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Patierno C, Fava GA, Carrozzino D. Illness Denial in Medical Disorders: A Systematic Review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2023; 92:211-226. [PMID: 37429268 DOI: 10.1159/000531260] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/23/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION Illness denial pertains to medical patients who do not acknowledge the presence or severity of their disease or the need of treatment. OBJECTIVE This systematic review was performed to clarify the clinical role and manifestations of illness denial, its impact on health attitudes and behavior, as well as on short- and long-term outcomes in patients with medical disorders. METHODS The systematic search according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines was conducted on PubMed, Scopus, and Web of Science. RESULTS The initial search yielded a total of 14,098 articles; 176 studies met the criteria for inclusion. Illness denial appeared to be a relatively common condition affecting a wide spectrum of health attitudes and behavior. In some cases, it may help a person cope with various stages of illness and treatment. In other situations, it may determine delay in seeking treatment, impaired adherence, and reduced self-management, leading to adverse outcomes. The Diagnostic Criteria for Psychosomatic Research (DCPR) were found to set a useful severity threshold for the condition. An important clinical distinction can also be made based on the DCPR for illness denial, which require the assessment of whether the patient has been provided with an adequate appraisal of the medical situation. CONCLUSIONS This systematic review indicates that patients with medical disorders experience and express illness denial in many forms and with varying degrees of severity. The findings suggest the need for a multidimensional assessment and provide challenging insights into the management of medical disorders.
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Affiliation(s)
- Chiara Patierno
- Department of Psychology "Renzo Canestrari," University of Bologna, Bologna, Italy
| | - Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Danilo Carrozzino
- Department of Psychology "Renzo Canestrari," University of Bologna, Bologna, Italy
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Ammitzbøll G, Levinsen AKG, Kjær TK, Ebbestad FE, Horsbøl TA, Saltbæk L, Badre-Esfahani SK, Joensen A, Kjeldsted E, Halgren Olsen M, Dalton SO. Socioeconomic inequality in cancer in the Nordic countries. A systematic review. Acta Oncol 2022; 61:1317-1331. [DOI: 10.1080/0284186x.2022.2143278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Gunn Ammitzbøll
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Danish Research Center for Equality in Cancer (COMPAS), Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Næstved, Denmark
| | | | - Trille Kristina Kjær
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Freja Ejlebæk Ebbestad
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Trine Allerslev Horsbøl
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lena Saltbæk
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Næstved, Denmark
| | - Sara Koed Badre-Esfahani
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark
| | - Andrea Joensen
- Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Eva Kjeldsted
- Danish Research Center for Equality in Cancer (COMPAS), Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Næstved, Denmark
| | - Maja Halgren Olsen
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Danish Research Center for Equality in Cancer (COMPAS), Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Næstved, Denmark
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Wilson JM, Smith K, Strough J, Delaney R. Knowing you are there makes the difference: perceived social support, preferences for using support, and health. J Women Aging 2020; 33:396-410. [PMID: 33347380 DOI: 10.1080/08952841.2020.1860633] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Using cluster analysis, we investigated whether perceived social support and individual differences in preferences to use support combined to form distinct profiles. Self-report data were collected from U.S. adults (N = 454; aged 40-90, Mage = 55.37, SD = 9.73). Four profiles were identified: disengaged, interpersonally connected, isolated independent, and connected independent. Profiles characterized by high perceived support were associated with better overall health, even among those who preferred not to use support; men and those not married or cohabiting were less likely to be in these profiles. Implications for understanding associations between social support and health and the identification of at-risk groups are discussed.
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Affiliation(s)
- Jenna M Wilson
- Department of Psychology, West Virginia University, Morgantown, United States
| | - Kelly Smith
- Department of Psychology, West Virginia University, Morgantown, United States
| | - JoNell Strough
- Department of Psychology, West Virginia University, Morgantown, United States
| | - Rebecca Delaney
- Department of Psychology, West Virginia University, Morgantown, United States.,School of Medicine, University of Utah, Salt Lake City, United States
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Rymarczyk K, Turbacz A, Strus W, Cieciuch J. Type C Personality: Conceptual Refinement and Preliminary Operationalization. Front Psychol 2020; 11:552740. [PMID: 33041918 PMCID: PMC7525034 DOI: 10.3389/fpsyg.2020.552740] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/20/2020] [Indexed: 12/24/2022] Open
Abstract
In this paper, we have presented our proposal for reconceptualization and operationalization of Type C (cancer-prone) personality. Based on theoretical analyses, taking into account both the literature on Type C and models of personality structure, we have proposed a two-facet structure of Type C, comprising Submissiveness (the interpersonal aspect) and Restricted Affectivity (the intrapersonal aspect). The study devoted to the validation of the measure of Type C involved 232 participants aged 18-70 (M = 29.35, SD = 8.93; 54% male). We used (a) our proposed measure of Type C personality and (b) the Circumplex of Personality Metatraits Questionnaire (CPM-Q-SF; Strus and Cieciuch, 2017), assessing personality metatraits. The measure of Type C proved to have acceptable internal consistency (Cronbach's alpha was 0.85 for Submissiveness and 0.78 for Restricted Affectivity). The measurement model in confirmatory factor analysis with two latent variables proved to be well-fitted to the data. We have also confirmed the hypothesis concerning the location of the two facets of Type C personality close to each other in the theoretically predicted area between the Delta-Plus/Self-Restraint and Beta-Minus/Passiveness metatraits (in the Circumplex of Personality Metatraits). The clinical value of the theoretically refined Type C can be tested in the next step in research on patients with cancer.
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Affiliation(s)
- Karolina Rymarczyk
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | - Anna Turbacz
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | - Włodzimierz Strus
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
| | - Jan Cieciuch
- Institute of Psychology, Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
- URPP Social Networks University of Zurich, Zurich, Switzerland
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Baker JL, Mailey B, Tokin CA, Blair SL, Wallace AM. Postmastectomy Reconstruction is Associated with Improved Survival in Patients with Invasive Breast Cancer: A Single-institution Study. Am Surg 2020. [DOI: 10.1177/000313481307901004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Breast reconstruction after mastectomy positively affects psychosocial well-being; however, the influence of reconstruction on cancer outcomes is unknown. The objective of our study was to compare survival in reconstructed versus nonreconstructed patients after mastectomy. All consecutive female patients diagnosed with invasive breast cancer and treated with mastectomy between 2002 and 2011 were identified from our single-institution database. All cancer operations were performed by two surgeons. Survival was calculated using the Kaplan-Meier method and compared using the log-rank test. To identify the effect of reconstruction on survival, a multivariate Cox regression analysis was performed. Of 474 patients treated, 340 (71.7%) underwent breast reconstruction. At a mean follow-up 3.3 years, reconstructed patients had a longer 5-year survival (91 vs 74%, P < 0.001). After controlling for age, race, payer source, cancer stage, triple negative status, and receipt of radiation or chemotherapy, reconstructed patients maintained a survival advantage over nonreconstructed patients (hazard ratio, 0.47; 95% confidence interval, 0.25 to 0.88; P = 0.02). Patients with breast cancer who undergo reconstruction have longer survival than nonreconstructed patients. The explanation for this finding may be related to improved psychosocial qualities of life versus possible antitumorigenic effects of implants.
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Affiliation(s)
- Jennifer L. Baker
- Department of Surgery, University of California, San Diego, San Diego, California
| | - Brian Mailey
- Department of Surgery, University of California, San Diego, San Diego, California
- Plastic and Reconstructive Surgery, University of California, San Diego, San Diego, California
| | - Christopher A. Tokin
- Department of Surgery, University of California, San Diego, San Diego, California
| | - Sarah L. Blair
- Department of Surgery, University of California, San Diego, San Diego, California
- Division of Surgical Oncology, University of California, San Diego, San Diego, California
| | - Anne M. Wallace
- Department of Surgery, University of California, San Diego, San Diego, California
- Division of Surgical Oncology, University of California, San Diego, San Diego, California
- Plastic and Reconstructive Surgery, University of California, San Diego, San Diego, California
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Wang Y, Chen K, Yang Y, Tan L, Chen L, Zhu L, Su F, Liu X, Li S. Incidence and survival outcomes of early male breast cancer: a population-based comparison with early female breast cancer. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:536. [PMID: 31807518 DOI: 10.21037/atm.2019.10.04] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background Male breast cancer (MBC) is a rare malignancy. We aimed to analyze the incidence trends, clinicopathological characteristics, and survival outcomes in early MBC comparison with early female breast cancer (FBC). Methods We included eligible MBC and FBC patients with stage I-II disease in the Surveillance, Epidemiology, and End Results (SEER) database from 2000-2015. Joinpoint regression was used to evaluate the trends in age-adjusted incidence. A one-to-four propensity score matching (PSM) analysis was performed to reduce bias in a retrospective study. Survival outcomes were evaluated using Kaplan-Meier analyses with the log-rank test and Cox proportional hazards regression analysis. Results Trends in the age-adjusted incidence rates of early MBC were stable [2000-2015, annual percentage change (APC) =0.50, 95% confidence interval (CI): -0.1 to 1.1, P=0.102]; however, the incidence of early FBC changed significantly over the time period (2000-2015, APC = 0.30, 95% CI: 0.0 to 0.6, P=0.045). In the matched cohort, unmarried status, higher grade, larger tumor size, and advanced lymph node (LN) status were associated with a higher risk of breast cancer death and death of any causes both in early MBC and FBC patients. The hormone receptor (HR) status was as a prognostic factor in FBC patients, but not in MBC. Early MBC had worse breast cancer-specific survival (BCSS) and overall survival (OS) than early FBC in stage I, stage II and HR-positive subgroup of patients. Conclusions The biological behavior, clinicopathological features, and clinical outcomes of early MBC are different from that of FBC. Further studies on individualized treatment approaches in MBC are needed.
