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Coleman D, Hurtado-de-Mendoza A, Montero A, Sawhney S, Wang JHY, Lobo T, Graves KD. Stigma, social support, and spirituality: associations with symptoms among Black, Latina, and Chinese American cervical cancer survivors. J Cancer Surviv 2024; 18:710-726. [PMID: 36417116 PMCID: PMC10200827 DOI: 10.1007/s11764-022-01283-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 10/21/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Few studies have examined experiences of stigma and factors associated with symptoms among cervical cancer survivors from diverse racial and ethnic backgrounds. We investigated survivorship experiences and patient-reported outcomes in the SPADE symptom cluster (sleep disturbance, pain interference, anxiety, depression, and energy/fatigue) among Black, Latina, and Chinese American women diagnosed with cervical cancer. METHODS In two phases of research with cervical cancer survivors, we collected qualitative data through individual interviews (N=12; recruited through community referrals) and quantitative data from an observational cohort study (N=91; recruited through 4 national cancer registries). We coded interview transcripts to describe the survivors' experiences. We then evaluated associations between social support, spirituality, and SPADE symptom cluster domains using linear regression models. RESULTS Qualitative analysis yielded four themes: perceptions of stigma, empowerment, physical and psychological effects, and social support. These concepts revolved around internal and external stigmas, emotional responses, strengthened faith, and different social support types. Quantitative analyses indicated that greater spirituality was associated with lower symptom burden on all five SPADE domains (p<0.01). We observed nuanced associations between specific types of social support and SPADE domains. CONCLUSIONS The survivorship experiences of Black, Latina, and Chinese American women with cervical cancer are negatively influenced by perceptions of stigma. Higher scores on spirituality and varied types of social support were significantly associated with fewer symptoms in the SPADE symptom cluster. IMPLICATIONS FOR CANCER SURVIVORS Results suggest targets for future interventions to reduce symptom burden among women diagnosed with cervical cancer by leveraging spirituality and social support.
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Affiliation(s)
- DeJuana Coleman
- Georgetown University, 37th and O Streets, Washington, DC, NW, 20007, USA
| | - Alejandra Hurtado-de-Mendoza
- Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, NW, 20007, USA
| | - Abigail Montero
- Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, NW, 20007, USA
| | - Sabrina Sawhney
- Georgetown University, 37th and O Streets, Washington, DC, NW, 20007, USA
| | - Judy Huei-Yu Wang
- Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, NW, 20007, USA
| | - Tania Lobo
- Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, NW, 20007, USA
| | - Kristi D Graves
- Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, 2115 Wisconsin Avenue, Suite 300, Washington, DC, NW, 20007, USA.
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Minchew LA, Cesario SK, Richmond MM, Mbango CM. Examining the Burden of Self-Blame Attribution Among Women With Cervical Cancer. J Holist Nurs 2024; 42:143-155. [PMID: 37710995 DOI: 10.1177/08980101231194218] [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] [Indexed: 09/16/2023]
Abstract
Background:Self-blame for past sexual behaviors or for the personal character may be associated with the development of cervical cancer. Purpose: Aims were to understand the burden of self-blame attribution (SBA) among women with cervical cancer by (1) examining relationships between SBA, psychological distress (PD), and spiritual well-being (SWB); (2) determining differences between behavioral (BSB) and characterological self-blame (CSB) attribution; and (3) describing associations between SBA and unwanted past sexual experiences. Methods: Women attending a cancer center in the southeastern United Stats (N = 106) completed an online survey including a demographic questionnaire and three instruments: (1) SBA for Cancer Scale; (2) Psychological Distress Subscale of the Psychological Adjustment to Cancer Scale-Self Report; and (3) Functional Assessment of Cancer Therapy-Spiritual Well-being. Results: Women with cervical cancer, 26-64 years of age, identified moderate levels of SBA, PD, and SWB. Relationships were found between PD, BSB and CSB, and unwanted sexual experiences. Significant inverse correlations between religious faith, BSB, unwanted sexual experiences, and SWB were noted. Unwanted sexual experiences were a significant predictor of SBA. Conclusion: SBA places women at risk for increased burden. Recognizing SBA in vulnerable cancer survivors is important to providing holistic nursing care.
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García JC, Maraver FM, Rodríguez Jiménez I, Ríos-Pena L, Carmen Rubio Rodríguez M. Female sexual function in long-term cervical cancer survivors compared with healthy women and women affected by benign gynecological disorders. Eur J Obstet Gynecol Reprod Biol 2024; 299:43-53. [PMID: 38833773 DOI: 10.1016/j.ejogrb.2024.05.027] [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: 02/14/2024] [Revised: 04/06/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE To compare the female sexual function between cervical cancer survivors and healthy women or with benign gynecological diseases. STUDY DESIGN From January 1, 2010 to January 31, 2019, a case-control study was conducted to compare the female sexual function of 106 cervical cancer survivors from a tertiary hospital and 185 women admitted to a gynecological outpatient clinic from the same health area for a routine gynecological examination (n=46) or for a benign gynecological disorder (symptomatic, n=113; asymptomatic, n=26). We prospectively assessed the female sexual function using the Female Sexual Function Index (FSFI). For the contrastive analysis hypothesis, we employed R statistical software. RESULTS Cervical cancer survivors reported lower sexual activity rates than controls, in general, did (47.12% vs. 88.65%, p=0.0001), and, particularly, compared with healthy and symptomatic controls (47.12% vs. 82.61%, p=0.003; 47.12% vs. 87.61%, p=0.0001, respectively). Sixty and fifty-eight hundredths percent of the cervical cancer survivors experienced female sexual dysfunction, mainly due to hypoactive sexual desire (93.27%). Female sexual dysfunction was diagnosed in 64.32% of the controls, with sexual arousal disorders being the most common diagnosis (44.86%). Compared with controls, cervical cancer survivors exhibited considerably lower FSFI total scores and in sexual desire and lubrication domains (p <0.000; p <0.0001; p=0.023). CONCLUSIONS Cervical cancer survivors had worse female sexual function and less sexual activity than controls did, although scores in both groups were in range of FSD. Rates of female sexual dysfunction were similar across cervical cancer survivors and controls, with hypoactive sexual desire and sexual arousal disorders as the most common diagnoses, respectively.
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Affiliation(s)
- Jorge Cea García
- Clinical Management Unit for Obstetrics and Gynecology, University Hospital Virgen Macarena, 3 Dr Fedriani Ave., 41 009 Seville, Spain.
| | - Francisco Márquez Maraver
- Clinical Management Unit for Obstetrics and Gynecology, University Hospital Virgen Macarena, 3 Dr Fedriani Ave., 41 009 Seville, Spain
| | - Inmaculada Rodríguez Jiménez
- Clinical Management Unit for Obstetrics and Gynecology, University Hospital Virgen Macarena, 3 Dr Fedriani Ave., 41 009 Seville, Spain
| | - Laura Ríos-Pena
- Institute of Science and Technology, Loyola University, De las Universidades Ave., 41 704 Dos Hermanas, Seville, Spain
| | - M Carmen Rubio Rodríguez
- Department of Radiation Oncology in HM Hospitals, University Hospital Sanchinarro, 10 De Oña St., 28 050, Madrid, Spain and Puerta del Sur, 70 Carlos V Ave., 28 938, Móstoles, Madrid, Spain.
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4
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Seyfu DT, Abebe SN, Haile S, Ayana BA. Health related quality of life and its predictive factors on cervical cancer patients in two teaching hospitals, Addis Ababa, Ethiopia. BMC Womens Health 2024; 24:209. [PMID: 38566073 PMCID: PMC10986003 DOI: 10.1186/s12905-024-03046-7] [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: 06/16/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Cervical cancer is the second most prevalent and the leading cause of cancer related deaths among Ethiopian women; and about three fourth are diagnosed at advanced stages. Cervical cancer can affect the health-related quality of life (HRQOL) in multiple ways. The main aim of this study was to describe the HRQOL of cervical cancer patients and the predictive factors using validated tools. METHODS Institution based cross-sectional study was conducted among 264 cervical cancer patients using the validated Amharic version of European Organization for Research and Treatment of Cancer (EORTC) modules; QLQ-C30 and QLQ CX24. Descriptive statistics were used to summarize the raw data. One way ANOVA was used to determine the significance of mean differences between the dependent and independent variables. Binary and multivariable regression analysis were used to measure the association between Global Health Status and independent factors. The level of significance was set at p-value < 0.05. RESULTS On EORTC QLQ-C30 scales, the mean Global Health Status (GHS) was 42.57 ± 23.31. The least and highest affected functions were physical and social, mean (SD) = 76.39 ± 23.24 and 50.40 ± 32.19, respectively. The financial difficulty was the most affected among the symptom scales, 57.83 ± 35.34. Only physical function and financial difficulty have shown an independent association with GHS, (AOR = 0.21, 95% CI = 0.05-0.84), (AOR = 0.21 95% CI = 0.07-0.59), respectively. Illiterate, can read and write, were among the predictor factors that showed an independent association with the Global Health Status. Among the EORTC QLQ-CX24 symptom scales, the highest affected score was for sexual worry, mean (SD) = 51.81 + 32.197. CONCLUSIONS In an effort to improve the Global Health Status of cervical cancer patients in Ethiopia; physical function and financial difficulty should be the priority areas. The Illiterate and those who lack formal education need due attention in order to improve the health-related quality-of-life.
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Affiliation(s)
- Daniel Terefe Seyfu
- Department of Obstetrics and Gynecology, Yirgalem Hospital, Yirgalem, Ethiopia
| | - Shiferaw Negash Abebe
- Department of Obstetrics and Gynecology, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Sofanit Haile
- Department of Obstetrics and Gynecology, Addis Ababa University, Addis Ababa, Ethiopia
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Peerenboom R, Ackroyd S, Lee N. The burden of cervical cancer survivorship: Understanding morbidity and survivorship needs through hospital admissions. Gynecol Oncol Rep 2024; 51:101328. [PMID: 38318201 PMCID: PMC10839575 DOI: 10.1016/j.gore.2024.101328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/07/2024] Open
Abstract
Objective To describe disease- and treatment-related survivorship burden amongst survivors of cervical cancer and identify risk factors for hospital admissions after initial treatment. Methods Retrospective chart review including patients treated for cervical cancer from 2014 to 2020 at a single urban academic institution. Clinical, demographic, and hospital admission characteristics were summarized. Associations between patient characteristics and likelihood of admission were examined using univariate and multivariate regression. Results Of 366 patients undergoing surveillance following completion of primary treatment, 156 (43 %) were hospitalized for cancer or treatment-related sequela in the median follow-up of 3.6 years (IQR 1.4-6.4), with a median of 2 admissions (IQR 1-4.5) per patient and 570 unique admissions. While 65 (35 %) of admitted patients had multiple reasons for admission, the most common reasons for admission were: gastrointestinal complications (43 %), infection (38 %), genitourinary complications (33 %), and pain control (23 %). A substantial proportion of admitted patients underwent interventions including surgical procedures (57 %), transfusion of blood products (40 %), and interventional radiology procedures (28 %) and utilized supportive care services including case management (53 %), physical therapy (40 %), and occupational therapy (36 %). On multivariate analysis, odds of admission were higher among Black patients (aOR 2.4, p <.01), uninsured patients (aOR 2.7, p <.05), those with lower performance status (aOR 1.4, p <.05), and those with recurrence (aOR 5.5, p <.001). Conclusion Survivors of cervical cancer represent a high-risk population frequently hospitalized after initial treatment. Black patients, uninsured patients, those with recurrence, and those with lower performance status faced higher odds of admission. Comprehensive, team-based care is necessary to address complex survivorship needs.
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Affiliation(s)
- Rayne Peerenboom
- University of Chicago, Pritzker School of Medicine, United States
| | - Sarah Ackroyd
- University of Chicago, Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, United States
| | - Nita Lee
- University of Chicago, Department of Obstetrics and Gynecology, Section of Gynecologic Oncology, United States
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Vali M, Maleki Z, Nikbakht HA, Hassanipour S, Kouhi A, Nazemi S, Hajizade-Valokolaee M, Nayeb M, Ghaem H. Survival rate of cervical cancer in Asian countries: a systematic review and meta-analysis. BMC Womens Health 2023; 23:671. [PMID: 38098009 PMCID: PMC10722657 DOI: 10.1186/s12905-023-02829-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE Cancer is one of the main causes of death, and cervical cancer is the fourth most common cancer and the fourth leading cause of death from malignancy among women. Knowing the survival rate is used to evaluate the success of current treatments and care. This study was conducted to assess the survival rate of cervical cancer in Asia. METHODS This systematic survey was conducted on four international databases, including Medline/PubMed, ProQuest, Scopus, and Web of Knowledge, and includes manuscripts that were published until the end of August 2021. Selected keywords were searched for international databases including cervical neoplasms [mesh], survival analysis or survival or survival rate, Asian countries (name of countries). The Newcastle-Ottawa Qualitative Evaluation Form was used for cohort studies to evaluate the quality of the articles. The analysis process was performed to evaluate the heterogeneity of the studies using the Cochran test and I2 statistics. Additionally, a meta-regression analysis was performed based on the year of the study. RESULTS A total of 1956 articles were selected and reviewed based on their title. The results showed that 110 articles met the inclusion criteria. According to the randomized model, the 1, 3, 5, and 10-year survival rates of cervical cancer were 76.62% (95% Confidence Interval (CI), 72.91_80.34), 68.77% (95% CI, 64.32_73.21), 62.34% (95% CI, 58.10_66.59), and 61.60% (95% CI, 52.31_70.89), respectively. Additionally, based on the results of meta-regression analysis, there was an association between the year of the study and the survival rate, elucidating that the survival rate of cervical cancer has increased over the years. CONCLUSIONS Results can provide the basic information needed for effective policy making, and development of public health programs for prevention, diagnosis, and treatment of cervical cancer.
