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Gregory ME, Cao W, Rahurkar S, Jonnalagadda P, Stock JC, Ghazi SM, Reid E, Berk AL, Hebert C, Li L, Addison D. Exploring the Incorporation of a Novel Cardiotoxicity Mobile Health App Into Care of Patients With Cancer: Qualitative Study of Patient and Provider Perspectives. JMIR Cancer 2023; 9:e46481. [PMID: 38085565 PMCID: PMC10751627 DOI: 10.2196/46481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/05/2023] [Accepted: 11/08/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Cardiotoxicity is a limitation of several cancer therapies and early recognition improves outcomes. Symptom-tracking mobile health (mHealth) apps are feasible and beneficial, but key elements for mHealth symptom-tracking to indicate early signs of cardiotoxicity are unknown. OBJECTIVE We explored considerations for the design of, and implementation into a large academic medical center, an mHealth symptom-tracking tool for early recognition of cardiotoxicity in patients with cancer after cancer therapy initiation. METHODS We conducted semistructured interviews of >50% of the providers (oncologists, cardio-oncologists, and radiation oncologists) who manage cancer treatment-related cardiotoxicity in the participating institution (n=11), and either interviews or co-design or both with 6 patients. Data were coded and analyzed using thematic analysis. RESULTS Providers indicated that there was no existing process to enable early recognition of cardiotoxicity and felt the app could reduce delays in diagnosis and lead to better patient outcomes. Signs and symptoms providers recommended for tracking included chest pain or tightness, shortness of breath, heart racing or palpitations, syncope, lightheadedness, edema, and excessive fatigue. Implementation barriers included determining who would receive symptom reports, ensuring all members of the patient's care team (eg, oncologist, cardiologist, and primary care) were informed of the symptom reports and could collaborate on care plans, and how to best integrate the app data into the electronic health record. Patients (n=6, 100%) agreed that the app would be useful for enhanced symptom capture and education and indicated willingness to use it. CONCLUSIONS Providers and patients agree that a patient-facing, cancer treatment-related cardiotoxicity symptom-tracking mHealth app would be beneficial. Additional studies evaluating the role of mHealth as a potential strategy for targeted early cardioprotective therapy initiation are needed.
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Affiliation(s)
- Megan E Gregory
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, Univeristy of Florida, Gainesville, FL, United States
| | - Weidan Cao
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH, United States
| | - Saurabh Rahurkar
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH, United States
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Pallavi Jonnalagadda
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, United States
| | - James C Stock
- Cardio-Oncology Program, Division of Cardiovascular Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
- Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Sanam M Ghazi
- Cardio-Oncology Program, Division of Cardiovascular Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Endia Reid
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH, United States
| | - Abigail L Berk
- Biomedical Sciences Program, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Courtney Hebert
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH, United States
| | - Lang Li
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH, United States
| | - Daniel Addison
- Cardio-Oncology Program, Division of Cardiovascular Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
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Hasannejadasl H, Roumen C, van der Poel H, Vanneste B, van Roermund J, Aben K, Kalendralis P, Osong B, Kiemeney L, Van Oort I, Verwey R, Hochstenbach L, J. Bloemen- van Gurp E, Dekker A, Fijten RRR. Development and external validation of multivariate prediction models for erectile dysfunction in men with localized prostate cancer. PLoS One 2023; 18:e0276815. [PMID: 36867616 PMCID: PMC9983834 DOI: 10.1371/journal.pone.0276815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 10/14/2022] [Indexed: 03/04/2023] Open
Abstract
While the 10-year survival rate for localized prostate cancer patients is very good (>98%), side effects of treatment may limit quality of life significantly. Erectile dysfunction (ED) is a common burden associated with increasing age as well as prostate cancer treatment. Although many studies have investigated the factors affecting erectile dysfunction (ED) after prostate cancer treatment, only limited studies have investigated whether ED can be predicted before the start of treatment. The advent of machine learning (ML) based prediction tools in oncology offers a promising approach to improve the accuracy of prediction and quality of care. Predicting ED may help aid shared decision-making by making the advantages and disadvantages of certain treatments clear, so that a tailored treatment for an individual patient can be chosen. This study aimed to predict ED at 1-year and 2-year post-diagnosis based on patient demographics, clinical data and patient-reported outcomes (PROMs) measured at diagnosis. We used a subset of the ProZIB dataset collected by the Netherlands Comprehensive Cancer Organization (Integraal Kankercentrum Nederland; IKNL) that contained information on 964 localized prostate cancer cases from 69 Dutch hospitals for model training and external validation. Two models were generated using a logistic regression algorithm coupled with Recursive Feature Elimination (RFE). The first predicted ED 1 year post-diagnosis and required 10 pre-treatment variables; the second predicted ED 2 years post-diagnosis with 9 pre-treatment variables. The validation AUCs were 0.84 and 0.81 for 1 year and 2 years post-diagnosis respectively. To immediately allow patients and clinicians to use these models in the clinical decision-making process, nomograms were generated. In conclusion, we successfully developed and validated two models that predicted ED in patients with localized prostate cancer. These models will allow physicians and patients alike to make informed evidence-based decisions about the most suitable treatment with quality of life in mind.