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Affiliation(s)
- Yan Wang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Kai Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Yaping Yang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Luyuan Tan
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Lili Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Liling Zhu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Fengxi Su
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Xue Liu
- College of Basic Medicine, Jining Medical University, Jining 272067, China
| | - Shunrong Li
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.,Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
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7
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Sipilä R, Hintsa T, Lipsanen J, Tasmuth T, Estlander AM, Kalso E. The relationship between anger regulation, mood, pain, and pain-related disability in women treated for breast cancer. Psychooncology 2019; 28:2002-2008. [PMID: 31325347 DOI: 10.1002/pon.5182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/09/2019] [Accepted: 07/15/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Anger, depressive symptoms, and anxiety are known reactions to cancer and suggested to modulate pain experience. We examined the association between anger regulation, mood, and pain in 952 breast cancer patients followed for 3 years. METHODS Preoperatively, the patients completed questionnaires about depressive symptoms (BDI), state anxiety (STAI), anger regulation (STAXI-2), and pains in the surgical and other areas. Experimental pain sensitivity was tested. In the follow-up, BDI and STAI were assessed at 1 and at 6 months and at 1, 2, and 3 years after surgery. Pain in the surgical area was evaluated during the first 7 days and at 1 and 3 years after surgery. Pain-related disability was assessed at 3 years after surgery. Latent profile analyses were performed to identify mood profiles, and regression analyses to find independent predictors for mood and pain variables. RESULTS Anger inhibition and pain had associations with ongoing depressive symptoms and anxiety. Pain-related disability was associated with high anxiety at a hazard ratio (HR) of 2.24 (95% CI, 1.17-4.27), with older age (HR 1.07, 95% CI, 1.01-1.13), and with pain in the surgical area (HR 3.04, 95% CI, 2.41-3.85), but not with anger variables. Any relationship between anger regulation and pain intensity disappeared after controlling for age and mood. CONCLUSIONS Different forms of pain are important to recognize and treat to support breast cancer patients' psychological well-being. Anger inhibition could be a target for psychotherapeutic intervention, to help with ongoing mood symptoms. The relationship between anger regulation and pain is not straightforward.
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Affiliation(s)
- Reetta Sipilä
- Division of Pain Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki University Hospital, Helsinki, Finland
| | - Taina Hintsa
- Department of Educational Sciences and Psychology, Philosophical Faculty, University of Eastern Finland, Joensuu, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tiina Tasmuth
- Division of Pain Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki University Hospital, Helsinki, Finland
| | - Ann-Mari Estlander
- Division of Pain Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki University Hospital, Helsinki, Finland
| | - Eija Kalso
- Division of Pain Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki University Hospital, Helsinki, Finland
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Mai TTX, Choi JH, Lee MK, Chang YJ, Jung SY, Cho H, Lee ES. Prognostic Value of Post-diagnosis Health-Related Quality of Life for Overall Survival in Breast Cancer: Findings from a 10-Year Prospective Cohort in Korea. Cancer Res Treat 2019; 51:1600-1611. [PMID: 30999723 PMCID: PMC6790846 DOI: 10.4143/crt.2018.426] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 04/10/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose We aimed to evaluate health-related quality of life (HRQOL) at 1-year post-diagnosis in breast cancer (BC) patients and its association with overall survival using data from the National Cancer Center Hospital. Materials and Methods Data of a BC cohort were first obtained between 2004 and 2006 and followed up. HRQOL was assessed using EORTC QLQ-C30 and BC specific module QLQ-BR23 few days after diagnosis and 1 year after that. We examined and compared the difference in the two HRQOL scores measured for each patient by the patient’s current survival status. The Cox proportional hazards model was fitted to evaluate the impact of HRQOL on survival, with adjustment for baseline HRQOL and other factors. Results Of 299 enrolled patients, 206 responded at 1-year post-diagnosis (80.6%) and were followed up for 11.6 years on average. At 1-year post-diagnosis, survivors had better HRQOL scores than those who died, although their health status was similar at baseline. Survivors reported significant increase 1 year after diagnosis in global health status and emotional scales. Between the groups, functional scales such as physical, role, and emotional were significantly different. Functional scales, including physical (adjusted hazard ratio [aHR], 0.70), role (aHR, 0.68), emotional (aHR, 0.72), and symptom scales, including fatigue (aHR, 1.34), dyspnea (aHR, 1.29), appetite loss (aHR, 1.24) were significantly associated with overall survival. Patients who were less worried about future health had favorable survival(aHR, 0.83). Conclusion Besides treatment-related symptoms, non-medical aspects at 1-year post-diagnosis, including functional well-being and future perspective, are predictive of long-term survival. Intervention to enhance physical, role, and emotional support for women soon after their BC diagnosis might help to improve disease survival outcomes afterwards.
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Affiliation(s)
- Tran Thi Xuan Mai
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Jin Hyuk Choi
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Myung Kyung Lee
- College of Nursing, Kyungpook National University, Daegu, Korea
| | - Yoon Jung Chang
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Hospice and Palliative Care Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - So-Youn Jung
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
| | - Hyunsoon Cho
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eun Sook Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.,Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
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Pinto E, Cavallin F, Scarpa M. Psychological support of esophageal cancer patient? J Thorac Dis 2019; 11:S654-S662. [PMID: 31080642 PMCID: PMC6503274 DOI: 10.21037/jtd.2019.02.34] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 02/04/2019] [Indexed: 12/22/2022]
Abstract
Important questions are still open about psychological aspects in esophageal cancer (EC) and about the related psychological support. How to cope with the cancer diagnosis and poor prognosis: a psychological counselling may be a valid option to personalize the communication to patients with a poor prognosis. How to cope with long chemoradiotherapy: after neoadjuvant therapy, patients know that curative process is not completed, and they perceive the severity of the neoadjuvant side effects, considering themselves "fragile" and far from a healthy condition before the major surgery they are going to undergo. Therefore, this is a particularly crucial point when psychological support may be useful. How to cope with change of nutritional habits: esophagectomy for cancer strongly impairs nutritional function in the early postoperative period and feeding Jejunostomy impairs emotional function. How to cope with sleep disturbances: most cancer patients report disturbed sleep after cancer diagnosis and/or following cancer treatment. Psychological intervention aims to identify underlying concerns worsening sleep quality. How to cope with postoperative complications: the occurrence of such complications reduces patient's satisfaction and has a negative effect on doctor-patient relationship. How to cope with long-term functions impairment: EC patients need a plan for the future.
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Affiliation(s)
- Eleonora Pinto
- Esophageal and Digestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Institute of Oncology (IOV-IRCCS), Padova, Italy
| | | | - Marco Scarpa
- General Surgery Unit, Azienda Ospedaliera di Padova, Padova, Italy
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Oliveri S, Arnaboldi P, Pizzoli SFM, Faccio F, Giudice AV, Sangalli C, Luini A, Pravettoni G. PTSD symptom clusters associated with short- and long-term adjustment in early diagnosed breast cancer patients. Ecancermedicalscience 2019; 13:917. [PMID: 31123500 PMCID: PMC6467457 DOI: 10.3332/ecancer.2019.917] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Indexed: 12/28/2022] Open
Abstract
Objectives We performed an observational prospective cohort study to investigate post-traumatic stress symptoms, emerging after cancer diagnosis, which could influence patients’ short- and long-term adjustment to illness, in order to foster screening measures and management of psychological factors in daily clinical pathways. Methods Patients’ post-traumatic stress symptoms, psychological well-being and perceived quality of life were assessed through standardised questionnaires. The Profile of Mood States questionnaire was administered at pre-operative assessment (T0), surgical admission (T1) and discharge from hospital (T2). The Impact of Event Scale and the State-Trait Anxiety Inventory were administered at T0, T1, T2 and 2 years after discharge (T3). At 2-year follow-up, women were also asked to rate their perceived quality of life on a 0–10 visual analogue scale. Results Between January 2014 and April 2015, 150 women were enrolled. Results showed that more than 90% of patients experienced post-traumatic stress symptoms after cancer diagnosis (14% with severe symptoms and 76.7% with moderate symptoms) and post-traumatic stress disorder (PTSD) symptoms that persisted up to the 2-year from discharge follow-up, with significant improvement only 2 years after hospital discharge. In particular, mediation models showed that intrusive thoughts impede mood adjustment to the disease during the pre-surgical phase, with anxiety amplifying the negative effect, while symptoms of avoidance are more detrimental in the long term for patients’ quality of life. Conclusion PTSD symptom clusters have different influence on short- and long-term reaction to illness. Based on this evidence, appropriate interventions to manage PTSDs in the context of oncology should be developed.