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Affiliation(s)
- Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Maleki
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein-Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Department of Biostatistics & Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Aida Kouhi
- Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sina Nazemi
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Maryam Hajizade-Valokolaee
- Department of Health, Health Systems Research, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - MohammadReza Nayeb
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Haleh Ghaem
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
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7
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Korompelis P, Rundle S, Cassar V, Ratnavelu N, Ralte A, Biliatis I, Kucukmetin A. Conservative surgical approaches for small volume FIGO stage IB1 cervical cancer. Updated survival and obstetric outcomes of an expanded cohort. Gynecol Oncol 2023; 176:155-161. [PMID: 37542842 DOI: 10.1016/j.ygyno.2023.07.018] [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: 05/09/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE Standard surgical treatment of FIGO stage 1B1 cervical cancer is open radical surgery. However, there is increasing evidence that for small tumours a more conservative approach can minimise fertility consequences without impacting on long term oncologic outcomes. The objective of our study is to present survival and obstetric outcomes following extended follow-up for patients who underwent conservative management of small-volume stage 1B1 disease. METHODS All patients with FIGO stage 1B1 cancer and estimated tumour volume of <500 mm3 in a loop biopsy specimen treated in Northern Gynaecological Oncology Centre between December 2000 and December 2021, were included in the study. Clinico-pathological and demographic data were collated alongside detailed follow-up and obstetric outcomes in conjunction with primary care and death register. RESULTS 117 patients underwent conservative surgery for small volume stage 1B1 disease. 58 (49.5%) underwent fertility sparing conservative management with LLETZ while 59 (50.5%) underwent simple hysterectomy. Overall, 95% (111/117) of the patients underwent bilateral pelvic lymphadenectomy and 1 positive node was identified. There was no death related to cervical cancer and 1 recurrence identified during a median follow up of 8.5 years (1-20). 17 pregnancies have been recorded in patients underwent LLETZ and 17 live babies were born. No second trimester miscarriages were noted and there was one preterm delivery (36 weeks). CONCLUSION Non-radical surgery with negative pelvic lymphadenectomy for smallvolume stage 1B1 cervical cancer ensures excellent survival without compromising obstetric outcomes. Should these results be verified by the ongoing prospective studies, radical surgery for these patients may be avoided.
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Affiliation(s)
- Porfyrios Korompelis
- Northern Gynaecological Oncology Centre (NGOC), Queen Elizabeth Hospital, Gateshead, UK.
| | - Stuart Rundle
- Northern Gynaecological Oncology Centre (NGOC), Queen Elizabeth Hospital, Gateshead, UK
| | - Viktor Cassar
- Northern Gynaecological Oncology Centre (NGOC), Queen Elizabeth Hospital, Gateshead, UK
| | - Nithya Ratnavelu
- Northern Gynaecological Oncology Centre (NGOC), Queen Elizabeth Hospital, Gateshead, UK
| | - Angela Ralte
- Pathology Department, Queen Elizabeth Hospital, Gateshead, UK
| | | | - Ali Kucukmetin
- Northern Gynaecological Oncology Centre (NGOC), Queen Elizabeth Hospital, Gateshead, UK
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8
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Vidrine JI, Fennell BS, Simmons VN, Sutton SK, Jones SR, Woodward HW, Hoogland CE, Vidrine DJ. Enhancing long-term smoking abstinence among individuals with a history of cervical intraepithelial neoplasia or cervical cancer (Project ACCESS): protocol for a randomized clinical trial. BMC Public Health 2023; 23:1284. [PMID: 37403057 DOI: 10.1186/s12889-023-16189-3] [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: 05/30/2023] [Accepted: 06/25/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The prevalence of smoking among cervical cancer survivors is high and evidence-based smoking cessation interventions are critically needed. This paper describes the study design, methods, and data analysis plans for a randomized clinical trial (RCT) designed to evaluate the efficacy of a novel, personally tailored SMS-delivered text-based digital treatment adjuvant designed to enhance the long-term efficacy of a "Motivation And Problem-Solving" (MAPS) approach for smoking cessation among individuals with a history of cervical intraepithelial neoplasia (CIN) or cervical cancer. MAPS is a phone counseling approach designed to facilitate long-term abstinence that comprises 6 counseling calls over 12 months. The current trial is evaluating the efficacy of MAPS+, which comprises all MAPS components plus a 24-month digital treatment adjuvant. This trial represents a logical extension of our previous RCT, which compared the efficacy of MAPS to a quitline control condition and found that MAPS resulted in greater than a 2-fold increase in smoking abstinence at 12 months (i.e., 26.4% vs. 11.9%). This treatment effect was no longer significant at 18 months, suggesting that efficacy dissipated as time from the end of treatment increased. The primary aim of the current trial is to compare the efficacy of MAPS + and ST in facilitating long-term abstinence. METHODS Individuals who smoke and have a history of cervical cancer or CIN (N = 340) are recruited throughout Florida and randomly assigned to Standard Treatment [ST] or MAPS+. ST participants are electronically connected with the Florida Quitline. MAPS + consists of 6 proactive MAPS-based counseling calls over 12 months plus the novel, personally tailored, text message-based treatment adjuvant delivered over 24 months. All participants receive 12 weeks of combination nicotine replacement therapy (patch and lozenge) and are followed for 24 months. Participant recruitment commenced in December 2022 and is ongoing. DISCUSSION This study builds on promising results from our recent trial which found that MAPS was associated with substantially higher abstinence from smoking at the end of the 12-month treatment period. Finding that this low-burden, personally tailored digital treatment adjuvant improves the long-term efficacy of MAPS would have important clinical and public health implications. TRIAL REGISTRATION Clinical Trials Registry NCT05645146; https://clinicaltrials.gov/ct2/show/NCT05645146 ; Registered on December 9, 2022.
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Grants
- 22K02, Principal Investigator JIV James and Esther King Florida Biomedical Research Program
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- P30CA076292, awarded to Moffitt Cancer Center NCI Cancer Center Support Grant
- T32CA090314-18, MPIs: Vadaparampil, Simmons National Institutes of Health Training Grant in Behavioral Oncology
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Affiliation(s)
- Jennifer I Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA.
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
- Department of Psychology, University of South Florida, Tampa, FL, USA.
| | - Bethany Shorey Fennell
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Steven K Sutton
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA
| | - Sarah R Jones
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Honor W Woodward
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Charles E Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
| | - Damon J Vidrine
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL, 33612, USA
- Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
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Zhao J, Kong Y, Xiang Y, Yang J. The research landscape of the quality of life or psychological impact on gynecological cancer patients: A bibliometric analysis. Front Oncol 2023; 13:1115852. [PMID: 36824135 PMCID: PMC9941849 DOI: 10.3389/fonc.2023.1115852] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/10/2023] [Indexed: 02/09/2023] Open
Abstract
Background Gynecological cancer is one of the most common cancers in women. The quality of life (QoL) or psychological impact has emerged as an outcome indicator in many clinical trials of gynecological cancer and gained much concern in the clinical setting at the start of the 21st century. Our paper conducted a bibliometric analysis of QoL or psychological impact on gynecological cancer patients to show the status and hotspots. Methods Related publications from 2000 to 2022 were included by screening from the Web of Science Core Collection (WOSCC) on 26 June 2022. The bibliometrics was analyzed and visualized by bibliometrix R-package, VOSviewer, and CiteSpace V. Results A total of 6,479 publications were included in our study. The publications in this field were increased annually. The United States (n = 2,075) was the country with the most published papers. Sydney University (n = 167) was the most productive affiliation. Gynecologic Oncology and Journal of Clinical Oncology were the most relevant and most cited sources, respectively. The article written by Bray F et al. has the highest citation. Kim J and Aaronson NK ranked first in most productive author and most co-cited author, respectively. The keywords "mortality", "fertility preservation", and "palliative care" have bursts till 2022, which represented the frontiers of this field. Conclusion Our study provides an overall analysis of QoL or psychological impact on gynecological cancer patients, which can serve as a reference in future research.
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Affiliation(s)
- Jiayuan Zhao
- National Clinical Research Center for Obstetric & Gynecologic Diseases/Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yujia Kong
- National Clinical Research Center for Obstetric & Gynecologic Diseases/Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yang Xiang
- National Clinical Research Center for Obstetric & Gynecologic Diseases/Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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10
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Qian M, Wang L, Xing J, Shan X, Wu J, Liu X. Prevalence of sexual dysfunction in women with cervical cancer: a systematic review and meta-analysis. PSYCHOL HEALTH MED 2023; 28:494-508. [PMID: 35946648 DOI: 10.1080/13548506.2022.2110270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cervical cancer (CC) is a common malignant gynaecological tumour. However, as survival rates have improved, increasing attention has focused on the quality of the survivors' sex lives. We conducted a meta-analysis to investigate the prevalence and severity of female sexual dysfunction (FSD) in women with CC. We searched the PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, and Wang Fang databases, and extracted data from all studies published up to December 2020 that evaluated sexual dysfunction in patients with CC with the female sexual function index (FSFI). Studies were screened according to specific inclusion and exclusion criteria, and the qualities of the included studies were evaluated. Sixteen studies with a total of 2009 women with CC, including 1306 women with FSD, were included in the meta-analysis. Among patients with CC, the incidence of FSD was 80% (95% confidence interval (95%CI) 0.74-0.87) and the average FSFI score was 20.25 (95%CI 18.96-21.53). These results revealed a high prevalence of FSD and poor sexual function among women with CC, suggesting a need to assess sexual function regularly in these women with CC to improve early recognition of FSD and thereby allow appropriate interventions to enhance the sex life of affected patients.
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Affiliation(s)
- Maolin Qian
- School of Medicine, Nantong University, Nantong, People's Republic of China
| | - Lan Wang
- School of Medicine, Nantong University, Nantong, People's Republic of China
| | - Jiajun Xing
- School of Medicine, Nantong University, Nantong, People's Republic of China
| | - Xiao Shan
- School of Medicine, Nantong University, Nantong, People's Republic of China
| | - Juan Wu
- Department of Gynecology, Affiliated Hospital of Nantong University, Nantong, People's Republic of China
| | - Xiaoqin Liu
- Department of Gynecology, Affiliated Hospital of Nantong University, Nantong, People's Republic of China
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11
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Chang CP, Wilson CM, Rowe K, Snyder J, Dodson M, Deshmukh V, Newman M, Fraser A, Smith K, Date A, Stanford JB, Gaffney D, Mooney K, Hashibe M. Sexual dysfunction among gynecologic cancer survivors in a population-based cohort study. Support Care Cancer 2022; 31:51. [PMID: 36526929 PMCID: PMC9850804 DOI: 10.1007/s00520-022-07469-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022]
Abstract
Treatment for gynecologic cancer is associated with sexual dysfunction, which may present during and/or after treatment. The aim of this study was to investigate the risk of sexual dysfunction among gynecologic cancer survivors compared to cancer-free women in a population-based cohort study. We identified a cohort of 4863 endometrial, ovarian, and cervical cancer survivors diagnosed between 1997 and 2012 in the Utah Cancer Registry. Up to five cancer-free women were matched to cancer survivors (N = 22,693). We used ICD-9 codes to identify sexual dysfunction. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for sexual dysfunction with adjustment for potential confounders. Approximately 6.6% of gynecologic cancer survivors had sexual dysfunction diagnoses 1-5 years after cancer diagnosis. Gynecologic cancer survivors had higher risks of overall sexual dysfunction (HR: 2.51, 95% CI: 2.16, 2.93), dyspareunia (HR: 3.27, 95% CI: 2.63, 4.06), and vaginal dryness (HR: 2.63, 95% CI: 2.21, 3.12) compared to a general population of women, 1-5 years after cancer diagnosis. Sexual dysfunction was associated with advance cancer stage (HRRegional vs. Localized: 1.61, 95% CI: 1.19, 2.31), radiation therapy (HR: 1.73, 95% CI: 1.29, 2.31), and chemotherapy (HR: 1.80, 95% CI: 1.30, 2.50). This large cohort study confirms that there is an increased risk of sexual dysfunction among gynecologic cancer survivors when compared to the general population. Further investigation is needed to address the risk factors for sexual dysfunction and to improve patient-provider communication, diagnosis, documentation, and treatment of sexual dysfunction among gynecologic cancer survivors.
