
| | | | - Wendy W.T. Lam
- Centre for Psycho‐Oncological Research and Training, Division of Behavioural Sciences, School of Public HealthThe University of Hong Kong Hong Kong
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Thom B, Boekhout AH, Corcoran S, Adsuar R, Oeffinger KC, McCabe MS. Advanced Practice Providers and Survivorship Care: They Can Deliver. J Oncol Pract 2019; 15:e230-e237. [PMID: 30615587 DOI: 10.1200/jop.18.00359] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION As the number of cancer survivors grows, new models of survivorship care are being implemented, but there is limited evaluation to date. This retrospective review assesses the concordance of care provided to adult-onset cancer survivors by advanced practice providers (nurse practitioners and physician assistants) with Institute of Medicine guidelines for survivorship care. METHODS Records from three survivorship clinics at a single institution were reviewed for frequency of recurrence surveillance, screening for second cancers, symptom management (physical, psychological), health promotion education (alcohol, tobacco, cholesterol, and bone density screenings; diet/exercise discussion), care coordination, and provision of care plan. Data were characterized using descriptive statistics. RESULTS Over 2 years, 9,052 unique survivorship visits occurred; 210 breast, 208 prostate, and 204 colorectal visits were randomly selected for review. All patients with breast cancer underwent surveillance for recurrence; 99% were screened for new cancers. Discussion of health promotion activities ranged from 83% to 100%; 91% of patients were reviewed for physical symptoms, and 93% were reviewed for psychological symptoms. All patients with prostate cancer underwent recurrence surveillance; 97% were screened for new primaries. Health promotion activities ranged from 70% to 97%, and symptoms were discussed in 89% of visits. All patients with colorectal cancer underwent a surveillance colonoscopy for recurrence; 97% had a carcinoembryonic antigen test. Among women, 97% had mammograms, and 96% had a Papanicolaou test; 83% of men had a prostate-specific antigen test. Health promotion activities ranged from 69% to 100%, and symptoms were discussed in 93% to 97% of visits. CONCLUSIONS Findings suggest that advanced practice providers can provide survivorship care in accordance with Institute of Medicine standards, which provide a normative standard. This assessment is an important step in evaluating survivorship outcomes.
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Affiliation(s)
| | - Annelies H Boekhout
- 2 Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | | | | | | | - Mary S McCabe
- 1 Memorial Sloan Kettering Cancer Center, New York, NY
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Schepisi G, De Padova S, De Lisi D, Casadei C, Meggiolaro E, Ruffilli F, Rosti G, Lolli C, Ravaglia G, Conteduca V, Farolfi A, Grassi L, De Giorgi U. Psychosocial Issues in Long-Term Survivors of Testicular Cancer. Front Endocrinol (Lausanne) 2019; 10:113. [PMID: 30858829 PMCID: PMC6397854 DOI: 10.3389/fendo.2019.00113] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/07/2019] [Indexed: 01/20/2023] Open
Abstract
Testicular cancer is the most frequent tumor in young males aged 15-39 years. As cure rates are currently around 90%, the prevalence of survivors is increasing. However, a disease-free condition does not necessarily correspond to a life free of physical and psychosocial health problems. The aim of this review was to explore psychosocial morbidity among testicular cancer survivors. A literature search was conducted in three electronic databases (PubMed, Medline, and Embase). The results of the search on cancer survivors were then combined with those of the search on psychosocial concerns and work performance. Eighty-four publications met the inclusion criteria. Physical, psychological, work-related problems and changing perspectives about work and life in general influenced life and career decisions among testicular cancer survivors. Individual health, sexual relationships and work problems, affect several important aspects of survival and significantly influence the QoL of long-term survivors.