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Affiliation(s)
- Serena Oliveri
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
| | - Paola Arnaboldi
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
| | - Silvia Francesca Maria Pizzoli
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
| | - Flavia Faccio
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
| | - Alice V Giudice
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
| | - Claudia Sangalli
- Data management, European Institute of Oncology, 20141, Milan, Italy
| | - Alberto Luini
- Division of Senology, European Institute of Oncology, 20141, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy.,Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology, 20141, Milan, Italy
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Early quality-of-life and psychological predictors of disease-free time and survival in localized prostate cancer. Qual Life Res 2018; 28:677-686. [PMID: 30511254 PMCID: PMC6394517 DOI: 10.1007/s11136-018-2069-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2018] [Indexed: 01/06/2023]
Abstract
PURPOSE The constructs evaluated in investigating association between psychosocial factors and cancer survival has varied between studies, and factors related to quality of life (QOL) have shown contradictory results. We investigated the effect of socioeconomic and early QOL and psychological factors on disease-free time and survival in localized prostate cancer. METHODS A consecutive sample of patients with localized prostate cancer (T1-3, N0, M0) treated with external beam radiotherapy completed validated questionnaires on coping with cancer (the Ways of Coping Questionnaire WOC-CA), anger expression (the Anger Expression Scale), life events (the Life Experience Survey), and various aspects of QOL (the Rotterdam Symptom Checklist, the Depression Scale DEPS, the EORTC QLQ-C30, the LENT-SOMA outcome measure) approximately 4.5 months after diagnosis. Cox regression analyses were used to determine the predictors of the disease-free and overall survival times measured from the date of diagnosis to the date of a PSA-relapse and date of death. RESULTS After controlling for biological prognostic factors, age, and adjuvant hormonal therapies, moderate and high socioeconomic status and an increased level of pain predicted longer survival, whereas an increased level of prostate-area symptoms and fatigue and, especially, reports of no/few physical symptoms were predictors of a shorter survival time. A longer PSA-relapse-free time was predicted by Cognitive Avoidance/Denial coping, whereas problems in social functioning, hopelessness, and an excellent self-reported QOL predicted a shorter PSA-relapse-free time. CONCLUSIONS Higher socioeconomic status was prognostic for longer survival, as previously reported. Patients with a seemingly good QOL (few physical complaints, excellent self-reported QOL) had poorer prognoses. This association may due to the survival decreasing effect of emotional non-expression; patients with high emotional non-expression may over-report their wellbeing in simple measures, and thus actually be in need of extra attention and care.
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Threats to Belonging among Breast Cancer Survivors: Consequences for Mental and Physical Health. CURRENT BREAST CANCER REPORTS 2018. [DOI: 10.1007/s12609-018-0262-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Mohammadian M, Pakzad R, Towhidi F, Makhsosi BR, Ahmadi A, Salehiniya H. Incidence and mortality of kidney cancer and its relationship with HDI (Human Development Index) in the world in 2012. ACTA ACUST UNITED AC 2017; 90:286-293. [PMID: 28781525 PMCID: PMC5536208 DOI: 10.15386/cjmed-691] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 08/06/2016] [Indexed: 12/13/2022]
Abstract
Background and aims Kidney cancer is among the cancers that have the highest growth rate in all age and racial groups in the world and is as the most deadly type of urinary tract cancer. Since awareness about this cancer incidence status and mortality is essential for better planning, this study aimed to investigate the incidence and mortality rate of kidney cancer and its relationship with the development index in the world in 2012. Method This study was an ecological study conducted based on GLOBOCAN project of the World Health Organization (WHO) for the countries in the world. The correlation between Standardized Incidence Rates (SIRs) and Standardized Mortality Rates (SMRs) of kidney cancer with HDI and its components was assessed using SPSS18. Results In total, 337,860 incidence cases (213,924 were men and 123,936 women) and 143,406 deaths (90,802 cases in men and 52,604 in women) of kidney cancer were recorded in 2012. A positive correlation of 0.731 was seen between SIR of kidney cancer and HDI (p≤0.001). Also, a negative correlation of 0.627 was seen between SMR of kidney cancer and HDI (p≤0.001). Conclusion The incidence and mortality rate of kidney cancer is higher in developed countries. A significant positive correlation has been seen between the standardized incidence and mortality rate of kidney cancer with the Human Development Index and its components. We need more studies to examine variation in incidence and mortality of kidney cancer and its related factors in the world.
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Affiliation(s)
- Maryam Mohammadian
- Health Promotion Research Center, Department of Epidemiology and Biostatistics, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Reza Pakzad
- Ilam University of Medical Sciences, Ilam, Iran
| | - Farhad Towhidi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Abbas Ahmadi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Salehiniya
- Zabol University of Medical Sciences, Zabol, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of medical sciences, Tehran, Iran
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Hui L, Huang T, Lian J, Zhou F, Gao C, Lin Y, Tu H, Nan K, Li Z, Wei Y. Potential prognostic value of clinical characteristics, hormone status and major depressive disorder in breast cancer. Future Oncol 2017; 13:1493-1503. [PMID: 28589742 DOI: 10.2217/fon-2017-0515] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
AIM To identify independent factors predicting overall survival (OS) of breast cancer (BC) patients. PATIENTS & METHODS Two hundred and eighty one women with BC were recruited and clinical characteristics including lymphovascular invasion, clinical stage of Tumor Node Metastasis and positive axillary lymph nodes were documented; immunohistochemistry/fluorescence in situ hybridization was used to examine the expression of estrogen receptor, progesterone receptor, HER2 and Ki-67; major depressive disorder was assessed with Diagnostic and Statistical Manual of Mental Disorders V. RESULTS Multivariable analyses indicated that in BC patients, lymphovascular invasion, Tumor Node Metastasis, pN, Ki-67 and major depressive disorder were significantly negatively correlated with OS; estrogen receptor was significantly positively associated with OS. CONCLUSION Early diagnostic approaches and effective psychologic intervention are indispensable for BC patients.
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Affiliation(s)
- Lingyun Hui
- Research Center of Medical Laboratory, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Tianhe Huang
- Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.,Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, PR China
| | - Jie Lian
- Department of Clinical Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - Fuling Zhou
- Department of Clinical Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Chengge Gao
- Department of Psychology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Yan Lin
- Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Honglei Tu
- Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Kejun Nan
- Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Zongfang Li
- National-local Joint Engineering Research Center of Biodiagnostics & Biotherapy, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Yongchang Wei
- Department of Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.,Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, PR China
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15
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Mahdavifar N, Ghoncheh M, Pakzad R, Momenimovahed Z, Salehiniya H. Epidemiology, Incidence and Mortality of Bladder Cancer and their Relationship with the Development Index in the World. Asian Pac J Cancer Prev 2016; 17:381-6. [PMID: 26838243 DOI: 10.7314/apjcp.2016.17.1.381] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bladder cancer is an international public health problem. It is the ninth most common cancer and the fourteenth leading cause of death due to cancer worldwide. Given aging populations, the incidence of this cancer is rising. Information on the incidence and mortality of the disease, and their relationship with level of economic development is essential for better planning. The aim of the study was to investigate bladder cancer incidence and mortality rates, and their relationship with the the Human Development Index (HDI) in the world. MATERIALS AND METHODS Data were obtained from incidence and mortality rates presented by GLOBOCAN in 2012. Data on HDI and its components were extracted from the global bank site. The number and standardized incidence and mortality rates were reported by regions and the distribution of the disease were drawn in the world. For data analysis, the relationship between incidence and death rates, and HDI and its components was measured using correlation coefficients and SPSS software. The level of significance was set at 0.05. RESULTS In 2012, 429,793 bladder cancer cases and 165,084 bladder death cases occurred in the world. Five countries that had the highest age-standardized incidence were Belgium 17.5 per 100,000, Lebanon 16.6/100,000, Malta 15.8/100,000, Turkey 15.2/100,000, and Denmark 14.4/100,000. Five countries that had the highest age-standardized death rates were Turkey 6.6 per 100,000, Egypt 6.5/100,000, Iraq 6.3/100,000, Lebanon 6.3/100,000, and Mali 5.2/100,000. There was a positive linear relationship between the standardized incidence rate and HDI (r=0.653, P<0.001), so that there was a positive correlation between the standardized incidence rate with life expectancy at birth, average years of schooling, and the level of income per person of population. A positive linear relationship was also noted between the standardized mortality rate and HDI (r=0.308, P<0.001). There was a positive correlation between the standardized mortality rate with life expectancy at birth, average years of schooling, and the level of income per person of population. CONCLUSIONS The incidence of bladder cancer in developed countries and parts of Africa was higher, while the highest mortality rate was observed in the countries of North Africa and the Middle East. The program for better treatment in developing countries to reduce mortality from the cancer and more detaiuled studies on the etiology of are essential.