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Affiliation(s)
- Chun-Pin Chang
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.
| | - Christina M Wilson
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kerry Rowe
- Intermountain Healthcare, Salt Lake City, UT, USA
| | - John Snyder
- Intermountain Healthcare, Salt Lake City, UT, USA
| | - Mark Dodson
- Intermountain Healthcare, Salt Lake City, UT, USA
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Vikrant Deshmukh
- University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Michael Newman
- University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Alison Fraser
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Ken Smith
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Ankita Date
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Joseph B Stanford
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - David Gaffney
- Department of Radiation Oncology, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Kathi Mooney
- College of Nursing, and Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
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12
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Mohamad Muhit AM, Sy-Cherng Woon L, Nik Mhd Nor NS, Sidi H, Mohd Kalok AH, Kampan N@C, Shafiee MN. Sexual Dysfunction among Gynaecological Cancer Survivors: A Descriptive Cross-Sectional Study in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15545. [PMID: 36497627 PMCID: PMC9737182 DOI: 10.3390/ijerph192315545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/09/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Sexual dysfunction is a major issue among gynaecological cancer survivors. This study aimed to evaluate the prevalence of sexual dysfunction among survivors of gynaecological cancer in Malaysia and to determine its risk factors. METHODS A cross-sectional study was conducted of 116 married women with gynaecological cancer who attended the gynaeoncology and oncology clinics at Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Sociodemographic and clinical data were collected. Sexual dysfunction was measured using the Malay Version Female Sexual Function Index (MVFSFI). Univariate and multivariate logistic regression analyses were used to determine the risk factors of female sexual dysfunction. RESULTS The prevalence of sexual dysfunction among gynaecological cancer survivors was 60% (70 out of 116). Sexual dissatisfaction was the most prevalent domain of sexual dysfunction at 68.1%. Sexual dysfunction was significantly associated with low education levels (Primary level, AOR = 4.92, 95% CI: 1.12-21.63; secondary level, AOR = 4.06, 95% CI: 1.14-14.44). Non-Malays were significantly more likely to have sexual dysfunction compared with Malays (AOR = 3.57, 95% CI: 1.16-11.06). In terms of treatment, combinations of surgery and radiotherapy (AOR = 4.66, 95% CI: 1.01-21.47) as well as surgery and chemoradiation (AOR = 5.77, 95% CI: 1.20-27.85) were considered. CONCLUSIONS Gynaecological cancer survivors with lower education levels, non-Malay ethnicity, and receiving treatment combinations of surgery and radiotherapy or surgery and chemoradiation have a higher risk of sexual dysfunction. A holistic approach in managing the various sociocultural and clinical issues is required to prevent sexual dysfunction among these patients.
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Affiliation(s)
- Akmal Muzamir Mohamad Muhit
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Luke Sy-Cherng Woon
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Nik Sumayyah Nik Mhd Nor
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Aida Hani Mohd Kalok
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Nirmala @ Chandralega Kampan
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Mohamad Nasir Shafiee
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
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Chou HH, Chang SC, Sukarom I, Saxena K, Pavelyev A, Wu YH, Chang CJ. The Clinical and Economic Impact of a Nonavalent Versus Bivalent Human Papillomavirus National Vaccination Program in Taiwan. Value Health Reg Issues 2022; 32:79-87. [PMID: 36116338 DOI: 10.1016/j.vhri.2022.06.006] [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: 09/10/2021] [Revised: 05/10/2022] [Accepted: 06/09/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This study aimed to estimate the epidemiologic and economic impact of a nonavalent human papillomavirus (HPV) vaccination program for 13- to 14-year-old females compared with that of the bivalent vaccine in Taiwan. METHODS A previously developed dynamic transmission model for the nonavalent HPV vaccine was adapted to the Taiwan setting. The natural history of cervical cancer and genital warts was simulated by the HPV model assuming an 80% vaccination coverage rate in girls aged 13 to 14 years of age with a 2-dose schedule for the nonavalent and bivalent HPV vaccines. A lifetime duration of vaccine protection was assumed for the HPV vaccine types. RESULTS The model estimated that the nonavalent HPV vaccine would prevent an additional 15 951 cervical cancer cases, 6600 cervical cancer-related deaths, 176 702 grade 2 or grade 3 cervical intraepithelial neoplasia cases, 103 959 grade 1 cervical intraepithelial neoplasia cases, and 1 115 317 genital warts cases compared with the bivalent HPV vaccine. The nonavalent HPV vaccination program was projected to cost an additional New Taiwan dollars (NTD) 675.21 per person and to produce an additional 0.00271 quality-adjusted life-year per person over 100 years compared with the bivalent HPV vaccine. Thus, the incremental cost-effectiveness ratio of the nonavalent HPV vaccine versus the bivalent HPV vaccine was NTD 249 462/quality-adjusted life-year. CONCLUSIONS A nonavalent HPV vaccination program for 13- to 14-year-old girls would have additional public health and economic impacts and would be highly cost-effective compared with the bivalent HPV vaccine, relative to per capita gross domestic product, which is estimated at NTD 746 526 for Taiwan.
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Affiliation(s)
- Hung-Hsueh Chou
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Chang Gung University, School of Medicine, Taoyuan, Taiwan
| | - Shu-Chen Chang
- Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan
| | | | | | | | | | - Chee Jen Chang
- Graduate Institute of Clinical Medical Sciences, Research Services Center for Health Information, Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Cardiology, Chang Gung Memorial Hospital, Linkou, Taiwan.
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14
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Clinician and Patient Communication on Body Image, Sexuality, and Sexual Function in Gynecologic Cancer: An Integrative Review. SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-022-09736-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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15
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Donovan EK, Covens AL, Kupets RS, Leung EW. The role of oophoropexy in patients with gynecological cancer who need radiation therapy. Int J Gynecol Cancer 2022; 32:380-388. [DOI: 10.1136/ijgc-2021-002471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 12/06/2021] [Indexed: 11/03/2022] Open
Abstract
Pelvic radiotherapy is an essential component of cancer therapy for patients with cervical and other gynecological malignancies. The ovaries are particularly radiosensitive, and even low radiotherapy doses may result in impaired or complete loss of ovarian function, causing hormonal disturbances and infertility. Recent advances in both surgery and radiotherapy have facilitated the ability of some patients to maintain ovarian function through ovarian transposition and careful radiotherapy planning. Multidisciplinary discussions should be undertaken to consider which candidates are appropriate for transposition. Generally, patients under age 35 should be considered due to ovarian reserve, likelihood of oophoropexy success, and radioresistance of ovaries. Those patients with small squamous cell tumors, minimal extra-uterine extension, and no lymphovascular invasion or lymph node involvement are ideal candidates to minimize risk of ovarian metastasis. Patients should be assessed and counseled about the risks of ovarian metastasis and the likelihood of successful ovarian preservation before undergoing oophoropexy and starting treatment. Oophoropexy should be bilateral if possible, and ovaries should be placed superior and lateral to the radiotherapy field. Studies limiting the mean ovarian dose to less than 2–3 Gray have demonstrated excellent preservation of ovarian function. Intensity modulated radiotherapy and volumetric modulated arc therapy techniques have the potential to further minimize the dose to the ovary with excellent outcomes. The addition of brachytherapy to the treatment regimen will probably cause minimal risk to transposed ovaries. Oophoropexy before radiotherapy may preserve the hormonal function of ovaries for a duration, and fertility might be possible through surrogate pregnancy. Successful ovarian transposition has the potential to improve the overall health and wellbeing, reproductive options, and potentially quality of life in patients with cervical and other gynecological cancers.
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16
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Gonçalves V, Quinn GP. Fertility support for patients with gynaecological cancers - a vital but neglected issue. Nat Rev Clin Oncol 2022; 19:147-148. [PMID: 34987190 DOI: 10.1038/s41571-021-00595-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Vânia Gonçalves
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Faculty of Economics, University of Coimbra, Coimbra, Portugal.
| | - Gwendolyn P Quinn
- Department of Obstetrics and Gynecology, Grossman School of Medicine, New York University, New York, NY, USA.,Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA
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17
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Campos LS, De Nardi SP, Limberger LF, Caldas JM. Sexual function and disease progression in women with advanced cancer. Support Care Cancer 2022; 30:5093-5098. [DOI: 10.1007/s00520-022-06797-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/31/2021] [Indexed: 11/30/2022]
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18
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Stanca M, Căpîlna DM, Trâmbițaș C, Căpîlna ME. The Overall Quality of Life and Oncological Outcomes Following Radical Hysterectomy in Cervical Cancer Survivors Results from a Large Long-Term Single-Institution Study. Cancers (Basel) 2022; 14:cancers14020317. [PMID: 35053481 PMCID: PMC8773665 DOI: 10.3390/cancers14020317] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 12/31/2021] [Accepted: 01/07/2022] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Romania maintains its regrettably leading position in terms of mortality caused by cervical cancer in Europe, with any available studies evaluating the oncological outcomes and quality of life of these patients. Our study could provide a historical comparison for future randomized controlled trials in Eastern Europe needed to confirm these results. Abstract (1) Background: Cervical cancer patients have been found to have worse quality of life (QoL) scores due to cancer treatment, not only when compared to the general population, but also when compared to other gynecological cancer survivors. In Eastern European developing countries, the health care system often cannot afford the uppermost standardized treatment for these patients. In the absence of a comparable study in our country, the authors’ aim for this retrospective cross-sectional observational study was to evaluate the overall survival (OS) and the QoL o cervical cancer survivors; (2) Methods: 430 patients were analyzed. The first objective is to evaluate the OS rates of patients with cervical cancer stages IA2 to IIB undergoing radical hysterectomy (RH) +/− neoadjuvant or adjuvant radiotherapy +/− chemoradiotherapy treatment combinations. The second objective is to assess their QoL, using two standardized questionnaires issued by the European Organisation for Research and Treatment of Cancer (EORTC), namely QLQ-C30 and QLQ-CX24. (3) Results: The mean age of the participants was 51 years (22–76) and the average follow-up time was 65 months (2–128). At the time of the analysis, 308 out of 430 patients were alive, with a mean five-year OS of 72.4%. The multivariate Cox regression analysis identified stage IIB, parametrial invasion, and the lymph node metastases as independent prognostic risk factors negatively impacting the OS. Of the 308 patients still alive at the time of the analysis, 208 (68%) answered the QoL questionnaires. The QLQ-C30 shows a good long-term Global QoL of 64.6 (median), good functioning scores, and a decent symptom scale value. However, the EORTC QLQ-CX24 showed high values of cervical cancer-specific symptoms, namely: lymphedema, peripheral neuropathy, severe menopausal symptoms, and distorted body-image perception. The results also indicate a significant decline in the quality of sexual life with a low sexual enjoyment and decreased level of sexual activities. (4) Conclusion: Despite a good OS, in this setting of patients, cervical cancer survivors have a modest QoL and sexual function. Our study may provide a comparison for future randomized, controlled trials in Eastern European countries needing to confirm these results.
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Affiliation(s)
- Mihai Stanca
- First Obstetrics and Gynecology Clinic, University of Medicine, Pharmacy, Science and Technology “G.E. Palade” of Târgu Mureș, Gheorghe Marinescu Street, Number 38, 540142 Targu Mures, Romania; (D.M.C.); (M.E.C.)
- Correspondence: ; Tel.: +40-074-2537323
| | - Dan Mihai Căpîlna
- First Obstetrics and Gynecology Clinic, University of Medicine, Pharmacy, Science and Technology “G.E. Palade” of Târgu Mureș, Gheorghe Marinescu Street, Number 38, 540142 Targu Mures, Romania; (D.M.C.); (M.E.C.)
| | - Cristian Trâmbițaș
- Anatomy and Embryology Department, University of Medicine, Pharmacy, Science and Technology “G.E. Palade” of Târgu Mureș, Gheorghe Marinescu Street, Number 38, 540142 Targu Mures, Romania;
| | - Mihai Emil Căpîlna
- First Obstetrics and Gynecology Clinic, University of Medicine, Pharmacy, Science and Technology “G.E. Palade” of Târgu Mureș, Gheorghe Marinescu Street, Number 38, 540142 Targu Mures, Romania; (D.M.C.); (M.E.C.)
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19
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Gonçalves V, Ferreira PL, Saleh M, Tamargo C, Quinn GP. OUP accepted manuscript. Oncologist 2022; 27:e251-e264. [PMID: 35274725 PMCID: PMC8914481 DOI: 10.1093/oncolo/oyab051] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/03/2021] [Indexed: 11/14/2022] Open
Abstract
Background Gynecologic cancers standard treatment often requires the removal of some reproductive organs, making fertility preservation a complex challenge. Despite heightened oncofertility awareness, knowledge about fertility attitudes and decisions of young patients with gynecologic cancer is scarce. The aim of this systematic review was to highlight what is currently known about knowledge, attitudes, and decisions about fertility, fertility preservation, and parenthood among these patients. Methods Peer-reviewed journals published in English were searched in PubMed, Web of Science and EMBASE from January 1, 2000 to July 1, 2020. Childbearing, fertility, fertility preservation, pregnancy, and parenthood attitudes/decisions after gynecologic cancer from women’s perspective were evaluated. Results A total of 13 studies comprised the review. Most of the women valued fertility preservation procedures that could be regarded as a means to restore fertility. A unique feature identified was that fertility preservation was seen also as a way to restore gender identity perceived to be lost or threatened during diagnosis and treatment. Fertility counseling was suboptimal, with wide variability among studies reviewed. Comparisons between gynecologic cancers and other cancer types about fertility counseling rates were inconclusive. The potential negative impact of impaired fertility on patients’ mental health and quality of life was also documented. Conclusions Fertility and parenthood were important matters in patients’ lives, with the majority of patients expressing positive attitudes toward future childbearing. Results confirm that the inclusion of patients with gynecologic cancer in research studies focusing on this topic still remains low. Additionally, the provision of fertility counseling and referral by health professionals is still suboptimal.