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Affiliation(s)
- Giuseppe Schepisi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
- *Correspondence: Giuseppe Schepisi
| | - Silvia De Padova
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Delia De Lisi
- Medical Oncology Department, Santa Chiara Hospital, Trento, Italy
| | - Chiara Casadei
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Elena Meggiolaro
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Federica Ruffilli
- Psycho-Oncology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Giovanni Rosti
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Cristian Lolli
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Giorgia Ravaglia
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Vincenza Conteduca
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Alberto Farolfi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Luigi Grassi
- Hospital Psychiatry Unit, Department of Biomedical and Specialty Surgical Sciences, Integrated Department of Mental Health and Addictive Behavior, Institute of Psychiatry, St. Anna University Hospital and NHS Community Health Trusts, University of Ferrara, Ferrara, Italy
| | - Ugo De Giorgi
- Medical Oncology Department, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
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Ratcliff C, Naik AD, Martin LA, Moye J. Examining cancer survivorship trajectories: Exploring the intersection between qualitative illness narratives and quantitative screening instruments. Palliat Support Care 2018; 16:712-718. [PMID: 29282156 PMCID: PMC6023785 DOI: 10.1017/s1478951517000967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This article examines the associations of quantitatively refined trajectories of adjustment to cancer survivorship determined by previously published qualitative narrative analysis. METHOD Patients completed measures of cancer-related worry (Cancer Related Worries Scale), depression (Patient Health Questionnaire-9), posttraumatic growth (Benefit Finding Scale), and open-ended survey questions 6, 12, and 18 months postdiagnosis of head and neck, esophageal, gastric, or colorectal cancer. Previously published narrative analysis revealed five distinct survivorship "paths," which were combined into four paths in the present article: Moving On, Seeing the World Differently, Taking One Day at a Time, and Never the Same. To determine the association of qualitatively determined paths with quantitatively assessed adjustment (i.e., Cancer Related Worries Scale, Patient Health Questionnaire-9, Benefit Finding Scale), we used linear multilevel modeling to regress the adjustment variables on time, path, the time-by-path interaction, and relevant covariates (age, stage, cancer site, ethnicity, and Deyo score). RESULTS There was a significant main effect of path on cancer worry, depression, and posttraumatic growth (p < 0.02 for all). Patients in the Moving On group reported consistently low worry, depression, and growth compared to the other groups. Patients in the Seeing the World Differently and Taking One Day at a Time paths both reported moderate worry and depression; but those in the Seeing the World Differently path reported the highest posttraumatic growth, whereas patients in the Taking One Day at a Time path reported little growth. Finally, patients in the Never the Same path reported the highest worry and depression but lowest posttraumatic growth.Significance of resultsThis longitudinal study reinforces the notion that cancer survivorship is not a one-size-fits-all experience nor a dichotomized experience of "distress" or "no distress." Additionally, this hypothesis-generating study suggests future directions for potential self-report measures to help clinicians identify cancer survivors' trajectory to develop a more patient-centered survivorship care plan.
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Affiliation(s)
- Chelsea Ratcliff
- South Central Mental Illness Research, Education and Clinical Center, Houston, Texas
- Houston VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas
- Baylor College of Medicine, Houston, Texas
| | - Aanand D. Naik
- Houston VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas
- Baylor College of Medicine, Houston, Texas
| | - Lindsey Ann Martin
- South Central Mental Illness Research, Education and Clinical Center, Houston, Texas
- Houston VA Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas
- Baylor College of Medicine, Houston, Texas
| | - Jennifer Moye
- VA Boston Healthcare System, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- New England Geriatric Research, Education and Clinical Center, Boston and Bedford, Massachusetts
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Yang Y, Sun H, Liu T, Zhang J, Wang H, Liang W, Chen Y, Zhang B. Factors associated with fear of progression in chinese cancer patients: sociodemographic, clinical and psychological variables. J Psychosom Res 2018; 114:18-24. [PMID: 30314574 DOI: 10.1016/j.jpsychores.2018.09.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/06/2018] [Accepted: 09/06/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Fear of progression (FoP) is a widespread problem among cancer patients and is considered to be one of the most distressing psychological consequences of cancer. The aim of this study was to investigate the association of sociodemographic, clinical, and psychological variables to FoP in Chinese cancer patients. METHODS In this cross-sectional study, six hundred and thirty-six cancer patients were recruited. All participants were asked to complete a personal information sheet, the Chinese version of Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder Questionnaire (GAD-7). Descriptive statistics and hierarchical multiple regression was conducted to analyze the data. RESULTS Hierarchical multiple regression revealed that childhood severe illness experience (P = .011), stress (P < .001), anxiety (P < .001), depressive symptom (P < .001) and personality (P = .042) were independently predictive of higher FoP. The final regression model explained up to 40.0% (adjusted R square: 38.8%) of the observed variance. CONCLUSION There are a number of factors that increase the likelihood of the development of FoP. The findings underline the necessity to provide effective psychological intervention for patients with high FoP in the future.