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Affiliation(s)
- Hajar Hasannejadasl
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Cheryl Roumen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Henk van der Poel
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Joep van Roermund
- Department of Urology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Katja Aben
- Department of Research & Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
- Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Petros Kalendralis
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Biche Osong
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Lambertus Kiemeney
- Department of Research & Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
| | - Inge Van Oort
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Renee Verwey
- Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | | | - Esther J. Bloemen- van Gurp
- Zuyd University of Applied Sciences, Heerlen, The Netherlands
- Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Andre Dekker
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Rianne R. R. Fijten
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
- * E-mail: ,
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3
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Muhandiramge J, Zalcberg JR, van Londen GJ, Warner ET, Carr PR, Haydon A, Orchard SG. Cardiovascular Disease in Adult Cancer Survivors: a Review of Current Evidence, Strategies for Prevention and Management, and Future Directions for Cardio-oncology. Curr Oncol Rep 2022; 24:1579-1592. [PMID: 35796941 PMCID: PMC9606033 DOI: 10.1007/s11912-022-01309-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW Cardiovascular disease is long-term complication of both cancer and anti-cancer treatment and can have significant ramifications for health-related quality of life and mortality. This narrative review explores the current evidence linking cardiovascular disease and cancer, as well as exploring strategies for the prevention and management of cardiovascular disease, and outlines future opportunities in the field of cardio-oncology. RECENT FINDINGS Cancer confers risk for various cardiovascular diseases including heart failure, cardiomyopathy, arrhythmia, coronary heart disease, stroke, venous thromboembolism, and valvular heart disease. Cancer treatment, in particular agents such as platinum-based chemotherapy, anthracyclines, hormonal treatments, and thoracic radiotherapy, further increases risk. While cardiovascular disease can be identified early and effectively managed in cancer survivors, cardiovascular screening and management does not typically feature in routine long-term cancer care of adult cancer survivors. Cancer and cancer treatment can accelerate the development of cardiovascular disease. Further research into screening and management strategies for cardiovascular disease, along with evidence-based guidelines, is required to ensure adult cancer survivors receive appropriate long-term care.
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Affiliation(s)
- Jaidyn Muhandiramge
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
- Austin Health, Heidelberg, VIC, Australia.
