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Liu L, Chen S. Predictors of Psychiatric Complications in Patients with Pancreatic Cancer: A Retrospective Cohort Study. ACTAS ESPANOLAS DE PSIQUIATRIA 2024; 52:495-502. [PMID: 39129682 PMCID: PMC11319747 DOI: 10.62641/aep.v52i4.1798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
BACKGROUND The relevant survey has shown a high incidence of psychiatric complications in patients with pancreatic cancer. While some studies have explored the factors influencing psychological complications in pancreatic cancer patients, some factors validated in other populations have not been confirmed in the pancreatic cancer population. This study aims to explore the predictors of psychiatric complications in patients with pancreatic cancer. METHODS Patients with pancreatic cancer admitted to Yueqing People's Hospital Affiliated to Wenzhou Medical University, from January 2021 to January 2022 were retrospectively analyzed. The structured clinical interview (SCID-I) based on Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) was used by nurses to assess the incidence of psychiatric complications during hospitalization (baseline) and 3 months after the start of treatment. Binary logistic regression was used to identify predictors of psychiatric complications. RESULTS 80 patients were enrolled in this study and 8 patients were diagnosed with psychiatric complications at base line. Among the rest 72 patients, 8 patients (11.11%) had new-onset psychiatric complications at 3-month follow-up. Gender (Odds Ratio (OR) = 1.674, p = 0.019), monthly income (OR = 1.735, p = 0.023) and sadness (M.D. Anderson Symptom Inventory (MDASI)) (OR = 1.804, p = 0.001) were all predictors for psychiatric complications in patients with pancreatic cancer. CONCLUSIONS Gender, monthly income and MDASI score are predictors of psychiatric complications in patients with pancreatic cancer.
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Affiliation(s)
- Lewei Liu
- Department of Digestive Endoscopy, Yueqing People's Hospital Affiliated to Wenzhou Medical University, 325600 Yueqing, Zhejiang, China
| | - Shuo Chen
- Department of Gastroenterology, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, 325000 Wenzhou, Zhejiang, China
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Bonafede M, d'Errico A, Rugarli S, Mensi C, Miligi L, Calisti R, della Gatta R, Piro S, Melis P, Vasselli D, Binazzi A. The psychological impact of diagnosis of sinonasal, nasopharyngeal, and laryngeal cancers: a systematic review. Front Psychol 2024; 15:1355186. [PMID: 39077217 PMCID: PMC11285066 DOI: 10.3389/fpsyg.2024.1355186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 06/19/2024] [Indexed: 07/31/2024] Open
Abstract
Objective High risk of degraded quality of life and psychological distress is observed in patients diagnosed with sinonasal, nasopharyngeal, and laryngeal cancers, which could be caused by exposure to carcinogens in workplaces. This review aimed to investigate the psychological impact of diagnosis associated with the possible occupational etiology of such neoplasms and to explore the instruments that evaluate the quality of life (QoL), anxiety, and depression in these patients. Methods Studies were considered for the review only if they described aspects of the psychological impact of the diagnosis of sinonasal, nasopharyngeal, and laryngeal cancers and reported results distinguished by the tumor site. The psychological impact was assessed in terms of health-related QoL, anxiety, and depression using reliable psychometric questionnaires administered at the time of diagnosis and 1 year later. Results In more than 5,900 records identified, 442 studies fulfilled the eligibility criteria and 436 were excluded after full-text screening, resulting in six studies to be finally included in the review. The EORTC Core Quality of Life questionnaire (EORTC QLQ-C30), EORTC QLQ-H&N35, and Functional Assessment of Cancer Therapy (FACT) were used to evaluate the QoL, whereas the Hospital Anxiety and Depression Scale (HADS) and Center for Epidemiologic Studies Depression Scale (CES-D) questionnaires were employed to assess anxiety and depression. QoL scores were similar to those of the general population at the time of diagnosis and remained unchanged or slightly improved at 1 year since diagnosis. In contrast, a higher prevalence of anxiety and depression was observed compared with the general population, although the results were inconsistent across the very few studies identified. No study investigating the association between the potential occupational etiology and QoL or distress was found. Conclusion Exploring the existing scientific literature on emotional distress in sinonasal, nasopharyngeal, and laryngeal cancer patients was prompted by concerns over the disfiguring nature of treatment and the additional emotional burden resulting from their occupational etiology. Unfortunately, neither a crucial element nor other risk factors (lifestyle, smoking, drinking, etc.) were examined in any study. Patients' employment history should be considered in order to assess the possible impact of believing they are affected by an occupational exposure disease in the evaluation of their psychological distress. This history would support evidence-based recommendations about dedicated psychological interventions.
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Affiliation(s)
- Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Angelo d'Errico
- Epidemiology, Local Health Unit ASL TO3, Piedmont Region, Grugliasco, Italy
| | - Sabrina Rugarli
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Lucia Miligi
- Sinonasal Cancer Registry of Tuscany, Occupational and Environmental Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Firenze, Italy
| | - Roberto Calisti
- Sinonasal Cancer Registry of Marche, Department of Prevention, Unit of Workplace Prevention and Safety and of Occupational Epidemiology (SPreSAL Epi Occ), Macerata Health Authority, Civitanova Marche, Italy
| | - Rosa della Gatta
- Sinonasal Cancer Registry of Marche, Department of Prevention, Unit of Workplace Prevention and Safety and of Occupational Epidemiology (SPreSAL Epi Occ), Macerata Health Authority, Civitanova Marche, Italy
| | - Sara Piro
- Sinonasal Cancer Registry of Tuscany, Occupational and Environmental Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Firenze, Italy
| | - Paola Melis
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Donatella Vasselli
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Alessandra Binazzi
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Roma, Italy
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Joubert A, Jankowski-Cherrier B, Rossi A, Teyssier L, Suraud V, Presle E, Pommier R, Massoubre C, Verot E. Impact of horticultural therapy on patients admitted to psychiatric wards, a randomised, controlled and open trial. Sci Rep 2024; 14:14378. [PMID: 38909093 PMCID: PMC11193794 DOI: 10.1038/s41598-024-65168-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 06/18/2024] [Indexed: 06/24/2024] Open
Abstract
Psychiatric inpatients often endure anxiety. This randomized trial assessed the impact of horticultural therapy on anxiety in adult psychiatric inpatients over four weeks, compared to standard care. Recruiting 211 inpatients from six units were randomized into control (n = 105) and experimental (n = 106) groups. Control received usual care; the experimental group had horticultural therapy alongside usual care. Anxiety, measured using HADS-A scale at four weeks, aimed to establish horticultural therapy's superiority. After four weeks, horticultural therapy significantly reduced anxiety compared to standard care (P < 0.001). These results argue in favor of integrating horticultural therapy into psychiatric nursing practices.Trial registration: No Clinical Trail: NCT02666339 (1st registration: 28/01/2016).
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Affiliation(s)
- Aude Joubert
- CHU Saint-Etienne, Pôle de Psychiatrie, Psychiatrie Secteur plaine - CMP, CATTP Et Hôpital de Jour Andrézieux, 42055, Saint-Etienne, France
| | - Blandine Jankowski-Cherrier
- CHU Saint-Etienne, Pôle de Psychiatrie, Unité d'admission N°3 - Secteur Plaine, 42055, Saint-Etienne, France
| | - Audrey Rossi
- CHU Saint-Etienne, Pôle de Psychiatrie, Psychiatrie Secteur plaine - CMP, CATTP Et Hôpital de Jour Andrézieux, 42055, Saint-Etienne, France
| | - Laure Teyssier
- CHU Saint-Etienne, Pôle de Psychiatrie, Psychiatrie Secteur plaine - CMP, CATTP Et Hôpital de Jour Andrézieux, 42055, Saint-Etienne, France
| | - Valérie Suraud
- CHU Saint-Etienne, Pôle de Psychiatrie, Psychiatrie Secteur plaine - CMP, CATTP Et Hôpital de Jour Andrézieux, 42055, Saint-Etienne, France
| | - Emilie Presle
- Department of Clinical Investigation Centre, CIC 1408-INSERM Clinical Investigation Centre, CIC 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France
- Unité de Recherche Clinique, Pharmacologie Clinique, Centre Hospitalo-Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Romain Pommier
- REHALise, Centre Référent de Réhabilitation Psychosociale de Saint-Etienne, Rehacoor42, CHU de Saint-Etienne, Saint-Etienne, France
| | - Catherine Massoubre
- Laboratoire TAPE-EA 7423, Université Jean Monnet, Service Universitaire CHU Saint-Etienne, Saint-Etienne, France
| | - Elise Verot
- Department of Clinical Investigation Centre, CIC 1408-INSERM Clinical Investigation Centre, CIC 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France.
- Laboratoire Parcours Santé Systémique, Université Claude Bernard Lyon 1, Université de Lyon, P2S UR 4129, 69008, Lyon, France.
- Chaire Hygée, Institut PRESAGE, Université Jean Monnet, Université de Lyon, 42023, Saint-Etienne, France.
- Laboratoire Parcours Santé Systémique, Université Jean Monnet, Université de Lyon, P2S UR 4129, 42270, Saint-Etienne, France.
- Nursing Sciences and Health Technics Department, Faculty of Medicine, Jean Monnet University, 42271, Saint Priest en Jarez, France.
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Gosselin LE, Villemure-Poliquin N, Audet N. Quality of Life After Head and Neck Cancer Surgery and Free Flap Reconstruction: A Systematic Review. J Otolaryngol Head Neck Surg 2024; 53:19160216241248666. [PMID: 38888940 PMCID: PMC11155320 DOI: 10.1177/19160216241248666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/03/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Different factors can affect the quality of life of patients treated for head and neck cancer undergoing major surgical intervention. However, it remains unclear which specific factors and what possible interventions could have the greatest influence on quality of life postoperatively for patients undergoing surgical resection with free flap reconstruction. The objective of our systematic review was to identify which factors, at the time of surgical treatment, are associated with a worse postoperative quality of life for patients undergoing surgical resection with free flap reconstruction for head and neck cancer. METHODS We performed a systematic review of MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), from their inception through November 2021. We included peer reviewed studies that evaluated the impact of specific factors on quality of life for adult patients who underwent surgery with free flap reconstruction for head and neck cancer. Two reviewers independently screened citations for eligibility and extracted data. Risk of bias of each study was evaluated using the New-Castle Ottawa Scale. Vote counting and qualitative review were used to synthesize results. All relevant findings were reported. RESULTS We initially identified 1971 articles. We included 22 articles in our systematic review, totaling 1398 patients. There was a high level of variability for factors evaluated throughout studies and many studies presented small sample sizes. However, some factors were associated with worse long-term quality of life, including older age, radiotherapy, higher tumor stage, dysphagia, anxiety as well as depressive symptoms. Very few articles analyzed their data for specific tumor subsites and the impact of psychosocial factors was rarely evaluated throughout studies. CONCLUSIONS For patients with head and neck cancer requiring free flap reconstruction, some specific factors may correlate with changes in quality of life. However, these findings are based on very few and mostly underpowered studies. A better understanding of factors affecting quality of life could allow a more personalized and overall better quality of care for patients.
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Affiliation(s)
- Laura-Elisabeth Gosselin
- Department of Ophthalmology and Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Noémie Villemure-Poliquin
- Department of Ophthalmology and Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Nathalie Audet
- Department of Ophthalmology and Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
- Department of Surgery, Service of Otorhinolaryngology—Head and Neck Surgery, Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, QC, Canada
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Chen T, Grose E, Noel CW, Villemure-Poliquin N, Eskander A. Interventions to Reduce Psychosocial Burden in Head and Neck Cancer Patients: A Narrative Review. J Otolaryngol Head Neck Surg 2024; 53:19160216241251701. [PMID: 39276012 PMCID: PMC11403701 DOI: 10.1177/19160216241251701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2024] Open
Abstract
BACKGROUND The diagnosis and treatment of head and neck cancer (HNC) is associated with several life-altering morbidities including change in appearance, speech, and swallowing, all of which can significantly affect quality of life and cause psychosocial stress. COMMENTARY The aim of this narrative review is to provide an overview of the evidence on psychosocial interventions for patients with HNC. Evidence regarding screening tools, psychological interventions, smoking and alcohol cessation, and antidepressant therapy in the HNC population is reviewed. CONCLUSION There is a large body of evidence describing various psychosocial interventions and several of these interventions have shown promise in the literature to improve psychosocial and health outcomes in the HNC population. Psychosocial interventions should be integrated into HNC care pathways and formal recommendations should be developed.
