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Krok-Schoen JL, Nikahd M, Hyer M, Felix AS, Nolan TS, Ridgway-Limle EA, Xu M, Quick AM, Paoletta C, Horn M, Arthur EK. Social determinants of health and depressive symptoms before and after cancer diagnosis. J Women Aging 2024:1-12. [PMID: 38830008 DOI: 10.1080/08952841.2024.2357865] [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: 10/25/2023] [Accepted: 05/15/2024] [Indexed: 06/05/2024]
Abstract
Despite frequent reports of mental health needs among older women with cancer, depressive symptoms often go unrecognized and untreated, particularly in socially vulnerable survivors. Here, we examined associations of sociodemographic factors and social limitations with depressive symptoms from pre-diagnosis to post-diagnosis in older women diagnosed with breast or gynecological cancer. Using the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey (SEER-MHOS) linked dataset, we used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between sociodemographic factors (race, ethnicity, marital status, rurality) and social limitations (i.e., health interfering with social activities) on depressive symptoms in women aged ≥65 years with breast or gynecologic cancer (n = 1,353). Most participants had breast cancer (82.0%), stage I-II cancer (85.8%), received surgery for their cancer (94.8%), and radiation treatment (50.6%). Prior to diagnosis, 11.8% reported depressive symptoms, which nearly doubled to 22.4% at follow-up. Participants were 2.7 times more likely of reporting depressive symptoms after cancer diagnosis compared with pre-cancer diagnosis (95%CI: 2.10-3.48). Race, ethnicity, rurality, marital status, and social interference were significantly associated with an increased risk of depressive symptoms after cancer diagnosis than before their cancer diagnosis (p < 0.05). In summary, depressive symptoms increased following a cancer diagnosis. Our results suggest potential avenues for intervention that could lead to reduced depressive symptoms among older female cancer survivors.
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Affiliation(s)
- Jessica L Krok-Schoen
- Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Melica Nikahd
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Madison Hyer
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Ashley S Felix
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Timiya S Nolan
- Division of Preventive Medicine, Heersink School of Medicine, The University of Alabama, Birmingham, Alabama, USA
| | | | - Menglin Xu
- Department of Internal Medicine, The James Comprehensive Cancer Center, The Ohio State Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - Allison M Quick
- Department of Radiation Oncology, The James Comprehensive Cancer Center, The Ohio State Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
| | - Camille Paoletta
- Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Marissa Horn
- Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Elizabeth K Arthur
- Nursing Research, The James Comprehensive Cancer Center, The Ohio State Wexner Medical Center, The Ohio State University, Columbus, Ohio, USA
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Hatlevoll I, Kristensen AK, Solheim TS, Elvebakken H, Salvesen Ø, Oldervoll LM, Wibe A, Hofsli E. Do older patients with colorectal cancer experience more deterioration in health-related quality of life than younger patients during the first year of palliative chemotherapy? A prospective real-world observational study. J Geriatr Oncol 2024; 15:101715. [PMID: 38359528 DOI: 10.1016/j.jgo.2024.101715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/04/2023] [Accepted: 01/25/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION The primary aim was to evaluate changes in health-related quality of life (HRQoL) in a real-life population among younger (< 70 years) and older patients with metastatic colorectal cancer (mCRC) during the first year of palliative chemotherapy. The secondary aims were to assess the impact of chemo-break on HRQoL and to report overall survival (OS). MATERIALS AND METHODS Patients with newly diagnosed mCRC, ≥ 18 years, and scheduled for first line palliative chemotherapy were included in this multicentre longitudinal observational study. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (0-100) was filled in at baseline and every second month. Changes or differences in QoL scores of >20, 10-20, and 5-10 points were considered to be of large, moderate, and small clinical magnitude, respectively. Comparing means of different QoL scores between groups or over time, a threshold of 5-10 was considered the minimally important difference (MID). Treatments, patient characteristics, and tumour characteristics were prospectively registered. RESULTS A total of 214 patients were included, and 146 were alive after one year. Four months after start of treatment, large deteriorations in fatigue and physical functioning were reported by 40% and 25% of the patients, respectively. Changes in global QoL, physical functioning, role functioning, fatigue, pain, and nausea/vomiting were not significantly different between the age groups and reached baseline levels after one year. Patients on chemo-break reported significant improvements in several HRQoL domains. Median OS was 17.5 months [95% confidence interval 14.4-20.5] with no difference between younger and older patients. DISCUSSION Older patients did not experience more deterioration in HRQoL than younger patients during the first year of palliative chemotherapy. Measures to mitigate the deteriorations in fatigue and physical functioning observed during the first months of palliative treatment are warranted. TRIAL REGISTRATION NCT02395224, March 23, 2015, retrospectively registered.
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Affiliation(s)
- Ingunn Hatlevoll
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Oncology, St. Olav's Hospital, Trondheim, Norway.
| | | | - Tora S Solheim
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Oncology, St. Olav's Hospital, Trondheim, Norway
| | - Hege Elvebakken
- Department of Oncology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway
| | - Øyvind Salvesen
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Line M Oldervoll
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway; Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Norway
| | - Arne Wibe
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Surgery, St. Olav's Hospital, Trondheim, Norway
| | - Eva Hofsli
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Oncology, St. Olav's Hospital, Trondheim, Norway
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Ahmedzai HH, Oldervoll LM, Sweetmore AMH, Hauken MA. Community-Based Multidimensional Cancer Rehabilitation in Norway: A Feasibility Study. Cancer Nurs 2024; 47:E123-E133. [PMID: 36066332 DOI: 10.1097/ncc.0000000000001161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cancer survival is often accompanied by late effects that can be mitigated by tailored rehabilitation. In Norway, this has traditionally been offered as residential programs, whereas community-based cancer rehabilitation programs are lacking. OBJECTIVE This study aimed to assess the feasibility and acceptability of a newly developed community-based multidimensional cancer rehabilitation program in Norway. METHODS A feasibility study with a mixed methods explanatory sequential design was implemented. The intervention was a 12-week group-based rehabilitation program comprising 5 components: goal setting, physical exercise, psychoeducation, individual follow-up consultations, and peer support. Feasibility was assessed through recruitment, retention, and intervention delivery. Acceptability was assessed through intervention adherence and participant evaluation. Qualitative data were generated from focus group interviews. Statistical analyses were descriptive, and qualitative data were transcribed and analyzed using framework analyses. RESULTS Sixty participants started, and 55 completed the 12-week rehabilitation program. The majority were female (80%), and the mean age was 56 years. The largest diagnostic group was breast cancer (42%). Retention was high (92%), as were adherence rates for all intervention components. The exercise component was rated the most beneficial, followed by individual consultations and peer support. Qualitative findings contributed to explaining the high adherence and positive evaluation. CONCLUSION High retention, strong adherence, and positive evaluation imply that the community-based program was feasible and acceptable to cancer survivors. IMPLICATION FOR PRACTICE The results will aid intervention refinement and contribute to a future randomized controlled trial to examine its effectiveness. If successful, the rehabilitation program could be implemented in the Norwegian Cancer Pathway "Home."