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Affiliation(s)
- Vânia Gonçalves
- Corresponding author: Vânia Gonçalves, Centre for Health Studies and Research of the University of Coimbra (CEISUC), Faculty of Economics, Av. Dias da Silva 165, 3004-512 Coimbra, Portugal.
| | - Pedro L Ferreira
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Mona Saleh
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christina Tamargo
- Department of Internal Medicine, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Gwendolyn P Quinn
- Departments of Obstetrics and Gynecology and Population Health, Grossman School of Medicine, New York University, New York, NY, USA
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20
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Sun L, Liu K, Li X, Zhang Y, Huang Z. Benefit-finding experiences of cervical cancer survivors in rural Yunnan province, China: A qualitative study. Nurs Open 2021; 9:2637-2645. [PMID: 34120415 PMCID: PMC9584485 DOI: 10.1002/nop2.962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 05/21/2021] [Accepted: 05/27/2021] [Indexed: 11/06/2022] Open
Abstract
AIM To explore and describe cervical cancer patients' benefit-finding experiences in rural China. DESIGN The phenomenological approach was used in this qualitative study. METHODS In-depth, semi-structured interviews were conducted with 21 patients, from July to August of 2019. The data, which were collected, were analysed using the Colaizzi analysis procedure. RESULTS According to the analysis results, the four benefit-finding experience themes of the cervical cancer patients were, respectively, determined to be as follows: Health cognition and behaviour changes; reshaping of personal strength; focussing on relationships with others; and facing life positively. CONCLUSIONS The individual's cognition of health and their own strong qualities, and their external social support systems and information obtained and transmitted through interpersonal interactions, can promote the benefit finding. The findings suggest that medical staff should understand the traditional concepts of their patients, use their positive psychological potential, and build targeted nursing measures.
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Affiliation(s)
- Liyuan Sun
- Health Science Center, Shenzhen University, Shenzhen, China
| | - Ke Liu
- Health Science Center, Shenzhen University, Shenzhen, China
| | - Xilin Li
- Health Science Center, Shenzhen University, Shenzhen, China
| | - Yao Zhang
- Health Science Center, Shenzhen University, Shenzhen, China
| | - Zhilan Huang
- Health Science Center, Shenzhen University, Shenzhen, China
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21
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Kiss SL, Fandi A, Cozlea AL, Gheorghe M, Stanca M, Bacalbașa N, Moldovan AA, Căpîlna ME. Abdominal radical trachelectomy as fertility-sparing management for early stages of cervical cancer: Our experience in 18 cases. Exp Ther Med 2021; 22:674. [PMID: 33986839 PMCID: PMC8111865 DOI: 10.3892/etm.2021.10106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/18/2021] [Indexed: 11/05/2022] Open
Abstract
The aim of this study was to present our experience of 18 cases of abdominal radical trachelectomy (ART), including 5 performed during pregnancy, analyzing patient selection, surgical complications, and oncological and obstetrical outcomes. This reproductive study included all early stage cervical cancer patients referred for ART at the 1st Obstetrics and Gynecology Clinic of the Emergency Clinical County Hospital Targu Mures, between 2010 and 2020. A total of 19 women were considered for ART, and only 1 case required conversion to radical hysterectomy. The patient mean age was 31 years (range 24-38 years), and 66.67% of the patients were nulliparous. Six women (33.33%) had stage IA2, 4 (22.22%) had stage IB1, 5 (27.78%) had stage IB2, and 4 (22.22%) had stage IB3 disease. One intraoperative complication occurred in this series, which consisted in both right ureteral and bladder injuries. Early postoperative complications were represented by urinary bladder dysfunction (33.33%), symptomatic pelvic lymphocele (11.1%), peritonitis (5.5%), and wound infection (5.5%). Late postoperative complications included cervical stenosis (5.5%), amenorrhea (11.1%), and pelvic abscess (5.5%). Four out of the 18 patients were operated on during pregnancy between 14 and 20 weeks; 2 of them gave birth at term, 2 of them aborted shortly after the surgery. Two vaginal recurrences were recorded; both were managed by hysterectomy, partial colpectomy and adjuvant chemoradiotherapy. At this moment, all patients are alive with no evidence of disease and 3 of them managed to conceive. In conclusion, ART should be recommended as a fertility-preserving procedure for women in their reproductive age. In selected cases, ART can be performed during pregnancy with encouraging results.
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Affiliation(s)
- Szilard Leo Kiss
- First Obstetrics and Gynecology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania
| | - Anas Fandi
- First Obstetrics and Gynecology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania
| | - Alexandra Lavinia Cozlea
- First Obstetrics and Gynecology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania
| | - Mihai Gheorghe
- First Obstetrics and Gynecology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania
| | - Mihai Stanca
- First Obstetrics and Gynecology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania
| | - Nicolae Bacalbașa
- Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020022 Bucharest, Romania
| | | | - Mihai Emil Căpîlna
- First Obstetrics and Gynecology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania
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22
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Skorstengaard M, Frederiksen ME, Baillet MVP, Beau AB, Jensen PT, Rygaard C, Hallas J, Lynge E. Cervical cancer survivors and health care use: A Danish population-based register study. Gynecol Oncol 2021; 161:565-572. [PMID: 33618844 DOI: 10.1016/j.ygyno.2021.02.003] [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: 11/27/2020] [Accepted: 02/03/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the impact of a cervical cancer (CC) diagnosis on use of health care and prescription drugs. METHODS This population-based register-study included Danish women aged 23-59 years and diagnosed with CC in 2001-2005. Women with a cervical screening outcome were used as comparison group. We obtained number of contacts to general practitioners (GPs), hospitals, psychologists/psychiatrists and defined daily doses (DDD) of analgesic/psychotropic prescription drugs. A difference-in-differences-design was used to estimate effect of a CC diagnosis on health-care use from five-year periods before and after the diagnosis/screening outcome. RESULTS In total, 926 women with CC and 1,004,759 women without cancer were included. In five years following the date of CC diagnosis, CC patients had increased their use of GPs with 8.6 (95% CI 4.8-12.4) contacts more than women in the comparison group, and with 4.12 (95% CI 3.99-4.25) more hospital contacts. In contrast, use of psychologists/psychiatrists was low and largely unaffected by the CC diagnosis. For use of prescription drugs, analgesics increased with 80 (95% CI 60-100) DDD more in CC patients than in comparison women, and for psychotropics with 304 (95% CI 261-347) DDD more. CONCLUSIONS A CC diagnosis was followed by an increase in use of GPs, hospitals, and analgesic/psychotropic prescription drugs, while use of psychologist/psychiatrist was largely unaffected. This pattern may indicate that pain/mental health concerns after CC either persisted or were alleviated by other means only.
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Affiliation(s)
- Malene Skorstengaard
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark.
| | - Maria Eiholm Frederiksen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark
| | | | - Anna-Belle Beau
- Pharmacologie Médicale, Faculté de Médecine, Université Paul-Sabatier III, CHU Toulouse, UMR INSERM 1027, Toulouse, France
| | - Pernille Tine Jensen
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark; Institute of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus, Denmark
| | - Carsten Rygaard
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen K, Denmark
| | - Jesper Hallas
- Clinical Pharmacology, University of Southern Denmark, J. B. Winsløws Vej 19, 2, 5000 Odense C, Denmark
| | - Elsebeth Lynge
- Nykøbing Falster Hospital, University of Copenhagen, Ejegodvej 63, 4800 Nykøbing Falster, Denmark
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Kpoghomou MA, Geneau M, Menard J, Stiti M, Almont T, Ghose B, Attal J, Delannes M, Huyghe E, Ducassou A. Assessment of an onco-sexology support and follow-up program in cervical or vaginal cancer patients undergoing brachytherapy. Support Care Cancer 2021; 29:4311-4318. [PMID: 33411047 DOI: 10.1007/s00520-020-05898-9] [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: 03/25/2020] [Accepted: 11/16/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Women's sexual health and wellbeing with cervical or vaginal cancer may be largely affected by complications from external beam radiotherapy (EBRT) and utero-vaginal brachytherapy (BT), of which vaginal stenosis is the main complication. The objective of this study was to assess the impact of support by a nurse sexologist on sexuality, vaginal side-effects, and the quality of clinical follow-up in patients treated with brachytherapy for cervical or vaginal cancer. METHODS We performed a retrospective study of the sexuality of women treated for cervical or vaginal cancer. Data from patients with cervical or vaginal cancer who underwent brachytherapy between 2013 and 2017 were collected at Institut Universitaire de Cancer de Toulouse-Oncopôle (IUCT-Oncopôle). Patients were divided into two groups: group A (intervention group) received support from a nurse sexologist and group B (control group) did not. The chi-square test and a logistic multivariate model were used for data analysis. RESULTS A total of 156 patients were included in this study, including 57.7% who were followed by a nurse sexologist. We observed low compliance in using vaginal dilators after brachytherapy and/or radiotherapy over time regardless of the group, and patients' sexual activity was inadequately addressed. Information regarding the resumption of sexuality 2 months after treatment was missing in 1.1% of patients in group A and in 36.4% of patients in group B. Multivariate analysis showed that patients in group A had a lower risk of developing vaginal stenosis with OR crude = 0.5 (95% CI = 0.25-0.92) and OR adj. = 0.5 (95% CI = 0.26-1.09) compared with those in group B. CONCLUSION This retrospective study highlights the lack of information collected by physicians during follow-up concerning the sexuality of patients with cervical or vaginal cancer treated by EBRT and BT. The support offered by nurse sexologists in improving patients' sexual activity and reducing their physical side-effects such as vaginal stenosis is likely to be beneficial. A prospective study is currently being conducted to validate the present findings.
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Affiliation(s)
- Marce-Amara Kpoghomou
- Pôle Centre de Psychiatrie générale, Unité d'hospitalisation Adulte "L'Odyssée", Centre Hospitalier Henri Guérin Pierrefeu-du-var, Toulon, France.
| | - Marion Geneau
- Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France
| | - Josiane Menard
- Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France
| | - Moufid Stiti
- Pôle Centre de Psychiatrie générale, Unité d'hospitalisation Adulte "L'Odyssée", Centre Hospitalier Henri Guérin Pierrefeu-du-var, Toulon, France
| | - Thierry Almont
- EA 3694 Human Fertility Research Group, Paule de Viguier, Reproductive Medicine Department, Toulouse University Hospital, Toulouse, France.,French Education and Research Group in Andrology, Urology and Sexology (GEFRAUS), Reproductive Medicine Department, Paule de Viguier University Hospital, Toulouse, France
| | - Bishwajit Ghose
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Justine Attal
- Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France
| | - Martine Delannes
- Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France
| | - Eric Huyghe
- EA 3694 Human Fertility Research Group, Paule de Viguier, Reproductive Medicine Department, Toulouse University Hospital, Toulouse, France.,French Education and Research Group in Andrology, Urology and Sexology (GEFRAUS), Reproductive Medicine Department, Paule de Viguier University Hospital, Toulouse, France
| | - Anne Ducassou
- Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France
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24
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Shylasree TS, Ranade R, Kattepur AK, Kaur S, Dusane R, Maheshwari A, Mahantshetty U, Chopra S, Engineer R, Kerkar RA. Quality of life in long term survivors of cervical cancer: A cross sectional study. Indian J Cancer 2021; 58:171-178. [PMID: 34100410 DOI: 10.4103/ijc.ijc_712_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Quality of life (QOL) is an important parameter to evaluate and modify in patients treated for cervical cancer as long-term survival is excellent in early-stage and reasonably good in locally advanced stage compared to other solid cancers. The aim of the study was the cross sectional evaluation of the quality of life in survivors completing at least 3 years of follow-up after curative therapy for cervical cancer at a tertiary cancer institute. Methods All patients, following primary curative treatment with no evidence of recurrence and completing at least 3 years follow-up, were assessed for QOL using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-30 and its cervical cancer module (Cx24). Patients were subdivided based on the modality of treatment. Analysis was done using Kruskal-Wallis and Mann-Whitney U test. Results One hundred seven patients were analyzed out of the 113 patients initially included. Treated patients showed good global QOL (mean value: 84.07) and functional scores (covering all domains). In the cervical cancer module, sexual activity, sexual enjoyment, and sexual function were low in the majority of the respondents. Chronic lymphedema, symptom experience, and sexual worry were significant across all the treatment arms. Conclusion Cervical cancer survivors have an overall good QOL. However, certain concerns related to the sexual quality of life, symptom experience, and chronic lymphedema need to be addressed appropriately.