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Affiliation(s)
- Tanya Chen
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Elysia Grose
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Christopher W Noel
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Noemie Villemure-Poliquin
- Department of Ophthalmology and Otolaryngology-Head and Neck Surgery, Université Laval, Quebec City, QC, Canada
| | - Antoine Eskander
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and Michael Garron Hospital, Toronto, ON, Canada
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Heyda A, Księżniak-Baran D, Wygoda A, Składowski K. Low Post-Treatment Quality of Life and the High Incidence of Pain Are Common and Significantly Exacerbated in Depressed Head and Neck Patients Treated with Definitive Accelerated Radiotherapy. Cancers (Basel) 2023; 16:79. [PMID: 38201507 PMCID: PMC10777976 DOI: 10.3390/cancers16010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: The goal of this study is to evaluate psychological tolerance and health-related quality of life (QOL) in head and neck (HN) cancer patients treated with definitive accelerated radiotherapy (DART). (2) Methods: 76 recurrence-free patients eligible for the study, who were treated with DART in the CAIR-2 phase III clinical study (median of follow-up = 47 months), completed EORTC QLQ-C30 with the H&N35 module, Hospital Anxiety and Depression Scale (HADS) and Visual-Analog Scales (VAS) of pain in HN and the neck/arm areas. (3) Results: The most dominant symptoms measured with QLQ-C30 were as follows: fatigue (44/100), sleeplessness (39/100), financial problems (38/100) and pain (32/100). Within the H&N35, the highest scores were reported on the subscales of sticky saliva (60/100), mouth dryness (65/100) and increased intake of painkillers (50/100). Pain (VAS) was reported by 87% (HN area) and 78% (shoulder area) of the patients, with a mean score of 3/10. One-third of the patients reported depressive moods (HADS ≥ 15 points) with an average score of 12.5/42 p. The depressed group, who smoked more as compared to the non-depressed group before DART (96% vs. 78%) and required steroids treatment (85% vs. 58%) during DART, also scored significantly worse on 23 of the 35 subscales of QLQ-C30 and H&N35 and experienced more intense pain (VAS). Women and less-advanced patients scored better in several aspects of quality of life. (4) Conclusions: Patients treated with DART struggle with low quality of life and persistent treatment-related symptoms including constant pain. HNC survivors, especially those who are depressed, may require additional psychosocial, rehabilitation and medical intervention programmes.
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Affiliation(s)
- Alicja Heyda
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-102 Gliwice, Poland
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List MA, Knackstedt M, Liu L, Kasabali A, Mansour J, Pang J, Asarkar AA, Nathan C. Enhanced recovery after surgery, current, and future considerations in head and neck cancer. Laryngoscope Investig Otolaryngol 2023; 8:1240-1256. [PMID: 37899849 PMCID: PMC10601592 DOI: 10.1002/lio2.1126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 11/15/2022] [Indexed: 10/31/2023] Open
Abstract
Objectives Review of the current and relevant literature to develop a list of evidence-based recommendations that can be implemented in head and neck surgical practices. To provide rationale for the multiple aspects of comprehensive care for head and neck surgical patients. To improve postsurgical outcomes for head and neck surgical patients. Methods Extensive review of the medical literature was performed and relevant studies in both the head and neck surgery and other surgical specialties were considered for inclusion. Results A total of 18 aspects of perioperative care were included in this review. The literature search included 276 publications considered to be the most relevant and up to date evidence. Each topic is concluded with recommendation grade and quality of evidence for the recommendation. Conclusion Since it's conception, enhanced recovery after surgery (ERAS) protocols have continued to push for comprehensive and evidence based postsurgical care to improve patient outcomes. Head and neck oncology is one of the newest fields to develop a protocol. Due to the complexity of this patient population and their postsurgical needs, a multidisciplinary approach is needed to facilitate recovery while minimizing complications. Current and future advances in head and neck cancer research will serve to strengthen and add new principles to a comprehensive ERAS protocol. Level of Evidence 2a.
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Affiliation(s)
- Marna A. List
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Mark Knackstedt
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Lucy Liu
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Ahmad Kasabali
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
- College of MedicineLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Jobran Mansour
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - John Pang
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Ameya A. Asarkar
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
| | - Cherie‐Ann Nathan
- Department of Otolaryngology/HNSLouisiana State University Health‐ShreveportShreveportLouisianaUSA
- Feist‐Weiller Cancer CenterShreveportLouisianaUSA
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Berg M, Silander E, Bove M, Johansson L, Nyman J, Hammerlid E. Fatigue in Long-Term Head and Neck Cancer Survivors From Diagnosis Until Five Years After Treatment. Laryngoscope 2023; 133:2211-2221. [PMID: 36695154 DOI: 10.1002/lary.30534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/09/2022] [Accepted: 12/08/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Fatigue due to cancer is a challenging symptom that might be long-lasting after cancer treatment. The aim of this study was to follow the development of fatigue among head and neck cancer (HNC) patients prospectively and longitudinally and to analyze predictors for acute and chronic fatigue. METHODS HNC patients treated with curative intent were included at diagnosis and completed the following questionnaires multiple times, up to 5 years after treatment: the EORTC QLQ-FA12 for fatigue, EORTC QLQ-C30, and HNC-specific EORTC QLQ-H&N35 together with an anxiety and depression questionnaire. Predictors of fatigue were evaluated at 3 months and 5 years after treatment. RESULTS Of the 311 study participants, 74% responded at the 5-year follow-up. Physical fatigue was significantly worse 3 months after treatment, while emotional and cognitive fatigue were the worst at diagnosis and at 3 months. All fatigue domains were significantly better after 1 year, and the fatigue scores remained stable from 1 until 5 years after treatment. Three months after chemoradiotherapy, physical fatigue was more significant, but no long-term differences due to treatment modalities were found. Depression and anxiety were predictors for chronic emotional fatigue, and local HN pain and swallowing problems were predictors for chronic physical fatigue. Better global quality of life at diagnosis was associated with less physical and emotional fatigue. CONCLUSION Fatigue was worst in the short term for HNC patients and improved after 1 year, and long-term fatigue remained stable up to 5 years after treatment. A few predictors for chronic fatigue were found. LEVEL OF EVIDENCE 3 Laryngoscope, 133:2211-2221, 2023.
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Affiliation(s)
- Malin Berg
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ewa Silander
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mogens Bove
- Department of Otorhinolaryngology, Northern Alvsborg County Hospital (NAL), Trollhättan, Sweden
| | - Leif Johansson
- Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden
| | - Jan Nyman
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eva Hammerlid
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
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Thilges S, Mumby P, Sinacore J, Clark J, Czerlanis C. Implementing a cognitive behavioral intervention for patients with head and neck cancer. Support Care Cancer 2023; 31:476. [PMID: 37466682 DOI: 10.1007/s00520-023-07948-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Sequelae of and therapies for head and neck cancers (HNC) are associated with physical and functional impairment as well as increased levels of psychological distress post treatment. Given the impact of HNC and treatment on functioning (i.e., eating and talking), health-related quality of life (HRQOL) is a significant area of survivorship concern within this population. Although prior research indicates that the incidence of anxiety and depression ranges from 15 to 50%, to date, there is a paucity of research on specific psychosocial interventions related to HNC treatment and completed studies have been limited by infrequent use of a randomized design and provision of non-standardized psychosocial interventions. This study aimed to address these gaps and utilize a brief cognitive behavioral intervention (CBI) to improve (1) self-efficacy for coping with cancer, (2) depressive symptoms, (3) other psychological symptoms, and (4) HRQOL among patients with HNC. METHODS In an effort to conduct a randomized clinical trial of those undergoing treatment for HNC, eighty-eight patients were assigned to receive either a standardized CBI or usual psychological care (N = 47 and 41, respectively) with a 1-year follow-up. The means of all variables for both groups, adjusted for baseline, were visually compared at 3, 6, and 12 months post treatment. RESULTS As has been a challenge in other longitudinal HNC studies, a high degree of attrition occurred, with a loss of 35 patients from the CBI group and 29 from the usual care group. Despite the high attrition, analysis of existing data indicated that the effect of CBI was discernable among the patients who completed the course of the study. Of the 38 comparisons, 34 showed that the CBI group had the favorable outcome. Important considerations for implementation of a structured psychotherapy intervention during active cancer treatment with multiple barriers including communication challenges and practical limitations were realized. CONCLUSIONS The impact of HNC treatment can be particularly distressing as it often results in functional impairment and markedly changed activities of daily living among survivors. However, engaging in therapeutic methods to cope and manage distress during treatment can influence QOL and mood into the survivorship phase.
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Affiliation(s)
- Sarah Thilges
- Department of Psychiatry and Behavioral Neurosciences, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA.
| | - Patricia Mumby
- Department of Psychiatry and Behavioral Neurosciences, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA
| | - James Sinacore
- Department of Public Health Sciences, Loyola University, 2160 South First Avenue, Maywood, IL, 60153, USA
| | - Joseph Clark
- Department of Hematology and Oncology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA
| | - Cheryl Czerlanis
- Department of Hematology and Oncology, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL, 60153, USA
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Tiksnadi BB, Triani N, Fihaya FY, Turu' Allo IJ, Iskandar S, Putri DAE. Validation of Hospital Anxiety and Depression Scale in an Indonesian population: a scale adaptation study. Fam Med Community Health 2023; 11:fmch-2022-001775. [PMID: 37277187 DOI: 10.1136/fmch-2022-001775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
OBJECTIVE This study aims to adapt the English-language Hospital Anxiety and Depression Scale (HADS) to the Indonesian language and evaluate the validity and reliability of the adapted version (ie, HADS-Indonesia). DESIGN A cross-sectional study was conducted between June and November 2018. First, a translation and back-translation process was conducted by a committee consisting of the researchers, a psychiatrist, a methodology consultant and two translators. Face and convergent validity and test-retest reliability evaluations were conducted. Next, structural validity and internal consistency analyses were performed. An intraclass correlation coefficient (ICC) test evaluated the scale's test-retest reliability. A Spearman's rank correlation coefficient was calculated to evaluate the correlation between HADS-Indonesia and Zung's Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) for convergent validity evidence. Next, a structural validity analysis using exploratory factor analysis (EFA) and an internal consistency evaluation based on Cronbach's alpha was conducted. SETTING This study was conducted in three villages in Jatinangor subdistrict, Sumedang Regency, West Java province, Indonesia; the villages were chosen based on their profiles. PARTICIPANTS A total of 200 participants (male: n=91, 45.50% and female: n=109, 54.50%), with a mean age of 42.41 (14.25) years, were enrolled in this study using a convenience sampling method. The inclusion criteria were age ≥18 years old with basic Indonesian language literacy. RESULTS The overall HADS-Indonesia's ICC value was 0.98. There was a significant positive correlation between HADS-Indonesia's anxiety subscale and Zung's SAS (rs=0.45, p=0.030) and between the depression subscale of HADS-Indonesia and Zung's SDS (rs=0.58, p<0.001). The Kaiser-Meyer-Olkin statistics (KMO) (KMO=0.89) and Bartlett's test of sphericity (χ2(91, N=200)=1052.38, p<0.001)) indicated an adequate number of samples for EFA. All items' commonality was >0.40 and the average inter-item correlation was 0.36. EFA yielded a 2-factor solution explaining 50.80% (40.40%+10.40%) of the total variance. All items from the original HADS were retained, including its original subscales. The adapted HADS-Anxiety subscale consisted of seven items (alpha=0.85), and the HADS-Depression subscale consisted of seven items (alpha=0.80). CONCLUSIONS HADS-Indonesia is a valid and reliable instrument for use in the general population of Indonesia. However, further studies are warranted to provide more sophisticated validity and reliability evidence.