| | - John R Zalcberg
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Department of Medical Oncology, Alfred Hospital, Melbourne, VIC, Australia
| | - G J van Londen
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erica T Warner
- Clinical and Translational Epidemiology Unit, MGH Cancer Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Prudence R Carr
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Andrew Haydon
- Department of Medical Oncology, Alfred Hospital, Melbourne, VIC, Australia
| | - Suzanne G Orchard
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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Morgans AK, Shore N, Cope D, McNatty A, Moslehi J, Gomella L, Sartor O. Androgen receptor inhibitor treatments: Cardiovascular adverse events and comorbidity considerations in patients with non-metastatic prostate cancer. Urol Oncol 2020; 39:52-62. [PMID: 32958445 DOI: 10.1016/j.urolonc.2020.08.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/24/2020] [Accepted: 08/02/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Prostate cancer and cardiovascular (CV) disease share several risk factors, with the incidence of both rising with increasing age. Systemic prostate cancer therapies may increase CV risk. For example, gonadotropic releasing hormone agonists have been associated with increased development of CV risk factors, and potentially with CV disease. For men with non-metastatic castration-resistant prostate cancer (nmCRPC), the opportunity to mitigate CV risk by appropriate selection of therapy (i.e., use of newer agents such as androgen receptor inhibitors) may be possible. The phase 3 PROSPER, SPARTAN, and ARAMIS trials for enzalutamide, apalutamide, and darolutamide, the 3 approved androgen receptor inhibitors for men with nmCRPC, were all associated with increased metastasis-free survival in patients with metastatic castration-resistant prostate cancer (mCRPC). Our objective in writing this review is to improve awareness of the relationship between long-term androgen deprivation and increased risk for CV disease and inform treatment decision making for patients with mCRPC who also have CV comorbidities. METHODS The PubMed database was searched from 2010 to November 5, 2019 for articles pertaining to androgen receptor inhibitors, androgen inhibition, apalutamide, darolutamide, enzalutamide, CV, and CaP. RESULTS We found literature describing the relationship between androgen inhibition and CV disease and risks. Given the increased risk of CV disease due to exposure to gonadotropic releasing hormone agonist therapy alone, understanding the potential for additional CV risks is important for patients with CV comorbidities when an androgen receptor inhibitor is added to their treatment. Another important consideration is the possibility of drug-drug interactions with comedications. CONCLUSION Management strategies for patients with mCRPC also treated for comorbidities including CV disease require appropriate selection of therapy, diet, and exercise to meet the needs of the individual patient profile.
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Affiliation(s)
- Alicia K Morgans
- Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Neal Shore
- Carolina Urologic Research Center, 823 82nd Pkwy Suite B, Myrtle Beach, SC 29572
| | - Diane Cope
- Florida Cancer Specialists and Research Institute, 8260 Gladiolus Dr, Fort Myers, FL 33908
| | - Andrea McNatty
- Mayo Clinic Arizona, 5881 E. Mayo Blvd., Phoenix, AZ 85054
| | - Javid Moslehi
- Cardio-Oncology Program, Vanderbilt University Medical Center, 1215 21st Ave., Nashville, TN 37232
| | - Leonard Gomella
- Sidney Kimmel Cancer Center at Thomas Jefferson University, 1025 Walnut St. Suite 1112, Philadelphia, PA 19107
| | - Oliver Sartor
- Tulane University Medical School, 1430 Tulane Ave., Box 8642, New Orleans 70112 LA
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van Leeuwen M, Kieffer JM, Efficace F, Fosså SD, Bolla M, Collette L, Colombel M, De Giorgi U, Holzner B, van de Poll-Franse LV, van Poppel H, White J, de Wit R, Osanto S, Aaronson NK. International evaluation of the psychometrics of health-related quality of life questionnaires for use among long-term survivors of testicular and prostate cancer. Health Qual Life Outcomes 2017; 15:97. [PMID: 28490338 PMCID: PMC5426020 DOI: 10.1186/s12955-017-0670-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/28/2017] [Indexed: 11/23/2022] Open
Abstract
Background Understanding of the physical, functional and psychosocial health problems and needs of cancer survivors requires cross-national and cross-cultural standardization of health-related quality of life (HRQoL) questionnaires that capture the full range of issues relevant to cancer survivors. To our knowledge, only one study has investigated in a comprehensive way whether a questionnaire used to evaluate HRQoL in cancer patients under active treatment is also reliable and valid when used among (long-term) cancer survivors. In this study we evaluated, in an international context, the psychometrics of HRQoL questionnaires for use among long-term, disease-free, survivors of testicular and prostate cancer. Methods In this cross-sectional study, we recruited long-term survivors of testicular and prostate cancer from Northern and Southern Europe and from the United Kingdom who had participated in two phase III EORTC clinical trials. Participants completed the SF-36 Health Survey, the EORTC QLQ-C30 questionnaire, the QLQ-PR25 (for prostate cancer) or the QLQ-TC26 (for testicular cancer) questionnaires, and the Impact of Cancer questionnaire. Testicular cancer survivors also completed subscales from the Nordic Questionnaire for Monitoring the Age Diverse Workforce. Results Two hundred forty-two men (66% response rate) were recruited into the study. The average time since treatment was more than 10 years. Overall, there were few missing questionnaire data, although scales related to sexuality, satisfaction with care and relationship concerns of men without partners were missing in more than 10% of cases. Debriefing showed that in general the questionnaires were accepted well. Many of the survivors scored at the upper extremes of the questionnaires, resulting in floor and ceiling effects in 64% of the scales. All of the questionnaires investigated met the threshold of 0.70 for group level reliability, with the exception of the QLQ-TC26 (mean reliability .64) and the QLQ-PR25 (mean reliability .69). The questionnaires were able to discriminate clearly between patients with and without comorbid conditions. Conclusions The currently available HRQoL questionnaires exhibit acceptable psychometric properties and were well received by patients, but additional efforts are needed to ensure that the full range of survivor-specific issues is assessed.