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Affiliation(s)
- Hilde Hjelmeland Ahmedzai
- Author Affiliations: Centre for Crisis Psychology, University of Bergen (Dr Ahmedzai, Profs Hauken and Oldervoll), Norway; and The Healthy Life Centre, Askøy District Council (Ms Sweetmore), Norway
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Fitch MI, Nicoll I, Lockwood G, Strohschein FJ, Newton L. Cancer survivors 75 years and older: physical, emotional and practical needs. BMJ Support Palliat Care 2023; 13:e352-e360. [PMID: 33883172 DOI: 10.1136/bmjspcare-2020-002855] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/19/2021] [Accepted: 04/04/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To describe physical, emotional and practical concerns and access to help of Canadian cancer survivors aged 75+ years following treatment. METHODS A survey was designed to identify concerns and access to help across three supportive care domains for cancer survivors 1-3 years post-treatment. Random samples were drawn from 10 provincial cancer registries. Survey packages were mailed to 40 790 survivors with option to reply by mail or online in French or English. Descriptive analysis was conducted. RESULTS In total, 3274 (25%) survivors aged 75+ years responded to the survey. Fifty-five per cent were men, 72% had not experienced metastatic spread and 75% reported comorbid conditions. Eighty-one per cent reported experiencing at least one physical concern, 63% experienced at least one emotional concern and 30% experienced at least one practical concern. The most commonly reported concerns were for two physical changes (fatigue 62% and bladder/urinary problems 39%) and one emotional change (anxiety/fear of recurrence 53%). More than 50% did not receive assistance for 15 concerns across the three domains. The most frequently cited reason for not seeking help for a concern was that they were told it was normal and they did not think anything could be done. Unmet needs existed for all physical, emotional and practical changes ranging from 41% to 88% of respondents. CONCLUSIONS Many older adults are at risk for experiencing physical, emotional and practical concerns following cancer treatment yet are not obtaining help. Action is needed for early identification of these individuals to mitigate the impact of unmet needs for older cancer survivors.
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Affiliation(s)
- Margaret I Fitch
- Bloomberg Faculty of nursing, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Fay J Strohschein
- Department of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Lorelei Newton
- School of Nursing, University of Victoria, Victoria, British Columbia, Canada
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Alzhrani AA, Alsuhail AI, Rababah AA. Fatigue Prevalence Among Palliative Care Cancer Patients in Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia: A Cross-Sectional Study. J Palliat Care 2023; 38:424-431. [PMID: 37501537 DOI: 10.1177/08258597231191615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Objective: The aims of the current study are to assess the prevalence of cancer-related fatigue, to examine the difference in cancer-related fatigue severity in relation to patients' characteristics (age, gender, type of cancer, and palliative performance status), and to explore the correlation between cancer-related fatigue and pain, dyspnea, insomnia, and depression among palliative care patients. Methods: A cross-sectional descriptive observational study conducted at Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia. The study included cancer patients who received palliative care services from January 2016 to December 2021. Clinical data of study participants were retrospectively collected from Palliative Care department patient registry. Symptoms were assessed and scored using Edmonton Symptom Assessment Scale. Data analysis was performed using SPSS statistical software. Results: A total of 2616 patients were included in the study, 52.3% were females and 47.7% were males. The median age of study participants was 56 years (range: 2-101 years). Among all study population, the highest reported cancer type was gastrointestinal malignancy (33.5%), while the least was unknown primary malignancy (1.4%). With regards to Edmonton Symptom Assessment Scale, pain (86.4%) and fatigue (83%) were the highest reported symptom in comparison to constipation (17.3%) and insomnia (7.1%). Conclusion: Cancer-related fatigue is a prevalent and concerning issue among palliative care patients. It is essential that healthcare providers recognize the prevalence of fatigue among patients with life-limiting illnesses, assess patients for fatigue routinely, incorporate strategies for managing fatigue, work closely with affected individuals and their families in order to guide the establishment of a personalized care plan that addresses the patient's unique needs and preferences.
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Affiliation(s)
- Abdulaziz A Alzhrani
- Department of Palliative Care, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdullah I Alsuhail
- Department of Palliative Care, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Ahmad A Rababah
- Department of Palliative Care, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
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Badger TA, Segrin C, Crane TE, Chalasani P, Arslan W, Hadeed M, Sikorskii A. Social Determinants of Health and Symptom Burden During Cancer Treatment. Nurs Res 2023; 72:103-113. [PMID: 36729777 PMCID: PMC9991997 DOI: 10.1097/nnr.0000000000000636] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Cancer survivors (defined as individuals from diagnosis to the end of life) in treatment experience multiple physical and psychological symptoms (e.g., fatigue, pain, depression, anxiety, disturbed sleep) that influence their well-being and treatment outcomes. Underrepresented cancer survivors may disproportionately experience greater symptom burden (number of symptoms, symptom severity, depression, anxiety). OBJECTIVES The aim of this study was to examine the relationships of social determinants of health, including age, ethnicity, education, income and whether income meets the survivor's needs, neighborhood (rural vs. urban), access to healthcare (e.g., insurance), and social isolation, with symptom burden in cancer survivors. METHODS This secondary analysis included baseline data from 400 cancer survivors of solid tumor cancers undergoing chemotherapy or targeted therapy who participated in a larger randomized trial of symptom management interventions. Symptom burden was measured by the Center for Epidemiological Studies-Depression scale for depression and Patient-Reported Outcomes Measurement Information System scores for anxiety and social isolation, summed severity index of 16 symptoms from the General Symptom Distress Scale, and the total number of symptoms. Self-reported comorbid conditions were measured using the Bayliss tool. General linear models were used to relate symptom measures (one at a time) to age, number of comorbid conditions, level of education, marital status, income meeting needs, and size of metropolitan neighborhood. Additional covariates included site of cancer, its treatment, and whether the cancer was metastatic. RESULTS Non-Hispanic White survivors ( n = 191) were older and had more comorbid conditions, a higher proportion of metastatic cancers, and higher levels of education and income compared with Hispanic survivors ( n = 168) and non-Hispanic survivors of other races ( n = 41). Compared with the other two groups, Hispanic survivors had the lowest rate of health insurance availability, and non-Hispanic survivors of other races had the lowest social isolation. Age, number of comorbid conditions, and social isolation were significantly associated with number of symptoms, symptom severity, and depression. Age and social isolation were associated with anxiety. In addition, the symptom severity of non-Hispanic White survivors was lower than that of Hispanic survivors and non-Hispanic survivors of other races. DISCUSSION These findings highlight the health disparities in symptom burden experienced among cancer survivors when considering their social determinants of health. Assessing these may help clinicians address health disparities in cancer care.
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Wang K, Zhang A, De Fries CM, Hasche LK. Education Moderates the Association between Depressive Symptoms and Self-Rated Health among Older Adults with Cancer. HEALTH & SOCIAL WORK 2022; 48:hlac031. [PMID: 36473056 DOI: 10.1093/hsw/hlac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/01/2021] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
This study examined the association between depressive symptoms and self-rated health (SRH) and whether and how such association varies by education among older adults with cancer. Data came from the 2019 National Health Interview Survey. A total of 2,470 participants aged 65 or older who had been diagnosed with cancer by a doctor or other health professional were included in this study. Ordinal logistic regression was used to examine the association between depressive symptoms and SRH and whether and how such association varies by education among older adults with cancer. More depressive symptoms were associated with worse SRH. Such association became stronger with higher education among older adults with cancer. Findings confirm the associations between depressive symptoms and SRH among older adults with cancer. The differential impact of education on SRH and on the association between depressive symptoms and SRH highlights the importance of considering patients' educational attainment in a more comprehensive way when working with older adults with cancer. When conducting distress screening among cancer survivors, oncology social workers should be aware of the complex relationship between education and depression in relation to cancer survivors' SRH.