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Affiliation(s)
- Neda Mahdavifar
- Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran E-mail :
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Opioid-taking self-efficacy as influencing emotional status in patients with cancer pain. Eur J Oncol Nurs 2016; 25:77-82. [PMID: 27865256 DOI: 10.1016/j.ejon.2016.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/30/2016] [Accepted: 10/12/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE The purpose of this study was to evaluate how much of the variance in emotional status amongst Taiwanese cancer patients could be accounted for by opioid-taking self-efficacy. METHODS This cross-sectional study included 109 cancer patients who had taken prescribed opioid analgesics for cancer related pain in the past week and completed the Opioid-Taking Self-Efficacy Scale-CA (OTSES-CA) and Hospital Anxiety and Depression Scale. RESULTS There was a significant and negative correlation between scores on anxiety and self-efficacy total scale (r = -0.29, p < 0.01), self-efficacy communication subscale (r = -0.37, p < 0.01), self-efficacy acquiring help subscale (r = -0.22, p < 0.05) and self-efficacy managing treatment related concerns subscale (r = -0.32, p < 0.01). However, the correlation between scores on depression and the self-efficacy total scale was not significant (r = -0.18, p > 0.05); only the self-efficacy communication subscale was significantly and negatively associated with depression (r = -0.27, p < 0.01). The opioid-taking self-efficacy total scale accounted for 8% of predicting the patients' anxiety. Opioid-taking self-efficacy subscales accounted for 20% (R2 = 0.20, p = 0.000) of the variance in predicting anxiety and 10% (R2 = 0.10, p = 0.02) of the variance in predicting depression. CONCLUSIONS This study highlights the potential importance of a patient's opioid-taking self-efficacy beliefs in their emotional status, which is relevant to cancer pain.
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Markar SR, Mavroveli S, Petrides KV, Scarpa M, Christophe V, Castoro C, Mariette C, Lagergren P, Hanna GB. Applied investigation of person-specific and context-specific factors on postoperative recovery and clinical outcomes of patients undergoing gastrointestinal cancer surgery: multicentre European study. BMJ Open 2016; 6:e012236. [PMID: 27798009 PMCID: PMC5093381 DOI: 10.1136/bmjopen-2016-012236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Cancer treatments have greatly advanced over the past two decades causing survival improvements and reduced complications from cancer surgery. However, the cancer diagnosis and the effects of treatment modalities pose a major risk to patients' psychological well-being. Given current interest and emerging evidence about the importance of psychological and social factors on cancer survival and coping with cancer treatments, this study will build and expand research in order to identify key modifiable psychosocial variables that contribute to better physical and mental health following gastrointestinal cancer (GIC) surgery. OBJECTIVES To elucidate the incidence of postoperative psychiatric morbidity within 6 months following GIC surgery. To identify key measurable modifiable preoperative psychological factors that can significantly affect postoperative psychiatric morbidity in patients undergoing surgery for GIC. To clarify the changes seen in a patient's psychological well-being during their treatment pathway for GIC. METHODS AND ANALYSIS This multicentre study has an observational longitudinal study design. In total, 1000 patients will be screened with a multicomponent psychological questionnaire at four different time points: at diagnosis, preoperatively, 1 and 6 months after surgery. Data from this questionnaire will be linked to postoperative complications including psychiatric morbidity, length of hospital stay and recovery to normal activity. ETHICS AND DISSEMINATION NHS Health Research Authority approval was gained on (REC reference 15.LO/1847) for the completion of this study. Multiple platforms will be used for the dissemination of the research data, including international clinical and patient group presentations and publication of research outputs in a high impact clinical journal.
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Affiliation(s)
- Sheraz R Markar
- Department of Surgery & Cancer, Imperial College London, London, UK
| | - Stella Mavroveli
- Department of Surgery & Cancer, Imperial College London, London, UK
| | | | - Marco Scarpa
- Esophageal and Digestive Tract Surgical Unit, Veneto Institute of Oncology, Padova, Veneto, Italy
| | | | - Carlo Castoro
- Esophageal and Digestive Tract Surgical Unit, Veneto Institute of Oncology, Padova, Veneto, Italy
| | - Christophe Mariette
- Department of Digestive and Oncology surgery, University Hospital Claude Huriez, Lille, France
| | - Pernilla Lagergren
- Department of Molecular Medicine & Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - George B Hanna
- Department of Surgery & Cancer, Imperial College London, London, UK
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18
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Coping strategies and cancer incidence and mortality: The Japan Public Health Center-based prospective study. Cancer Epidemiol 2016; 40:126-33. [DOI: 10.1016/j.canep.2015.12.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/27/2015] [Accepted: 12/07/2015] [Indexed: 11/20/2022]
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Brandão T, Tavares R, Schulz MS, Matos PM. Measuring emotion regulation and emotional expression in breast cancer patients: A systematic review. Clin Psychol Rev 2016; 43:114-27. [DOI: 10.1016/j.cpr.2015.10.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 08/25/2015] [Accepted: 10/16/2015] [Indexed: 01/17/2023]
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Ávila M, Brandão T, Teixeira J, Coimbra JL, Matos PM. Attachment, emotion regulation, and adaptation to breast cancer: assessment of a mediational hypothesis. Psychooncology 2015; 24:1514-20. [DOI: 10.1002/pon.3817] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 03/08/2015] [Accepted: 03/10/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Marisa Ávila
- Faculty of Psychology and Educational Sciences; University of Porto, Psychology Center; Porto Portugal
| | - Tânia Brandão
- Faculty of Psychology and Educational Sciences; University of Porto, Psychology Center; Porto Portugal
| | - Joana Teixeira
- Faculty of Psychology and Educational Sciences; University of Porto, Psychology Center; Porto Portugal
| | - Joaquim Luis Coimbra
- Faculty of Psychology and Educational Sciences; University of Porto, Psychology Center; Porto Portugal
| | - Paula Mena Matos
- Faculty of Psychology and Educational Sciences; University of Porto, Psychology Center; Porto Portugal
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21
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Liang SY, Wu SF, Chao TC, Tseng LM, Wu WW, Wang TJ, Lu YY. The Impact of Pain on the Quality of Life of Taiwanese Oncology Patients. Pain Manag Nurs 2015; 16:128-36. [DOI: 10.1016/j.pmn.2014.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 05/23/2014] [Accepted: 05/27/2014] [Indexed: 11/12/2022]
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Tu CH, Hsu MC, Chi SC, Lin HY, Yen YC. Routine depression screening and diagnosing strategy for cancer inpatients. Psychooncology 2014; 23:1057-67. [PMID: 24798464 DOI: 10.1002/pon.3547] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 03/17/2014] [Accepted: 03/17/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Clinical practice guidelines frequently recommend systematic screening for depression in cancer patients to improve recognition and prompt appropriate management. We aimed to screen major depressive disorder (MDD) in cancer inpatients using a structured tool and explore its applicability. METHODS Cancer inpatients were routinely screened by nurses using the Taiwanese Depression Questionnaire (TDQ), and for those screened positive, this was followed by a non-mandated referral to a psychiatrist for clinical evaluation and diagnosis. Patients who completed this two-stage procedure comprised the analysis sample. RESULTS Routine screening of 8800 patients in a period of 27 months yielded 1087 (26.9%) positive first-time screens. Of them, 298 (27.4%) completed the psychiatric consultation. Depressive disorders were diagnosed in 185 patients (62.1%), mainly adjustment disorder (23.8%) and MDD (21.5%). The estimated prevalence of MDD was 21.5%. Area under the curve was 0.72, a result produced by the receiver operating characteristic curve of the TDQ scores relative to the clinical psychiatric diagnoses of MDD. A TDQ cutoff score of ≧26 provided an optimal diagnostic accuracy for MDD. CONCLUSIONS This two-stage depression screening and diagnosing strategy is practical for improving recognition of MDD and other depressive disorders in cancer patients and could be routinely applied, rather than selectively, in a comprehensive cancer care system.
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Affiliation(s)
- Chun-Hsien Tu
- Department of Psychiatry, E-Da Hospital, Kaohsiung, Taiwan; Department of Nursing, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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23
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Beyond psychiatric classification in oncology: Psychosocial dimensions in cancer and implications for care. PSYCHO-ONCOLOGIE 2013. [DOI: 10.1007/s11839-013-0436-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Salonen P, Rantanen A, Kellokumpu-Lehtinen PL, Huhtala H, Kaunonen M. The quality of life and social support in significant others of patients with breast cancer--a longitudinal study. Eur J Cancer Care (Engl) 2013; 23:274-83. [PMID: 24237363 DOI: 10.1111/ecc.12153] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2013] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to evaluate prospectively the quality of life (QOL) and received social support from the network and nurses in significant others of breast cancer patients and identify factors predicting negative changes in their QOL within 6 months. The quasi-random longitudinal study conducted for the breast cancer patients and their significant others. Patients were quasi-randomised to supportive intervention group (via telephone at baseline and face-to-face at follow-up) and control group. This paper reports results of significant others (N = 165). The QOL data were collected using the Quality of Life Index - Cancer Version (QLI-CV). Support from network in aid increased the risk of negative changes in health and functioning. Retired significant others had a greater risk of more negative changes in their global and in socio-economic QOL than other. Relatives had a smaller risk to negative changes both in their global and in their family QOL than spouses/partners/boyfriends of patients with breast cancer. QOL of the significant others should be supported more intensively and enhanced by the use of individually tailored methods on the basis of significant others and their family needs.