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Affiliation(s)
- Marieke van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, The Netherlands
| | - Jacobien M Kieffer
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, The Netherlands
| | - Fabio Efficace
- Unit, Italian Group for Adult Hematologic Diseases (GIMEMA) Data Center, Via Benevento 6, Rome, Italy
| | - Sophie D Fosså
- Oslo University Hospital, Radiumhospital, National Advisory Unit on Late Effects after Cancer Treatment, Oslo, Norway
| | - Michel Bolla
- Department of Radiation Oncology, Centre Hospitalier Universitaire A Michallon, BP217, 38043, Grenoble cedex 09, France
| | | | - Marc Colombel
- Department of General Urology and Oncology, Hôpital Édouard Herriot, 5 Place d'Arsonval, Lyon, France
| | - Ugo De Giorgi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) - IRCCS, Meldola, Italy
| | - Bernhard Holzner
- Department of Psychiatry, Innsbruck University Hospital, Sternwartestraße 15, Innsbruck, Austria
| | - Lonneke V van de Poll-Franse
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, The Netherlands.,Comprehensive Cancer Organisation Netherlands (CCCS), Netherlands Cancer Registry, Zernikestraat 29, Eindhoven, The Netherlands.,Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Hendrik van Poppel
- Department of Urology, University Hospital, K.U. Leuven, Herestraat 49, Leuven, Belgium
| | - Jeff White
- The Beatson West of Scotland Cancer Center, Glasgow, Scotland
| | - Ronald de Wit
- Department of Medical Oncology, Rotterdam Cancer Institute (Dr Daniel den Hoed Kliniek) and Erasmus University Medical Center, 's-Gravendijkwal 230, Rotterdam, The Netherlands
| | - Susanne Osanto
- Department of Clinical Oncology, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam, The Netherlands.
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Reeve BB, Chen RC, Moore DT, Deal AM, Usinger DS, Lyons JC, Talcott JA. Impact of comorbidity on health-related quality of life after prostate cancer treatment: combined analysis of two prospective cohort studies. BJU Int 2014; 114:E74-E81. [DOI: 10.1111/bju.12723] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Bryce B. Reeve
- Lineberger Comprehensive Cancer Center; University of North Carolina at Chapel Hill; Chapel Hill NC USA
- Department of Health Policy & Management; Gillings School of Global Public Health; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - Ronald C. Chen
- Lineberger Comprehensive Cancer Center; University of North Carolina at Chapel Hill; Chapel Hill NC USA
- Department of Radiation Oncology; University of North Carolina at Chapel Hill; Chapel Hill NC USA
- Cecil G. Sheps Center for Health Services Research; University of North Carolina at Chapel Hill; Chapel Hill NC USA
- School of Medicine; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - Dominic T. Moore
- Lineberger Comprehensive Cancer Center; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - Allison M. Deal
- Lineberger Comprehensive Cancer Center; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - Deborah S. Usinger
- Cecil G. Sheps Center for Health Services Research; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - Jessica C. Lyons
- Lineberger Comprehensive Cancer Center; University of North Carolina at Chapel Hill; Chapel Hill NC USA
| | - James A. Talcott
- Continuum Cancer Centers of New York; New York NY USA
- Albert Einstein School of Medicine; Bronx NY USA
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Chronic disease burden among cancer survivors in the California Behavioral Risk Factor Surveillance System, 2009-2010. J Cancer Surviv 2014; 8:448-59. [PMID: 24715532 DOI: 10.1007/s11764-014-0350-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 02/08/2014] [Indexed: 12/18/2022]
Abstract