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Affiliation(s)
- Badai Bhatara Tiksnadi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran / Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Nurlita Triani
- Department of Psychiatry, Faculty of Medicine, Universitas Padjadjaran / Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Faris Yuflih Fihaya
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran / Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Iswandy Janetputra Turu' Allo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran / Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Shelly Iskandar
- Department of Psychiatry, Faculty of Medicine, Universitas Padjadjaran / Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
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Bhat B, Balasubramanium RK, Krishnamurthy R, Rinkel RNMP. Validation and Psychometric Evaluation of the Kannada Version of the Speech Handicap Index in Individuals with Oral and Oropharyngeal Cancer. Indian J Otolaryngol Head Neck Surg 2022; 74:5019-5027. [PMID: 36742590 PMCID: PMC9895559 DOI: 10.1007/s12070-021-02645-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/17/2021] [Indexed: 02/07/2023] Open
Abstract
The current study aimed to adapt and validate the speech handicap index into the Kannada language, and also to investigate its psychometric properties in Kannada speaking individuals with oral and oropharyngeal cancers. This is a cross-sectional study and it was carried out in two phases. The first phase dealt with the translation of the English version of SHI into the Kannada language, and its validation on 95 healthy individuals and 25 individuals with oral or oropharyngeal cancer. The second phase dealt with the investigation of speech-related quality of life among 50 Kannada speaking individuals with oral and oropharyngeal cancers. The SHI-K has very good internal consistency (Cronbach's Alpha is 0.98) and exhibited good test-retest reliability (ICC = 0.94). The mean scores of the disordered group, for the psychosocial scores (t (118) = 25.87, p < 0.01), for speech scores (t (118) = 19.74, p < 0.01), for total SHI scores (t (188) = 26.45, p < 0.01), for overall rating (t (118) = 16.81, p < 0.01) were statistically significant and greater than the healthy group (p < 0.01). A statistically significant association was found between clinical-stage, total SHI scores, and rating [χ2 (4, N = 50) = 3.82, p = 0.02], but not for sex, tumor site, and type of treatment received. SHI-K is a valid and reliable tool to assess the speech-related quality of life of individuals with speech disorders. This tool can allow clinicians to plan better rehabilitation, and it can be used as an outcome tool for any treatment studies. The findings of the study emphasize the importance of considering patient priorities before commencing surgical or therapeutic interventions.
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Affiliation(s)
- Bhavana Bhat
- Department of Audiology and Speech Language Pathology, Manipal Academy of Higher Education, Kasturba Medical College, Mangalore, Manipal, Karnataka India
| | - Radish Kumar Balasubramanium
- Department of Audiology and Speech Language Pathology, Manipal Academy of Higher Education, Kasturba Medical College, Mangalore, Manipal, Karnataka India
| | - Rahul Krishnamurthy
- Department of Audiology and Speech Language Pathology, Manipal Academy of Higher Education, Kasturba Medical College, Mangalore, Manipal, Karnataka India
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12
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van Beek FE, Jansen F, Baatenburg de Jong RJ, Langendijk JA, Leemans CR, Smit JH, Takes RP, Terhaard CHJ, Custers JAE, Prins JB, Lissenberg-Witte BI, Verdonck-de Leeuw IM. Psychological Problems among Head and Neck Cancer Patients in Relation to Utilization of Healthcare and Informal Care and Costs in the First Two Years after Diagnosis. Curr Oncol 2022; 29:3200-3214. [PMID: 35621650 PMCID: PMC9139910 DOI: 10.3390/curroncol29050260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/13/2022] [Accepted: 04/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background: To investigate associations between psychological problems and the use of healthcare and informal care and total costs among head and neck cancer (HNC) patients. Method: Data were used of the NETherlands QUality of Life and Biomedical Cohort study. Anxiety and depression disorder (diagnostic interview), distress, symptoms of anxiety and depression (HADS), and fear of cancer recurrence (FCR) and cancer worry scale (CWS) were measured at baseline and at 12-month follow-up. Care use and costs (questionnaire) were measured at baseline, 3-, 6-, 12-, and 24-month follow-up. Associations between psychological problems and care use/costs were investigated using logistic and multiple regression analyses. Results: Data of 558 patients were used. Distress, symptoms of anxiety or depression, FCR, and/or anxiety disorder at baseline were significantly associated with higher use of primary care, supportive care, and/or informal care (odds ratios (ORs) between 1.55 and 4.76). Symptoms of anxiety, FCR, and/or depression disorder at 12-month follow-up were significantly associated with use of primary care, supportive care, and/or informal care (ORs between 1.74 and 6.42). Distress, symptoms of anxiety, and FCR at baseline were associated with higher total costs. Discussion: HNC patients with psychological problems make more use of healthcare and informal care and have higher costs. This is not the result of worse clinical outcomes.
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Affiliation(s)
- Florie E. van Beek
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands;
| | - Femke Jansen
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, Amsterdam UMC Location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (C.R.L.); (I.M.V.-d.L.)
- Correspondence:
| | - Rob J. Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, Erasmus Cancer Institute, Erasmus MC, 3015 GD Rotterdam, The Netherlands;
| | - Johannes A. Langendijk
- Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
| | - C. René Leemans
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, Amsterdam UMC Location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (C.R.L.); (I.M.V.-d.L.)
| | - Johannes H. Smit
- Department of Psychiatry, Neuroscience Campus Amsterdam and Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Medical Center, 1081 HV Amsterdam, The Netherlands;
| | - Robert P. Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Chris H. J. Terhaard
- Department of Radiation Oncology, University Medical Center, 3584 CX Utrecht, The Netherlands;
| | - José A. E. Custers
- Department of Medical Psychology 926, Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (J.A.E.C.); (J.B.P.)
| | - Judith B. Prins
- Department of Medical Psychology 926, Radboud University Medical Center, Radboud Institute for Health Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; (J.A.E.C.); (J.B.P.)
| | - Birgit I. Lissenberg-Witte
- Department of Epidemiology and Data Science, Amsterdam UMC, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
| | - Irma M. Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam Public Health Research Institute, Amsterdam UMC Location VUmc, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (C.R.L.); (I.M.V.-d.L.)
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13
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McDowell L, Rischin D, Gough K, Henson C. Health-Related Quality of Life, Psychosocial Distress and Unmet Needs in Older Patients With Head and Neck Cancer. Front Oncol 2022; 12:834068. [PMID: 35242716 PMCID: PMC8885992 DOI: 10.3389/fonc.2022.834068] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/24/2022] [Indexed: 01/22/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the most common cancer involving the mucosal surfaces of the head and neck and is associated with a number of etiological factors, including cigarette smoking, alcohol and betel nut consumption and exposure to high-risk human papillomavirus. The risk of HNSCC increases with age, peaking in the seventh and eighth decade, but this varies by anatomical and histological subtype. While several advancements have been made in the treatment of head and neck cancer (HNC) in recent decades, undertaking curative treatment still subjects the majority of HNSCC patients to substantial treatment-related toxicity requiring patients to tolerate a gamut of physical, psychological, and emotional demands on their reserves. In conjunction with other patient-related factors, clinicians involved in treating patients with HNSCC may incorporate advancing chronological age into their decision-making process when determining treatment recommendations. While advancing chronological age may be associated with increased concerns regarding physical treatment tolerability, clinicians may also be concerned about heightened vulnerability in various health and wellbeing outcomes. The available literature, however, does not provide evidence of this vulnerability in patients with advancing age, and, in many instances, older patients self-report greater resilience compared to their younger counterparts. While this data is reassuring it is limited by selection bias and heterogeneity in trial and study design and the absence of a consistent definition of the elderly patient with HNSCC. This narrative review article also includes a review of the measures used to assess HRQL, psychosocial outcomes and unmet needs in elderly or older patients with HNSCC.
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Affiliation(s)
- Lachlan McDowell
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Danny Rischin
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.,Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Karla Gough
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, VIC, Australia
| | - Christina Henson
- Department of Radiation Oncology, Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, United States
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14
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Berg M, Adnan A, Högmo A, Sjödin H, Gebre-Medhin M, Laurell G, Reizenstein J, Farnebo L, Norberg LS, Notstam I, Holmberg E, Cange HH, Hammerlid E. A national study of health-related quality of life in patients with cancer of the base of the tongue compared to the general population and to patients with tonsillar carcinoma. Head Neck 2021; 43:3843-3856. [PMID: 34558771 DOI: 10.1002/hed.26882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This exploratory, registry-based, cross-sectional study aimed to evaluate patients' health-related quality of life (HRQOL) in a subsite of oropharyngeal cancer: cancer of the base of the tongue (CBT). METHODS CBT patients, treated with curative intent, completed the EORTC QLQ-C30 and QLQ-H&N35 questionnaires 15 months after diagnosis. The HRQOL of CBT patients was compared to reference scores from the general population and to that of tonsillar carcinoma patients. RESULTS The 190 CBT patients scored significantly worse than members of the general population on most scales. CBT patients with human papilloma virus (HPV)-positive tumors had significantly better HRQOL on 8 of 28 scales than HPV-negative patients. Compared to 405 tonsillar carcinoma patients, CBT patients had significantly worse HRQOL on 8 of the 28 scales, the majority local head and neck related problems. CONCLUSION One year after treatment, CBT patients' HRQOL was significantly worse in many areas compared to that of the general population and slightly worse than that of tonsillar carcinoma patients.
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Affiliation(s)
- Malin Berg
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ali Adnan
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Högmo
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Helena Sjödin
- Theme Cancer, HHLH, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Gebre-Medhin
- Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Johan Reizenstein
- Department of Oncology, Örebro University Hospital and Örebro University, Örebro, Sweden
| | - Lovisa Farnebo
- Department of Otorhinolaryngology, Anaesthetics, Operations and Specialty Surgery Center, Department of Biomedical and Clinical Sciences, Linköping, Sweden
| | | | - Isak Notstam
- Department of Clinical Sciences/ENT, Umeå University, Umeå, Sweden
| | - Erik Holmberg
- Regional Cancer Center Western Sweden, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hedda Haugen Cange
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eva Hammerlid
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
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15
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Rogers SN, Monssen C, Humphris GM, Lowe D, Kanatas A. Which Head and Neck Cancer Patients Are Most at Risk of High Levels of Fear of Cancer Recurrence. Front Psychol 2021; 12:671366. [PMID: 34335384 PMCID: PMC8322117 DOI: 10.3389/fpsyg.2021.671366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/07/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Fear of cancer recurrence (FCR) is recognized as a common concern for patients with head and neck cancer (HNC). The aim of this study is to describe in greater detail the demographic and clinical characteristics of HCN patients who indicate a high level of FCR in their review consultation. Methods: A pragmatic cluster-controlled trial was conducted between January 2017 and December 2018 at two UK HNC centers (Leeds and Liverpool) to test the efficacy of a prompt tool called the Patient Concerns Inventory (PCI). Patients completed the PCI and the UW-QOLv4 which included a single 5 category rating of FCR. Secondary statistical analyses focused on variables associated with high FCR. Results: Two hundred and eighty-eight trial patients were recruited in this trial. At a median of 194 days after diagnosis and 103 days after the end of treatment 8% stated (n = 24) “I get a lot of fears of recurrence and these can really preoccupy my thoughts” and 3% (n = 8) “I am fearful all the time that my cancer might return, and I struggle with this.” Thus, 11% (n = 32) responded in the worst two categories, 95% Confidence interval 7.7–15.3% for high FCR. Stepwise logistic regression resulted in female gender (p < 0.001), age (p = 0.007), and receiving financial benefits (p = 0.01) as independent predictors. Conclusions: Around one in ten HNC patients attending routine outpatient follow-up consultations report high FCR, however for female patients under the age of 55 the rate was one in three. This group requires specialist attention and could be the focus of a multicenter intervention trial.