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Affiliation(s)
- Kaipeng Wang
- PhD, is assistant professor, Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO 80208-7100, USA
| | - Anao Zhang
- PhD, ACSW, is assistant professor, School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Carson M De Fries
- MSW, is a PhD student, Graduate School of Social Work, University of Denver, Denver, CO, USA
| | - Leslie K Hasche
- PhD, is associate professor, Graduate School of Social Work, University of Denver, Denver, CO, USA
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Zhang A, Wang K, Acquati C, Kamat A, Walling E. Age as a moderator for the association between depression and self-rated health among cancer survivors: a U.S. based population study. J Psychosoc Oncol 2022:1-16. [PMID: 36154823 DOI: 10.1080/07347332.2022.2124393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Self-rated health (SRH) is a salient outcome for cancer survivors. Although depression is a well-studied correlate with SRH, few studies have focused on the role of cancer survivors' age on the association between depression and SRH. This study evaluates demographic and psychosocial factors associated with cancer survivors' SRH. We also assess the moderating role of age to the association between depression and SRH. MATERIALS AND METHODS This paper analyzed 2,470 U.S. cancer survivors from the 2019 National Health Interview Survey. Two ordered logistic regression models with complex survey weights were used for analyses. Missing data was addressed using multiple imputations by chained equations. RESULTS Being female, higher education and higher income were positively associated with better SRH. While the relationship between higher education and higher income was consistent with previous findings, the positive association between being female and SRH was different from previous studies. Age significantly moderated the association between depression and SRH, evidenced by results of the joint tests of all interaction term coefficients being statistically significant, F(2, 544.6) = 5.13, p < 0.01. CONCLUSIONS The findings of the study highlighted the significance of screening for social determinants of health and health disparity when supporting cancer survivors. Additionally, findings of this study emphasized the significance of adopting an age-specific approach when evaluating and addressing depression across different age groups of cancer survivors.
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Affiliation(s)
- Anao Zhang
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, Texas, USA.,Department of Health Disparities Research, MD Anderson Cancer Center, The University of Texas, Houston, Texas, USA
| | - Aarti Kamat
- Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | - Emily Walling
- Medical School, University of Michigan, Ann Arbor, Michigan, USA
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Agostinelli G, Muzzatti B, Serpentini S, Spina M, Annunziata MA. Cancer-Related Psychological Distress in Lymphoma Survivor: An Italian Cross-Sectional Study. Front Psychol 2022; 13:872329. [PMID: 35558708 PMCID: PMC9088809 DOI: 10.3389/fpsyg.2022.872329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022] Open
Abstract
Cancer is becoming a chronic disease, and the number of cancer survivors continues to increase. Lymphoma survivors are also increasing in numbers, and anxiety and depression are among the consequences they face. This study aimed to explore psychological distress in a sample of 212 lymphoma survivors. Information through a socio-demographic form and the compilation of questionnaires to assess anxiety, depression, quality of life, and the impact of cancer on lymphoma survivors was collected and analyzed. In the sample examined, 17% of lymphoma survivors were anxiety caseness, and 12.3% were depression caseness, and of these, 8% presented with concomitant anxiety depression. This study identified some variables associated with psychological distress in lymphoma survivors: female sex; living as a couple; a diagnosis of Hodgkin lymphoma; systematic treatment and/or radiotherapy; sleep disorders; no regular physical activity; and present or past use of psychiatric drugs. Our cross-sectional study results suggest that some of the variables investigated may be useful in identifying lymphoma survivors who are more likely to report psychological distress. It is important to monitor psychological distress along the entire trajectory of survivorship in order to identify early the presence of anxiety and depression and to provide timely psychological support.
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Affiliation(s)
- Giulia Agostinelli
- Unit of Oncological Psychology - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Barbara Muzzatti
- Unit of Oncological Psychology - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | | | - Michele Spina
- Unit of Oncological Medicine - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
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Fitch MI, Nicoll I, Newton L, Strohschein FJ. Challenges of Survivorship for Older Adults Diagnosed with Cancer. Curr Oncol Rep 2022; 24:763-773. [PMID: 35286555 PMCID: PMC8918886 DOI: 10.1007/s11912-022-01255-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 11/26/2022]
Abstract
Purpose of Review The purpose of this brief review is to highlight significant recent developments in survivorship research and care of older adults following cancer treatment. The aim is to provide insight into care and support needs of older adults during cancer survivorship as well as directions for future research. Recent Findings The numbers of older adult cancer survivors are increasing globally. Increased attention to the interaction between age-related and cancer-related concerns before, during, and after cancer treatment is needed to optimize outcomes and quality of life among older adult survivors. Issues of concern to older survivors, and ones associated with quality of life, include physical and cognitive functioning and emotional well-being. Maintaining activities of daily living, given limitations imposed by cancer treatment and other comorbidities, is of primary importance to older survivors. Evidence concerning the influence of income and rurality, experiences in care coordination and accessing services, and effectiveness of interventions remains scant for older adults during survivorship. Summary There is a clear need for further research relating to tailored intervention and health care provider knowledge and education. Emerging issues, such as the use of medical assistance in dying, must be considered in this population.
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Affiliation(s)
- Margaret I. Fitch
- Bloomberg Faculty of Nursing, University of Toronto, 207 Chisholm Ave, Toronto, ON M4C 4V9 Canada
| | | | - Lorelei Newton
- School of Nursing, STN CSC, University of Victoria, PO Box 1700, Victoria, BC V8W 2Y2 Canada
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Examining a Fatigue Management Model in Older Individuals. Rehabil Nurs 2022; 47:50-59. [DOI: 10.1097/rnj.0000000000000360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Oswald LB, Hyland KA, Eisel SL, Hoogland AI, Knoop H, Nelson AM, Pinilla-Ibarz J, Sweet K, Jacobsen PB, Jim HS. Correlates of fatigue severity in patients with chronic myeloid leukemia treated with targeted therapy. Support Care Cancer 2022; 30:87-94. [PMID: 34231041 PMCID: PMC8639627 DOI: 10.1007/s00520-021-06408-1] [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: 03/29/2021] [Accepted: 06/28/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE Tyrosine kinase inhibitors (TKIs) substantially improve survival for patients with chronic myeloid leukemia (CML), but fatigue associated with TKIs can negatively impact patients' quality of life and adherence. This study sought to identify correlates of fatigue (e.g., sociodemographic characteristics, clinical characteristics, health behaviors) among patients with CML taking TKIs who reported moderate to severe fatigue. METHODS Adults with CML experiencing at least moderate fatigue were recruited for a pilot trial of a cognitive behavioral intervention to improve fatigue. Data collected pre-intervention were used to explore concurrent correlates of fatigue in univariate and multivariable models. RESULTS Participants (N = 44, 48% female) were M = 55.6 years old (SD = 12.6) and had been diagnosed with CML M = 5.2 years prior (SD = 5.3). Participants had been taking their current TKI for M = 2.5 years (SD = 2.7). Most participants (64%) had previously been treated with ≥ 1 other TKI. More than three-quarters of participants (77%) reported severe fatigue. In univariate models, worse fatigue was associated with higher BMI (r = -0.36, p = 0.018), prior treatment with other TKI(s) (r = - 0.34, p = 0.024), worse sleep disturbance (r = - 0.51, p < 0.001), and less physical activity (r = 0.31, p = 0.043). In a multivariable model, significant univariate correlates accounted for 39% of the variance in fatigue. Worse fatigue remained significantly correlated with higher BMI (β = - 0.33, p = 0.009) and more disturbed sleep (β = - 0.45, p < 0.001). CONCLUSION Results may inform future research aiming to identify fatigued patients with CML at risk for experiencing more severe fatigue during TKI therapy. Identifying predictors of fatigue severity could aid clinicians in identifying which patients will benefit from referrals to supportive therapy. TRIAL REGISTRATION NCT02592447, October 30, 2015.