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Affiliation(s)
- T S Shylasree
- Department of Gynecological Oncology, Tata Memorial Centre, Homi Bhabha National University, Mumbai, Maharashtra, India
| | - Rohit Ranade
- Department of Gynecological Oncology, Tata Memorial Centre, Homi Bhabha National University, Mumbai, Maharashtra, India
| | - Abhay K Kattepur
- Department of Gynecological Oncology, Tata Memorial Centre, Homi Bhabha National University, Mumbai, Maharashtra, India
| | - Satinder Kaur
- Department of Gynecological Oncology, Tata Memorial Centre, Homi Bhabha National University, Mumbai, Maharashtra, India
| | - Rohit Dusane
- Department of Biostatistics and Clinical Research Methodology, Tata Memorial Centre, Homi Bhabha National University, Mumbai, Maharashtra, India
| | - Amita Maheshwari
- Department of Gynecological Oncology, Tata Memorial Centre, Homi Bhabha National University, Mumbai, Maharashtra, India
| | - Umesh Mahantshetty
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National University, Mumbai, Maharashtra, India
| | - Supriya Chopra
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National University, Mumbai, Maharashtra, India
| | - Reena Engineer
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National University, Mumbai, Maharashtra, India
| | - Rajendra A Kerkar
- Department of Gynecological Oncology, Tata Memorial Centre, Homi Bhabha National University, Mumbai, Maharashtra, India
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25
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Manne SL, Kashy DA, Kissane DW, Ozga M, Virtue SM, Heckman CJ. The course and predictors of perceived unsupportive responses by family and friends among women newly diagnosed with gynecological cancers. Transl Behav Med 2020; 9:682-692. [PMID: 30189025 DOI: 10.1093/tbm/iby087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Perceived unsupportive responses from close others play an important role in psychological adaptation of patients with cancer. Little is known about whether these negative responses change after someone experiences a serious life event, and even less is known about the individual characteristics and related factors that might contribute to both the levels of and changes in perceived unsupportive responses over the course of adaptation to an experience. This longitudinal study aimed to evaluate changes in perceived unsupportive behavior from family and friends among women newly with gynecologic cancer as well as initial demographic, disease, and psychological factors that predict the course of perceived unsupportive behavior over time. Women (N = 125) assigned to the usual care arm of a randomized clinical trial comparing a coping and communication intervention with a supportive counseling intervention to usual care completed six surveys over an 18 month period. Growth models using multilevel modeling were used to predict unsupportive responses over time. Average levels of perceived unsupportive responses from family and friends were low. Unsupportive responses varied from patient to patient, but patients did not report a systematic change in perceived unsupportive responses over time. Cultivating meaning and peace and coping efficacy were associated with fewer perceived unsupportive responses as well as reductions in perceived unsupportive responses over time. Emotional distress, cancer concerns, functional impairment, holding back sharing concerns, and cognitive and behavioral avoidance predicted higher perceived unsupportive responses over time. The findings are discussed in terms of the self-presentation theory and social network responses to persons undergoing difficult life events.
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Affiliation(s)
- Sharon L Manne
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, Section of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Deborah A Kashy
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - David W Kissane
- Department of Psychiatry, Monash University, Melbourne, Australia
| | - Melissa Ozga
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Shannon Myers Virtue
- Clinical Psychology, Helen Graham Cancer Center, Christiana Care Health System, Wilmington, DE, USA
| | - Carolyn J Heckman
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Temple Health, Philadelphia, PA, USA
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26
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Noh SY, Shin JH, Yang WJ, Chu HH, Park S, Chen C, Lee WH. Arterioureteral fistula: overview of clinical characteristics, endovascular management, and outcomes. MINIM INVASIV THER 2020; 31:197-205. [PMID: 32678715 DOI: 10.1080/13645706.2020.1782939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Arterioureteral fistula (AUF) is a condition resulting from the pathologic connection between the ureter and the artery. Despite the low incidence, it can lead to devastating clinical consequences due to massive hematuria with a considerable mortality rate. MATERIAL AND METHODS From January 2009 to December 2018, eight patients with AUF from two tertiary referral centers were included. Clinical data including presenting symptoms, previous pelvic surgery or radiotherapy, indwelling ureteral stents, primary vascular pathology, angiographic findings, type of treatment, survival, and recurrence were analyzed. RESULTS All eight patients (six women, mean age 62.4 ± 14.5 years) presented with macroscopic hematuria and were successfully treated by endovascular management. One patient developed AUF due to an underlying iliac artery aneurysm, and the rest were due to secondary causes. Six patients had a history of an indwelling ureteral stent for a median of 5.5 months (1-84 months). All of the patients were successfully treated by endovascular management. For the median follow up of 987 days, three patients had recurrence of hematuria in a mean of 6.3 months, two patients were treated by surgery, while one was treated by endovascular treatment. CONCLUSION AUF should be confirmed through a purposeful iliac angiogram or ureterography when suspected based on a relevant history or CT findings. AUF can be successfully treated by endovascular management. The surgical option should be considered in cases of recurrence. ABBREVIATIONS AUF: arterioureteral fistula; CIA: common iliac artery; DJ: double J; EIA: external iliac artery; IIA: internal iliac artery; NBCA: N-butyl cyanoacrylate; PCN: percutaneous nephrostomy.
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Affiliation(s)
- Seung Yeon Noh
- Department of Radiology, Kyung Hee University Medical Center, Seoul, Korea
| | - Ji Hoon Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Jin Yang
- Department of Radiology, Korea University Guro Hospital, Seoul, Korea
| | - Hee Ho Chu
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Suyoung Park
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
| | - Chengshi Chen
- Department of Radiology, Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China
| | - Woong Hee Lee
- Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan-si, Korea
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27
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Oppenheimer A, Panel P, Rouquette A, du Cheyron J, Deffieux X, Fauconnier A. Validation of the Sexual Activity Questionnaire in women with endometriosis. Hum Reprod 2020; 34:824-833. [PMID: 30989214 DOI: 10.1093/humrep/dez037] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/12/2019] [Accepted: 02/23/2019] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Is the Sexual Activity Questionnaire (SAQ) a valid tool for patients treated for symptomatic endometriosis? SUMMARY ANSWER For women having surgical treatment for endometriosis, we determined that the SAQ is a valid and responsive tool. WHAT IS KNOWN ALREADY Endometriosis adversely affects sexual quality of life. Suitable validated sexual quality of life instruments for endometriosis are lacking both in clinical practice and for research. STUDY, DESIGN, SIZE, DURATION A total of 367 women with proven endometriosis undergoing medical or surgical treatment were included in an observational study conducted between 1 January 2012 and 31 December 2014 in two French tertiary care centers. Both hospitals are reference centers for endometriosis treatment. Of these 367 women, 267 were sexually active and constituted the baseline population. PARTICPANTS/MATERIALS, SETTINGS, METHODS Women >18 years old with histological or radiological proven endometriosis, consulting for painful symptoms of at least 3 months duration, infertility, or other symptoms (bleeding, cysts) were invited to complete self-administered questionnaires before (T0) and 12 months after treatment (T1). Tests of data quality included descriptive statistics of the data, missing data levels, floor and ceiling effects, structural validity and internal consistency.The construct validity was obtained by testing presupposed relationships between previously established SAQ scores and prespecified characteristics of the patients by comparing different subgroups of patients at T0. Sensitivity to change was subsequently calculated by comparing the SAQ score between T1 and T0 overall and for different subgroups of treatment. Effect sizes (to T1) were calculated according to Cohen's method. The minimally important difference was estimated by a step-wise triangulation approach (including anchor-based method). MAIN RESULTS AND THE ROLE OF CHANCE In total, 267 sexually active patients (204 surgical and 63 medical treatment) completed the SAQ at T0 and 136 (50.9%) at T1. The SAQ score ranged from 2.0 to 28.0 (mean ± SD: 16.8 ± 5.7).The SAQ score was one-dimensional according to the scree plot with good internal consistency (Cronbach alpha = 0.78, 95% CI 0.74-0.81) and had good discriminative ability according to pain descriptors and quality of life in endometriosis. The SAQ was responsive in patients treated by surgery but the effect size was low (0.3, 95% CI (0.0-0.6), P = 0.01). The minimally important difference was determined at 2.2. LIMITATIONS, REASONS FOR CAUTION The effect size for medical treatment was non-significant. Other effect sizes were low but statistically significant. This could be explained by lower libido due to progestin intake, which was used for both surgically and medically treated patients. WIDER IMPLICATIONS OF THE FINDINGS The SAQ is easy to use, valid and effective in assessing sexual quality of life in patients with endometriosis. This patient-reported score could be used as a primary outcome for future clinical studies. The minimally important difference estimation will be useful for future research. We recommend using 2.2 for the minimally important difference of the SAQ. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by the 'Direction à la Recherche Clinique et à l'Innovation' of Versailles, France and the 'Institut de Recherche en Santé de la Femme' (IRSF). The authors have no conflicts of interest to declare.
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Affiliation(s)
- A Oppenheimer
- EA 7285 Research Unit 'Risk and Safety in Clinical Medicine for Women and Perinatal Health', Versailles-Saint-Quentin University (UVSQ), Montigny-le-Bretonneux, France.,Department of Reproductive Medicine and Fertility Preservation, Hôpital universitaire Antoine Béclère, 157, rue de la Porte de Trivaux, Clamart, France
| | - P Panel
- Department of Gynecology and Obstetrics, Centre Hospitalier de Versailles, Le Chesnay, France
| | - A Rouquette
- CESP, Faculté de Médecine, Université Paris Sud, Faculté de Médecine UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.,AP-HP, Bicêtre Hôpitaux Universitaires Paris Sud, Public Health and Epidemiology Department, Le Kremlin-Bicêtre, France
| | - J du Cheyron
- Department of Gynecology and Obstetrics, Centre Hospitalier Intercommunal de Poissy-Saint-Germain-en-Laye, Poissy, France
| | - X Deffieux
- EA 7285 Research Unit 'Risk and Safety in Clinical Medicine for Women and Perinatal Health', Versailles-Saint-Quentin University (UVSQ), Montigny-le-Bretonneux, France.,Department of Gynecology and Obstetrics, Hôpital universitaire Antoine-Béclère, AP-HP, Clamart, France
| | - A Fauconnier
- EA 7285 Research Unit 'Risk and Safety in Clinical Medicine for Women and Perinatal Health', Versailles-Saint-Quentin University (UVSQ), Montigny-le-Bretonneux, France.,Department of Gynecology and Obstetrics, Centre Hospitalier Intercommunal de Poissy-Saint-Germain-en-Laye, Poissy, France
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28
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Sexual Inactivity During the Last 4 Weeks in Long-Term Cervical Cancer Survivors: Prevalence and Associated Factors. J Sex Med 2020; 17:1359-1369. [DOI: 10.1016/j.jsxm.2020.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/02/2020] [Accepted: 03/22/2020] [Indexed: 11/24/2022]
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Body Image, Sexuality, and Sexual Functioning in Women With Gynecologic Cancer: An Integrative Review of the Literature and Implications for Research. Cancer Nurs 2020; 44:E252-E286. [PMID: 32332264 DOI: 10.1097/ncc.0000000000000818] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cervical and uterine cancers are common in women. Diagnosis and treatment of these cancers can lead to significant issues with body image, sexuality, and sexual functioning. A comprehensive review can improve understanding of these 3 concepts, in turn enhancing identification and management. OBJECTIVES To (1) present the qualitative, descriptive, and correlational research literature surrounding body image, sexuality, and sexual functioning in women with uterine and cervical cancer; (2) identify gaps in the literature; and (3) explore the implications of the findings for future research. METHODS A comprehensive search of the literature was undertaken by searching PubMed, CINAHL, and PsycINFO using predetermined subject headings, keywords, and exploded topics. After a comprehensive evaluation using specific criteria, 121 articles were reviewed. RESULTS Qualitative studies provided information about women's issues with body image, sexuality, and sexual functioning, whereas quantitative studies focused primarily on sexual functioning. The literature lacks correlational studies examining body image and sexuality. Significant issues regarding communication and quality of life were noted, and few studies were based on clear conceptual models. CONCLUSION The state of the science gleaned from this review reveals that while much is known about sexual functioning, little is known about body image and sexuality. IMPLICATIONS FOR PRACTICE Further work is warranted to develop conceptual models and research on body image, sexuality, and sexual functioning as a foundation for interventions to improve quality of life.
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30
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Long-term patient-reported distress in locally advanced cervical cancer patients treated with definitive chemoradiation. Clin Transl Radiat Oncol 2020; 23:1-8. [PMID: 32368623 PMCID: PMC7186264 DOI: 10.1016/j.ctro.2020.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 04/10/2020] [Accepted: 04/11/2020] [Indexed: 11/23/2022] Open
Abstract
Treatment of cervical cancer with definitive chemo-radiation can be associated with distress. Cervical cancer patients distress at diagnosis is predictive of distress in follow-up. These symptoms significantly improve over time to an extent that is meaningful for patients. This information can be used to inform survivorship planning.
Background and purpose To evaluate longitudinal patient-reported distress in cervical cancer patients treated with definitive chemoradiation (CRT). Materials and methods Between 2011 and 2016, consenting cervical cancer patients treated with definitive CRT who completed ≥ 2 revised Edmonton Symptom Assessment System (ESAS-r) questionnaires at clinical visits, including baseline, were included. A linear mixed model was used to assess the longitudinal trend in ESAS-r. A minimal clinically important difference (MCID) for total ESAS-r score was defined as a change of 3-points for improvement and 4-points for deterioration. The proportion of patients with an MCID over time was described using moving averages. To test for changes, mixed effects logistic models were fitted, each of which included patient-specific random intercepts and random slopes. Results 67 patients were eligible for analysis (736 ESAS-r assessments). Median (range) follow-up was 24 months (range: 15–45) and compliance at 12 months was 60% (40/67). There was a significant decrease in ESAS-r scores over time. Baseline ESAS-r was strongly predictive of ESAS-r at follow-up (p < 0.001). The proportion of patients with an MCID for improvement from baseline significantly increased over time (p < 0.001) and the proportion with an MCID for deterioration significantly decreased over time (p < 0.001). No predictors for distress were found. Conclusions Long-term cervical cancer survivors experience distress that significantly improves over time to an extent expected to be clinically meaningful for patients. Implementing cervical cancer specific patient-reported outcome tools into practice could better inform patient needs.