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Affiliation(s)
- Simon N Rogers
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, United Kingdom.,Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, United Kingdom
| | - Camilla Monssen
- School of Medicine, Medical and Biological Sciences, North Haugh, St. Andrews, United Kingdom
| | - Gerald M Humphris
- School of Medicine, Medical and Biological Sciences, North Haugh, St. Andrews, United Kingdom
| | - Derek Lowe
- Astraglobe Ltd., Congleton, United Kingdom
| | - Anastasios Kanatas
- Leeds Teaching Hospitals and St. James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds, United Kingdom
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16
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Ahmadi Bakhsh SD, Moradi N, Naderifar E, Dastoorpour M, Razmjoo S. Cross-Cultural Adaptation and Validation of the Speech Handicap Index into Persian. Folia Phoniatr Logop 2021; 74:54-61. [PMID: 34348316 DOI: 10.1159/000518025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 06/11/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The aim of the present study was to adapt and validate the Speech Handicap Index (SHI) into the Persian language. PATIENTS AND METHODS The original published English version of the SHI was translated into Persian using the translation protocol and guidelines of the International Quality of Life Assessment. One hundred participants with oral and oropharyngeal cancer and 40 healthy participants completed the Persian SHI. Forty participants of the patient group completed the Persian SHI a second time after a 2-weeks period to evaluate test-retest reliability. Content validity (content validity index and content validity ratio), internal consistency (Cronbach α coefficient), test-retest reliability (intraclass correlations), and construct validity (confirmatory factor analysis) were examined. Control group and patient group values were compared to determine the clinical validity. RESULTS A significant discrimination coefficient was found across all items, and the content and clinical validity were found to be acceptable. The Persian SHI showed a high internal consistency and test-retest reliability. The construct validity was within the acceptable range. CONCLUSIONS The P-SHI is considered to be a valid and reliable questionnaire for speech assessment in Persian-speaking patients with head and neck cancer.
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Affiliation(s)
- Seyede Dena Ahmadi Bakhsh
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Negin Moradi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ehsan Naderifar
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Dastoorpour
- Department of Epidemiology and Biostatistics, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Biostatistics and Epidemiology, Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sasan Razmjoo
- Department of Clinical Oncology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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17
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Silva ACAE, Santos IC, Carmo CND, Mattos IE. Symptoms and factors associated with symptom clusters among older adults with oral and oropharyngeal cancers at diagnosis. GERIATRICS, GERONTOLOGY AND AGING 2021. [DOI: 10.53886/gga.e0210055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: Describe differences in pretreatment symptoms and the composition of symptom clusters in older patients with oral and oropharyngeal cancer.
METHODS: In this cross-sectional study, quality of life (QoL) assessments for cancer patients (EORCT QLQ-C30 and QLQ-H & N35) were applied to 161 cases of oral and oropharyngeal cancer at the time of enrollment in an outpatient clinic. They were used to evaluate QoL-related symptoms reported by patients, according to their occurrence. To identify symptom clusters, an exploratory factor analysis (EFA) was performed, and the relationships between these clusters and independent variables were assessed with linear regression models. RESULTS: The most prevalent symptoms were pain (52%), worry (48%), and weight loss (44%). Five factors were extracted from the EFA, of which 3 were noteworthy. The dysphagia cluster was common to both cancer sites, although more frequent in oropharyngeal cancer patients, and included symptoms such as difficulty swallowing, pain, and weight loss. The psychological cluster included symptoms related to feeling worried, nervous, and depressed. The asthenia cluster, in addition to being age-related, may represent the advanced stage or progression of the disease. CONCLUSION: The dysphagia cluster loaded the most symptoms and was common to both cancers. In addition to pain (one of the main symptoms of the dysphagia cluster), psychological symptoms were also important in both groups of patients. Adequate and early control of these symptom clusters at diagnosis could favor better management of symptoms during treatment.
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18
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Speksnijder CM, Lankhorst PJM, de Bree R, de Haan AFJ, Koole R, Merkx MAW. Depression and related factors after oral oncological treatment: a 5-year prospective cohort study. Support Care Cancer 2020; 29:2907-2916. [PMID: 33001267 PMCID: PMC8062368 DOI: 10.1007/s00520-020-05795-1] [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: 12/03/2019] [Accepted: 09/22/2020] [Indexed: 11/29/2022]
Abstract
PURPOSES Being diagnosed with oral cancer is a life-threatening life event. It often induces social, emotional and psychological consequences and may cause depressive disorders. The primary aim of this study was to identify and quantify the personal and clinical characteristics involved in depression for patients who have been treated for oral cavity malignancies, with a 5-year follow-up period after treatment. The secondary aim of this study was to identify the clinical factors that increase a patient's risk of experiencing depression 5 years after treatment. METHODS Patients with primary oral cancer were assessed for up to 5 years after primary treatment. A mixed-model analysis was performed, with depression measured by the Center for Epidemiologic Studies Depression Scale as outcome measure. RESULTS A total of 141 patients were included in the study. Factors associated with depression were gender, tumour location and having an emotion-oriented coping style. The occurrence of depression within 5 years after treatment could be reliably predicted by a patient's gender, the location of their tumour and the extent to which they had an emotion-oriented coping style. CONCLUSIONS This study revealed that being female, having a maxillary tumour and having an emotion-oriented coping style are associated with higher levels of depressive symptoms in patients treated for oral cancer up to 5 years post-treatment. A substantial proportion of the patients with oral cancer experienced high levels of depression both before and after their treatment, suggesting that adequate diagnostics and care are needed to try to prevent severe depression in these patients.
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Affiliation(s)
- Caroline M Speksnijder
- Cancer Center, Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. .,Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. .,Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, P.O. Box 85.500, 3508, GA, Utrecht, The Netherlands.
| | - Petra J M Lankhorst
- Department of Medical Oncology, Deventer Hospital, Deventer, The Netherlands
| | - Remco de Bree
- Cancer Center, Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anton F J de Haan
- Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ron Koole
- Department of Medical Oncology, Deventer Hospital, Deventer, The Netherlands
| | - Matthias A W Merkx
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
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19
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Urdang ZD, Rosales DH, Chen Q, Li RJ, Andersen PE, Gross ND, Clayburgh DR. Follow-Up Phone Interviews and Attendance Motivation From A Free Head and Neck Cancer Screening. EAR, NOSE & THROAT JOURNAL 2020; 101:89-94. [PMID: 32703031 DOI: 10.1177/0145561320940866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Head and Neck Cancer Awareness and Screening Programs (HNCASP) are popular community outreach events hosted by academic and community otolaryngology departments. However, long-term follow-up of participants is lacking. PATIENTS AND METHODS Participants of a HNCASP held at an academic cancer center prospectively filled out demographic and risk factor surveys followed by HNC screening examination. A phone interview was conducted for participants between 2012 and 2016 with suspicious findings to assess outcomes. RESULTS Participants were largely Caucasian, female, and had health insurance, reflecting the setting at an academic medical center. Despite this, there were 156 (16.8%) positive screenings; 47 of these completed follow up interviews. Twelve (1.1% of all participants) cancer cases were confirmed. DISCUSSION A significant proportion of HNCASP participants benefited from this screening opportunity. Education regarding HNC is the primary benefit and motivational factor for attendance of HNCASPs, although a significant subset of patients was identified that needed follow-up, and several cancers were detected.
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Affiliation(s)
- Zachary D Urdang
- Department of General Surgery, Oregon Health and Science University, Portland, OR, USA
| | - David H Rosales
- Equity Internship Program, Oregon Health and Science University, Portland, OR, USA
| | - QiLiang Chen
- Department of Anesthesiology, Stanford University, Palo Alto, CA, USA
| | - Ryan J Li
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR, USA
| | - Peter E Andersen
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR, USA
| | - Neil D Gross
- Department of Otolaryngology-Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, USA
| | - Daniel R Clayburgh
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR, USA
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Psychological Distress Before and After Surgical Resection of Benign Orofacial Tumors: A Prospective Study. J Oral Maxillofac Surg 2020; 78:1654.e1-1654.e7. [PMID: 32422191 DOI: 10.1016/j.joms.2020.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 04/09/2020] [Accepted: 04/09/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE We evaluated the presence and level of psychological distress in patients before and after resection of benign orofacial tumors and identified the variables associated with this psychological distress. MATERIALS AND METHODS The present study used the Hospital Anxiety and Depression Scale and the Rosenberg Self-Esteem Scale. A questionnaire that included these 2 scales was administered to the patients before surgery and at 1, 2, and 6 weeks after surgery. The scores at the various intervals were statistically compared, and the relationships between the variables (eg, age, gender, education, marital status, occupation, lesion size) and psychological distress were also tested. RESULTS Of the 31 patients, 29% had abnormal levels of anxiety before surgery, and 12.9% reported abnormal depression levels before surgery. The proportion of patients with abnormal anxiety levels increased from 29% before surgery to 38.7, 38.7, and 35.5% at 1, 2, and 6 weeks after surgery, respectively. The proportion of patients with abnormal depression levels at all intervals after surgery remained the same as that before surgery (12.9%). All the patients had normal self-esteem levels both before and after surgery. Using a paired t test, the mean anxiety scores at all intervals after surgery were significantly greater than the mean anxiety score before surgery. Analyses of the relationships between the independent variables and psychological distress (anxiety and depression) found the level of education to be significantly associated with anxiety before and after surgery. In contrast, the lesion size was significantly associated with depression both before and after surgery. CONCLUSIONS The results of the present study suggest that abnormal anxiety and depression will be present in some patients with benign orofacial tumors both before and after surgery. The patients' education level and lesion size were strongly associated with the level of psychological distress present in patients with benign orofacial tumors.
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Shunmugasundaram C, Rutherford C, Butow PN, Sundaresan P, Dhillon HM. What are the optimal measures to identify anxiety and depression in people diagnosed with head and neck cancer (HNC): a systematic review. J Patient Rep Outcomes 2020; 4:26. [PMID: 32328839 PMCID: PMC7181465 DOI: 10.1186/s41687-020-00189-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 03/12/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND A cancer diagnosis is potentially life-threatening, likely causing distress and uncertainty, which may be psychologically debilitating. Depression and anxiety are commonly underdiagnosed and undertreated in cancer patients. Head and neck cancer (HNC) patients face particular challenges that may contribute to distress. This review aims to: i) identify patient reported outcome measures (PROMs) designed to assess anxiety and depression in HNC; and ii) determine their suitability for use in research and clinical practice to screen patients. METHODS We searched five electronic databases between July 2007 to July 2019 for studies assessing anxiety and depression in HNC patients. Searches were limited to this period to account for advances in cancer treatment. Records were screened for eligibility by one reviewer and 10% cross-checked by a second across all stages of the review. In addition to the electronic searches, PROM databases were searched for additional measures of anxiety and depression. All retrieved PROMs were mapped against Diagnostic and Statistical Manual-5 criteria for anxiety and depression to assess content coverage. Then, their psychometric properties appraised against the COSMIN checklist. RESULTS Electronic searches identified 98 records, from which five anxiety and eight depression measures were retrieved. PROM database searches retrieved an additional four anxiety and four depression measures; a total of nine anxiety and 12 depression measures were appraised. Content coverage of anxiety measures ranged from 50% to 75% and depression measures from 42% to 100%. Demonstration of psychometric properties against COSMIN criteria ranged from 57% to 71% for anxiety measures (three PROMs > 70%) and from 29% to 86% for depression measures (nine PROMs > 70%). Three anxiety and seven depression measures had established clinical cut-offs in cancer populations. CONCLUSIONS The Patient Health Questionnaire-9, Zung Self-rating Depression and Zung Self-rating Anxiety Scales demonstrated good content coverage along with excellent psychometric properties, and thus were considered the most suitable PROMs to assess psychological distress in HNC populations. It is important to have PROMs assessing psychological distress that capture a comprehensive set of subjective symptoms. The identified PROMs will help researchers and health professionals in clinical-decision making, thereby potentially improving quality of life in HNC patients.