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Affiliation(s)
- Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Kelly A. Hyland
- Department of Psychology, University of South Florida, Tampa, FL
| | - Sarah L. Eisel
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam
| | - Ashley M. Nelson
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA
| | | | - Kendra Sweet
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL
| | - Paul B. Jacobsen
- Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, MD
| | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
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Azizoddin DR, Schreiber K, Beck MR, Enzinger AC, Hruschak V, Darnall BD, Edwards RR, Allsop MJ, Tulsky JA, Boyer E, Mackey S. Chronic pain severity, impact, and opioid use among patients with cancer: An analysis of biopsychosocial factors using the CHOIR learning health care system. Cancer 2021; 127:3254-3263. [PMID: 34061975 PMCID: PMC9981278 DOI: 10.1002/cncr.33645] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/09/2021] [Accepted: 04/21/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Despite the biopsychosocial underpinnings of chronic noncancer pain, relatively little is known about the contribution of psychosocial factors to chronic cancer pain. The authors aimed to characterize associations between biopsychosocial factors and pain and opioid use among individuals with chronic pain and cancer. METHODS The authors conducted a retrospective, cross-sectional study of 700 patients with chronic pain and cancer seeking treatment at an academic tertiary pain clinic. Patients completed demographic questionnaires and validated psychosocial and pain measures. Multivariable, hierarchical linear and logistic regressions assessed the relative contributions of biopsychosocial factors to the primary dependent variables of pain severity, pain interference, and opioid use. RESULTS Participants were 62% female and 66% White with a mean age of 59 ± 15 years, and 55% held a college degree or higher. Older age, African American or "other" race, sleep disturbance, and pain catastrophizing were significantly associated with higher pain severity (F(5,657) = 22.45; P ≤ .001; R2 = 0.22). Depression, sleep disturbance, pain catastrophizing, lower emotional support, and higher pain severity were significantly associated with pain interference (F(5,653) = 9.47; P ≤ .001; R2 = 0.44). Lastly, a poor cancer prognosis (Exp(B) = 1.62) and sleep disturbance (Exp(B) = 1.02) were associated with taking opioids, whereas identifying as Asian (Exp(B) = 0.48) or Hispanic (Exp(B) = 0.47) was associated with lower odds of using opioids. CONCLUSIONS Modifiable psychological factors-specifically sleep disturbance, depression, and pain catastrophizing-were uniquely associated with pain and opioid use in patients with chronic pain and diverse cancer diagnoses. Future behavioral pain interventions that concurrently target sleep may improve pain among patients with cancer. LAY SUMMARY Feeling depressed, worrying about pain, and bad sleep are related to higher pain symptoms in individuals with chronic pain and cancer. Specifically, those who struggle to sleep have worse pain and use more opioids. Also, individuals who have a bad prognosis for their cancer are more likely to be using opioid pain medications. Although race and cancer are related to chronic pain in patients, psychological well-being is also strongly related to this same pain.
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Affiliation(s)
- Desiree R. Azizoddin
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts
| | - Kristin Schreiber
- Harvard Medical School, Boston, Massachusetts,Department of Anesthesiology, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Andrea C. Enzinger
- Harvard Medical School, Boston, Massachusetts,Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Valerie Hruschak
- Department of Anesthesiology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Beth D. Darnall
- Division of Pain Medicine, Department of Anesthesiology, Perioperative Medicine, and Pain Medicine, Stanford University, Stanford, California
| | - Robert R. Edwards
- Harvard Medical School, Boston, Massachusetts,Department of Anesthesiology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Matthew J. Allsop
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - James A. Tulsky
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts,Harvard Medical School, Boston, Massachusetts,Division of Palliative Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Sean Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative Medicine, and Pain Medicine, Stanford University, Stanford, California
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14
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Lacy M, Fong M, Bolton C, Maranzano M, Bishop M, Artz A. Cognitive functioning of older adults prior to hematopoietic stem cell transplantation. Bone Marrow Transplant 2021; 56:2575-2581. [PMID: 34031555 DOI: 10.1038/s41409-021-01331-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 10/26/2020] [Accepted: 04/26/2021] [Indexed: 11/09/2022]
Abstract
Hematopoietic cell transplantation is increasingly used in older adults with hematological malignancies. Younger adult patients who undergo HCT have shown to commonly present with cognitive impairment and depression prior to transplant; however, little research has been done to understand the cognitive and emotional functioning of older adults undergoing HCT. This study aimed to investigate the rate of cognitive impairment in a retrospective sample of older adult HCT candidates prior to transplant using a comprehensive battery. Ninety-three patients over the age of 60 completed a neuropsychology test battery that assessed standard domains of cognitive and emotional functioning. Impairment was defined as z-scores = < -1.5 on at least two tests or a z score = < -2.0 on at least one test. Results indicated that over 68% of patients were impaired with nearly a third of the sample showing impairment in verbal learning and memory and approximately one fifth showing impairments in aspects of executive function, processing speed, and visual learning. Ten percent of the patients endorsed symptoms indicative of a clinical level of depression. Medical comorbidities nor depression predicted cognitive impairment. These findings suggest that older adults candidates for HCT are at risk for cognitive impairment prior to transplant and thus cognition should be a consideration when developing treatment plans.
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Affiliation(s)
- Maureen Lacy
- University of Chicago Medical Center, Chicago, USA.
| | - Mandy Fong
- Washington University in St. Louis, St. Louis, MO, USA
| | | | | | | | - Andrew Artz
- City of Hope National Medicine Center, Duarte, CA, USA
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15
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Lei R, Sun Y, Liao J, Yuan Y, Sun L, Liu Y, Yang X, Ma W, Yu Z. Sex hormone levels in females of different ages suffering from depression. BMC WOMENS HEALTH 2021; 21:215. [PMID: 34022874 PMCID: PMC8141202 DOI: 10.1186/s12905-021-01350-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 05/09/2021] [Indexed: 11/15/2022]
Abstract
Background There are only a few studies on sex hormones in females of different ages suffering from depression, and their conclusions are not uniform until now. This study aimed to investigate the correlation between the severity of depression in females and factors such as sex hormones and differences in sex hormone levels in females of different ages, exploring variations after treatment. Methods A total of 169 females with depression were selected and divided into the first-episode (91 cases) and recurrent (78 cases) groups. Then, on the basis of their age, the first-episode patients were divided into the young (48 cases, age < 45 years), perimenopausal (20 cases, 45–55 years), and elderly groups (23 cases, age > 55 years); the patients with recurrent depression were classified into the young (37 cases, age < 45 years), perimenopausal (19 cases, 45–55 years), and elderly groups (22 cases, age > 55 years). The patients were assessed in accordance with the International Classification of Diseases of mental and behavioral disorders. The serum progesterone, prolactin, estradiol, and testosterone levels in the patients were measured, and differences in sex hormone levels of the groups were analyzed. Results The estradiol level was negatively correlated with age and the prolactin level was positively correlated with occupation. The severity of depression in females was found to be negatively correlated with age. The serum progesterone and estradiol levels in the young group were significantly higher than those in the elderly group, regardless of the first episode or recurrence. Estradiol levels in the perimenopausal and elderly groups with first-episode depression were significantly higher than those in the same group with recurrent depression. However, there was no significant difference in the serum progesterone, prolactin, estradiol, and testosterone levels in the recurrent group before and after treatment. Conclusions Sex hormone levels, especially estradiol, varied among females of different ages suffering from depression. Recurrent depression also has a certain effect on sex hormone levels in females. Not only should the age and relapse be considered when studying the sex hormone levels of females with depression, but also attention should be paid to whether the patients have used antidepressants before their sexual hormonal testing.