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31
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Tsai JM, Hsu CY, Tsai LY, Tsay SL. Translation and validation of Taiwan Chinese version of the self-regulation questionnaire for gynecologic cancer survivors. Taiwan J Obstet Gynecol 2020; 58:614-620. [PMID: 31542081 DOI: 10.1016/j.tjog.2019.05.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To culturally adapt the self-regulation questionnaire to the Taiwan Chinese version (TC-SRQ) and to evaluate its psychometric properties for gynecologic cancer survivors. MATERIALS AND METHODS A cross-sectional study was employed with a purposive sample of 287 gynecologic cancer survivors. The TC-SRQ was adapted from a Germany version through back-translation to ensure its quality. For construct validity, confirmatory factor analysis (CFA) was used to assess the TC-SRQ measurement model with fit indexes including the χ2 test, the root mean square error of approximation (RMSEA), and the normed fit index (NFI), the comparative fit index (CFI), and non-normed fit indices (NNFI). For concurrent validity, the Taiwanese version of the European Organization for Research and Treatment of Cancer's 30-item core quality of life (EORTC QLQ-C30) questionnaire was used as a criterion measure for quality of life (QOL). Reliability was evaluated by internal consistency and test-retest reliability. RESULTS For a modified measurement model of TC-SRQ, the model fit (χ2 = 311.23, P = .0; RMSEA = .088; NFI = .97, CFI = .98, NNFI = .97) was acceptable. The evidence of construct validity of TC-SRQ scale was confirmed by the model estimates. TC-SRQ correlated positively with the global QOL, physical, cognitive, emotional, and social functioning domains, and negatively with fatigue and pain domains of EORTC QLQ-C30. For known groups validity, TC-SRQ was correlated with groups attributed by age, family support, health status, and sleep quality. A Cronbach's α of .91 indicated good internal consistency; the test-retest reliability was .82. CONCLUSIONS TC-SRQ is a valid and reliable instrument for assessing self-regulation in gynecologic cancer survivors.
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Affiliation(s)
- Jung-Mei Tsai
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan; Mackay Memorial Hospital, Taipei City, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan; Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
| | - Chen-Yuan Hsu
- Department of Nursing, Dayeh University, Changhua, Taiwan
| | - Li-Yun Tsai
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan.
| | - Shiow-Luan Tsay
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan.
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32
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Shankar A, Patil J, Luther A, Mandrelle K, Chakraborty A, Dubey A, Saini D, Bharat RP, Abrol D, Bharti SJ, Bentrad V. Sexual Dysfunction in Carcinoma Cervix: Assessment in Post Treated Cases by LENTSOMA Scale. Asian Pac J Cancer Prev 2020; 21:349-354. [PMID: 32102510 PMCID: PMC7332127 DOI: 10.31557/apjcp.2020.21.2.349] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Indexed: 11/25/2022] Open
Abstract
Treatment for cervical cancer consists of hysterectomy, radiotherapy, chemotherapy and targeted therapy in different combination based on stage at presentation. However, late consequences of such radical treatments are known but not many Indian studies have reported it. Quality of life and impact on sexual health has become an important issue in view of long survival of cervical cancer patients. LENTSOMA scale is one such scale validated for scoring radiotherapy related morbidity. However, there is need for a comprehensive scale covering all aspects of physical and psychological disruptions to provide complete recovery and rehabilitation. The study was prospective and patients who were treated for cervical cancer on follow up were included in this study. A total of 85 patients, who were treated with surgery, radiotherapy, chemotherapy alone or in combination, comprising of stage I to stage IV disease, participated in this study. Findings of this study showed that pain during intercourse and altered sexual life were reported by 32.9% and 25.9% patients respectively whereas 24.7% found it problematic and in 22.3% patients, alteration in interest in sex were reported. Vaginal stenosis was seen in 75.29% of patients after treatment with decreased frequency of intercourse after treatment was seen in 16.4 % of patients. Combination of surgery and radiotherapy in cervical cancer patients caused more sexual dysfunction and dissatisfaction, especially in lower age group. Treatment morbidity in term of sexual function was more with advanced stage disease and with the patients on longer follow up. Sexual function is an important aspect of quality of life but there is no single self-report measure in routine clinical follow up use which is brief, easy to complete and incorporates all (physical, psychological, emotional) aspects of sexual health for people affected by cancer.
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Affiliation(s)
- Abhishek Shankar
- Preventive Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Jaineet Patil
- Radiation Oncology, Christian Medical College, Ludhiana, India
| | - Anil Luther
- General Surgery, Christian Medical College, Ludhiana, India
| | - Kavita Mandrelle
- Obstetrics & Gynecology, Christian Medical College, Ludhiana, India
| | | | - Anusha Dubey
- Indian Society of Clinical Oncology, Delhi, India
| | - Deepak Saini
- Indian Society of Clinical Oncology, Delhi, India
| | - Ram Pukar Bharat
- Radiation Oncology, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Deepak Abrol
- Radiation Oncology, Government Medical College, Kathua, JK, India
| | - Sachidanand Jee Bharti
- Oncoanaesthesia and Palliative Medicine, Dr BR Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India
| | - Veronika Bentrad
- Department of Tumour Biochemistry & Oncopharmacology, RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, NASU, Kiev, Ukraine
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Oemrawsingh A, van Leeuwen N, Venema E, Limburg M, de Leeuw FE, Wijffels MP, de Groot AJ, Hilkens PHE, Hazelzet JA, Dippel DWJ, Bakker CH, Voogdt-Pruis HR, Lingsma HF. Value-based healthcare in ischemic stroke care: case-mix adjustment models for clinical and patient-reported outcomes. BMC Med Res Methodol 2019; 19:229. [PMID: 31805876 PMCID: PMC6896707 DOI: 10.1186/s12874-019-0864-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 11/08/2019] [Indexed: 12/15/2022] Open
Abstract
Background Patient-Reported Outcome Measures (PROMs) have been proposed for benchmarking health care quality across hospitals, which requires extensive case-mix adjustment. The current study’s aim was to develop and compare case-mix models for mortality, a functional outcome, and a patient-reported outcome measure (PROM) in ischemic stroke care. Methods Data from ischemic stroke patients, admitted to four stroke centers in the Netherlands between 2014 and 2016 with available outcome information (N = 1022), was analyzed. Case-mix adjustment models were developed for mortality, modified Rankin Scale (mRS) scores and EQ-5D index scores with respectively binary logistic, proportional odds and linear regression models with stepwise backward selection. Predictive ability of these models was determined with R-squared (R2) and area-under-the-receiver-operating-characteristic-curve (AUC) statistics. Results Age, NIHSS score on admission, and heart failure were the only common predictors across all three case-mix adjustment models. Specific predictors for the EQ-5D index score were sex (β = 0.041), socio-economic status (β = − 0.019) and nationality (β = − 0.074). R2-values for the regression models for mortality (5 predictors), mRS score (9 predictors) and EQ-5D utility score (12 predictors), were respectively R2 = 0.44, R2 = 0.42 and R2 = 0.37. Conclusions The set of case-mix adjustment variables for the EQ-5D at three months differed considerably from the set for clinical outcomes in stroke care. The case-mix adjustment variables that were specific to this PROM were sex, socio-economic status and nationality. These variables should be considered in future attempts to risk-adjust for PROMs during benchmarking of hospitals.
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Affiliation(s)
- Arvind Oemrawsingh
- Center for Medical Decision Making, Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
| | - Nikki van Leeuwen
- Center for Medical Decision Making, Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Esmee Venema
- Center for Medical Decision Making, Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.,Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Martien Limburg
- Department of Neurology, Flevoziekenhuis, Almere, the Netherlands.,Stroke Knowledge Network Netherlands, Utrecht, the Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Markus P Wijffels
- Department of Neurorehabilitation, Rijndam Rehabilitation, Rotterdam, the Netherlands
| | - Aafke J de Groot
- Department of General Practice and Elderly Care Medicine, Amsterdam University Medical Center, Amsterdam, the Netherlands / Vivium Naarderheem, Naarden, the Netherlands
| | - Pieter H E Hilkens
- Department of Neurology, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Jan A Hazelzet
- Center for Medical Decision Making, Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Diederik W J Dippel
- Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Carla H Bakker
- Expert Centre Quality Registries, Leiden University Medical Center, Leiden, the Netherlands
| | - Helene R Voogdt-Pruis
- Stroke Knowledge Network Netherlands, Utrecht, the Netherlands.,EnCorps, Hilversum, the Netherlands
| | - Hester F Lingsma
- Center for Medical Decision Making, Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
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Kang J, Park EJ, Lee J. Cancer Survivorship in Primary Care. Korean J Fam Med 2019; 40:353-361. [PMID: 31779063 PMCID: PMC6887764 DOI: 10.4082/kjfm.19.0108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/25/2019] [Accepted: 10/30/2019] [Indexed: 12/11/2022] Open
Abstract
With the early detection of cancer and improvement in cancer therapy, the number of cancer survivors is rapidly increasing. This number is expected to reach 2 million by the end of 2019. Cancer survivors struggle with not only cancer-related health problems but also diverse acute and chronic diseases. These health issues make cancer survivorship more complex, and proper care coordination is necessary. This study aimed to summarize the definition of cancer experience and management of cancer survivors, specifically focused on gastric, colorectal, lung, breast, thyroid, prostate, and cervical cancers. Furthermore, it aimed to discuss the role of primary care in cancer survivorship and survivorship care models and the National Policy for Cancer Survivors and Future Challenges.
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Affiliation(s)
- Jihun Kang
- Department of Family Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
| | - Eun Ju Park
- Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jungkwon Lee
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Benard VB, Greek A, Jackson JE, Senkomago V, Hsieh MC, Crosbie A, Alverson G, Stroup AM, Richardson LC, Thomas CC. Overview of Centers for Disease Control and Prevention's Case Investigation of Cervical Cancer Study. J Womens Health (Larchmt) 2019; 28:890-896. [PMID: 31264934 DOI: 10.1089/jwh.2019.7849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background: Despite advances in cervical cancer screening, a significant number of women in the United States have not received adequate screening. Studies have suggested that approximately half of the women who developed cervical cancer were not adequately screened. The Centers for Disease Control and Prevention (CDC) Case Investigation of Cervical Cancer (CICC) Study took a unique approach to reconstruct the time before a woman's cervical cancer diagnosis and understand the facilitators and barriers to screening and care. This article provides an overview of the study. Methods: This study included all cervical cancer survivors diagnosed with invasive cervical cancer aged 21 years and older in three U.S. states from 2014-2016. The study design consisted of three different data collection methods, including comprehensive registry data, a mailed survey, and medical chart abstraction. This overview compares the characteristics of cervical cancer survivors in the three states by study participation and eligibility status. Results: Registries identified 2,748 women diagnosed with invasive cervical cancer. Of these, 1,730 participants were eligible for participation, 28% (n = 481) enrolled in the study and 23% (n = 400) consented to the medical chart abstraction. Conclusion: The CICC Study is unique in that it addresses, with medical record verification, the medical history of woman 5 years before their cervical cancer diagnosis as well as provides information from the woman on her health care behaviors. This study provides data on a general population of cervical cancer survivors in three states that could be used to guide interventions to increase cervical cancer screening.
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Affiliation(s)
- Vicki B Benard
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Virginia Senkomago
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mei-Chin Hsieh
- 3Louisiana Tumor Registry and Epidemiology Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Amanda Crosbie
- 4New Jersey Department of Health, Cancer Epidemiology Services, Trenton, New Jersey
| | | | - Antoinette M Stroup
- 6Rutgers School of Public Health, Piscataway, New Jersey.,7Rutgers Cancer Institute of New Jersey (CINJ), New Brunswick, New Jersey
| | - Lisa C Richardson
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cheryll C Thomas
- 1Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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Tsatsou I, Parpa E, Tsilika E, Katsaragakis S, Batistaki C, Dimitriadou E, Mystakidou K. A Systematic Review of Sexuality and Depression of Cervical Cancer Patients. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:739-754. [PMID: 31018789 DOI: 10.1080/0092623x.2019.1610125] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objectives: The goal of this article is to investigate the correlation between sexuality and depression of cervical cancer (CC) patients. Methods: A bibliographical search was carried out in the databases CINAHL, PubMed, and Cochrane Library with the following terms in English for the years 2006 to 2017: sexuality, sexual function, sexual dysfunction, sexual problems, mood, depression, emotional distress, cervical cancer. Results: Fourteen studies were included. They present heterogeneity in the stage of the disease, the selected treatments, and their sample. From the studies, only 7 are evaluated as good methodologically. Sexual dysfunction and depression of CC patients persist for many years after treatments. The younger women, those who underwent radiotherapy, and those who had chronic fatigue, as an aftereffect of treatments, had increased depression. Women that underwent surgery and adjuvant therapy experienced the highest rates of depressive symptoms. There is a positive relationship between sexuality and depression in patients with CC. Conclusions: Sexuality and depression οf women with CC are affected by their therapies to a significant extent. There is a positive correlation between the two variables. The existing methodologically good studies are scarce, and for this reason the results cannot be generalized in all CC patients.