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Affiliation(s)
- Yuan Yang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Centre, Guangdong General Hospital, Guangzhou, Guangdong 510080, China
| | - Ting Liu
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Jingying Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Hongmei Wang
- Department of Radiotherapy, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Weijiang Liang
- Department of Oncology, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China
| | - Yu Chen
- Nursing School, Southern Medical University, Guangzhou, Guangdong 510515, China
| | - Bin Zhang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, Guangdong 510515, China.
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Champagne A, Ivers H, Savard J. Utilization of health care services in cancer patients with elevated fear of cancer recurrence. Psychooncology 2018; 27:1958-1964. [DOI: 10.1002/pon.4748] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 03/14/2018] [Accepted: 04/17/2018] [Indexed: 11/10/2022]
Affiliation(s)
| | - Hans Ivers
- School of Psychology; Université Laval; Quebec Qc Canada
- Université Laval Cancer Research Center; Quebec Qc Canada
- CHU de Québec-Université Laval Research Center; Quebec Qc Canada
| | - Josée Savard
- School of Psychology; Université Laval; Quebec Qc Canada
- Université Laval Cancer Research Center; Quebec Qc Canada
- CHU de Québec-Université Laval Research Center; Quebec Qc Canada
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Development and Feasibility of a Group Cognitive-Behavioral Therapy for Fear of Cancer Recurrence. COGNITIVE AND BEHAVIORAL PRACTICE 2018. [DOI: 10.1016/j.cbpra.2017.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Brown SL, Hope-Stone L, Heimann H, Damato B, Salmon P. Predictors of anxiety and depression 2 years following treatment in uveal melanoma survivors. Psychooncology 2018; 27:1727-1734. [DOI: 10.1002/pon.4715] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 03/08/2018] [Accepted: 03/17/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Stephen L. Brown
- Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
| | - Laura Hope-Stone
- Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
- Liverpool Ocular Oncology Centre; Royal Liverpool and Broadgreen University Hospital, NHS Trust; Liverpool UK
| | - Heinrich Heimann
- Liverpool Ocular Oncology Centre; Royal Liverpool and Broadgreen University Hospital, NHS Trust; Liverpool UK
| | - Bertil Damato
- Liverpool Ocular Oncology Centre; Royal Liverpool and Broadgreen University Hospital, NHS Trust; Liverpool UK
- Ocular Oncology Service; University of California; San Francisco CA USA
| | - Peter Salmon
- Institute of Psychology, Health and Society; University of Liverpool; Liverpool UK
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Smith AB, Rutherford C, Butow P, Olver I, Luckett T, Grimison P, Toner G, Stockler M, King M. A systematic review of quantitative observational studies investigating psychological distress in testicular cancer survivors. Psychooncology 2018; 27:1129-1137. [PMID: 29171109 DOI: 10.1002/pon.4596] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/28/2017] [Accepted: 11/05/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Testicular cancer (TC) affects young men and may cause psychological distress despite a good prognosis. This systematic review evaluated the prevalence, severity, and correlates of anxiety, depression, fear of cancer recurrence (FCR), and distress in TC survivors. METHODS A systematic search of literature published 1977 to 2017 was conducted to find quantitative studies including TC survivor-reported outcomes relevant to review objectives. The quality of included articles was assessed, and a narrative synthesis conducted. RESULTS Of 6717 articles identified, 66 (39 good, 20 fair, and 7 poor quality) reporting results from 36 studies were included. Testicular cancer survivors' mean anxiety levels were higher than in the general population, while mean depression and distress were no different. Clinically significant anxiety (≈1 in 5) and to a lesser extent distress (≈1 in 7), but not depression, were more prevalent in TC survivors than the general population. Approximately 1 in 3 TC survivors experienced elevated FCR. Poorer psychological outcomes were more common among TC survivors who were single, unemployed/low socio-economic status, suffering from co-morbidities, experiencing worse symptoms/side effects, and using passive coping strategies. CONCLUSIONS Many TC survivors do not experience significant psychological morbidity, but anxiety and FCR are prevalent. Inadequate coping resources (eg, low socio-economic status and social support) and strategies (eg, avoidance) and greater symptoms/side effects were associated with poorer outcomes. Theoretically driven prospective studies would aid understanding of how outcomes change over time and how to screen for risk. Age and gender appropriate interventions that prevent and manage issues specific to TC survivors are also needed.