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Affiliation(s)
- Rong Lei
- Department of Adult Psychiatry, Second People's Hospital of Huizhou, Huizhou, China
| | - Yan Sun
- Department of Clinical Psychology, Kailuan Mental Health Centre Affiliated to North China University of Science and Technology, Tangshan, China
| | - Jiawen Liao
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Yuan Yuan
- Department of Geriatric Psychiatry, Second People's Hospital of Huizhou, Huizhou, China
| | - Linlin Sun
- School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Yugeng Liu
- Department of Mood Disorders, Tianjin Mental Health Centre, Tianjin, China
| | - Xinyu Yang
- School of Psychology and Mental Health, North China University of Science and Technology, Tangshan, China
| | - Wenyou Ma
- Department of Clinical Psychology, Kailuan Mental Health Center Affiliated to North China University of Science and Technology, Tangshan, China.
| | - Zhenjian Yu
- Department of Clinical Psychology, Kailuan Mental Health Center Affiliated to North China University of Science and Technology, Tangshan, China.
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16
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Zhang X, Pennell ML, Bernardo BM, Clark J, Krok-Schoen JL, Focht BC, Crane TE, Shadyab AH, Paskett ED. Body image, physical activity and psychological health in older female cancer survivors. J Geriatr Oncol 2021; 12:1059-1067. [PMID: 33967023 DOI: 10.1016/j.jgo.2021.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/08/2021] [Accepted: 04/29/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To determine the association of physical activity and body image with psychological health outcomes and whether body image mediates the association of physical activity with psychological health among older female cancer survivors. MATERIALS AND METHODS Data from the Women's Health Initiative (WHI) Life and Longevity after Cancer (LILAC) Study were used. Surveys assessed body image (appearance, attractiveness, scars), moderate-strenuous physical activity (min/week), and psychological health (depression, anxiety, distress). A mediation analysis was conducted to estimate the percentage of the total effect of physical activity on psychological health mediated by body image concerns. RESULTS Among 4567 female cancer survivors aged 66-98 years, the average time since cancer diagnosis was 9.2 years. Approximately 50% reported no moderate-strenuous physical activity; 15% reported depressive symptoms, 6% reported anxiety, and 5% reported psychological distress; 3% had concerns with appearance, 20% had concerns with attractiveness, and 21% had concerns with scars. When unadjusted for body image concerns, every 30 min/week increase in physical activity was associated with lower risk of depressive symptoms (RR = 0.93, 95%CI: 0.90-0.96), anxiety (RR = 0.92, 95%CI: 0.87-0.97), and distress (RR = 0.92, 95%CI: 0.87-0.98). Body image concerns with appearance mediated 7%, 8.8%, and 14.5% of the association between physical activity and depressive symptoms, anxiety, and distress, respectively. CONCLUSION Older female cancer survivors reported body image concerns, which were associated with both physical activity and psychological health. Our findings suggest that interventions designed to address body image concerns in older female cancer survivors could serve to improve the benefit of physical activity on psychological health.
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Affiliation(s)
- Xiaochen Zhang
- Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America
| | - Michael L Pennell
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Brittany M Bernardo
- Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America
| | - Justin Clark
- Department of Mathematics and Statistics, Kenyon College, Gambier, OH, United States of America
| | - Jessica L Krok-Schoen
- Division of Health Sciences and Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, United States of America
| | - Brian C Focht
- Kinesiology, Department of Human Sciences, The Ohio State University, Columbus, OH, United States of America
| | - Tracy E Crane
- Biobehavioral Health Sciences Division, College of Nursing, University of Arizona, Tucson, AZ, United States of America
| | - Aladdin H Shadyab
- Department of Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, United States of America
| | - Electra D Paskett
- Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America.
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17
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Hajjay A, Hassan SAM, Rayes R, Alzahrani L, Alotaibi KF, Alharbi S. Risk Factors Linked to Depression After Treatment in Cancer Survivors in Jeddah, Saudi Arabia. Cureus 2021; 13:e12710. [PMID: 33614315 PMCID: PMC7883560 DOI: 10.7759/cureus.12710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background While many cancer patients survive long after diagnosis, one is bound to experience long-term and latent side effects as a result of the treatment. This experience results in a poor quality of life, morbidity, and mortality for cancer survivors. Understanding how to manage these side-effects is quite important and a key to cancer survivorship. Objective Given the importance of this area, the main objective of this study seeks to understand the risk factor associated with cancer survivorship. Methods A cross-sectional study was conducted among 154 cancer survivors from King Fahad General and Kind Abdul-Aziz hospitals. Descriptive and inferential statistics were used in analyzing the responses. Descriptive statistics were used in understanding the extent of the risk factors while inferential statistics were used to understand the cross-relationships. Results This study included 154 cancer survivors aged 18 and above at King Fahad Hospital and King Abdul-Aziz Hospital in Jeddah, Makkah Region, KSA. Thirty-one (20.1%) of the sample were males and 123 (79.9%) were females. Of all the survivors who screened, 111 (72.9%) symptoms occur before treatment, 116 (75.3%) within the treatment, and 57 (37.09%) after treatment. The relationship between Socioeconomic Status Cross Symptoms categories demonstrated below includes accommodation type, education level, age, gender, and job. Conclusion The study concludes that post-cancer treatment symptoms are highly affected by other factors such as social-economic status as well as family support. As a result, the study recommends the establishment of educational materials on post-treatment symptoms, care-plans, and support groups for cancer survivors.
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Affiliation(s)
- Adel Hajjay
- Medicine and Surgery, Batterjee Medical College, Jeddah, SAU
| | | | - Rida Rayes
- Medicine and Surgery, Batterjee Medical College, Jeddah, SAU
| | | | | | - Shurooq Alharbi
- Medicine and Surgery, Batterjee Medical College, Jeddah, SAU
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18
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Calidad de Vida: a systematic review of quality of life in Latino cancer survivors in the USA. Qual Life Res 2020; 29:2615-2630. [PMID: 32430782 DOI: 10.1007/s11136-020-02527-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cancer is the leading cause of death among Hispanics/Latinos. Thus, understanding health-related quality of life (HRQOL) needs among this diverse racial/ethnic group is critical. Using Ferrell's multidimensional framework for measuring QOL, we synthesized evidence on HRQOL needs among Hispanic/Latino cancer survivors. METHODS We searched MEDLINE/PubMed, EMBASE, CINAHL, and PsycINFO, for English language articles published between 1995 and January 2020, reporting HRQOL among Hispanic/Latino cancer survivors in the USA. RESULTS Of the 648 articles reviewed, 176 met inclusion criteria, with 100 of these studies focusing exclusively on breast cancer patients and no studies examining end-of-life HRQOL issues. Compared with other racial/ethnic groups, Hispanics/Latinos reported lower HRQOL and a higher symptom burden across multiple HRQOL domains. Over 80% of studies examining racial/ethnic differences in psychological well-being (n = 45) reported worse outcomes among Hispanics/Latinos compared with other racial/ethnic groups. Hispanic/Latino cancer survivors were also more likely to report suboptimal physical well-being in 60% of studies assessing racial/ethnic differences (n = 27), and Hispanics/Latinos also reported lower social well-being relative to non-Hispanics/Latinos in 78% of studies reporting these outcomes (n = 32). In contrast, reports of spiritual well-being and spirituality-based coping were higher among Hispanics/Latinos cancer survivors in 50% of studies examining racial/ethnic differences (n = 15). DISCUSSION Findings from this review point to the need for more systematic and tailored interventions to address HRQOL needs among this growing cancer survivor population. Future HRQOL research on Hispanics/Latinos should evaluate variations in HRQOL needs across cancer types and Hispanic/Latino subgroups and assess HRQOL needs during metastatic and end-of-life disease phases.