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Affiliation(s)
- Chindhu Shunmugasundaram
- University of Sydney, School of Psychology, Centre for Medical Psychology and Evidence-Based Decision-Making, Sydney, Australia
- University of Sydney, School of Psychology, Psycho-Oncology Cooperative Research Group, Sydney, Australia
| | - Claudia Rutherford
- University of Sydney, School of Psychology, Quality of Life Office, Sydney, Australia
- University of Sydney, Sydney Nursing School, Cancer Nursing Research Unit (CNRU), Sydney, Australia
| | - Phyllis N Butow
- University of Sydney, School of Psychology, Centre for Medical Psychology and Evidence-Based Decision-Making, Sydney, Australia
- University of Sydney, School of Psychology, Psycho-Oncology Cooperative Research Group, Sydney, Australia
| | - Puma Sundaresan
- Radiation Oncology Network, Western Sydney Local Health District, Sydney, Australia
- University of Sydney, Faculty of Medicine, Sydney Medical School, Sydney, Australia
| | - Haryana M Dhillon
- University of Sydney, School of Psychology, Centre for Medical Psychology and Evidence-Based Decision-Making, Sydney, Australia.
- University of Sydney, School of Psychology, Psycho-Oncology Cooperative Research Group, Sydney, Australia.
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The course of symptoms of anxiety and depression from time of diagnosis up to 2 years follow-up in head and neck cancer patients treated with primary (chemo)radiation. Oral Oncol 2020; 102:104576. [DOI: 10.1016/j.oraloncology.2020.104576] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/07/2020] [Accepted: 01/14/2020] [Indexed: 11/17/2022]
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Psychological distress and nutritional status in head and neck cancer patients: a pilot study. Eur Arch Otorhinolaryngol 2020; 277:1211-1217. [PMID: 32025788 PMCID: PMC7072056 DOI: 10.1007/s00405-020-05798-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 01/18/2020] [Indexed: 12/24/2022]
Abstract
Purpose To determine whether the psychological state of patients with head and neck cancer (HCN) is associated with their nutritional status. Methods In 40 patients with locally advanced HNC treated with definitive or adjuvant (chemo)radiotherapy, psychological and nutritional status were assessed before treatment, at its completion and 3 months’ post-therapy. Psychosocial distress was measured using the Hospital Anxiety and Depression Scale questionnaire (HADS-A, HADS-D), whereas the nutritional status was evaluated using standard methods (Nutritional Risk Screening Tool 2002, anthropometric data, dynamometry and laboratory tests) and with a bioelectrical impedance analysis parameter phase angle (PA). Results Before treatment, more patients were screened positive for anxiety than at treatment completion (p = 0.037) or 3 months’ post-therapy (p = 0.083). Depression prevalence was non-significantly higher at the end and after therapy. Compared to the baseline, more cachectic patients and a reduction of PA values were found at successive assessments. Anxiety was more often recorded among malnourished/cachectic patients (assessment 1, p = 0.017; assessment 2, p = 0.020) who were also found more frequently depressed (assessment 2, p = 0.045; assessment 3, p = 0.023). Significantly higher PA values were measured in patients without distress determined at 3 months’ post-therapy by the HADS-A (p = 0.027). Conclusion The association between the psychological and nutritional status found in this pilot study and the options for intervention warrants further clarification in a larger prospective trial.
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Zahid JA, Grummedal O, Madsen MT, Gögenur I. Prevention of depression in patients with cancer: A systematic review and meta-analysis of randomized controlled trials. J Psychiatr Res 2020; 120:113-123. [PMID: 31655426 DOI: 10.1016/j.jpsychires.2019.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/04/2019] [Accepted: 10/09/2019] [Indexed: 01/06/2023]
Abstract
Depression and depressive symptoms are prevalent in patients with cancer. Depression is underdiagnosed and therefore, patients often receive inadequate treatment for depression. We have assessed the evidence of primary prophylactic treatment for depression in patients with cancer. The systematic review was prospectively registered at PROSPERO and was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Five electronic databases were searched on the 31st of May 2018 and two independent reviewers screened the papers. Randomized controlled trials of adult patients with cancer treated prophylactically with an antidepressive intervention of any kind using validated assessment tools to measure depression or depressive symptoms were included. No language or publication year restrictions were applied. Seven out of eighteen studies reported a statistically significant prophylactic effect on depression. The studies were classified into three groups based on the type of intervention. The meta-analyses showed a significant difference in favour of pharmacotherapy (RR 0.34, 95% CI 0.18; 0.63), psychotherapy (SMD -0.23,95% CI -0.46; 0.00), and other interventions (SMD -0.17, 95% CI -0.31; -0.03). Only one study had overall low risk of bias and the rest had high risk of bias predominantly due to blinding, incomplete data, or allocation concealment. Preventive measures have been examined in patients with cancer, but no convincing evidence for any specific intervention is present. Depression in patients with cancer can be prevented and prophylactic treatment should be given during oncological treatment but further high quality studies testing safe interventions are still needed.
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Affiliation(s)
- Jawad Ahmad Zahid
- Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark.
| | - Ole Grummedal
- Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark.
| | - Michael Tvilling Madsen
- Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark.
| | - Ismail Gögenur
- Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark.
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Brown SL, Hughes M, Campbell S, Cherry MG. Could worry and rumination mediate relationships between self‐compassion and psychological distress in breast cancer survivors? Clin Psychol Psychother 2019; 27:1-10. [DOI: 10.1002/cpp.2399] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 09/06/2019] [Accepted: 09/06/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Stephen L. Brown
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | - Maria Hughes
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | - Sophie Campbell
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | - M. Gemma Cherry
- Department of Psychological Sciences University of Liverpool Liverpool UK
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Klug N, Butow PN, Burns M, Dhillon HM, Sundaresan P. Unmasking Anxiety: A Qualitative Investigation of Health Professionals; Perspectives of Mask Anxiety in Head and Neck Cancer. J Med Imaging Radiat Sci 2019; 51:12-21. [PMID: 31759941 DOI: 10.1016/j.jmir.2019.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/17/2019] [Accepted: 09/20/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND To ensure precision of treatment, patients requiring radiation therapy for treatment of head and neck cancer (HNC) are stabilized using a fitted thermoplastic immobilization mask. Despite evidence that many patients experience significant anxiety when restrained in the mask, there is a lack of proven interventions to prevent or manage mask-related anxiety. The Promoting Action on Research Implementation in Health Services implementation framework promotes consideration of context and culture when developing interventions to ensure successful implementation if proven effective. Health professionals (HPs) play a crucial role in the management of patients' psychological concerns, yet no studies have explored their perspectives of mask anxiety and how it should be managed. The aim of this study, therefore, was to elicit and analyse HPs' perspectives of mask anxiety, using the Promoting Action on Research Implementation in Health Services framework, to guide the development of implementation-ready interventions to reduce mask anxiety. METHODS Semistructured interviews were conducted with 20 HPs involved in the care of HNC patients, including radiation oncologists, radiation therapists, nurses, and psychologists, from nine hospitals in NSW, Australia. Framework analysis methods were used. RESULTS Participants were on average 40 years old (range, 27-56), the majority were female (75%), and they had worked from 1 to 22 years with HNC patients. Six emergent themes were identified: (1) Mask anxiety is a significant problem but is easily missed; (2) Context matters; (3) Trust is critical; (4) Choice and control facilitate adjustment; (5) Psychological strategies are valued; and (6) Culture matters. Subgroup analysis also highlighted differences in perspectives between specialties. CONCLUSIONS Participants identified key principles underlying successful intervention. Two significant barriers to mask-anxiety intervention were identified: (1) a lack of empirical evidence surrounding its prevalence and predictors and (2) contextual and systematic hurdles making the health system potentially unresponsive to change. These data suggest a need for further descriptive studies and careful development of interventions which will address these hurdles.
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Affiliation(s)
- Natalie Klug
- Centre for Medical Psychology & Evidence-Based Decision-Making School of Psychology, University of Sydney, Sydney, New South Wales, Australia
| | - Phyllis N Butow
- Centre for Medical Psychology & Evidence-Based Decision-Making School of Psychology, University of Sydney, Sydney, New South Wales, Australia; Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, New South Wales, Australia.
| | - Melissa Burns
- Radiation Oncology Network, Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Haryana M Dhillon
- Centre for Medical Psychology & Evidence-Based Decision-Making School of Psychology, University of Sydney, Sydney, New South Wales, Australia; Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, New South Wales, Australia
| | - Purnima Sundaresan
- Radiation Oncology Network, Western Sydney Local Health District, Sydney, New South Wales, Australia; Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Rajeev-Kumar G, Moreno J, Kelley A, Sharma S, Gupta V, Bakst R. Emotional Quality of Life After Radiation Therapy for Oropharyngeal Carcinoma. Adv Radiat Oncol 2019; 4:674-682. [PMID: 31673660 PMCID: PMC6817535 DOI: 10.1016/j.adro.2019.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 04/24/2019] [Accepted: 05/02/2019] [Indexed: 12/03/2022] Open
Abstract
Purpose Substantial research exists on the physical toxicities from radiation therapy (RT) for oropharyngeal cancers, but emotional quality of life is understudied. The purpose of this study is to map the effects and time course of radiation-related changes in mood and anxiety and to investigate the physical factors that drive these changes. Methods and materials We prospectively collected University of Washington Quality of Life questionnaires and identified patients with oropharyngeal cancer who were treated with curative-intent RT between 2013 and 2016 and had completed questionnaires within 12 months after RT (n = 69). We analyzed swallow, saliva, taste, chewing, speech, pain, mood, and anxiety scores, using a scale from 0 to 100. We conducted a multivariate regression analysis to identify physical functioning predictors of worse emotional scores. Results Physical functioning scores declined from before RT to 3 months after RT and then began improving but did not rebound to baseline levels within 12 months. Patient mood slightly declined, but anxiety improved immediately after RT, with both generally improving such that scores were higher at the 12-month follow-up than at initial consult. Analysis showed that longer duration of treatment is associated with a higher likelihood of worse mood scores at 12 months (odds ratio [OR], 1.446; P < .01). Worse swallow score is associated with a greater likelihood of worse mood score at 3 months (OR, 0.971; P < .01) and 12 months (OR, 0.975; P < .01). A worse taste score is associated with a greater likelihood of worse anxiety score at 3 months (OR, 0.979; P < .05) and 12 months (OR, 0.982; P < .05). Conclusions Emotional changes are associated with certain treatment-associated toxicities. A patient's emotional health is complex and likely multifactorial in nature. Our study identified key associations and time points to potentially intervene upon.
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Affiliation(s)
- Greeshma Rajeev-Kumar
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jaison Moreno
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Amy Kelley
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sonam Sharma
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Vishal Gupta
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Richard Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
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Patil V, Noronha V, Joshi A, Deodhar J, Goswami S, Chakraborty S, Ramaswamy A, Dhumal S, M V C, Karpe A, Pande N, Talreja V, Chandrasekharan A, Turkar S, Prabhash K. Distress Management in Patients With Head and Neck Cancer Before Start of Palliative Chemotherapy: A Practical Approach. J Glob Oncol 2019; 4:1-10. [PMID: 30241232 PMCID: PMC6223409 DOI: 10.1200/jgo.17.00044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose This study reports the incidence of distress, the factors associated with distress, and a practical strategy to resolve distress in patients with head and neck cancer who are starting palliative chemotherapy. Methods Adult patients with head and neck cancer planned for palliative chemotherapy underwent distress screening before the start of treatment as part of this single-arm prospective study. Patients who had a distress score > 3 on the National Comprehensive Cancer Network (NCCN) distress thermometer were counseled initially by the clinician. Those who continued to have high distress after the clinician-led counseling were referred to a clinical psychologist and were started on palliative chemotherapy. After counseling, distress was measured again. The relation between baseline distress and compliance was tested using Fisher's exact test. Results Two hundred patients were enrolled, and the number of patients with high distress was 89 (44.5% [95% CI, 37.8% to 51.4%]). The number of patients who had a decrease in distress after clinician-led counseling (n = 88) was 52 (59.1% [95% CI, 48.6% to 68.8%]) and after psychologist-led counseling (n = 32) was 24 (75.0% [95% CI, 57.6% to 72.2%]; P = .136). Compliance rates did not differ between the patients with or without a high level of distress at baseline (74.2% v 77.4%, P = .620). Conclusion The incidence of baseline distress is high in patients awaiting the start of palliative chemotherapy. It can be resolved in a substantial number of patients using the strategy of clinician-led counseling, with additional referral to a clinical psychologist as required. Patients with a greater number of emotional problems usually require psychologist-led counseling.
