Beyond the treatment: The role of race, sex, and education in health trajectories between cancer survivors and noncancer older adults

INTRODUCTION

The number of older, long-term cancer survivors is increasing. However, little is known about how cancer and aging affect the health trajectories of older adults differently. In addition, the impact of race, sex, and education on the processes of aging and the cancer experience needs further investigation. The current study aims to address this knowledge gap by combining two National Cancer Institute (NIC)-funded longitudinal studies conducted in Cleveland from 1998 to 2010.

MATERIALS AND METHODS

The unique cross-sequential design facilitates a comparison between the health changes in long-term (five years +) older cancer survivors (breast, prostate, and colorectal cancer) and demographically matched older adults without a history of cancer in the same geographic area within the same period. The study also captured comprehensive information on how socioeconomic status interacts with cancer and aging over time. General linear models were employed in the data analysis.

RESULTS

The findings showed that early cancer experience did not affect long-term cancer survivors' health status in later life. Conversely, comorbidities, being an African American, being female, and having education less than a college degree significantly decreased the health trajectory in later life for all older adults. Moreover, compared to other groups, older African American cancer survivors reported a dramatic decrease in self-reported health after controlling for other conditions.

DISCUSSION

Study findings can inform public policy and social services to offer comprehensive treatment plans and help individuals overcome their diseases and lead longer and healthier lives.

Identifying themes for assessing cancer-related cognitive impairment identified by topic modeling and qualitative content analysis of public online comments (Preprint)

Background

Cancer-related cognitive impairment (CRCI) is a common and significant adverse effect of cancer and its therapies. However, its definition and assessment remain difficult due to limitations of currently available measurement tools.

Objective

This study aims to evaluate qualitative themes related to the cognitive effects of cancer to help guide development of assessments that are more specific than what is currently available.

Methods

We applied topic modeling and inductive qualitative content analysis to 145 public online comments related to cognitive effects of cancer.

Results

Topic modeling revealed 2 latent topics that we interpreted as representing internal and external factors related to cognitive effects. These findings lead us to hypothesize regarding the potential contribution of locus of control to CRCI. Content analysis suggested several major themes including symptoms, emotional/psychological impacts, coping, “chemobrain” is real, change over time, and function. There was some conceptual overlap between the 2 methods regarding internal and external factors related to patient experiences of cognitive effects.

Conclusions

Our findings indicate that coping mechanisms and locus of control may be important themes to include in assessments of CRCI. Future directions in this field include prospective acquisition of free-text responses to guide development of assessments that are more sensitive and specific to cognitive function in patients with cancer.

Correlates of posttraumatic growth among spouses of newly diagnosed gynecological cancer survivors: A cross-sectional study

PURPOSE

Despite increasing research on posttraumatic growth (PTG) of spouses of cancer patients, and the positive effects of spouses' PTG on both spouses and patients, there is little information on PTG and its correlates among husbands of gynecological cancer survivors, especially those of newly diagnosed survivors. We aimed to assess PTG among spouses of newly diagnosed gynecological cancer survivors and to examine its correlates.

METHODS

In a cross-sectional study, a total of 400 spouses of newly diagnosed gynecological cancer survivors were recruited and completed questionnaires with information on general characteristics, rumination, self-disclosure, locus of control, and PTG. Univariate analysis and multiple linear regression analysis were performed.

RESULTS

The mean score of PTG among the spouses was 57.77 (SD = 12.03). There were significant differences in PTG among spouses with different education levels, marriage duration, number of children, per capita monthly income, other traumatic events within 6 months, and time since diagnosis groups. Pearson's correlation analysis revealed that deliberate rumination, self-disclosure, and locus of control were significantly associated with PTG. The multiple regression model revealed that 53.6% of the variance in PTG was explained by marriage duration, time since diagnosis, self-disclosure, deliberate rumination, and internality locus of control.

CONCLUSIONS

This study was one of the early attempts in evaluating PTG among spouses of newly diagnosed gynecological cancer survivors and identified several significant, potentially modifiable factors (self-disclosure, deliberate rumination, and internality locus of control) associated with PTG, providing an important guide for the development of effective psychosocial interventions for this population.

Locus of control, personality and depression symptoms in cancer: Testing a moderated mediation model

OBJECTIVE

To investigate the mediator role of locus of control on the relationship between the Big Five personality traits and the manifestation of depression symptoms in cancer outpatients.

METHOD

Participants consisted of 220 cancer outpatients (138 women and 82 men), evaluated individually at the hospital waiting room. The measures applied were as follows: The NEO-Five Factor Inventory (NEO-FFI), Multidimensional Health Locus of Control (MHLC) Scale and Hospital Anxiety and Depression Scale (HADS).

RESULTS

The factor structure of NEO-FFI was reexamined. A moderated mediation model was found for the powerful others external locus of control (LOC), depression symptoms and extraversion and conscientiousness traits across sex.

CONCLUSIONS

Extraverted individuals can seek for others' support and use their attachments to find someone to guide them; conscientious patients can rely on their physician and follow every rule and orientation demanded, temporarily delegating to others the responsibility for their lives. All these strategies can help to decrease symptoms of depression. The perception of control can be taught, and it may be specifically relevant for mental health and in the performance of health behaviours.

A systematic review and qualitative synthesis of the experience of living with colorectal cancer as a chronic illness

OBJECTIVE

Advances in detection and treatment mean that over 50% of people diagnosed with colorectal cancer can expect to live for more than ten years following treatment. Studies show that colorectal cancer patients can experience numerous physical and psychological late effects. The aim of this study was to conduct a systematic review and qualitative synthesis on the experiences of living with colorectal cancer as a chronic illness.

METHODS

Electronic searches of online databases were undertaken of peer reviewed and grey literature. Forty-seven papers were eligible for inclusion in the review, capturing the experiences of over 700 participants, the findings from which were analysed using thematic synthesis.

RESULTS

Three higher order concepts were identified which were prevalent across studies and countries and which related to the supportive care needs of patients; common physical and psychological late effects of cancer; and methods of psychosocial adjustment to living with and beyond colorectal cancer.

CONCLUSION

The results are considered in the context of existing theoretical approaches to chronic illness and the need to develop a theoretical approach which fully encapsulates the experience of living with colorectal cancer as a chronic illness in order to inform interventions to support patient adjustment.