PURPOSE The California Behavioral Risk Factor Surveillance System estimates that 56.6 % of cancer survivors report ever being diagnosed with a chronic disease. Few studies have assessed potential variability in comorbidity by cancer type. METHODS We used data collected from a representative sample of adult participants in the 2009 and 2010 California Behavioral Risk Factor Surveillance System (n = 18,807). Chronic diseases were examined with cancer survivorship in case/non-case and case/case analyses. Prevalence ratios (PR) and corresponding 95 % confidence intervals (95 % CI) were estimated using Cox proportional hazards models, with adjustment on race, sex, age, education, smoking, and drinking. RESULTS Obesity was associated with gynecological cancers (PR 1.74; 95 % CI 1.26-2.41), and being overweight was associated with gynecological (PR 1.40; 95 % CI 1.05-1.86) and urinary (PR 2.19; 95 % CI 1.21-3.95) cancers. Arthritis was associated with infection-related (PR 1.78; 95 % CI 1.12-2.83) and hormone-related (PR 1.20; 95 % CI 1.01-1.42) cancers. Asthma was associated with infection- (PR 2.26; 95 % CI 1.49-3.43), hormone- (PR 1.46; 95 % CI 1.21-1.77), and tobacco- (PR 1.86; 95 % CI 1.25-2.77) related cancers. Chronic obstructive pulmonary disease (COPD) was associated with infection- (PR 2.16; 95 % CI 1.22-3.83) and tobacco-related (PR 2.24; 95 % CI 1.37-3.66) cancers and with gynecological cancers (PR 1.60; 95 % 1.00-2.56). CONCLUSIONS This is the first study to examine chronic disease burden among cancer survivors in California. Our findings suggest that the chronic disease burden varies by cancer etiology. IMPLICATIONS FOR CANCER SURVIVORS A clear need has emerged for future biological and epidemiological studies of the interaction between chronic disease and cancer etiology in survivors.
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Schaake W, de Groot M, Krijnen WP, Langendijk JA, van den Bergh ACM. Quality of life among prostate cancer patients: a prospective longitudinal population-based study. Radiother Oncol 2013; 108:299-305. [PMID: 23932157 DOI: 10.1016/j.radonc.2013.06.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/18/2013] [Accepted: 06/19/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the course of quality of life (QoL) among prostate cancer patients treated with external beam radiotherapy and to compare the results with QoL of a normal age-matched reference population. PATIENTS AND METHODS The study population was composed of 227 prostate cancer patients, treated with radiotherapy. The EORTC QLQ-C30 was used to assess QoL before radiotherapy and six months, one year, two years and three years after completion of radiotherapy. Mixed model analyses were used to investigate longitudinal changes in QoL. QoL of prostate cancer patients was compared to that of a normative cohort using a multivariate analysis of covariance. RESULTS A significant decline in QoL was observed after radiotherapy (p<0.001). The addition of hormonal therapy to radiotherapy was associated with a lower level of role functioning. Patients with coronary heart disease and or chronic obstructive pulmonary disease or asthma had a significantly worse course in QoL. Although statistically significant, all differences were classified as small or trivial. CONCLUSION Prostate cancer patients experience a small worsening of QoL as compared with baseline and as compared with a normal reference population. As co-morbidity modulates patients' post-treatment QoL, a proper assessment of co-morbidity should be included in future longitudinal analyses on QoL.
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Affiliation(s)
- Wouter Schaake
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, The Netherlands; Hanze University of Applied Sciences, Professorship in Health Care and Nursing, Groningen, The Netherlands.