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Affiliation(s)
- Ioanna Tsatsou
- Oncology Hematology Dept, Hellenic Airforce General Hospital , Athens , Greece
| | - Efi Parpa
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens , Athens , Greece
| | - Eleni Tsilika
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens , Athens , Greece
| | | | | | - Eleni Dimitriadou
- Oncology Hematology Dept, Hellenic Airforce General Hospital , Athens , Greece
| | - Kyriaki Mystakidou
- Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens , Athens , Greece
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Hoover DS, Spears CA, Vidrine DJ, Walker JL, Shih YCT, Wetter DW. Smoking Cessation Treatment Needs of Low SES Cervical Cancer Survivors. Am J Health Behav 2019; 43:606-620. [PMID: 31046890 PMCID: PMC6686858 DOI: 10.5993/ajhb.43.3.14] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: We investigated the treatment needs and preferences of low socioeconomic status cervical cancer survivors to inform the adaptation of a theoretically- and empirically-based Motivation and Problem-Solving approach to facilitate cessation in this at-risk population. Methods: Individual in-depth interviews were conducted with 12 female smokers with cervical cancer. Interviews were audio-recorded, transcribed, and analyzed using NVivo 10. Results: Most participants did not believe that smoking caused cervical cancer and attributed their diagnosis solely to human papillomavirus. They suggested that cessation treatment for cervical cancer survivors include psychoeducation about the impact of smoking on health and cancer and the benefits of quitting, pharmacotherapy, planning for quitting, strategies for coping with cravings/withdrawal, social support, real-time support, a nonjudgmental and understanding counselor, tailoring, and follow-up. They recommended that negativity/judgment and being told that "smoking is bad" not be included in treatment. Participants also suggested that treatment address stress management, issues specific to cervical cancer survivorship, and physical activity and healthy eating. Conclusions: Results highlight the unique treatment needs of low socioeconomic status smokers with cervical cancer and will inform the adaptation of an existing evidence-based inter- vention to encourage smoking cessation in this population.
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Tsai LY, Lee SC, Wang KL, Tsay SL, Tsai JM. A correlation study of fear of cancer recurrence, illness representation, self-regulation, and quality of life among gynecologic cancer survivors in Taiwan. Taiwan J Obstet Gynecol 2019; 57:846-852. [PMID: 30545539 DOI: 10.1016/j.tjog.2018.10.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine the correlations among fear of cancer recurrence (FCR), illness representation (IR), self-regulation (SR), and quality of life (QOL) in gynecologic cancer survivors. MATERIALS AND METHODS A cross-sectional study was conducted with 287 participants recruited from a medical center in northern Taiwan. Four questionnaires, the Assessment of Survivor Concerns (ASC), the Brief Illness Perception Questionnaire (BIPQ), the Self-Regulation Questionnaire (SRQ), and the European Organization for Research and Treatment of Cancer's Quality-of-Life Questionnaire-Core 30-item (EORTC QLQ-C30), were used to assess FCR, IR, SR, and QOL respectively. Data pertaining to socio-demographic characteristics and self-reported medical status was also collected from the participants. Stepwise regression analysis was performed to identify predictors of QOL. RESULTS The results showed that FCR (r = -.21, P < .01) and IR (r = -.44, P < .01) was negatively correlated with global QOL subscale of the EORTC QLQ-C30. SR, IR, and health status in the self-reported medical status explained 39% of the variance in global QOL, with SR of the largest. CONCLUSIONS Our findings provided valuable information to healthcare professionals about the ability of SR to affect QOL and negative impacts of FCR and IR on gynecologic cancer survivors.
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Affiliation(s)
- Li-Yun Tsai
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan
| | - Shu-Chen Lee
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan; Mackay Memorial Hospital, Taipei City, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan
| | - Kung-Liahng Wang
- Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan; Taitung MacKay Memorial Hospital, Taitung, Taiwan
| | - Shiow-Luan Tsay
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan.
| | - Jung-Mei Tsai
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan; Mackay Memorial Hospital, Taipei City, Taiwan; Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan; Department of Nursing, Mackay Medical College, New Taipei City, Taiwan.
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Schneiderman N, McIntosh RC, Antoni MH. Psychosocial risk and management of physical diseases. J Behav Med 2019; 42:16-33. [PMID: 30632000 PMCID: PMC6941845 DOI: 10.1007/s10865-018-00007-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 12/18/2018] [Indexed: 12/24/2022]
Abstract
During the 40 years since the Yale conference on Behavioral Medicine and the founding of the Journal of Behavioral Medicine considerable progress has been made in understanding the role of psychosocial risk and management of physical diseases. We here describe the development of these fundamental concepts from early research on stress through studies of the Type A behavior pattern to more contemporary approaches to the relationship between psychosocial risks and benefits in relation to disease processes. This includes the relationship of psychosocial risk to cancers, cardiovascular diseases (CVD), cardiometabolic disorders, Human Immunodeficiency Virus (HIV)/Acquired Human Immune Deficiency Syndrome. During the past 40 years the effects of prolonged distress responses in the pathogenesis of some cancers and CVD have been well-established and modifiable behavioral, cognitive and social factors have been shown to produce favorable outcome components in the management of such diseases as breast cancer, coronary heart disease and HIV.
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Affiliation(s)
- Neil Schneiderman
- Health Division, Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Coral Gables, FL, 33124, USA.
| | - Roger C McIntosh
- Health Division, Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Coral Gables, FL, 33124, USA
| | - Michael H Antoni
- Health Division, Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Coral Gables, FL, 33124, USA
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Corrêa CSL, Leite ICG, Andrade APS, Carvalho SM, Borges RM, Guerra MR. Qualidade de vida e fatores associados em mulheres sobreviventes ao câncer do colo do útero. HU REVISTA 2019. [DOI: 10.34019/1982-8047.2017.v43.2898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
O tratamento para o câncer do colo do útero pode levar à ocorrência de efeitos adversos tardios, como disfunções sexuais, intestinais ou urinárias; menopausa precoce e linfedema em membro inferior, os quais podem ter impacto negativo na qualidade de vida. O objetivo do estudo foi avaliar a qualidade de vida de sobreviventes ao câncer do colo do útero, seus fatores associados e comparar a qualidade de vida com um grupo controle de mulheres sem história de câncer. O grupo câncer foi composto por mulheres com término do tratamento há três meses (n= 37). O grupo controle, de base populacional, foi composto por mulheres sem história de câncer (n= 37). A qualidade de vida foi avaliada pelo WHOQOL-bref e a função sexual pelo Female Sexual Function Índex. Variáveis clínicas, terapêuticas e socioeconômicas foram avaliadas por questionário desenvolvido pelos autores. Em comparação ao controle, o grupo câncer apresentou maior percentual de mulheres que viviam sem companheiro, que consideravam o relacionamento com o companheiro como ruim/regular e que apresentavam disfunções urinárias, intestinais e sexuais. Além disso, o grupo câncer apresentou piores escores nos domínios “Físico” e “Relações Sociais” do WHOQOL-bref (p=0,03 e 0,01, respectivamente). Foram fatores independentemente associados ao domínio “Físico”: linfedema de membros inferiores e retenção urinária; e ao domínio “Relações Sociais”: apoio social de amigos e estenose/encurtamento vaginal. Os resultados sugerem impacto negativo da doença e de seu tratamento sobre a qualidade de vida das sobreviventes. Deve-se investigar a qualidade de vida e os fatores que a influenciam, visando um atendimento mais integral, direcionado às necessidades das pacientes, por meio de equipe multiprofissional.
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Osann K, Wilford J, Wenzel L, Hsieh S, Tucker JA, Wahi A, Monk BJ, Nelson EL. Relationship between social support, quality of life, and Th2 cytokines in a biobehavioral cancer survivorship trial. Support Care Cancer 2019; 27:3301-3310. [PMID: 30612237 DOI: 10.1007/s00520-018-4617-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 12/12/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Benefits of social support (SS) during cancer survivorship are complex. This study examines change in SS over time in cervical cancer (CXCA) survivors who have completed definitive treatment and how changing SS impacts quality of life (QOL) and T-helper type 2 (Th2) cytokines. METHODS We conducted a randomized trial in 204 CXCA survivors to test if psychosocial telephone counseling (PTC) could improve QOL compared to usual care (UC). Although PTC did not target SS, data were collected at baseline, 4 and 9 months post-enrollment using the Medical Outcomes Survey Social Support scale. Biospecimens were collected to investigate associations with patient-reported outcomes. Data were analyzed using multivariate linear models and stepwise regression. RESULTS Participants' mean age was 43. PTC participants experienced increasing SS compared to UC at 4 months (PTC-UC = 5.1; p = 0.055) and 9 months (PTC-UC = 6.0; p = 0.046). Higher baseline SS and increasing SS were independently associated with improved QOL at 4 and 9 months after adjusting for patient characteristics (p < 0.05). Differences between study arms were not statistically significant. Improvements in QOL at 4 months were observed with increases in emotional/informational and tangible SS. Increasing SS predicted significant longitudinal decreases in IL-4 and IL-13 at 4 months that were larger in the PTC arm (interactions p = 0.041 and p = 0.057, respectively). CONCLUSION Improved SS was significantly associated with improved QOL independent of patient characteristics and study arm. Decreasing Th2 cytokines with increasing SS and QOL are consistent with a biobehavioral paradigm in which modulation of the chronic stress response is associated with shifts in immune stance.
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Affiliation(s)
- Kathryn Osann
- Department of Medicine, Division of Hematology/Oncology, University of California Irvine, 204 Sprague Hall, Irvine, CA, 92697, USA.
- Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA.
| | - Justin Wilford
- Program in Public Health, University of California Irvine, Irvine, CA, USA
| | - Lari Wenzel
- Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA
- Program in Public Health, University of California Irvine, Irvine, CA, USA
- Department of Medicine, University of California Irvine, Irvine, CA, USA
| | - Susie Hsieh
- Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA
- Department of Medicine, University of California Irvine, Irvine, CA, USA
| | - Jo A Tucker
- Department of Medicine, Division of Hematology/Oncology, University of California Irvine, 204 Sprague Hall, Irvine, CA, 92697, USA
| | - Aditi Wahi
- Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA
- Department of Medicine, University of California Irvine, Irvine, CA, USA
| | - Bradley J Monk
- School of Medicine, St. Joseph's Hospital and Medical Center, Creighton University, Phoenix, AZ, USA
| | - Edward L Nelson
- Department of Medicine, Division of Hematology/Oncology, University of California Irvine, 204 Sprague Hall, Irvine, CA, 92697, USA
- Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA
- Institute for Immunology, University of California Irvine, Irvine, CA, USA
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Impact of cervical cancer on quality of life of women in Hubei, China. Sci Rep 2018; 8:11993. [PMID: 30097622 PMCID: PMC6086893 DOI: 10.1038/s41598-018-30506-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/31/2018] [Indexed: 02/08/2023] Open
Abstract
We aimed to assess the quality of life (QOL) of the patients with cervical cancer after initial treatment, the factors affecting QOL and their clinical relevance. A total of 256 patients with cervical cancer who visited Zhongnan Hospital of Wuhan University from January 2017 to December 2017 were enrolled in this study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 item (EORTC QLQ-C30) and cervical cancer module (EORTC QLQ-CX24) was used to assess the QOL of patients. More than half of the patients with cervical cancer reported an excellent QOL. Symptoms mostly experienced were insomnia, constipation, financial difficulties, and menopausal symptoms. Global QOL and social functioning were statistically associated with education level, occupation, the area of living, family income and treatment modality. Similarly, role functioning showed significant association with the stage of cancer, treatment modality and time since diagnosis. The rural area of living and poor economic status of the patients with cervical cancer has a negative impact on overall quality of life. Younger and educated patients are more worried about sexuality. Patients treated with multiple therapies had more problems with their QOL scales than patients treated with surgery only.
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Wilford J, Osann K, Hsieh S, Monk B, Nelson E, Wenzel L. Validation of PROMIS emotional distress short form scales for cervical cancer. Gynecol Oncol 2018; 151:111-116. [PMID: 30078504 DOI: 10.1016/j.ygyno.2018.07.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/21/2018] [Accepted: 07/29/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Cervical cancer patients are at high risk for emotional distress. In this study we evaluate the PROMIS emotional distress-Depression and -Anxiety Short Forms for assessing depression and anxiety in a cervical cancer population. METHODS A 15-item questionnaire was used in a cervical cancer biobehavioral randomized clinical trial, testing psychosocial telephone counseling (PTC) against usual care (UC). It was administered to 204 patients prior to randomization, four months post-enrollment, and nine months post-enrollment, together with legacy measures of depression. The short forms were evaluated in patients participating in this study over three time points for internal consistency, convergent validity, and responsiveness to change over time. RESULTS Overall, 45% and 47% of patients scored in the moderate to severe range for anxiety and depression, respectively. Internal consistency coefficients were ≥ 0.95 at baseline, 4 months, and 9 months for depression and anxiety. The average inter-item correlation was 0.65 and 0.73 at baseline assessment for depression and anxiety, respectively. The depression short form T-score was correlated with legacy distress scales ranging from 0.44-0.76, and the anxiety short form ranging from 0.45-0.78. The depression short form demonstrated sensitivity to change as patients randomized to the counseling intervention reported greater improvement over time in depression (p = 0.014), and a nonsignificant improvement in anxiety, compared to the patients receiving usual care. CONCLUSIONS The PROMIS depression and anxiety short forms reliably and validly assess cervical cancer-specific emotional distress, capture salient features of distress in this population, and perform as well or better than legacy measures.
