Fear of cancer recurrence in young women 5 years after diagnosis with a good-prognosis cancer: the VICAN-5 national survey

Mental Health Status of Patients with Thyroid Nodules: A Cross-Sectional Study

Purpose

This study aims to investigate the mental health status of patients with high-risk and low-risk thyroid nodules (TNs), and the potential psychological risk factors that may exist in patients with high-risk nodules.

Patients and Methods

In this cross-sectional study, a total of 7645 adults who participated in physical examinations from January 2021 to December 2023 were included. During the physical examination, they all completed thyroid ultrasound examinations and laboratory tests, and filled out self-administered questionnaires, as well as the Symptom Checklist-90 (SCL-90) and the Stress Self-Assessment Questionnaire-53 (SSQ-53). These were used to collect general information, mental health status, and stress levels of the subjects. According to the degree of malignant risk, TNs were categorized into high-risk groups (HRG) and low-risk groups (LRG). Differences between the two groups were compared in terms of general information, mental health status scores, and laboratory indicators.

Results

The overall detection rate of TNs was 34.5%, with a significantly higher rate in women. There were significant differences in age and gender between HRG and LRG; The total score of SCL-90 in the HRG was significantly higher than that in LRG (128.78±45.65 vs 120.59±31.68, p=0.044); HRG exhibited a higher proportion of positive rates in the somatization (P=0.033) and anxiety (P=0.048) factors of the SCL-90. Among the 10 factors of SCL-90, the scores of somatization (P=0.011), obsessive-compulsive (P=0.010), interpersonal sensitivity (P=0.032), depression (P=0.036) and additional factors (diet and sleep) (P=0.008) in HRG were significantly higher. The results of SSQ-53 suggest that the overall stress level in HRG is higher, and the cognitive stress is significantly higher than that in LRG (P=0.003). Multivariate logistic regression analysis showed that age, gender, and SCL-90 total score were risk factors for high-risk TNs.

Conclusion

High-risk TNs are more common in females and older adults. The existence of high-risk TNs is related to poor mental health status.

Fear of Cancer Recurrence and Fear of Cancer Progression, Digital Resource Engagement and Health Literacy: A Review

Cancer care is evolving, and digital resources are being introduced to support cancer patients throughout the cancer journey. Logistical concerns, such as health literacy and the emotional experience of cancer, need to be considered. Fear of cancer recurrence (FCR) and fear of cancer progression (FOP) are relevant emotional constructs that should be investigated. This scoping review explored two main objectives: first, the link between FCR/FOP and engagement with digital resources, and second, the link between FCR/FOP and health literacy. A database search was conducted separately for each objective. Relevant papers were identified, data were extracted, and a quality assessment was conducted. Objective 1 identified two relevant papers that suggested that higher levels of FCR were correlated with lower levels of engagement with digital resources. Objective 2 identified eight relevant papers that indicated that higher FCR/FOP is correlated with lower health literacy. However, one paper with a greater sample size and a more representative sample reported no significant relationship. There may be important relationships between the constructs of FCR/FOP, resource engagement, and health literacy and relationships may differ across cancer type and sex. However, research is limited. No studies examined the relationship between FOP and engagement or FCR/FOP and digital health literacy, and the number of studies identified was too limited to come to a firm conclusion. Further research is needed to understand the significance and relevance of these relationships.

The clinical effect of gratitude extension-construction theory nursing program on bladder cancer patients with fear of cancer recurrence

Objective

To explore the clinical effect of bladder cancer patients with Fear of Cancer Recurrence (FCR) after applying the gratitude extension construction theory nursing program.

Methods

168 patients with bladder cancer hospitalized in the Department of Urology from December 2021 to June 2023 in a hospital are study subjects. The experimental subjects are uniformly designed as an experimental group and a control group, with 52 participants in each group. The former receives routine nursing care, while the later receives nursing interventions based on gratitude extension construction theory. The baseline data, Quality of life Questionnaire-core 30, Quality of Life Questionnaire-non Invasive Bladder Cancer 24, Fear of Progression Questionnaire-Short Form, gratitude level questionnaire, Self-Rating Depression Scale, Self-rating Anxiety Scale, patient compliance behavior score, Overall Survival, and Progression-free Survival are evaluated.