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Affiliation(s)
- Allan Ben Smith
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, Liverpool Hospital, Liverpool, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia
| | - Claudia Rutherford
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
| | - Ian Olver
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia
- Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Tim Luckett
- Improving Palliative, Chronic and Aged Care through Clinical Trials Research and Translation (ImPaCCT), South Western Sydney Clinical School, Faculty of Health, University of New South Wales and University of Technology Sydney, Sydney, NSW, Australia
| | - Peter Grimison
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia
- Chris O'Brien Lifehouse, Sydney, NSW, Australia
- Sydney Medical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Guy Toner
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia
- Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC, Australia
| | - Martin Stockler
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group Limited (ANZUP), Sydney, NSW, Australia
- Sydney Cancer Centre, Concord Repatriation General Hospital, Concord, NSW, Australia
- Sydney Medical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Madeleine King
- Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, NSW, Australia
- School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
- Sydney Medical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
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Smith S, Eatough V, Smith J, Mihai R, Weaver A, Sadler GP. 'I know I'm not invincible': An interpretative phenomenological analysis of thyroid cancer in young people. Br J Health Psychol 2018; 23:352-370. [PMID: 29356226 PMCID: PMC5901396 DOI: 10.1111/bjhp.12292] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/17/2017] [Indexed: 11/30/2022]
Abstract
Objective Thyroid cancer is one of the most common cancers affecting young people and carries an excellent prognosis. Little is known about the psychosocial issues that face young people diagnosed with a treatable cancer. This study explored how young people experienced diagnosis, treatment, and how they made sense of an experience which challenged their views on what it means to have cancer. Method Semi‐structured interviews were conducted with eight young people diagnosed with either papillary or follicular thyroid cancer, and analysed with interpretative phenomenological analysis (IPA). Results Two inter‐related aspects of their experience are discussed: (1) the range of feelings and emotions experienced including feeling disregarded, vulnerability, shock and isolation; (2) how they made sense of and ascribed meaning to their experience in the light of the unique nature of their cancer. A thread running throughout the findings highlights that this was a disruptive biographical experience. Conclusions Young people experienced a loss of youthful immunity which contrasted with a sense of growth and shift in life perspective. Having a highly treatable cancer was helpful in aiding them to reframe their situation positively but at the same time left them feeling dismissed over a lack of recognition that they had cancer. The young peoples’ experiences point to a need for increased understanding of this rare cancer, more effective communication from health care professionals and a greater understanding of the experiential impact of this disease on young people. Suggestions to improve the service provision to this patient group are provided. Statement of contribution What is already known on this subject? Differentiated thyroid cancer has an excellent prognosis. Quality of life of thyroid cancer has marginally been explored in the literature. Little is known on the support needs of young people diagnosed with thyroid cancer.
What does this study add? Increased understanding of how young people make sense and cope with thyroid cancer despite the lack of support resources. Addressing illness perceptions through improved information support may aid coping and adjustment. Insight into the needs of young people diagnosed with thyroid cancer and recommendations on service improvements.
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Affiliation(s)
- Stephanie Smith
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, UK
| | - Virginia Eatough
- Department of Psychological Sciences, Birkbeck University of London, UK
| | - James Smith
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, UK
| | - Radu Mihai
- Department of Endocrine Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, UK
| | - Andrew Weaver
- Department of Oncology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, UK
| | - Gregory P Sadler
- Department of Endocrine Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, UK
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