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Affiliation(s)
- Justin Wilford
- Program in Public Health, University of California, Irvine, Irvine, CA, USA
| | - Kathryn Osann
- Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, Irvine, CA, USA; Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA
| | - Susie Hsieh
- Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, Irvine, CA, USA; Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA
| | - Bradley Monk
- Creighton University School of Medicine at St. Joseph's Hospital & Medical Center, Phoenix, AZ, USA
| | - Edward Nelson
- Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, Irvine, CA, USA; Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA; Institute for Immunology, University of California, Irvine, Irvine, CA, USA
| | - Lari Wenzel
- Program in Public Health, University of California, Irvine, Irvine, CA, USA; Department of Medicine, Division of Hematology/Oncology, University of California, Irvine, Irvine, CA, USA; Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA.
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Abstract
PURPOSE OF REVIEW Advances in cervical cancer screening and treatment have resulted in high cure rates in developed countries for early-stage disease. Current research focuses on minimizing morbidity and maximizing quality of life. RECENT FINDINGS Imaging has been disappointing in identifying small volume metastases. Sentinel lymph node biopsy represents a significant advantage with high sensitivity, low false negative rates, reduced morbidity, and equivalent survival in recent studies compared to pelvic lymphadenectomy. Non-radical surgical options are currently being investigated for early cervical cancer in a number of large prospective studies in patients at low risk for metastases. Evidence suggests that sentinel lymph node biopsy and non-radical surgery are safe approaches for the staging and management of early cervical cancer in appropriately selected patients with the potential to significantly reduce treatment-related morbidity.
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Johnson C, George M, Fader AN. Distress Screening: Evaluating a Protocol for Gynecologic Cancer Survivors
. Clin J Oncol Nurs 2018; 21:353-361. [PMID: 28524896 DOI: 10.1188/17.cjon.353-361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND A gynecologic cancer diagnosis and subsequent treatment may cause significant morbidity, leading to increased distress levels and poorer quality of life (QOL) for survivors. Clinicians have explored opportunities to integrate comprehensive distress management protocols into clinical settings using existing supportive care resources.
. OBJECTIVES The aims were to improve multidisciplinary management of distress using a clinical pathway for gynecologic cancer survivors and to improve patient satisfaction with distress management.
. METHODS This study is phase II of a quality improvement initiative to assess distress using the National Comprehensive Cancer Network Distress Thermometer and Patient Related Outcome Measures Information Systems QOL tool and to evaluate the use of a clinical pathway to identify and link gynecologic cancer survivors to multidisciplinary supportive care resources. The data were compared to results from phase I of this study with data triangulation that included medical record audits.
. FINDINGS Thirty-five percent of survivors reported distress scores of 5 or greater. The use of a clinical pathway model for universal distress screening increased referrals to multidisciplinary service teams from 19 to 34, with a 32% increase in social work referrals. Patients appreciated the comprehensive approach the healthcare team used to treat cancer and help improve QOL.
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Fregnani CMS, Fregnani JHTG, Longatto-Filho A. Methodological study to evaluate the psychometric properties of FACIT-CD in a sample of Brazilian women with cervical intraepithelial neoplasia. BMC Cancer 2017; 17:686. [PMID: 29037189 PMCID: PMC5644164 DOI: 10.1186/s12885-017-3676-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 10/08/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The occurrence of cervical intraepithelial neoplasia (CIN) is associated with changes in health-related quality of life, including psychological factors, such as fear and shame, and changes in sexuality and sexual satisfaction, such as decreased sexual desire and frequency of sexual intercourse. Personal relationships are the most affected because CIN is sexually transmitted and many women tend to blame their partner for disease transmission. The aim of this study was to evaluate the psychometric properties of the FACIT-CD questionnaire in Brazilian women diagnosed with CIN. METHODS The properties of the FACIT-CD questionnaire were tested on a sample of 439 women seen at the Department of Prevention of Barretos Cancer Hospital, including 329 patients who were diagnosed with CIN and 110 women who were not diagnosed with the disease. The analysed parameters included internal consistency (Cronbach's alpha), reproducibility (intraclass correlation coefficient), structural validity, convergent validity (correlation with the SF-12 and EORTC QLQ-CX24 questionnaires), discriminant validity (according to disease status, and self-rating of health), sensitivity, and responsiveness. RESULTS The Cronbach alpha values of the FACIT-CD scales were higher than 0.70 with the exception of the relationship scale (0.66). The FACIT-CD reproducibility was satisfactory, with variation in the intraclass correlation coefficients ranging between 0.50 and 0.83, although the 95% confidence interval (CI) was lower than 0.40 (0.33-0.64) on the treatment satisfaction scale. Regarding structural validity, only one item on the physical well-being scale was not kept in the original domain. The expected correlations between the FACIT-CD and SF-12 were not confirmed, whereas the correlations between the FACIT-CD and EORTC QLQ-CX24 were confirmed. The questionnaire was able to discriminate the groups according to disease status and self-rating of health. The sensitivity was low for the relationship scale and moderate for the other scales. The responsiveness of the FACIT-CD questionnaire varied between the groups that denominate the self-perception of health as no change, improvement or worsening. CONCLUSION Our results are encouraging and indicate that the FACIT-CD questionnaire is a promising tool for the analysis of the quality of life of women with CIN.
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Affiliation(s)
- Cristiane Menezes Sirna Fregnani
- Teaching and Research Institute of Barretos Cancer Hospital, Antenor Duarte Villela street, 1331. Barretos, São Paulo, Zip code: 14784-400 Brazil
| | | | - Adhemar Longatto-Filho
- Teaching and Research Institute of Barretos Cancer Hospital, Antenor Duarte Villela street, 1331. Barretos, São Paulo, Zip code: 14784-400 Brazil
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s, PT Government Associate Laboratory, Braga, Guimarães Portugal
- Laboratory of Medical Investigation (LIM) 14, FMUSP, São Paulo, Brazil
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Sandsund C, Towers R, Thomas K, Tigue R, Lalji A, Fernandes A, Doyle N, Jordan J, Gage H, Shaw C. Holistic needs assessment and care plans for women with gynaecological cancer: do they improve cancer-specific health-related quality of life? A randomised controlled trial using mixed methods. BMJ Support Palliat Care 2017; 10:e16. [PMID: 28847853 PMCID: PMC7286034 DOI: 10.1136/bmjspcare-2016-001207] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 01/09/2017] [Accepted: 04/01/2017] [Indexed: 12/20/2022]
Abstract
Objectives Holistic needs assessment (HNA) and care planning are proposed to address unmet needs of people treated for cancer. We tested whether HNA and care planning by an allied health professional improved cancer-specific quality of life for women following curative treatment for stage I–III gynaecological cancer. Methods Consecutive women were invited to participate in a randomised controlled study (HNA and care planning vs usual care) at a UK cancer centre. Data were collected by questionnaire at baseline, 3 and 6 months. The outcomes were 6-month change in European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 (version 3), global score (primary) and, in EORTC subscales, generic quality of life and self-efficacy (secondary). The study was blinded for data management and analysis. Differences in outcomes were compared between groups. Health service utilisation and quality-adjusted life years (QALY) (from Short Form-6) were gathered for a cost-effectiveness analysis. Thematic analysis was used to interpret data from an exit interview. Results 150 women consented (75 per group); 10 undertook interviews. For 124 participants (61 intervention, 63 controls) with complete data, no statistically significant differences were seen between groups in the primary endpoint. The majority of those interviewed reported important personal gains they attributed to the intervention, which reflected trends to improvement seen in EORTC functional and symptom scales. Economic analysis suggests a 62% probability of cost-effectiveness at a £30 000/QALY threshold. Conclusion Care plan development with an allied health professional is cost-effective, acceptable and useful for some women treated for stage I–III gynaecological cancer. We recommend its introduction early in the pathway to support person-centred care.
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Affiliation(s)
- Catherine Sandsund
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Richard Towers
- Lead Nurse Counsellor, Psychological Support Services, The Royal Marsden NHS Foundation Trust, London, UK
| | - Karen Thomas
- Senior Statistician Research Data Management and Statistics Unit, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Ruth Tigue
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Amyn Lalji
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Andreia Fernandes
- Gynaeoncology Unit, Clinical Services Division, The Royal Marsden NHS Foundation Trust, London, UK
| | - Natalie Doyle
- Nurse Consultant in Living With and Beyond Cancer, The Royal Marsden NHS Foundation Trust, London, UK
| | - Jake Jordan
- Surrey Health Economics Centre, School of Economics, University of Surrey, Guildford, UK
| | - Heather Gage
- Surrey Health Economics Centre, School of Economics, University of Surrey, Guildford, UK
| | - Clare Shaw
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, UK
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Li LR, Lin MG, Liang J, Hu QY, Chen D, Lan MY, Liang WQ, Zeng YT, Wang T, Fu GF. Effects of Intrinsic and Extrinsic Factors on the Level of Hope and Psychological Health Status of Patients with Cervical Cancer During Radiotherapy. Med Sci Monit 2017; 23:3508-3517. [PMID: 28720749 PMCID: PMC5531534 DOI: 10.12659/msm.901430] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background This study aimed to explore the factors affecting the level of hope and psychological health status of patients with cervical cancer (CC) during radiotherapy. Material/Methods A total of 480 CC patients were recruited. Psychological distress scale, Herth hope index, functional assessment cancer therapy-cervix, and Jolowiec coping scale were used to conduct surveys on psychological distress, level of hope, quality of life (QOL), and coping style to analyze the factors affecting the level of hope and psychological health status of CC patients. Results The morbidity of significant psychological distress in 480 CC patients during radiotherapy was 68%, and the main factors causing psychological distress were emotional problems and physical problems. During radiotherapy, most patients had middle and high levels of hope, and the psychological distress index of patients was negatively correlated with the level of hope. The QOL of CC patients during radiotherapy were at middle and high levels, and the QOL was positively correlated with confrontment, optimism, appeasement, and self-reliance, but it was negatively correlated with predestination and emotional expression. Conclusions For CC patients during radiotherapy, the morbidity of psychological distress was high, but they were at middle and high levels of hope.
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Affiliation(s)
- Li-Rong Li
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Mei-Guang Lin
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Juan Liang
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Qiong-Yan Hu
- Department of Nursing, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Dan Chen
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Meng-Ying Lan
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Wu-Qing Liang
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Yu-Ting Zeng
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Ting Wang
- Department of Radiation Oncology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
| | - Gui-Fen Fu
- Department of Nursing, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (mainland)
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Sung Uk L, Young Ae K, Young-Ho Y, Yeon-Joo K, Myong Cheol L, Sang-Yoon P, Sang-Soo S, Ji Eun P, Joo-Young K. General health status of long-term cervical cancer survivors after radiotherapy. Strahlenther Onkol 2017; 193:543-551. [PMID: 28492995 DOI: 10.1007/s00066-017-1143-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 04/17/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the global health status of long-term cervical cancer survivors (LCCS) who survived for more than 4 years after curative radiation treatment (RT). PATIENTS AND METHODS Medical records of 562 women treated with RT in our institution between 2003 and 2010 were reviewed. Excluding 259 women who died of disease or were lost to follow-up, disease status and late morbidities were evaluated in 303 LCCS. Quality of life (QoL) was analyzed in 168 LCCS using a questionnaire from the European Organization for the Research and Treatment of Cancer, and the results were compared with an age-matched healthy Korean female population. RESULTS Median follow-up was 6.8 years (range 4.1-12.5 years). There were 14 deaths (7 cancer specific) and 14 recurrences (5 local recurrences and 9 distant metastases). The median time to recurrence was 6.0 years (range 4.1-8.2 years). Grade ≥2 late toxicities were frequently observed in the bladder (19%) and small/large intestine (15%). Multivariate analysis revealed a higher rate of late toxicity in patients aged ≥51 years at diagnosis (small/large intestine: hazard ratio, HR, 2.5 [1.2-5.5]; bladder: HR 2.4 [1.3-4.5]; and bone: HR 4.3 [1.2-15.8]) than patients aged <51 years. Compared to the general population, LCCS exhibited a significantly higher rate of body image concerns, sexual dysfunction, lymphedema, and peripheral neuropathy. CONCLUSION New recurrences occurred in 5% of LCCS and grade ≥2 treatment-related morbidities were present in 33%. A significant proportion of LCCS also showed decreased cervical-cancer-specific QoL. These results suggest the need for long-term surveillance and follow-up care for LCCS.
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Affiliation(s)
- Lee Sung Uk
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of)
| | - Kim Young Ae
- Cancer Policy Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of)
| | - Yoon Young-Ho
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea (Republic of)
| | - Kim Yeon-Joo
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of).,Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of)
| | - Lim Myong Cheol
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of).,Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of).,Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea (Republic of)
| | - Park Sang-Yoon
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of)
| | - Seo Sang-Soo
- Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of)
| | - Park Ji Eun
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of)
| | - Kim Joo-Young
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of). .,Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea (Republic of). .,Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, 410-769, Goyang, Gyeonggi, Korea (Republic of).
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