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Affiliation(s)
- P Salonen
- Tauh Division of Administrative Services, Tampere University Hospital, Tampere, Finland
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Pérez M, Sefko JA, Ksiazek D, Golla B, Casey C, Margenthaler JA, Colditz G, Kreuter MW, Jeffe DB. A novel intervention using interactive technology and personal narratives to reduce cancer disparities: African American breast cancer survivor stories. J Cancer Surviv 2013; 8:21-30. [PMID: 24030573 DOI: 10.1007/s11764-013-0308-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 08/30/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE There has been a paucity of interventions developed for African American women to address persistent health disparities between African American and Caucasian breast cancer patients. We developed and piloted a technologically innovative, culturally targeted, cancer-communication intervention for African American breast cancer patients using African American breast cancer survivor stories. METHODS We rated 917 clips from a video library of survivors' stories for likability, clarity and length, and emotional impact (scaled responses) and categorized each clip by theme (Coping, Support and Relationships, Healthcare Experiences, Follow-up Care, Quality of Life, and Treatment Side Effects). We selected 207 clips told by 35 survivors (32-68 years old; 4-30 years after diagnosis), fitting one of 12 story topics, for inclusion in the interactive video program loaded onto a touch-screen computer. Videos can be searched by storyteller or story topics; stories with the strongest emotional impact were displayed first in the video program. RESULTS We pilot tested the video program with ten African American breast cancer survivors (mean age, 54; range 39-68 years), who, after training, watched videos and then evaluated the stories and video-program usability. Survivor stories were found to be "interesting and informative," and usability was rated highly. Participants identified with storytellers (e.g., they "think a lot like me," "have values like mine") and agreed that the stories convinced them to receive recommended surveillance mammograms. CONCLUSIONS This novel, cancer-communication technology using survivor stories was very favorably evaluated by breast cancer survivors and is now being tested in a randomized controlled clinical trial. IMPLICATIONS FOR CANCER SURVIVORS Breast cancer survivors can draw support and information from a variety of sources, including from other breast cancer survivors. We developed the survivor stories video program specifically for African American survivors to help improve their quality of life and adherence to follow-up care. Breast cancer survivors' experiences with treatment and living with cancer make them especially credible messengers of cancer information. Our novel, interactive technology is being tested in a randomized controlled trial and will be more broadly disseminated to reach a wider audience.
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Affiliation(s)
- Maria Pérez
- Washington University School of Medicine, 660 S. Euclid, Saint Louis, MO, 63110, USA,
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Spiegel D. Minding the body: Psychotherapy and cancer survival. Br J Health Psychol 2013; 19:465-85. [DOI: 10.1111/bjhp.12061] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 06/24/2013] [Indexed: 01/02/2023]
Affiliation(s)
- David Spiegel
- Department of Psychiatry & Behavioral Sciences; Stanford University School of Medicine; Stanford California USA
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Sheppard VB, Llanos AA, Hurtado-de-Mendoza A, Taylor TR, Adams-Campbell LL. Correlates of depressive symptomatology in African-American breast cancer patients. J Cancer Surviv 2013; 7:292-9. [PMID: 23471730 DOI: 10.1007/s11764-013-0273-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 02/18/2013] [Indexed: 12/16/2022]
Abstract
PURPOSE This study assessed the levels of depressive symptomatology in African-American women with breast cancer compared to those of women without breast cancer and examined demographic, psychosocial, and clinical factors correlated with depression. METHODS A total of 152 African-American women were recruited from Washington, DC and surrounding suburbs. Breast cancer patients (n = 76 cases) were recruited from a health care center and women without cancer were recruited from health fairs (n = 76 comparison). We assessed depression, psychosocial variables (ego strength and social support), and sociodemographic factors from in-person interviews. Stage and clinical factors were abstracted from medical records. Independent sample t test, chi square test, analyses of variance, and multiple regression models were used to identify differences in depression and correlates of depression among the cases and comparison groups. RESULTS Women with breast cancer reported significantly greater levels of depression (m = 11.5, SD = 5.0) than women without breast cancer (m = 3.9, SD = 3.8) (p < 0.001). Higher cancer stage (beta = 0.91) and higher age (beta = 0.11) were associated with depression in the breast patients, explaining 84 % of the variance. In the comparison group, ego strength and tangible support were inversely associated with depressive symptoms, accounting for 32 % of the variance. CONCLUSIONS Women with more advanced disease may require interdisciplinary approaches to cancer care (i.e., caring for the whole person). IMPLICATIONS FOR CANCER SURVIVORS Depression is often underrecognized and undertreated in African-American breast cancer patients. Understanding the factors related to depression is necessary to integrate psychosocial needs to routine cancer care to improve survivors' quality of life.
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Affiliation(s)
- Vanessa B Sheppard
- Department of Oncology, Lombardi Comprehensive Cancer Center, 3300 Whitehaven St. NW, Washington, DC 20007, USA.
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Sehlen S, Marten-Mittag B, Herschbach P, Schweden M, Book K, Henrich G, Dühmke E, Dinkel A. Health-related quality of life supersedes other psychosocial predictors of long-term survival in cancer patients undergoing radiotherapy. Acta Oncol 2012; 51:1020-8. [PMID: 22616951 DOI: 10.3109/0284186x.2012.683879] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND To investigate the prognostic value of several psychosocial factors for long-term survival in cancer patients. MATERIAL AND METHODS Baseline data were gathered in routine radiotherapy practice during 44 months. The analysis is based on 938 patients for whom follow-up data were available. Baseline psychosocial distress, depression, health-related quality of life (HRQOL), and life satisfaction were assessed using Questionnaire on Stress in Cancer Patients (QSC-R23), Self-Rating Depression Scale (SDS), Functional Assessment of Therapy - General (FACT-G) questionnaire, and Questions on Life Satisfaction (FLZ(M)). Patients were followed up for 7 to 10 years. Kaplan-Meier plots and Cox proportional hazards models were used to investigate associations between sociodemographic, clinical, psychosocial factors and overall survival (OS). RESULTS Patients' median survival time was 35 months (95% CI 28.9-41.1). Significant multivariate predictors of OS were age, health insurance type, Karnofsky performance status, cancer site, and cancer stage. Controlling for these variables, HRQOL was the only psychosocial predictor of survival (hazard ratio 0.988, 95% CI 0.979-0.997, p =0.009). The physical well-being and the functional well-being subscales of the FACT-G emerged as the relevant HRQOL facets predictive of survival. CONCLUSION HRQOL has incremental predictive value for long-term survival in cancer patients.
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Affiliation(s)
- Susanne Sehlen
- Department of Radiotherapy and Radiooncology, Klinikum Großhadern, Ludwig-Maximilians-Universität München, Munich, Germany
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Lutgendorf SK, De Geest K, Bender D, Ahmed A, Goodheart MJ, Dahmoush L, Zimmerman MB, Penedo FJ, Lucci JA, Ganjei-Azar P, Thaker PH, Mendez L, Lubaroff DM, Slavich GM, Cole SW, Sood AK. Social influences on clinical outcomes of patients with ovarian cancer. J Clin Oncol 2012; 30:2885-90. [PMID: 22802321 DOI: 10.1200/jco.2011.39.4411] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Previous research has demonstrated relationships of social support with disease-related biomarkers in patients with ovarian cancer. However, the clinical relevance of these findings to patient outcomes has not been established. This prospective study examined how social support relates to long-term survival among consecutive patients with ovarian cancer. We focused on two types of social support: social attachment, a type of emotional social support reflecting connections with others, and instrumental social support reflecting the availability of tangible assistance. PATIENTS AND METHODS Patients were prospectively recruited during a presurgical clinic visit and completed surveys before surgery. One hundred sixty-eight patients with histologically confirmed epithelial ovarian cancer were observed from the date of surgery until death or December 2010. Clinical information was obtained from medical records. RESULTS In a Cox regression model, adjusting for disease stage, grade, histology, residual disease, and age, greater social attachment was associated with a lower likelihood of death (hazard ratio [HR], 0.87; 95% CI, 0.77 to 0.98; P = .018). The median survival time for patients with low social attachment categorized on a median split of 15 was 3.35 years (95% CI, 2.56 to 4.15 years). In contrast, by study completion, 59% of patients with high social attachment were still alive after 4.70 years. No significant association was found between instrumental social support and survival, even after adjustment for covariates. CONCLUSION Social attachment is associated with a survival advantage for patients with ovarian cancer. Clinical implications include the importance of screening for deficits in the social environment and consideration of support activities during adjuvant treatment.
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Affiliation(s)
- Susan K Lutgendorf
- Department of Psychology, University of Iowa, E11 Seashore Hall, Iowa City, IA 52242, USA.