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9
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Teloken PE, Mulhall JP. Erectile Function Following Prostate Cancer Treatment: Factors Predicting Recovery. Sex Med Rev 2013; 1:91-103. [PMID: 27784588 DOI: 10.1002/smrj.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Prostate cancer represents the most common nonskin malignancy encountered in men, and the excellent long-term survival achieved in the majority of patients has allowed more attention to be given to the side effects associated with its treatment. Erectile function is one of the main concerns of patients when considering treatment options for prostate cancer. Not surprisingly, post-treatment sexual function is closely related to outcome satisfaction and has long-lasting effects on quality of life. Radical prostatectomy is currently the most commonly employed therapy for prostate cancer. Conflicting rates of erectile dysfunction have been reported after surgery, owing not only to different surgical techniques but also because of dissimilar patient populations and definitions. Providing accurate information to individual patients in regards to their chances of recuperating the ability to have intercourse after treatment is important not only because it allows patients to make informed decisions but also because it has the potential to reduce treatment dissatisfaction. This article mainly focuses on discussing predictors of erectile function after radical prostatectomy. Patient factors, surgical aspects, including comparisons between open, laparoscopic, and robotic approaches, and postoperative management issues that impact sexual outcomes are evaluated. Prediction models combining multiple factors are described. The definition and chronology of erectile function recovery and impact of sexual function on quality of life after surgery are also discussed. Teloken PE and Mulhall JP. Erectile function following prostate cancer treatment: Factors predicting recovery. Sex Med Rev 2013;1:91-103.
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Affiliation(s)
- Patrick E Teloken
- Department of Urology, Sir Charles Gaidner Hospital, Perth, Australia
| | - John P Mulhall
- Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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Thong MSY, Mols F, Verhoeven RHA, Liu L, Andrykowski MA, Roukema JA, van de Poll-Franse LV. Multiple primary cancer survivors have poorer health status and well-being than single primary cancer survivors: a study from the population-based PROFILES registry. Psychooncology 2012. [DOI: 10.1002/pon.3227] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Rob H. A. Verhoeven
- CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology; Tilburg University; Tilburg; The Netherlands
| | - Lifang Liu
- Department of Public Health; Erasmus Medical Center; Rotterdam; The Netherlands
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11
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Payne H, Pearcy R. Symptoms and health-related quality of life in castration-resistant prostate cancer: the patient's perspective. JOURNAL OF MEN'S HEALTH 2012. [DOI: 10.1016/j.jomh.2011.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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12
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Wahlgren T, Levitt S, Kowalski J, Nilsson S, Brandberg Y. Use of the Charlson Combined Comorbidity Index To Predict Postradiotherapy Quality of Life for Prostate Cancer Patients. Int J Radiat Oncol Biol Phys 2011; 81:997-1004. [DOI: 10.1016/j.ijrobp.2010.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 07/02/2010] [Accepted: 07/05/2010] [Indexed: 11/12/2022]
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Thong MSY, van de Poll-Franse L, Hoffman RM, Albertsen PC, Hamilton AS, Stanford JL, Penson DF. Diabetes mellitus and health-related quality of life in prostate cancer: 5-year results from the Prostate Cancer Outcomes Study. BJU Int 2011; 107:1223-31. [PMID: 21070583 PMCID: PMC3292346 DOI: 10.1111/j.1464-410x.2010.09861.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Study Type--Therapy (outcomes research) Level of Evidence 2b. What's known on the subject? and What does the study add? Comorbid diabetes can affect prostate cancer treatment decision-making and outcomes. Few longitudinal studies have investigated the effect of comorbid diabetes on general and cancer-specific health-related quality of life (HRQL) in prostate cancer. Our study found that men with prevalent diabetes (pre-prostate cancer diagnosis) generally had the poorest general HRQL, urinary control and sexual function scores over time, independent of treatment. Non-diabetic men had the best scores and men with incident diabetes (post-prostate cancer diagnosis) reported intermediate scores. OBJECTIVE • To investigate the association between prostate cancer, diabetes, and long-term general and cancer-specific health-related quality of life (HRQL) in a cohort of men with non-metastatic prostate cancer. PATIENTS AND METHODS • We used data from self-administered surveys to assess the HRQL of men with localized or locally advanced disease at 6 (baseline), 12, 24, and 60 months after initial diagnosis. • We examined changes in general and cancer-specific HRQL with repeated measures analyses using a mixed-model approach. RESULTS • In total, we evaluated 1811 men, including 13% with prevalent (pre-prostate cancer diagnosis) diabetes, 12% with incident (post-prostate cancer diagnosis) diabetes, and 75% who never reported being diagnosed with diabetes. • Generally, men with prevalent diabetes had the poorest scores on general HRQL and non-diabetic men the best scores, independent of treatment. • Similarly, men with prevalent diabetes had the lowest urinary control and sexual function scores over time, while men without diabetes had the highest scores. Men with incident diabetes reported intermediate scores. CONCLUSION • Prostate cancer survivors with comorbid diabetes have poorer general and cancer-specific HRQL than those without diabetes.