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19
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Zimmermann FF, Burrell B, Jordan J. Patients' experiences of a mindfulness intervention for adults with advanced cancer: a qualitative analysis. Support Care Cancer 2020; 28:4911-4921. [PMID: 32016601 DOI: 10.1007/s00520-020-05331-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/28/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE People with advanced cancer often experience significant emotional turmoil that accompanies their diagnosis and cancer-related treatments. Therefore, psychological interventions become relevant to address these impacts; however, there is a lack of research into the psychological support needs of those with advanced cancer (those not yet in palliative or end-of-life stages). In this context, we developed a mindfulness-based intervention, Coping with Cancer Mindfully (CCM), to provide psychological and emotional support to adults with advanced cancer. This article reports on qualitative interviews from a mixed method study of the CCM intervention exploring its utility and the extent it provides psychological support to this population in a pre-post-intervention design. METHODS Adults with advanced cancer (stage III or IV) were recruited via cancer-related services in Christchurch, New Zealand. Thematic analysis was used to analyse the semi-structured interviews. RESULTS Twenty participants were interviewed. Thematic analysis showed that at baseline, participants were experiencing distress but few had been offered psychological support; they reported feeling vulnerable and battling their cancers, and were seeking help. Post-intervention interviews reported that most participants' perspectives had shifted, from a state of vulnerability to one of self-encouragement, increased optimism, and taking new actions regarding their situations. The CCM intervention was identified as a readily available and positive tool of support. CONCLUSIONS Our findings suggest that those with advanced cancer should be offered options of psychological support at any stage post-diagnosis. At such an intense period in their lives, people with advanced cancer are likely to benefit from tailored psychological interventions. The CCM intervention with its focus on acceptance, meaning in life, and mindful coping has been shown to be acceptable to participants and as a supportive tool.
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Affiliation(s)
- Fernanda F Zimmermann
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand.
| | - Beverley Burrell
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
| | - Jennifer Jordan
- Psychological Medicine, University of Otago, Christchurch, New Zealand
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20
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Hernández R, Calderon C, Carmona-Bayonas A, Rodríguez Capote A, Jara C, Padilla Álvarez A, Gómez-Camacho MDLN, Beato C, Castelo B, Majem M, Muñoz MDM, Ivars A, Mangas-Izquierdo M, Rogado-Revuelta J, Jimenez-Fonseca P. Differences in coping strategies among young adults and the elderly with cancer. Psychogeriatrics 2019; 19:426-434. [PMID: 30723983 DOI: 10.1111/psyg.12420] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/06/2018] [Accepted: 12/31/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Coping with cancer and the oncologist-patient relationship can vary depending on the patient's age. Our aim is to examine and compare young and elderly adults with non-metastatic, resected cancer. METHODS Two groups of patients were selected, young (< 40 years) and elderly (> 70) with a diagnosis of non-metastatic, resected cancer requiring adjuvant chemotherapy from a pre-exiting, national database (NEOCOPING Study). Epidemiological variables were collected and subjects' emotional responses, perceptions of the physician-patient relationship, support network, fears, and regret about the decision to receive chemotherapy were assessed with questionnaires validated in previous studies: Mini-Mental Adjustment to Cancer, Brief Summary Inventory (18 items), European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-C30, Shared Decision-Making Questionnaire-Physician's version, Shared Decision-Making Questionnaire-Patient's version, and Informed Risk (physician and patient versions). RESULTS Data from 46 young and 46 elderly participants were collected. The most common neoplasms in both groups were breast (50%) and colorectal (22%). The younger adults had a higher level of education and were actively employed (72% vs. 7%). The leading coping strategy in the younger cohort was hope, and resignation among the elderly. Young adults sought more social support and the impact of diagnosis was more negative for them than for older individuals. No significant differences were detected in quality of life; both age groups demanded more time at their first visit with the doctor, while the older group exhibited greater satisfaction with shared decision-making. At the end of adjuvant chemotherapy, neither age group regretted their decision to receive said treatment. CONCLUSION Higher levels of education, greater demands of the labour market, and the advent of the age of information have entailed drastic changes in the physician-patient relationship paradigm. This is especially true in the younger cancer patient population, who require more information and active participation in decision-making, can display more anxiety about their diagnosis, but also greater capacity to fight.
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Affiliation(s)
- Raquel Hernández
- Department of Medical Oncology, University Hospital of the Canary Islands, Tenerife, Spain
| | - Caterina Calderon
- Department of Clinical Psychology and Psychobiology. Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | | | | | - Carlos Jara
- Department of Medical Oncology, University Hospital Fundación Alcorcón, Universidad Rey Juan Carlos, Madrid, Spain
| | - Airam Padilla Álvarez
- Department of Medical Oncology, University Hospital of the Canary Islands, Tenerife, Spain
| | | | - Carmen Beato
- Department of Medical Oncology, Hospital Grupo Quirón, Sevilla, Spain
| | - Beatriz Castelo
- Department of Medical Oncology, University Hospital La Paz, Madrid, Spain
| | - Margarita Majem
- Department of Medical Oncology, University Hospital Santa Creu and Sant Pau, Barcelona, Spain
| | | | - Alejandra Ivars
- Department of Medical Oncology, Morales Meseguer University Hospital, Murcia, Spain
| | | | | | - Paula Jimenez-Fonseca
- Department of Medical Oncology, University Hospital Central of Asturias, Oviedo, Spain
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21
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Rim SH, Yabroff KR, Dasari S, Han X, Litzelman K, Ekwueme DU. Preventive care service use among cancer survivors with serious psychological distress: An analysis of the medical expenditure panel survey data. Prev Med 2019; 123:152-159. [PMID: 30890353 PMCID: PMC6637742 DOI: 10.1016/j.ypmed.2019.03.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 02/12/2019] [Accepted: 03/15/2019] [Indexed: 01/07/2023]
Abstract
Serious psychological distress (SPD) can adversely impact health and quality of life after cancer. The purpose of this study is to examine the association between SPD and the receipt of preventive care services and cancer screening among survivors and adults without a cancer history. A total of 12,564 cancer survivors and 160,023 adults without a cancer history as comparison group were identified from the population-based Medical Expenditure Panel Survey (2008-2015). SPD was assessed using the 6-item Kessler Psychological Distress Scale. We examined use of preventive care and cancer screening services in cancer survivors and comparison adults with/without SPD. Multivariable logistic regression models were conducted for each outcome: preventive service (i.e. blood pressure, cholesterol, influenza vaccination, routine and dental check-up) or cancer screening (i.e. mammography, Papanicolau test, colorectal cancer screening) adjusting for demographic, comorbidity, usual source of care covariates. Adjusted odds ratios and 95% confidence intervals were calculated. Prevalence of SPD was 9.8% in cancer survivors compared to 4.6% in comparison adults. Survivors with SPD were more frequent utilizers of medical care, reporting 10 or more visits to the doctor's office in the past 12 months (29.3% vs. 14.1% without SPD). Having SPD was associated with lower odds of being up-to-date with preventive service use and cancer screening among age- and gender-eligible individuals. The magnitude of the effect was greater in adults' age ≥65 years. Better coordination of care and patient-physician discussions are likely needed to improve delivery of recommended preventive services for persons with SPD.