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Lehto US, Ojanen M, Dyba T, Aromaa A, Kellokumpu-Lehtinen P. Impact of life events on survival of patients with localized melanoma. PSYCHOTHERAPY AND PSYCHOSOMATICS 2012; 81:191-3. [PMID: 22433748 DOI: 10.1159/000334486] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Accepted: 10/09/2011] [Indexed: 11/19/2022]
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Saito-Nakaya K, Bidstrup PE, Nakaya N, Frederiksen K, Dalton SO, Uchitomi Y, Verkasalo P, Koskenvuo M, Pukkala E, Kaprio J, Johansen C. Stress and survival after cancer: A prospective study of a Finnish population-based cohort. Cancer Epidemiol 2012; 36:230-5. [DOI: 10.1016/j.canep.2011.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Revised: 04/14/2011] [Accepted: 04/27/2011] [Indexed: 11/28/2022]
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Herndon JE, Kornblith AB, Holland JC, Paskett ED. Effect of socioeconomic status as measured by education level on survival in breast cancer clinical trials. Psychooncology 2011; 22:315-23. [PMID: 22021121 DOI: 10.1002/pon.2094] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Revised: 10/05/2011] [Accepted: 10/05/2011] [Indexed: 11/10/2022]
Abstract
OBJECTIVES This paper aims to investigate the effect of socioeconomic status, as measured by education, on the survival of breast cancer patients treated on 10 studies conducted by the Cancer and Leukemia Group B. METHODS Sociodemographic data, including education, were reported by the patient at trial enrollment. Cox proportional hazards model stratified by treatment arm/study was used to examine the effect of education on survival among patients with early stage and metastatic breast cancer, after adjustment for known prognostic factors. RESULTS The patient population included 1020 patients with metastatic disease and 5146 patients with early stage disease. Among metastatic patients, factors associated with poorer survival in the final multivariable model included African American race, never married, negative estrogen receptor status, prior hormonal therapy, visceral involvement, and bone involvement. Among early stage patients, significant factors associated with poorer survival included African American race, separated/widowed, post/perimenopausal, negative/unknown estrogen receptor status, negative progesterone receptor status, >4 positive nodes, tumor diameter >2 cm, and education. Having not completed high school was associated with poorer survival among early stage patients. Among metastatic patients, non-African American women who lacked a high school degree had poorer survival than other non-African American women, and African American women who lacked a high school education had better survival than educated African American women. CONCLUSIONS Having less than a high school education is a risk factor for death among patients with early stage breast cancer who participated in a clinical trial, with its impact among metastatic patients being less clear. Post-trial survivorship plans need to focus on women with low social status, as measured by education.
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Affiliation(s)
- James E Herndon
- Department of Biostatistics & Bioinformatics, Duke University Medical Center, Durham, NC 27710, USA.
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The association of quality-of-life measures with malignancy and survival in patients with pancreatic pathology. Pancreas 2011; 40:1063-9. [PMID: 21785386 DOI: 10.1097/mpa.0b013e31821ad8eb] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES This study assessed whether pretreatment quality-of-life (QoL) scores could predict the presence of pancreatic malignancy and survival. METHODS Patients with pancreatic lesions completed the SF-36, containing 8 domains: physical functioning, role-physical, role-emotional, bodily pain, vitality, mental health, social functioning, and general health. Data obtained included age, sex, resectability, additional antineoplastic therapy, stage, pathology, and survival. Patients were categorized by pathology (benign vs malignant), stage (local, regional, or distant), resectability (resected vs not), survival (<1 vs >1 year), and their pretreatment QoL scores. RESULTS Of the 323 patients assessed, 210 had malignancies. In 6 of the 8 domains, patients with malignancies had lower median QoL scores compared with patients with benign lesions. Of the patients with malignancies, patients surviving at 1 year or less had lower pretreatment scores in all domains. Stage, resection, adjuvant therapy, and vitality score were independent predictors of survival. CONCLUSIONS Patients with pancreatic malignancies had lower QoL scores than patients with benign pancreatic disease. Patients with malignancies surviving at 1 year or less had lower scores, even after controlling for stage. This suggests that pretreatment QoL scores are associated with pancreatic malignancy and survival.
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Abstract
While the use of quality of life (QoL) assessments has been increasing in oncology, few studies have examined the prognostic significance of QoL in breast cancer. We investigated the association between QoL at presentation and survival in breast cancer. We examined 1,511 breast cancer patients treated at two single-system cancer centers between January 2001 and December 2008. QoL was evaluated using the validated survey instrument EORTC-QLQ-C30. Patient survival was defined as the time interval between the date of first patient visit and the date of death from any cause/date of last contact. Univariate and multivariate Cox regression analyses were performed to evaluate the prognostic significance of QoL after controlling for the effects of age, tumor stage, and prior treatment history. Mean age at presentation was 52.5 years. There were 590 analytic and 921 non-analytic patients. Patient stage of disease at diagnosis was I, 335; II, 591; III, 290; IV, 159; and 136 indeterminate. Median overall survival was 32.8 months (95% CI: 27.6-38.0). On univariate analysis, QoL function and symptom scales that were predictive of survival were physical (p < 0.001), role (p < 0.001), cognitive (p = 0.003), social (p < 0.001), fatigue (p < 0.001), nausea/vomiting (p < 0.001), pain (p < 0.001), dyspnea (p < 0.001), loss of appetite (p < 0.001), and constipation (p < 0.001). On multivariate analyses, only role function (degree of impairment of work and/or leisure/hobby related activities) was significantly associated with survival. This study suggests that baseline QoL (in particular, the role function) provides useful prognostic information in breast cancer.
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Affiliation(s)
- Edgar D Staren
- Office of Clinical Research, Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center, Zion, Illinois, USA.
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Trask PC, Bushmakin AG, Cappelleri JC, Tarazi J, Rosbrook B, Bycott P, Kim S, Stadler WM, Rini B. Baseline patient-reported kidney cancer-specific symptoms as an indicator for median survival in sorafenib-refractory metastatic renal cell carcinoma. J Cancer Surviv 2011; 5:255-62. [PMID: 21476015 DOI: 10.1007/s11764-011-0178-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Accepted: 03/09/2011] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The goal of the study was to determine the relationship of baseline Functional Assessment of Cancer Therapy-Kidney Cancer Symptom Index (FKSI) scores with median progression-free survival (mPFS) and median overall survival (mOS) after treatment with axitinib in patients with sorafenib-refractory metastatic renal cell carcinoma. METHODS As part of a multicenter, open-label, phase II study, patients (N = 62) reported symptoms at baseline using the FKSI, with higher scores indicating less severe symptoms. A Weibull (fully parametric) model was fit to time-to-event data to establish the relationship of baseline FKSI score with mPFS and mOS. Kaplan-Meier curves were obtained as sensitivity analyses. RESULTS Longer progression-free and overall survivals were associated with higher (more favorable) baseline FKSI-15 and FKSI disease-related symptoms (FKSI-DRS) subscale specific to kidney cancer scores. For example, for FKSI-15 scores of 0 (most symptoms), 30, and 60 (no symptoms), the mPFS were 0.72, 3.83, and 20.43 months, respectively, and the mOS were 1.05, 6.27, and 37.53 months. Similar patterns and interpretations were observed for the FKSI-DRS scores. The results from the Kaplan-Meier analyses supported the parametric model. DISCUSSIONS/CONCLUSIONS Baseline patient-reported kidney cancer symptoms are linked to mPFS and mOS in a clear and interpretable way. These results support the evaluation of patient-reported symptoms at baseline in clinical trials and in clinical practice to measure symptom severity and potentially predict progression-free and overall survival outcomes. IMPLICATIONS FOR CANCER SURVIVORS The results provide a heightened opportunity to use patient data not only to assist in medical treatment planning but also to prepare patients, who have advanced disease and an already reduced expected lifespan, with an opportunity to deal with the psychosocial aspects of the dying process.
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Affiliation(s)
- Peter C Trask
- Pfizer Oncology, Global Outcomes Research, Pfizer Inc, MS 6025-A3221, 50 Pequot Ave, New London, CT 06320, USA.
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Velanovich V, Wollner I. Quality of life and performance status in patients with pancreatic and periampullary tumors. Int J Clin Oncol 2011; 16:401-7. [PMID: 21347628 DOI: 10.1007/s10147-011-0200-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 01/27/2011] [Indexed: 12/15/2022]
Abstract
BACKGROUND To determine if pretreatment quality of life is associated with performance status in patients with pancreatic and periampullary tumors. METHODS Eighty consecutive patients evaluated for surgical treatment of pancreatic or periampullary tumors completed the social functioning SF-36, a generic quality of life instrument. This instrument measures 8 domains of quality of life: physical functioning (PF), role-physical (RP), role-emotional, bodily pain, vitality, mental health, social functioning, and general health (GH). The best possible score is 100 and the worst possible score is 0. Each patient was then assigned a Karnofsky performance score (KPS), with the best possible score of 100 (normal, no complaints, no evidence of disease) and worst score of 0 (dead). Data recorded included age, gender, pathology, stage, resection, use of chemotherapy, and radiation therapy. Statistical analysis was done using single and multiple linear regression analysis, correlation coefficients (r) and coefficient of determination (r (2)). RESULTS KPS was significantly associated with all domains of the SF-36 by single linear regression. By multiple linear regression, KPS was significantly associated with the PF domain (p < 0.001, r = 0.74), and nearly significantly associated with the RP (p = 0.07, r = 0.62) and GH (p = 0.06, r = 0.64) domains. This appears to be independent of tumor pathology and stage. CONCLUSION The results imply that pretreatment quality of life and performance status are related concepts in patients with pancreatic and periampullary tumors. This is primarily true for the physical component of the SF-36. However, despite statistical significance, coefficients of determination (r (2) values) suggest that there are additional factors determining both quality of life and performance status in patients with pancreatic and periampullary tumors.