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Affiliation(s)
- Melissa S Y Thong
- Center of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.
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Papadopoulos A, Vrettos I, Kamposioras K, Anagnostopoulos F, Giannopoulos G, Pectasides D, Niakas D, Economopoulos T. Impact of cancer patients' disease awareness on their family members' health-related quality of life: a cross-sectional survey. Psychooncology 2011; 20:294-301. [DOI: 10.1002/pon.1731] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Evers J, Kupper N, Kessing D, Davits R, Engelen A, Poortmans P, Mols F. No long-term effects of hormonal therapy preceding brachytherapy on urinary function and health-related quality of life among prostate cancer patients. Urology 2010; 76:1150-6. [PMID: 20869105 DOI: 10.1016/j.urology.2010.02.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2009] [Revised: 01/20/2010] [Accepted: 02/15/2010] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To prospectively investigate the influence of 3-month neoadjuvant hormonal therapy (NHT) before brachytherapy (BT) for low-risk prostate cancer (PCa) on urinary function and health-related quality of life (HRQL). METHODS Between 2003 and 2008, 300 patients with PCa were treated with BT using (125)I stranded seeds, of whom 86 received 3-month NHT to downsize the prostate before treatment. Urinary complaints were measured on all occasions with the International Prostate Symptom Score (n = 134) and European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire PR25 (EORTC-QLQ-PR25 questionnaire; n = 118) and HRQL with the EORTC-QLQ-C30 (n = 120) questionnaire. RESULTS Post-BT, urinary function became worse over the first 6 weeks and then improved steadily, but did not return to baseline levels at 1 year. At baseline, the NHT group reported worse urinary function compared with the non-NHT group (P < .01). However, the post-BT improvement of urinary function was better in the NHT group at 3 months (P < .05). Global HRQL, physical, role and social functioning decreased over the first 3 months (P < .05) post-BT but returned to baseline levels within 1 year. Emotional function steadily improved over the 1-year follow-up period (P < .001). The NHT group reported better global HRQL, social and emotional functioning 1 year post-BT compared with baseline (P < 05). All results were adjusted for comorbidity. This is a single-center study with a follow-up of 1 year, thereby potentially limiting the general applicability of the results. CONCLUSIONS Three months of NHT before BT might positively influence urinary function and HRQL up to 1 year post-BT. Therefore, PCa patients should not be dissuaded from considering NHT followed by BT because of prostate size.
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Affiliation(s)
- Judith Evers
- Department of Urology,TweeSteden Hospital, Tilburg, The Netherlands.
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Chirwa TF, Bogaerts J, Chirwa ED, Kazembe LN. Performance of selected nonparametric tests for discrete longitudinal data under different patterns of missing data. J Biopharm Stat 2009; 19:190-203. [PMID: 19127475 DOI: 10.1080/10543400802536248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Comparison of changes over time of a continuous response variable between treatment groups is often of main interest in clinical trials. When the distributional properties of the continuous response variable are not regular enough, or when the response is discrete, nonparametric techniques have been used. The relative performances of selected repeated measures nonparametric two-sample tests proposed by Wei and Lachin, Koziol, Wei and Johnson, and the adapted Wilcoxon Rank-Sum test are compared through simulations based on quality of life data. The Wilcoxon Rank-Sum test is the most powerful and is not significantly affected by the different patterns of missing data.
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Affiliation(s)
- T F Chirwa
- Applied Statistics and Epidemiology Research Group, Department of Mathematical Sciences, Chancellor College, Zomba, Malawi.
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