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Affiliation(s)
- Vijay Patil
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Vanita Noronha
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Amit Joshi
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Jayita Deodhar
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Savita Goswami
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Santam Chakraborty
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Anant Ramaswamy
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Sachin Dhumal
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Chandrakanth M V
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Ashay Karpe
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Nikhil Pande
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Vikas Talreja
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Arun Chandrasekharan
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Siddharth Turkar
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
| | - Kumar Prabhash
- Vijay Patil, Vanita Noronha, Amit Joshi, Jayita Deodhar, Savita Goswami, Santam Chakraborty, Anant Ramaswamy, Sachin Dhumal, M.V. Chandrakanth, Ashay Karpe, Nikhil Pande, Vikas Talreja, Arun Chandrasekharan, Siddharth Turkar, and Kumar Prabhash, Tata Memorial Centre, Mumbai, India
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Assessment of the psychometric properties of patient-reported outcomes of depression and anxiety in systemic lupus erythematosus. Semin Arthritis Rheum 2019; 49:260-266. [DOI: 10.1016/j.semarthrit.2019.03.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/11/2019] [Accepted: 03/01/2019] [Indexed: 01/12/2023]
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Abstract
The reasons for development of chronic pain are poorly understood. Chronic postoperative pain is linked to severe acute postoperative pain. Head and neck pain is often a complex phenomenon that requires meticulous diagnosis and treatment. Institution of early multimodal analgesic regimens by multidisciplinary teams may attenuate chronic pain formation and propagation in the otolaryngologic patient.
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Affiliation(s)
- Anuj Malhotra
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, KCC 8th Floor, Box 1010, New York, NY 10029, USA
| | - Mourad Shehebar
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, KCC 8th Floor, Box 1010, New York, NY 10029, USA
| | - Yury Khelemsky
- Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, KCC 8th Floor, Box 1010, New York, NY 10029, USA; Department of Neurology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, KCC 8th Floor, Box 1010, New York, NY 10029, USA.
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Kwan A, Katz P, Touma Z. The Assessment of Anxiety and Depression and its Associated Factors in SLE. Curr Rheumatol Rev 2019; 15:90-98. [PMID: 30255761 DOI: 10.2174/1573397114666180926101513] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 07/13/2018] [Accepted: 09/23/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Depression and anxiety are common neuropsychiatric complaints in patients with Systemic Lupus Erythematosus (SLE). While numerous studies have been performed to investigate the prevalence, impact, and associated factors of depression and anxiety, current literature presents mixed results. In particular, the prevalence of anxiety and depression varies substantially between studies due to methodological limitations, and heterogeneity in defining anxiety and depression, patient selection, and metrics used. Moreover, there is a lack of studies evaluating the validity, reliability, and interpretability of commonly used screening tools for depression and anxiety in SLE patients. RESULT AND CONCLUSION Further investigations should aim to reach a consensus surrounding the role of controversial associated factors in depression and anxiety of SLE patients, while also focusing on the identification of novel factors that have not yet been highlighted in the literature.
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Affiliation(s)
- Andrew Kwan
- Queen's University, Kingston, Ontario, Canada.,University of Toronto Lupus Clinic, Toronto Western Hospital, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto, Ontario, Canada
| | - Patricia Katz
- Department of Medicine, UCSF, Philip R. Lee Institute for Health Policy Studies, St, San Francisco, CA 94117, United States
| | - Zahi Touma
- University of Toronto Lupus Clinic, Toronto Western Hospital, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto, Ontario, Canada
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Williams H, Jajja MR, Baer W, Balch GC, Maithel SK, Patel AD, Patel D, Patel SG, Stetler JL, Winer JH, Gillespie TW, Kooby DA. Perioperative anxiety and depression in patients undergoing abdominal surgery for benign or malignant disease. J Surg Oncol 2019; 120:389-396. [DOI: 10.1002/jso.25584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 04/23/2019] [Accepted: 05/24/2019] [Indexed: 11/11/2022]
Affiliation(s)
| | - Mohammad Raheel Jajja
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
| | - Wendy Baer
- Winship Cancer Institute, Emory University Atlanta Georgia
- Department of PsychiatryEmory University Atlanta Georgia
| | - Glen C. Balch
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
| | - Shishir K. Maithel
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
| | | | - Dipan Patel
- Department of SurgeryEmory University Atlanta Georgia
| | | | | | - Joshua H. Winer
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
| | - Theresa W. Gillespie
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
| | - David A. Kooby
- Department of SurgeryEmory University Atlanta Georgia
- Winship Cancer Institute, Emory University Atlanta Georgia
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Chen MN, Ho KY, Hung YN, Su CC, Kuan CH, Tai HC, Cheng NC, Lin CC. Pre-treatment quality of life as a predictor of distant metastasis-free survival and overall survival in patients with head and neck cancer who underwent free flap reconstruction. Eur J Oncol Nurs 2019; 41:1-6. [PMID: 31358241 DOI: 10.1016/j.ejon.2019.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE This study examined the prognostic associations of pre-treatment quality of life (QoL) with overall survival (OS) and distant metastasis-free survival (DFMS) among patients with head and neck cancer (HNC) who underwent free flap reconstruction. METHODS A cohort of 127 HNC patients who received free flap reconstruction between November 2010 and June 2014 at a hospital were recruited. Pre-treatment QoL was measured by the University of Washington Quality of Life Questionnaire, which contains six physical domains, including speech, swallowing, appearance, saliva, taste and chewing, as well as the six social-emotional domains of pain, activity, recreation, shoulder, mood, and anxiety. Cox regression analyses were performed. RESULTS Results showed that pre-treatment QoL was predictive of OS and DMFS. Of the domains, swallowing, chewing, speech, taste, saliva, pain and shoulder were demonstrated to be significant predictors of OS. Additionally, swallowing, chewing, speech, pain and activity were demonstrated making significant contributions to DMFS. CONCLUSION Our data supported that physical domains of pre-treatment QoL were predictors for OS and DFMS in HNC patients with free-flap reconstruction. Longitudinal studies are warranted to clarify the prognostic abilities of social-emotional domains. Information on pre-treatment QoL should be taken into account to individualize care plan for these patients, and hence prolong their survival.
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Affiliation(s)
- M N Chen
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - K Y Ho
- School of Nursing, The University of Hong Kong, HKSAR, China.
| | - Y N Hung
- School of Gerontology and Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - C C Su
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan.
| | - C H Kuan
- Graduate Institute of Clinical Research, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
| | - H C Tai
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
| | - N C Cheng
- Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
| | - C C Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; School of Nursing, The University of Hong Kong, HKSAR, China; Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong.
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Korsten LHA, Jansen F, de Haan BJF, Sent D, Cuijpers P, Leemans CR, Verdonck-de Leeuw IM. Factors associated with depression over time in head and neck cancer patients: A systematic review. Psychooncology 2019; 28:1159-1183. [PMID: 30865357 PMCID: PMC6593868 DOI: 10.1002/pon.5058] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 03/05/2019] [Accepted: 03/07/2019] [Indexed: 11/22/2022]
Abstract
Objective To systematically review the literature on factors associated with a clinical diagnosis of depression or symptoms of depression (depression) among head and neck cancer (HNC) patients. Methods The search was conducted in PubMed, PsycINFO, and CINAHL. Studies were included if they investigated factors associated with depression among HNC patients, they were of prospective or longitudinal nature, and English full text was available. The search, data extraction, and quality assessment were performed by two authors. Based on the data extraction and quality assessment, the level of evidence was determined. Results In total, 35 studies were included: 21 on factors associated with depression at a single (later) time point, 10 on the course of depression, and four on both. In total, 77 sociodemographic, lifestyle, clinical, patient‐reported outcome measures, and inflammatory factors were extracted. Regarding depression at a single time point, there was strong evidence that depression at an earlier time point was significantly associated. For all other factors, evidence was inconclusive, although evidence suggests that age, marital status, education, ethnicity, hospital/region, sleep, smoking, alcohol, surgery, treatment, tumor location, and recurrence are not important associated factors. Regarding the course of depression, we found inconclusive evidence for all factors, although evidence suggests that gender, age, chemotherapy, pain, disease stage, treatment, and tumor location are not important associated factors. Conclusion Depression at an earlier time point is significantly associated with depression later on. Several sociodemographic and clinical factors seem not to be important factors associated with depression. For other factors, further research is warranted.
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Affiliation(s)
- Laura H A Korsten
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam
| | - Femke Jansen
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam.,Department of Clinical, Neuro and Development Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam
| | - Ben J F de Haan
- Department of Medical Informatics, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam
| | - Danielle Sent
- Department of Medical Informatics, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam
| | - Pim Cuijpers
- Department of Clinical, Neuro and Development Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam
| | - C René Leemans
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology - Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam.,Department of Clinical, Neuro and Development Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam
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Alltag S, Stein J, Pabst A, Weyerer S, Werle J, Maier W, Miebach L, Scherer M, Stark A, Wiese B, Mamone S, König HH, Bock JO, Riedel-Heller SG. Unmet needs in the depressed primary care elderly and their relation to severity of depression: results from the AgeMooDe study. Aging Ment Health 2018; 22:1032-1039. [PMID: 28521552 DOI: 10.1080/13607863.2017.1328480] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This study aims at examining the distribution of unmet environmental, physical, social and psychological care needs in a sample of the oldest old primary care patients with different levels of depression severity. Furthermore, the objective of this study was to analyze the association between specific unmet care needs and severity of depression. METHOD The sample of patients aged 75 years (n = 202) and more was derived from the multicenter prospective cohort study AgeMooDe ('Late-life depression in primary care: Needs, health care utilization and costs'). Patients were assessed via structured clinical interviews containing the German version of the Camberwell Assessment of Need for the Elderly (CANE) and the German Hospital Anxiety and Depression Scale (HADS-D). Descriptive statistics, Spearman correlation coefficients and binary logistic regression analyses were computed. RESULTS Unmet needs appeared to be substantially higher in the patient group with higher levels of depression severity according to the HADS-D score. Overall, there was weak positive linear correlation between depression and CANE total unmet needs. Except of the physical unmet needs category, all other CANE care categories showed little to moderate positive linear correlations with depression according to the HADS-D score. Depression and psychological unmet needs showed the strongest of all correlations, followed by social unmet needs. The binary logistic regression analysis revealed that patients having psychological unmet needs were 4.8 times more likely diagnosed with a probable depression. CONCLUSION Systematic needs assessment, especially psychological needs, may play a crucial role in the course of prevention and effective treatment of late-life depression in the primary care context.