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Affiliation(s)
- Vic Velanovich
- Division of General Surgery, K-8, Henry Ford Hospital, Detroit, MI 48202, USA.
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Liang SY, Li CC, Wu SF, Wang TJ, Tsay SL. The prevalence and impact of pain among Taiwanese oncology outpatients. Pain Manag Nurs 2011; 12:197-205. [PMID: 22117751 DOI: 10.1016/j.pmn.2010.10.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Revised: 10/17/2010] [Accepted: 10/18/2010] [Indexed: 10/18/2022]
Abstract
The purpose of this study was to report the prevalence and impact of pain among Taiwanese oncology outpatients who had experienced moderate pain. Ninety-two cancer outpatients in two teaching hospitals in the Taipei area of Taiwan were enrolled in a descriptive cross-sectional study. Outpatients aged ≥18 years who had been prescribed opioid analgesics for cancer-related pain completed the Brief Pain Inventory-Chinese questionnaire. Results of this study highlighted an important issue: undertreatment of cancer pain in the Taiwanese outpatients. Patients in this study reported that in the preceding 24 hours they had experienced a mean worst pain of 6.91 (SD 2.06, range 0-10). The average pain intensity in the preceding 24 hours was 5.21 (SD 1.69, range 0-10). Around 50% of the patients had pain most of the time and 25% of the patients had pain all of the time. In the preceding 24 hours the average pain relief experienced was 62.6% (SD 22.2%, range 0%-100%). Only 10.9% of patients experienced good pain relief (defined as 90%-100% of pain relief in the past 24 hours), whereas 45.7% experienced poor pain relief (defined as 0%-60% of pain relief in the past 24 hours). The mean pain interference with the patients' daily activities was 5.69 (SD 2.33, range 0-10). The findings of this study indicate the need for better programmatic efforts to improve relief of cancer pain in Taiwanese outpatients.
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Affiliation(s)
- Shu-Yuan Liang
- School of Nursing, National Taipei University of Nursing and Health Science, Taipei, Taiwan
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Giese-Davis J, Collie K, Rancourt KMS, Neri E, Kraemer HC, Spiegel D. Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: a secondary analysis. J Clin Oncol 2010; 29:413-20. [PMID: 21149651 DOI: 10.1200/jco.2010.28.4455] [Citation(s) in RCA: 314] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Numerous studies have examined the comorbidity of depression with cancer, and some have indicated that depression may be associated with cancer progression or survival. However, few studies have assessed whether changes in depression symptoms are associated with survival. METHODS In a secondary analysis of a randomized trial of supportive-expressive group therapy, 125 women with metastatic breast cancer (MBC) completed a depression symptom measure (Center for Epidemiologic Studies-Depression Scale [CES-D]) at baseline and were randomly assigned to a treatment group or to a control group that received educational materials. At baseline and three follow-up points, 101 of 125 women completed a depression symptom measure. We used these data in a Cox proportional hazards analysis to examine whether decreasing depression symptoms over the first year of the study (the length of the intervention) would be associated with longer survival. RESULTS Median survival time was 53.6 months for women with decreasing CES-D scores over 1 year and 25.1 months for women with increasing CES-D scores. There was a significant effect of change in CES-D over the first year on survival out to 14 years (P = .007) but no significant interaction between treatment condition and CES-D change on survival. Neither demographic nor medical variables explained this association. CONCLUSION Decreasing depression symptoms over the first year were associated with longer subsequent survival for women with MBC in this sample. Further research is necessary to confirm this hypothesis in other samples, and causation cannot be assumed based on this analysis.
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Abstract
OBJECTIVE To investigate the association of serum levels of proangiogenic cytokines with different indices of social support and loneliness by measuring the levels of expression of two important proangiogenic cytokines, vascular endothelial growth factor (VEGF), and interleukin-6 in tumors of colon and rectum. Lack of social support has been prospectively associated with cancer progression. METHODS Fifty-one newly diagnosed patients with colorectal tumors (mean age, 68.3 years) completed two measures of loneliness 1 to 2 days before their surgical treatment. The first was an explicit self-report questionnaire, which tapped into negative feelings as a result of low social support. The second was a standardized computer-based task, which measured loneliness implicitly. Immunohistochemical analyses were performed on tumor tissues post surgery to determine the expression of cytokines. RESULTS Logistic regression showed that higher levels of implicit loneliness independently predicted stronger expression of VEGF, controlling for Dukes stage and explicit loneliness, both of which were nonsignificant predictors. No significant relationships were found between the loneliness measures and interleukin-6. CONCLUSIONS The results of this study suggest VEGF to be an angiogenic mechanism through which loneliness may lead to worse cancer-related outcomes. Implications are discussed in terms of devising targeted psychosocial and immunotherapeutic interventions for cancer patients with low social support.
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Kuwahara A, Takachi R, Tsubono Y, Sasazuki S, Inoue M, Tsugane S. Socioeconomic status and gastric cancer survival in Japan. Gastric Cancer 2010; 13:222-30. [PMID: 21128057 DOI: 10.1007/s10120-010-0561-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 05/30/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND Few studies have investigated the association between socioeconomic status and the survival of cancer patients in Japan. METHODS We examined whether occupation or educational level was associated with the survival of 725 gastric cancer patients who were diagnosed within an ongoing large population-based cohort study. RESULTS After adjustment for age at diagnosis, and sex, we found that, compared with professionals or office workers, unemployed subjects (hazard ratio [HR], 2.23; 95% confidence interval [CI], 1.27-3.92) and manual laborers (HR, 1.68; 95% CI, 1.07-2.62) had an increased risk of gastric cancer death. After further adjustment for the clinical extent of disease, the increased risk disappeared. Educational level was not associated with the risk. CONCLUSIONS These findings suggest that a disparity in survival by occupation exists among Japanese gastric cancer patients, largely due to a lower proportion of early disease among the unemployed and manual laborers.
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Affiliation(s)
- Aya Kuwahara
- Department of Food and Nutritional Science, Shuko Junior College, Iwate, Japan
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Abstract
BACKGROUND The goal of the present study was to analyze associations between depression and mortality of cancer patients and to test whether these associations would vary by study characteristics. METHOD Meta-analysis was used for integrating the results of 105 samples derived from 76 prospective studies. RESULTS Depression diagnosis and higher levels of depressive symptoms predicted elevated mortality. This was true in studies that assessed depression before cancer diagnosis as well as in studies that assessed depression following cancer diagnosis. Associations between depression and mortality persisted after controlling for confounding medical variables. The depression-mortality association was weaker in studies that had longer intervals between assessments of depression and mortality, in younger samples and in studies that used the Beck Depression Inventory as compared with other depression scales. CONCLUSIONS Screening for depression should be routinely conducted in the cancer treatment setting. Referrals to mental health specialists should be considered. Research is needed on whether the treatment of depression could, beyond enhancing quality of life, extend survival of depressed cancer patients.
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Affiliation(s)
- M Pinquart
- Department of Psychology, Philipps University, Marburg, Germany.
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Ranchor AV, Sanderman R, Coyne JC. Invited commentary: personality as a causal factor in cancer risk and mortality--time to retire a hypothesis? Am J Epidemiol 2010; 172:386-8. [PMID: 20639286 DOI: 10.1093/aje/kwq210] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
In this issue of the Journal, Nakaya et al. (Am J Epidemiol. 2010;172(4):377-385) report null findings from a large-scale prospective study of the prognostic value of 2 personality dimensions, neuroticism and extraversion, for cancer risk and mortality. The study stands out because of its exceptionally large sample size and its methodological strengths. The authors discuss the Nakaya et al. study in the context of persistent beliefs about the role of personality in cancer onset and survival despite a pattern of null findings in the literature, as well as the influence of extreme outlier findings from one investigator group that continue to be cited. They question whether it is time for the field to move on from considering a role for personality in cancer to more promising and modifiable factors.
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Affiliation(s)
- Adelita V Ranchor
- Health Psychology Section, Department of Health Sciences, University Medical Center Groningen, University of Groningen, HPC FA12, POB 196, 9700 AD Groningen, the Netherlands.