Results

The basic data revealed no statistical significance. The quality of life questionnaire-core 30 and quality of life questionnaire-noninvasive bladder cancer 24 was no significant difference before treatment and after treatment for 1 month. After 9 months, There was a significant difference in pre-treatment scores. The experimental group had no significant difference before and after treatment. For the overall survival rates, the two groups were 67.25% and 79.56%. The progression-free survival rates were 56.35% and 72.35%, respectively, with statistical difference. The compliance rates were 86.54% and 98.08%. The compliance rate of the experimental group exceeded the control group. After 3, 6, and 12 months, the gratitude level questionnaire score and the fear of progression questionnaire-short form in the experimental group were improved. After 3, 6, and 12 months, the control group had no statistically significant difference in the gratitude level questionnaire and the fear of progression questionnaire-short form scores. Compared with the control group, the scores on the gratitude level questionnaire and the fear of progression questionnaire-short form were significantly higher after 3, 6, and 12 months of intervention.

Conclusion

After applying the gratitude extension construction theory nursing program, the FCR of bladder cancer patients is significantly reduced. The quality of life and compliance rate are significantly improved, and anxiety and depression are relieved.

Feasibility and preliminary efficacy of iConquerFear: a self-guided digital intervention for fear of cancer recurrence

PURPOSE

Approximately 50% of cancer survivors experience moderate-severe fear of cancer recurrence (FCR). Self-guided digital interventions have potential to address the high level of FCR-related unmet needs at scale, but existing digital interventions have demonstrated variable engagement and efficacy. This study aimed to evaluate the feasibility and preliminary efficacy of iConquerFear, a five-module self-guided digital FCR intervention.

METHODS

Eligible curatively treated breast cancer survivors were recruited. Participants reporting clinically significant FCR (≥ 13 on the Fear of Cancer Recurrence Inventory-Short Form; FCRI-SF) were given access to iConquerFear. Feasibility was indicated by > 50% of eligible participants enrolling in iConquerFear and recording moderate (≥ 120 min) or greater usage. Preliminary efficacy was evaluated via changes in self-reported FCR severity, anxiety, depression, intrusions and metacognitions from baseline to immediately and 3 months post-intervention.

RESULTS

Fifty-four (83%) of 65 eligible participants enrolled in iConquerFear; six subsequently withdrew. Thirty-nine (83%) participants recorded moderate (n = 24; 120-599 min) or high (n = 15; ≥ 600 min) usage. Engagement levels increased with participant age (p = 0.043), but were lower in participants with higher baseline FCR (p = 0.028). Qualitative feedback indicated engagement was sometimes limited by difficulties with navigation and relating to featured survivors. Participants reported significantly improved FCR (mean reduction (95%CI): baseline to post-intervention - 3.44 (- 5.18, - 1.71), baseline to 3-month follow-up - 4.52 (- 6.25, - 2.78), p =  < 0.001).

CONCLUSION

iConquerFear is a feasible and potentially efficacious intervention for reducing FCR in breast cancer survivors. Easier navigation and more relatable examples may enhance engagement.

IMPLICATIONS FOR CANCER SURVIVORS

iConquerFear may help address moderate but burdensome FCR levels in cancer survivors.

Comprehensive pan‑cancer analysis of potassium voltage-gated channel Q4 (KCNQ4) gene across multiple human malignant tumors

A large number of studies indicate that Potassium Voltage-Gated Channel Q4 (KCNQ4) gene is the cause of non-syndromic hearing loss, but there are few studies investigating the role of KCNQ4 in cancers and scarcity of comprehensive analysis of its involvement in the diagnosis, methylation, mutation, prognosis of various cancer types. Therefore, the aim of this study is to examine the anticancerous and immune effects of KCNQ4 in various cancers and its potential value in breast cancer. In this study, we explored the potential role of KCNQ4 in cancers using public databases and the R software for bioinformatics analysis. The results showed that the low expression of KCNQ4 across specific cancer types was positively associated with low mutation frequency and methylation, and the improved survival. Eight small molecule compounds were identified that could potentially target KCNQ4. In addition, immunohistochemistry confirmed that the KCNQ4 expression was low in breast cancer. In vitro experiments confirmed that overexpression of KCNQ4 inhibited cell migration and invasion and promoted apoptosis. In summary, our comprehensive pan-cancer analysis highlights the potential of KCNQ4 as a cancer marker, and can be used as an auxiliary prognostic indicator and an indicator for immunotherapy in certain tumor types.