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Affiliation(s)
- Sun Hee Rim
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
| | - K Robin Yabroff
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA, United States of America
| | - Sabitha Dasari
- Cyberdata Technologies, Inc., Atlanta, GA, United States of America
| | - Xuesong Han
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA, United States of America
| | - Kristin Litzelman
- University of Wisconsin-Madison, Madison, WI, United States of America
| | - Donatus U Ekwueme
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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22
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Magnuson A, Sattar S, Nightingale G, Saracino R, Skonecki E, Trevino KM. A Practical Guide to Geriatric Syndromes in Older Adults With Cancer: A Focus on Falls, Cognition, Polypharmacy, and Depression. Am Soc Clin Oncol Educ Book 2019; 39:e96-e109. [PMID: 31099668 DOI: 10.1200/edbk_237641] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Geriatric syndromes are multifactorial conditions that are prevalent in older adults. Geriatric syndromes are believed to develop when an individual experiences accumulated impairments in multiple systems that compromise their compensatory ability. In older adults with cancer, the presence of a geriatric syndrome is common and may increase the complexity of cancer treatment. In addition, the physiologic stress of cancer and cancer treatment may precipitate or exacerbate geriatric syndromes. Common geriatric syndromes include falls, cognitive syndromes and delirium, depression, and polypharmacy. In the oncology setting, the presence of geriatric syndromes is relevant; falls and cognitive problems have been shown to be predictive of chemotherapy toxicity and overall survival. Polypharmacy and depression are more common in older adults with cancer compared with the general geriatric population. Multiple screening tools exist to identify falls, cognitive problems, polypharmacy, and depression in older adults and can be applied to the oncology setting to identify patients at risk. When recognized, several interventions exist that could be considered for this vulnerable population. We review the available evidence of four geriatric syndromes in the oncology setting, including clinical implications, validated screening tools, potential supportive care, and therapeutic interventions.
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Affiliation(s)
- Allison Magnuson
- 1 Department of Medicine, Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY
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23
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van der Donk LJ, Tovote KA, Links TP, Roodenburg JLN, Kluin-Nelemans JC, Arts HJG, Mul VEM, van Ginkel RJ, Baas PC, Hoff C, Sanderman R, Fleer J, Schroevers MJ. Reasons for low uptake of a psychological intervention offered to cancer survivors with elevated depressive symptoms. Psychooncology 2019; 28:830-838. [PMID: 30762273 PMCID: PMC6593801 DOI: 10.1002/pon.5029] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/08/2019] [Accepted: 02/08/2019] [Indexed: 01/19/2023]
Abstract
Objective In line with screening guidelines, cancer survivors were consecutively screened on depressive symptoms (as part of standard care), with those reporting elevated levels of symptoms offered psychological care as part of a trial. Because of the low uptake, no conclusions could be drawn about the interventions' efficacy. Given the trial set‐up (following screening guidelines and strict methodological quality criteria), we believe that this observational study reporting the flow of participation, reasons for and characteristics associated with nonparticipation, adds to the debate about the feasibility and efficiency of screening guidelines. Methods Two thousand six hundred eight medium‐ to long‐term cancer survivors were consecutively screened on depressive symptoms using the Patient Health Questionnaire‐9 (PHQ‐9). Those with moderate depressive symptoms (PHQ‐9 ≥ 10) were contacted and informed about the trial. Patient flow and reasons for nonparticipation were carefully monitored. Results One thousand thirty seven survivors (74.3%) returned the questionnaire, with 147 (7.6%) reporting moderate depressive symptoms. Of this group, 49 survivors (33.3%) were ineligible, including 26 survivors (17.7%) already receiving treatment and another 44 survivors (30.0%) reporting no need for treatment. Only 25 survivors (1.0%) participated in the trial. Conclusion Of the approached survivors for screening, only 1% was eligible and interested in receiving psychological care as part of our trial. Four reasons for nonparticipation were: nonresponse to screening, low levels of depressive symptoms, no need, or already receiving care. Our findings question whether to spend the limited resources in psycho‐oncological care on following screening guidelines and the efficiency of using consecutive screening for trial recruitment in cancer survivors.
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Affiliation(s)
- Loek J van der Donk
- Department of Health Psychology University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - K Annika Tovote
- Department of Health Psychology University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Thera P Links
- Department of Endocrinology and Metabolic Diseases University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jan L N Roodenburg
- Department of Oral and Maxillofacial Surgery, Section of Oncology University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Johanna C Kluin-Nelemans
- Department of Haematology, University of Groningen, University Medical Center Groningen Groningen, Groningen, the Netherlands
| | - Henriette J G Arts
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Veronique E M Mul
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Robert J van Ginkel
- Department of Surgery, Laboratory for Translational Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Peter C Baas
- Department of Surgery, Martini Hospital, Groningen, the Netherlands
| | - Christiaan Hoff
- Department of Surgery, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Robbert Sanderman
- Department of Health Psychology University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Psychology, Health and Technology, University of Twente, Enschede, the Netherlands
| | - Joke Fleer
- Department of Health Psychology University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Maya J Schroevers
- Department of Health Psychology University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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24
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Ngamkham S, Holden JE, Smith EL. A Systematic Review: Mindfulness Intervention for Cancer-Related Pain. Asia Pac J Oncol Nurs 2019; 6:161-169. [PMID: 30931361 PMCID: PMC6371675 DOI: 10.4103/apjon.apjon_67_18] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Moderate-to-severe pain is a common problem experienced by patients with cancer. Although analgesic drugs are effective, adverse side effects are common and some analgesic drugs are addictive. Nonpharmacological treatment may be a way to treat cancer pain without causing negative side effects. Mindfulness is used as an effective nonpharmacological treatment to improve quality of life (QoL) and to address psychological problems including distress, anxiety, stress, and depression. However, the effect of mindfulness on pain severity has not been sufficiently investigated. Therefore, a systematic review was undertaken to describe the effectiveness of mindfulness interventions for pain and its underlying pathophysiologic mechanisms. The search was conducted in PubMed, Ovid MEDLINE, and CINAHL and included only empirical studies published from 2008 to 2017. Search terms included mindfulness, mindfulness-based intervention, meditation, cancer, pain, and cancer-related pain. Six studies met the search criteria. These studies tested several types of intervention including mindfulness-based stress reduction, mindfulness-based cognitive therapy, meditation with massage, and mindful awareness practices. Study outcomes include improved pain severity, anxiety, stress, depression, and QoL. However, most studies reviewed were conducted in the United States and Denmark. Further research is needed to test culturally appropriate mindfulness interventions to reduce pain.
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Affiliation(s)
- Srisuda Ngamkham
- Department of Nursing Administration and Professional Development, Boromarajonani College of Nursing Sawanpracharak Nakhonsawan, Nakhonsawan, Thailand
| | - Janean E Holden
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Ellen Lavoie Smith
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
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25
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Bower JE, Asher A, Garet D, Petersen L, Ganz PA, Irwin MR, Cole SW, Hurvitz SA, Crespi CM. Testing a biobehavioral model of fatigue before adjuvant therapy in women with breast cancer. Cancer 2018; 125:633-641. [PMID: 30561795 DOI: 10.1002/cncr.31827] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/23/2018] [Accepted: 10/01/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Fatigue is one of the most common and disabling side effects of cancer and its treatment. Although research typically has focused on fatigue that occurs during and after treatment, patients may experience fatigue even before treatment onset. The current study was designed to identify biobehavioral risk factors associated with fatigue before adjuvant therapy in women with early-stage breast cancer. METHODS Patients with stage 0 to stage IIIA breast cancer (270 women) were recruited before the onset of adjuvant or neoadjuvant therapy with radiotherapy, chemotherapy, and/or endocrine therapy. Host factors that may influence fatigue were identified from an empirically based, biobehavioral model and assessed using self-report questionnaires, medical record review, and blood collection (for genetic data). Fatigue was assessed by questionnaire. Linear regression analyses were used to evaluate the association between host factors and dimensions of fatigue, with general fatigue as the primary dimension of interest. RESULTS Fatigue was elevated at the pretreatment assessment compared with published controls. Bivariate analyses identified demographic, cancer-related, and biobehavioral correlates of fatigue. In the multivariable model, predictors of general fatigue included younger age, lower educational level, lower cancer stage, and history of childhood maltreatment (all P values <.05), with the full model accounting for approximately 18.4% of the variance in fatigue. Secondary analyses identified common and specific predictors of emotional, mental, and physical dimensions of fatigue. CONCLUSIONS Among women who have not yet initiated treatment of breast cancer, demographic and psychosocial factors are associated with elevated fatigue and could be used to identify at-risk patients for early intervention.