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Affiliation(s)
- Sophie Alltag
- a Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig , Leipzig , Germany
| | - Janine Stein
- a Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig , Leipzig , Germany
| | - Alexander Pabst
- a Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig , Leipzig , Germany
| | - Siegfried Weyerer
- b Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University , Mannheim , Germany
| | - Jochen Werle
- b Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University , Mannheim , Germany
| | - Wolfgang Maier
- c Department of Psychiatry , University of Bonn and German Center For Neurodegenerative Diseases Within the Helmholtz Association , Bonn , Germany
| | - Lisa Miebach
- c Department of Psychiatry , University of Bonn and German Center For Neurodegenerative Diseases Within the Helmholtz Association , Bonn , Germany
| | - Martin Scherer
- d Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Anne Stark
- d Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Birgitt Wiese
- e Institute For General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School , Hannover , Germany
| | - Silke Mamone
- e Institute For General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School , Hannover , Germany
| | - Hans-Helmut König
- f Department of Health Economics and Health Services Research, Hamburg Center For Health Economics , University Medical Centre Hamburg-Eppendorf, University of Hamburg , Hamburg , Germany
| | - Jens-Oliver Bock
- f Department of Health Economics and Health Services Research, Hamburg Center For Health Economics , University Medical Centre Hamburg-Eppendorf, University of Hamburg , Hamburg , Germany
| | - Steffi G Riedel-Heller
- a Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig , Leipzig , Germany
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Lee R, Molassiotis A, Rogers SN, Edwards RT, Ryder D, Slevin N. Protocol for the trismus trial-therabite versus wooden spatula in the amelioration of trismus in patients with head and neck cancer: randomised pilot study. BMJ Open 2018; 8:e021938. [PMID: 29602860 PMCID: PMC5884369 DOI: 10.1136/bmjopen-2018-021938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Patients can develop trismus from their head and neck cancer or as a result of treatment. Trismus affects the jaw muscles and makes mouth opening difficult. To potentially combat trismus, patients could undertake proactive jaw stretching exercises prior to, during and after radiotherapy, although currently these are not the standard of care. METHODS AND ANALYSIS This is a randomised, open-label, controlled, two-centre feasibility study, to assess the objective and subjective effectiveness and cost-effectiveness of therabite use compared with wooden spatula in ameliorating trismus in patients treated for stage 3 and 4 oral and oropharyngeal cancer, managed either by primary surgery followed by (chemo)radiotherapy or primary (chemo)radiotherapy. The principal objective assessment is measurement of maximum jaw opening. Assessments in all cases will be performed preradiotherapy and again at 3 and 6 months postintervention.Secondary aims of the study will be (1) to assess whether therabite or the wooden spatula intervention improves patients' quality of life, (2) reduce the level of post-treatment clinical management/healthcare use and (3) a nested qualitative study will explore the experience of the patient taking part in the intervention; data will be transcribed verbatim and analysis will be based on content analysis methods using the interview questions as the framework for examination. ETHICS AND DISSEMINATION North West Greater Manchester granted ethical approval (REC Reference 11/NW/0744). Good Clinical Practice and the Declaration of Helsinki have been adhered to. The results will be presented internationally and submitted to a peer-reviewed journal. Head and neck cancer charities and information websites will also be approached. TRIAL REGISTRATION NUMBER NCT01733797.
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Affiliation(s)
- Rana Lee
- Department of Clinical Oncology, The Christie NHS Foundation Trust Hospital, Manchester, UK
| | - Alex Molassiotis
- The School of Nursing, Hong Kong Polytechnic University, China, Hong Kong
| | - Simon N Rogers
- Evidence-Based Practice Research Centre (EPRC), Edge Hill University, Liverpool, UK
| | | | - David Ryder
- Clinical Trials Unit, The Christie NHS Foundation Trust Hospital, Manchester, UK
| | - Nick Slevin
- Department of Clinical Oncology, The Christie NHS Foundation Trust Hospital, Manchester, UK
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Cook SA, Salmon P, Hayes G, Byrne A, Fisher PL. Predictors of emotional distress a year or more after diagnosis of cancer: A systematic review of the literature. Psychooncology 2018; 27:791-801. [PMID: 29318702 PMCID: PMC5873392 DOI: 10.1002/pon.4601] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 10/27/2017] [Accepted: 11/23/2017] [Indexed: 11/12/2022]
Abstract
Objective Why some people recover emotionally after diagnosis and treatment of cancer and others do not is poorly understood. To identify factors around the time of diagnosis that predict longer‐term distress is a necessary step in developing interventions to reduce patients' vulnerability. This review identified the demographic, clinical, social, and psychological factors available at or within 3 months of diagnosis that are reliable predictors of emotional distress at least 12 months later. Methods A systematic search of literature for prospective studies addressing our research question and predicting a range of distress outcomes was conducted. Thirty‐nine papers (reporting 36 studies) were subjected to narrative synthesis of the evidence. Results There was no consistent evidence that demographic, clinical, or social factors reliably predicted longer‐term distress. Of the psychological factors examined, only baseline distress (significant in 26 of 30 relevant papers; 24 of 28 studies) and neuroticism (significant in all 5 papers/studies that examined it) consistently predicted longer‐term distress. The heterogeneity of included studies, particularly in populations studied and methodology, precluded meta‐analytic techniques. Conclusions This review supports current clinical guidance advising early assessment of distress as a marker of vulnerability to persistent problems. Additionally, neuroticism is also indicated as a useful marker of vulnerability. However, the review also highlights that more sophisticated research designs, capable of identifying the psychological processes that underlie the association between these marker variables and persistent distress, are needed before more effective early interventions can be developed.
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Affiliation(s)
- Sharon A Cook
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Peter Salmon
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Gemma Hayes
- The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Angela Byrne
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Peter L Fisher
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.,The Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK.,Nidaros DPS, Østmarka University Hospital, Trondheim, Norway
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38
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Fan CY, Chao HL, Lin CS, Huang WY, Chen CM, Lin KT, Lin CL, Kao CH. Risk of depressive disorder among patients with head and neck cancer: A nationwide population-based study. Head Neck 2017; 40:312-323. [PMID: 28963819 DOI: 10.1002/hed.24961] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 08/04/2017] [Accepted: 08/16/2017] [Indexed: 01/17/2023] Open
Affiliation(s)
- Chao-Yueh Fan
- Department of Radiation Oncology; Tri-Service General Hospital, National Defense Medical Center; Taipei Taiwan
| | - Hsing-Lung Chao
- Department of Radiation Oncology; Tri-Service General Hospital, National Defense Medical Center; Taipei Taiwan
| | - Chun-Shu Lin
- Department of Radiation Oncology; Tri-Service General Hospital, National Defense Medical Center; Taipei Taiwan
| | - Wen-Yen Huang
- Department of Radiation Oncology; Tri-Service General Hospital, National Defense Medical Center; Taipei Taiwan
| | - Chang-Ming Chen
- Department of Radiation Oncology; Tri-Service General Hospital, National Defense Medical Center; Taipei Taiwan
| | - Kuen-Tze Lin
- Department of Radiation Oncology; Tri-Service General Hospital, National Defense Medical Center; Taipei Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data; China Medical University Hospital; Taichung Taiwan
- College of Medicine; China Medical University; Taichung Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine; College of Medicine, China Medical University; Taichung Taiwan
- Department of Nuclear Medicine and PET Center; China Medical University Hospital; Taichung Taiwan
- Department of Bioinformatics and Medical Engineering; Asia University; Taichung Taiwan
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Ye Y, Bernabé DG, Salvo E, Viet CT, Ono K, Dolan JC, Janal M, Aouizerat BE, Miaskowski C, Schmidt BL. Alterations in opioid inhibition cause widespread nociception but do not affect anxiety-like behavior in oral cancer mice. Neuroscience 2017; 363:50-61. [PMID: 28673713 DOI: 10.1016/j.neuroscience.2017.06.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 06/12/2017] [Accepted: 06/21/2017] [Indexed: 01/06/2023]
Abstract
Widespread pain and anxiety are commonly reported in cancer patients. We hypothesize that cancer is accompanied by attenuation of endogenous opioid-mediated inhibition, which subsequently causes widespread pain and anxiety. To test this hypothesis we used a mouse model of oral squamous cell carcinoma (SCC) in the tongue. We found that mice with tongue SCC exhibited widespread nociceptive behaviors in addition to behaviors associated with local nociception that we reported previously. Tongue SCC mice exhibited a pattern of reduced opioid receptor expression in the spinal cord; intrathecal administration of respective mu (MOR), delta (DOR), and kappa (KOR) opioid receptor agonists reduced widespread nociception in mice, except for the fail flick assay following administration of the MOR agonist. We infer from these findings that opioid receptors contribute to widespread nociception in oral cancer mice. Despite significant nociception, mice with tongue SCC did not differ from sham mice in anxiety-like behaviors as measured by the open field assay and elevated maze. No significant differences in c-Fos staining were found in anxiety-associated brain regions in cancer relative to control mice. No correlation was found between nociceptive and anxiety-like behaviors. Moreover, opioid receptor agonists did not yield a statistically significant effect on behaviors measured in the open field and elevated maze in cancer mice. Lastly, we used an acute cancer pain model (injection of cancer supernatant into the mouse tongue) to test whether adaptation to chronic pain is responsible for the absence of greater anxiety-like behavior in cancer mice. No changes in anxiety-like behavior were observed in mice with acute cancer pain.
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Affiliation(s)
- Yi Ye
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States
| | - Daniel G Bernabé
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States
| | - Elizabeth Salvo
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States
| | - Chi T Viet
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States; Department of Oral Maxillofacial Surgery, College of Dentistry, New York University, United States
| | - Kentaro Ono
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States
| | - John C Dolan
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States; Department of Oral Maxillofacial Surgery, College of Dentistry, New York University, United States
| | - Malvin Janal
- Epidemiology and Health Promotion, College of Dentistry, New York University, United States
| | - Brad E Aouizerat
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States; Department of Oral Maxillofacial Surgery, College of Dentistry, New York University, United States
| | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California at San Francisco, San Francisco, CA, United States
| | - Brian L Schmidt
- Bluestone Center for Clinical Research, College of Dentistry, New York University, United States; Department of Oral Maxillofacial Surgery, College of Dentistry, New York University, United States.
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Wang CH, Huang LC, Yang CC, Chen CL, Chou YJ, Chen YY, Yang WC, Chen L. Short- and long-term use of medication for psychological distress after the diagnosis of cancer. Support Care Cancer 2017; 25:757-768. [PMID: 27785583 PMCID: PMC5266776 DOI: 10.1007/s00520-016-3456-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 10/10/2016] [Indexed: 11/12/2022]
Abstract
PURPOSE This study investigated the short- and long-term use of medication for psychological distress after the diagnosis of cancer. METHODS Longitudinal data from the Taiwan National Health Insurance database were used to follow 35,137 cancer patients for 2.5 years after being diagnosed in 2006 and 2007. RESULTS Among those patients who survived for at least 180 days, 20.9 % had used psychotropic medications; sedatives were the most frequently prescribed (14.3 %), followed by antidepressants (5.5 %), anxiolytics (3.6 %), and antipsychotics (2.7 %). Lung cancer, prostate cancer, and oral cancer showed a significant association with the regular use of medication in the first 180 days. Among patients who survived for at least 2.5 years, 4.8 % still used psychotropic medication on a regular basis. Lung cancer and prostate cancer were associated with such prolonged use. CONCLUSIONS This longitudinal study found that the type of cancer was significantly associated with the use of psychotropic drugs after the diagnosis was made. It provided information about the trajectory of that use and found that a small number of patients were still using those medications after 2.5 years.
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Affiliation(s)
- Cheng-Hsu Wang
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, 112, Taiwan
- Division of Hemato-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
- College of Medicine, Chang Gung University, Tao-Yuan, 333, Taiwan
| | - Lynn Chu Huang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, 350, Taiwan
| | - Chen-Chang Yang
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, 112, Taiwan
- Institute of Environmental & Occupational Health Sciences, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Clinical Toxicology & Occupational Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chi-Liang Chen
- Department of Accounting, College of Business, Chung Yuan Christian University, Chung-Li, 320, Taiwan
| | - Yiing-Jenq Chou
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, 112, Taiwan
| | - Yen-Yuan Chen
- Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei, 100, Taiwan
| | - Wei-Chih Yang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, 350, Taiwan
| | - Likwang Chen
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, 112, Taiwan.
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli, 350, Taiwan.