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Abstract
BACKGROUND The quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality. OBJECTIVES This meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which factors may moderate the risk. DATA EXTRACTION Data were extracted on several participant characteristics, including cause of mortality, initial health status, and pre-existing health conditions, as well as on study characteristics, including length of follow-up and type of assessment of social relationships. RESULTS Across 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period. Significant differences were found across the type of social measurement evaluated (p<0.001); the association was strongest for complex measures of social integration (OR = 1.91; 95% CI 1.63 to 2.23) and lowest for binary indicators of residential status (living alone versus with others) (OR = 1.19; 95% CI 0.99 to 1.44). CONCLUSIONS The influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality. Please see later in the article for the Editors' Summary.
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Affiliation(s)
- Julianne Holt-Lunstad
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America.
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Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med 2010; 7:e1000316. [PMID: 20668659 PMCID: PMC2910600 DOI: 10.1371/journal.pmed.1000316] [Citation(s) in RCA: 3316] [Impact Index Per Article: 236.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Accepted: 06/17/2010] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality. OBJECTIVES This meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which factors may moderate the risk. DATA EXTRACTION Data were extracted on several participant characteristics, including cause of mortality, initial health status, and pre-existing health conditions, as well as on study characteristics, including length of follow-up and type of assessment of social relationships. RESULTS Across 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period. Significant differences were found across the type of social measurement evaluated (p<0.001); the association was strongest for complex measures of social integration (OR = 1.91; 95% CI 1.63 to 2.23) and lowest for binary indicators of residential status (living alone versus with others) (OR = 1.19; 95% CI 0.99 to 1.44). CONCLUSIONS The influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality. Please see later in the article for the Editors' Summary.
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Affiliation(s)
- Julianne Holt-Lunstad
- Department of Psychology, Brigham Young University, Provo, Utah, United States of America.
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Beasley JM, Newcomb PA, Trentham-Dietz A, Hampton JM, Ceballos RM, Titus-Ernstoff L, Egan KM, Holmes MD. Social networks and survival after breast cancer diagnosis. J Cancer Surviv 2010; 4:372-80. [PMID: 20652435 DOI: 10.1007/s11764-010-0139-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Accepted: 06/29/2010] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Evidence has been inconsistent regarding the impact of social networks on survival after breast cancer diagnosis. We prospectively examined the relation between components of social integration and survival in a large cohort of breast cancer survivors. METHODS Women (N=4,589) diagnosed with invasive breast cancer were recruited from a population-based, multi-center, case-control study. A median of 5.6 years (Interquartile Range 2.7-8.7) after breast cancer diagnosis, women completed a questionnaire on recent post-diagnosis social networks and other lifestyle factors. Social networks were measured using components of the Berkman-Syme Social Networks Index to create a measure of social connectedness. Based on a search of the National Death Index, 552 deaths (146 related to breast cancer) were identified. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. RESULTS Higher scores on a composite measure of social connectedness as determined by the frequency of contacts with family and friends, attendance of religious services, and participation in community activities was associated with a 15-28% reduced risk of death from any cause (p-trend=0.02). Inverse trends were observed between all-cause mortality and frequency of attendance at religious services (p-trend=0.0001) and hours per week engaged in community activities (p-trend=0.0005). No material associations were identified between social networks and breast cancer-specific mortality. CONCLUSIONS Engagement in activities outside the home was associated with lower overall mortality after breast cancer diagnosis.
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Affiliation(s)
- Jeannette M Beasley
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., M3-A410, Seattle, WA 98109-1024, USA
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Depressive symptoms among young breast cancer survivors: the importance of reproductive concerns. Breast Cancer Res Treat 2010; 123:477-85. [PMID: 20130979 DOI: 10.1007/s10549-010-0768-4] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 01/22/2010] [Indexed: 10/19/2022]
Abstract
Breast cancer diagnosis and treatment can negatively impact fertility in premenopausal women and influence reproductive planning. This study investigates whether concerns about reproduction after breast cancer treatment were associated with long-term depressive symptoms. Participants include 131 women diagnosed with early-stage breast cancer at age 40 or younger participating in the Women's Healthy Eating and Living (WHEL) Survivorship Study. Participants were enrolled an average of 1.5 years postdiagnosis and depressive symptoms were monitored 6 times throughout the average additional 10 year follow-up period. Detailed recall of reproductive concerns after treatment was collected an average of 12 years postdiagnosis. Multilevel regression was used to evaluate whether mean long-term depressive symptoms differed as a function of reproductive concerns and significant covariates. Multilevel regression identified greater recalled reproductive concerns as an independent predictor of consistent depressive symptoms after controlling for both social support and physical health (B = 0.02, SE = 0.01, P = 0.04). In bivariate analyses, being nulliparous at diagnosis and reporting treatment-related ovarian damage were both strongly associated with higher reproductive concerns and with depressive symptoms. Reported reproductive concerns after breast cancer treatment were a significant contributor to consistent depressive symptoms. Younger survivors would benefit from additional information and support related to reproductive issues.
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Montazeri A. Quality of life data as prognostic indicators of survival in cancer patients: an overview of the literature from 1982 to 2008. Health Qual Life Outcomes 2009; 7:102. [PMID: 20030832 PMCID: PMC2805623 DOI: 10.1186/1477-7525-7-102] [Citation(s) in RCA: 372] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 12/23/2009] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Health-related quality of life and survival are two important outcome measures in cancer research and practice. The aim of this paper is to examine the relationship between quality of life data and survival time in cancer patients. METHODS A review was undertaken of all the full publications in the English language biomedical journals between 1982 and 2008. The search was limited to cancer, and included the combination of keywords 'quality of life', 'patient reported-outcomes' 'prognostic', 'predictor', 'predictive' and 'survival' that appeared in the titles of the publications. In addition, each study was examined to ensure that it used multivariate analysis. Purely psychological studies were excluded. A manual search was also performed to include additional papers of potential interest. RESULTS A total of 451 citations were identified in this rapid and systematic review of the literature. Of these, 104 citations on the relationship between quality of life and survival were found to be relevant and were further examined. The findings are summarized under different headings: heterogeneous samples of cancer patients, lung cancer, breast cancer, gastro-oesophageal cancers, colorectal cancer, head and neck cancer, melanoma and other cancers. With few exceptions, the findings showed that quality of life data or some aspects of quality of life measures were significant independent predictors of survival duration. Global quality of life, functioning domains and symptom scores - such as appetite loss, fatigue and pain - were the most important indicators, individually or in combination, for predicting survival times in cancer patients after adjusting for one or more demographic and known clinical prognostic factors. CONCLUSION This review provides evidence for a positive relationship between quality of life data or some quality of life measures and the survival duration of cancer patients. Pre-treatment (baseline) quality of life data appeared to provide the most reliable information for helping clinicians to establish prognostic criteria for treating their cancer patients. It is recommended that future studies should use valid instruments, apply sound methodological approaches and adequate multivariate statistical analyses adjusted for socio-demographic characteristics and known clinical prognostic factors with a satisfactory validation strategy. This strategy is likely to yield more accurate and specific quality of life-related prognostic variables for specific cancers.
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Affiliation(s)
- Ali Montazeri
- Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.
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Nausheen B, Gidron Y, Peveler R, Moss-Morris R. Social support and cancer progression: a systematic review. J Psychosom Res 2009; 67:403-15. [PMID: 19837203 DOI: 10.1016/j.jpsychores.2008.12.012] [Citation(s) in RCA: 159] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 12/22/2008] [Accepted: 12/23/2008] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The variability in the conceptualization and categorization of social support has resulted in mixed findings regarding its role in cancer progression. This systematic review identifies and summarizes the evidence for the significance of two important indices of social support in progression of different cancers. METHOD We used systematic and replicable methods to search, select, and evaluate findings. RESULTS Thirty-one longitudinal prospective findings (in 26 papers) which were selected for inclusion categorized social support into structural and functional support. The types of cancer included in these studies fell into three major categories: breast cancer (16), other cancer (10), and mixed cancers (5). Results suggest that the evidence for the relationship between social support and cancer progression is sufficiently strong for breast cancer as shown by five out of seven methodologically sound studies but consistently unconvincing for other types of cancer or in studies which combined different types of cancer. Structural support indices were found to be more frequently associated with disease progression than the indices of functional support in breast cancer. Disease-related variables such as severity, treatment, nodal status, and site of metastasis were found to be significant predictors of cancer progression, and it is suggested that these variables must be considered when conducting studies on the role of psychosocial factors in cancer-related outcomes including progression. CONCLUSION Methodological limitations of the studies and counterintuitive findings are discussed, and further conclusive research, particularly randomized controlled trials of social support interventions, is warranted to support the findings of this systematic review.
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Affiliation(s)
- Bina Nausheen
- Mental Health Group, Division of Clinical Neurosciences, School of Medicine, University of Southampton, Royal South Hants Hospital, Brinton's Terrace, Southampton, UK.
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Satin JR, Linden W, Phillips MJ. Depression as a predictor of disease progression and mortality in cancer patients. Cancer 2009; 115:5349-61. [PMID: 19753617 DOI: 10.1002/cncr.24561] [Citation(s) in RCA: 629] [Impact Index Per Article: 41.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Jillian R Satin
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada.
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