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Affiliation(s)
- Julienne E Bower
- Department of Psychology, University of California at Los Angeles, Los Angeles, California.,Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.,Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California.,Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California
| | - Arash Asher
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Deborah Garet
- Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California
| | - Laura Petersen
- Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California
| | - Patricia A Ganz
- Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.,School of Medicine, University of California at Los Angeles, Los Angeles, California.,School of Public Health, University of California at Los Angeles, Los Angeles, California
| | - Michael R Irwin
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.,Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California
| | - Steve W Cole
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.,Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California.,Department of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Sara A Hurvitz
- Department of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.,Department of Biostatistics, University of California at Los Angeles, Los Angeles, California
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26
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Calderon C, Carmona-Bayonas A, Beato C, Ghanem I, Hernandez R, Majem M, Rosa Diaz A, Higuera O, Mut Lloret M, Jimenez-Fonseca P. Risk of malnutrition and emotional distress as factors affecting health-related quality of life in patients with resected cancer. Clin Transl Oncol 2018; 21:687-691. [PMID: 30284234 DOI: 10.1007/s12094-018-1954-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 09/11/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This study analyzes the prevalence of malnutrition, depression, anxiety, and somatization and which factor has the biggest effect on quality of life (QoL) in individuals with resected cancer. METHODS A prospective study was conducted among 747 participants. Participants completed the EORTC-QLQ30, MST, and BSI-18 questionnaires. RESULTS Prevalence for risk of malnutrition, depression, anxiety, and somatization were 36.4%, 35.5%, 35.2%, and 48.8%, respectively. Hierarchical multiple regression analyses revealed that malnutrition risk, somatization, depression, and anxiety accounted for 50.8% of the variance in functional scale, 45.3% in symptom scale, and 52.2% in global health. Malnutrition, somatization, depression, and anxiety displayed high explanatory power on all health-related QoL (HRQoL) scales. CONCLUSION The risk of malnutrition and psychological symptoms is strongly associated with HRQoL in cancer patients; thus, medical oncologists should develop effective interventions that contribute to lowering the risk of malnutrition and psychological distress, thereby improving subjects' HRQoL before initiating adjuvant chemotherapy.
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Affiliation(s)
- C Calderon
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - A Carmona-Bayonas
- Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain
| | - C Beato
- Department of Medical Oncology, Hospital Universitario Virgen de la Macarena, Sevilla, Spain
| | - I Ghanem
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - R Hernandez
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - M Majem
- Department of Medical Oncology, Hospital Universitari Santa Creu i Sant Pau, Barcelona, Spain
| | - A Rosa Diaz
- Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain
| | - O Higuera
- Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain
| | - M Mut Lloret
- Department of Medical Oncology, Hospital Universitario Son Espases, Mallorca, Spain
| | - P Jimenez-Fonseca
- Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain.
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27
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Ritt-Olson A, Miller K, Baezconde-Garbanati L, Freyer D, Ramirez C, Hamilton A, Milam J. Depressive Symptoms and Quality of Life Among Adolescent and Young Adult Cancer Survivors: Impact of Gender and Latino Culture. J Adolesc Young Adult Oncol 2018; 7:384-388. [PMID: 29768076 DOI: 10.1089/jayao.2017.0078] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Ethnic and sex variations in depressive symptoms and quality of life (QOL) among adolescent and young adult (AYA) childhood cancer survivors were explored among a sample of Latino and non-Latino childhood cancer survivors (CCSs) (n = 194) treated at hospitals in Los Angeles County. Latinos scored higher in depressive symptoms and lower in QOL when compared with non-Latinos. Males had higher depressive symptoms. Among Latinos, higher levels of acculturation were associated with depression and a poorer QOL, and we found that more acculturated Latino males were more likely to have meaningful levels of depression than less acculturated males or females. Interventions addressing depressive symptoms may be most needed for Hispanic male CCSs.
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Affiliation(s)
- Anamara Ritt-Olson
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
| | - Kimberly Miller
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
| | - Lourdes Baezconde-Garbanati
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
| | - David Freyer
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California.,2 Department of Pediatrics, Keck School of Medicine of the University of Southern California , Los Angeles, California.,3 Department of Medicine, Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles , Los Angeles, California.,4 Department of Medicine, USC Norris Comprehensive Cancer Center , Los Angeles, California
| | - Cynthia Ramirez
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
| | - Ann Hamilton
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
| | - Joel Milam
- 1 Department of Preventive Medicine, Keck School of Medicine of the University of Southern California , Los Angeles, California
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28
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Di Marco M, Rubbi I, Baldi A, Di Lorenzo R, Magnani D, Cremonini V, Sarli L, Artioli G, Ferri P. Evaluation of fatigue in patients with pancreatic cancer receiving chemotherapy treatment: a cross-sectional observational study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:18-27. [PMID: 29644986 PMCID: PMC6357627 DOI: 10.23750/abm.v89i4-s.7063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 02/27/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM OF THE WORK Cancer-related fatigue (CRF) is one of the most common symptoms experienced by cancer patients (CPs) and negatively affects quality of life. Although CRF is frequently experienced, it is often underreported, underdiagnosed and undertreated. The objectives of this study were to evaluate the level of fatigue in patients with pancreatic cancer undergoing chemotherapy and to analyse its correlation with patients' demographic and clinical variables. METHODS A cross-sectional observational study was implemented in the Oncology Day Hospital of a Northern Italian hospital. A sample of 48 patients receiving chemotherapy were evaluated through the Brief Fatigue Inventory Italian version (BFI-I) between 1 May and 12 October 2016. Data were statistically analysed. RESULTS Most of our patients (94%) experienced fatigue. Women as well as patients with an age ≥65 years reported more fatigue. Anemia, pain and a weight loss of over 16 kg in the last 6 months were significantly related to the perception of fatigue. Regarding life habits, smoking was related to high global score of BFI-I. CONCLUSIONS In accordance with literature, our study suggests that fatigue is a frequent symptom influenced by many constitutional, clinical and environmental factors. Our results highlight the need for an early and regular evaluation of fatigue among cancer patients, in order to implement all those pharmacological and non-pharmacological interventions with proven efficacy in attenuating this symptom.
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Affiliation(s)
- Mariacristina Di Marco
- Department of Specialist, Diagnostic and Experimental Medicine, Sant'Orsola - Malpighi Hospital, University of Bologna, Bologna, Italy.
| | - Ivan Rubbi
- School of Nursing, University of Bologna, Bologna, Italy.
| | - Agnese Baldi
- School of Nursing, University of Bologna, Bologna, Italy.
| | - Rosaria Di Lorenzo
- Department of Mental Health, Local Health Authority (AUSL) of Modena, Modena, Italy.
| | - Daniela Magnani
- School of Nursing, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
| | - Valeria Cremonini
- School of Nursing, ASL Romagna and University of Bologna, Bologna, Italy School of Nursing, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
| | - Leopoldo Sarli
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Giovanna Artioli
- Local Health Centre - Santa Maria Nuova Hospital Scientific Institute for Research, Hospitalization and Health Care, Reggio Emilia, Italy.
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