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Ghazali N, Roe B, Lowe D, Tandon S, Jones T, Brown J, Shaw R, Risk J, Rogers SN. Screening for distress using the distress thermometer and the University of Washington Quality of Life in post-treatment head and neck cancer survivors. Eur Arch Otorhinolaryngol 2017; 274:2253-2260. [PMID: 28168421 DOI: 10.1007/s00405-017-4474-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/18/2017] [Indexed: 03/04/2023]
Abstract
The primary aim was to determine the efficacy of the Distress Thermometer (DT) in screening for anxiety and mood problems against the University of Washington Quality of Life, version 4 (UWQOL). Secondary aims were to evaluate the association between demographic, clinical and health-related QOL variables with significant distress. Two hundred and sixty one disease-free HNC ambulatory patients attending routine follow-up clinics were prospectively recruited. Both DT and UWQOL were completed pre-consultation. Receiver operating characteristic (ROC) curve analyses of DT score for anxiety dysfunction yielded an area under the curve (AUC) of 0.877, with a sensitivity of 84% (43/51) and specificity of 76% (159/210) for a DT cut-off of ≥4; with a corresponding AUC of 0.825 for mood with sensitivity 78% (28/36) and specificity 71% (159/225). Treatment with radiotherapy and a longer consultation time were associated with significant distress (DT ≥4). Significant distress was also reported in two third of those reporting less than "Good" overall QOL. Distress levels were particularly associated with poor Social-Emotional function, more so than the association seen with poor physical function. DT is a reasonable screening tool for distress in the HNC population. The DT cut-off score ≥4 was effective in identifying those with significant distress. Significant distress is associated in survivors with poor health-related quality of life, those who received radiotherapy and patients who have longer consultation times in clinic.
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Affiliation(s)
- Naseem Ghazali
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK. .,Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK.
| | - Brenda Roe
- Faculty of Health and Social Care, Evidence-Based Practice Research Centre, Edge Hill University, Ormskirk, UK
| | - Derek Lowe
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK.,Faculty of Health and Social Care, Evidence-Based Practice Research Centre, Edge Hill University, Ormskirk, UK
| | - Sank Tandon
- ENT Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - Terry Jones
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.,ENT Unit, Aintree University Hospitals NHS Trust, Liverpool, UK
| | - James Brown
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK
| | - Richard Shaw
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.,Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK
| | - Janet Risk
- Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Simon N Rogers
- Regional Maxillofacial Unit, Aintree University Hospitals NHS Trust, Lower Lane, Liverpool, L9 7AL, UK.,Faculty of Health and Social Care, Evidence-Based Practice Research Centre, Edge Hill University, Ormskirk, UK
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Psychological management for head and neck cancer patients: United Kingdom National Multidisciplinary Guidelines. The Journal of Laryngology & Otology 2017; 130:S45-S48. [PMID: 27841113 PMCID: PMC4873900 DOI: 10.1017/s0022215116000426] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessment and interventions for the psychological management in this patient group. Recommendations • Audit of information supplied to patients and carers should be conducted on an annual basis to update and review content and media presentation. (G) • Patients and carers should be invited to discuss treatment options and relate possible outcomes to functional retention or loss to provide a patient-centred approach. (G) • Clinical staff should inspect their systems of assessment to make them sensitive enough to identify patients with psychological difficulties. (G) • Flexibility, rather than rigid formulation is required to assess patients frequently, and to allow for change in circumstances to be noted. (G) • Multidisciplinary teams should determine the supportive care services available and commission extra assistance to provide patients and carers with timely information, education or brief supportive advice. (G) • Multidisciplinary teams need to inspect specialist services for mental health interventions at structured and complex levels for the small proportion of patients with more serious, but rarer, psychological difficulties. (G) • Clinical staff at all levels should receive communication skills training to raise and maintain consultation expertise with difficult patient and/or carer interactions. (G).
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Abstract
Answer questions and earn CME/CNE Laryngeal cancer remains one of the most common tumors of the respiratory tract. Fortunately, significant advancements have been made over the past decade in the treatment of laryngeal cancer. Although surgery has been the historical mainstay for localized disease and still is an integral part of treatment, nonsurgical options like radiation and systemic therapy have emerged as viable options. In addition, in the metastatic setting, novel agents are showing promise for this patient population. The care for patients with laryngeal cancer continues to evolve and truly requires a multidisciplinary team-based approach. Unique morbidities, such as loss of natural voice, respiration, and airway protection during swallowing, are observed with this disease and require special consideration. CA Cancer J Clin 2017;67:31-50. © 2016 American Cancer Society.
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Affiliation(s)
- Conor E Steuer
- Assistant Professor, Department of Hematology Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - Mark El-Deiry
- Associate Professor, Department of Otolaryngology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - Jason R Parks
- Resident, Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - Kristin A Higgins
- Assistant Professor, Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
| | - Nabil F Saba
- Professor and Director of the Head and Neck Medical Oncology Program, Department of Hematology Oncology, Winship Cancer Institute of Emory University, Atlanta, GA
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Van Liew JR, Brock RL, Christensen AJ, Karnell LH, Pagedar NA, Funk GF. Weight loss after head and neck cancer: A dynamic relationship with depressive symptoms. Head Neck 2016; 39:370-379. [PMID: 27704695 DOI: 10.1002/hed.24601] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Weight loss and depressive symptoms are critical head and neck cancer outcomes, yet their relation over the illness course is unclear. METHODS Associations between self-reported depressive symptoms and objective weight loss across the year after head and neck cancer diagnosis were examined using growth curve modeling techniques (n = 564). RESULTS A reciprocal covariation pattern emerged-changes in depressive symptoms over time were associated with same-month changes in weight loss (t [1148] = 2.05; p = .041), and changes in weight loss were associated with same-month changes in depressive symptoms (t [556] = 2.43; p = .015). To the extent that depressive symptoms increased, patients lost incrementally more weight than was lost due to the passage of time and vice versa. Results also suggested that pain and eating-related quality of life might explain the reciprocal association between depressive symptoms and weight loss. CONCLUSION In head and neck cancer, a transactional interplay between depressive symptoms and weight loss unfolds over time. © 2016 Wiley Periodicals, Inc. Head Neck 39: 370-379, 2017.
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Affiliation(s)
- Julia R Van Liew
- Department of Psychology, The University of Iowa, Iowa City, Iowa
| | - Rebecca L Brock
- Department of Psychology, The University of Nebraska - Lincoln, Lincoln, Nebraska
| | - Alan J Christensen
- Department of Psychology, The University of Iowa, Iowa City, Iowa.,Department of Internal Medicine, The University of Iowa College of Medicine, Iowa City, Iowa
| | - Lucy Hynds Karnell
- Department of Otolaryngology - Head and Neck Surgery, The University of Iowa College of Medicine, Iowa City, Iowa
| | - Nitin A Pagedar
- Department of Otolaryngology - Head and Neck Surgery, The University of Iowa College of Medicine, Iowa City, Iowa
| | - Gerry F Funk
- Department of Otolaryngology, Grande Ronde Hospitals and Clinics, La Grande, Oregon
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Sullivan DR, Forsberg CW, Ganzini L, Au DH, Gould MK, Provenzale D, Lyons KS, Slatore CG. Depression symptom trends and health domains among lung cancer patients in the CanCORS study. Lung Cancer 2016; 100:102-109. [PMID: 27597288 PMCID: PMC5015687 DOI: 10.1016/j.lungcan.2016.08.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 08/09/2016] [Accepted: 08/14/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Among lung cancer patients depression symptoms are common and impact outcomes. The aims of this study were to determine risk factors that contribute to persistent or new onset depression symptoms during lung cancer treatment, and examine interactions between depression symptoms and health domains that influence mortality. MATERIALS AND METHODS Prospective observational study in five healthcare systems and 15 Veterans Affairs medical centers. Patients in the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium with lung cancer were eligible. The 8-item Center for Epidemiologic Studies Depression (CES-D) scale was administered at baseline and follow-up. Scores ≥4 indicated elevated depressive symptoms. Health domains were measured using validated instruments. We applied logistic regression and Cox proportional hazards modeling to explore the association between depression symptoms, health domains, and mortality. RESULTS Of 1790 participants, 38% had depression symptoms at baseline and among those still alive, 31% at follow-up. Risk factors for depression symptoms at follow-up included younger age (OR=2.81), female sex (OR=1.59), low income (OR=1.45), not being married (OR=1.74) and current smoking status (OR=1.80); high school education was associated with reduced odds of depression symptoms at follow-up, compared with lesser educational attainment (OR=0.74) (all p values <0.05). Patients with depression symptoms had worse health-related quality of life, vitality, cancer-specific symptoms, and social support than patients without depression symptoms (all p<0.001). The association between depression symptoms and increased mortality is greater among patients with more lung cancer symptoms (p=0.008) or less social support (p=0.04). CONCLUSIONS Patient risk factors for depression symptoms at follow-up were identified and these subgroups should be targeted for enhanced surveillance. Patients with depression symptoms suffer across all health domains; however, only more lung cancer symptoms or less social support are associated with worse mortality among these patients. These potentially modifiable health domains suggest targets for possible intervention in future studies.
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Affiliation(s)
- D R Sullivan
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, United States; Health Services Research and Development, Veterans Affairs Portland Health Care System, Portland, OR, United States.
| | - C W Forsberg
- Health Services Research and Development, Veterans Affairs Portland Health Care System, Portland, OR, United States
| | - L Ganzini
- Health Services Research and Development, Veterans Affairs Portland Health Care System, Portland, OR, United States; Division of Geriatric Psychiatry, Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - D H Au
- Health Services Research and Development Service, Veterans Affairs Puget Sound Health Care System, and Department of Medicine, University of Washington, Seattle, WA, United States
| | - M K Gould
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - D Provenzale
- VA Cooperative Studies Program Epidemiology Center-Durham, Durham VA Medical Center, and Duke University, Durham, NC, United States
| | - K S Lyons
- School of Nursing, Oregon Health and Science University, Portland, OR, United States
| | - C G Slatore
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, United States; Health Services Research and Development, Veterans Affairs Portland Health Care System, Portland, OR, United States; Section of Pulmonary and Critical Care Medicine, Veterans Affairs Portland Health Care System, Portland, OR, United States
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Kelly C, Paleri V, Downs C, Shah R. Deterioration in quality of life and depressive symptoms during radiation therapy for head and neck cancer. Otolaryngol Head Neck Surg 2016; 136:108-11. [PMID: 17210344 DOI: 10.1016/j.otohns.2006.06.1278] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2006] [Accepted: 06/29/2006] [Indexed: 11/25/2022]
Abstract
OBJECTIVE: The aim of this study was to assess the quality of life and psychologic profile during radiation therapy for head and neck cancer. STUDY DESIGN AND SETTING: The University of Washington QoL instrument and the Hospital Anxiety and Depression Scale were administered to 202 patients at two or three time points during radiation therapy. RESULTS: A total of 118 (54.6%) patients completed the questionnaires at the beginning and at the end of the study. A mid-treatment dataset was also available for 67 (31.0%) patients. There was a statistically significant deterioration in composite QoL scores ( P < 0.000) and a statistically significant increase in depression ( P < 0.000). There was no difference in anxiety levels ( P = 0.276). CONCLUSION: Patients undergoing radiation are increasingly depressed as treatment progresses, with worsening QoL during the treatment. SIGNIFICANCE: This study underlines the need for good psychologic support during radiation therapy in head and neck cancer. © 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.
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Affiliation(s)
- Charles Kelly
- Northern Centre for Cancer Treatment, Newcastle upon Tyne, UK
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McCaffrey JC, Weitzner M, Kamboukas D, Haselhuhn G, Lamonde L, Booth-Jones M. Alcoholism, depression, and abnormal cognition in head and neck cancer: A pilot study. Otolaryngol Head Neck Surg 2016; 136:92-7. [PMID: 17210341 DOI: 10.1016/j.otohns.2006.06.1275] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2006] [Accepted: 06/29/2006] [Indexed: 12/01/2022]
Abstract
OBJECTIVE: To determine prevalence of alcohol abuse and dependency, depression, and cognitive impairment in presurgical head and neck cancer patients. STUDY DESIGN: Standardized testing by diagnostic interview was used to determine major depression and alcoholism. Mattis Dementia Rating Scale examined cognitive ability preoperatively. Twenty-four patients with advanced head and neck cancer participated. SETTING: University hospital. RESULTS: A total of 63.6% met criteria for alcohol abuse and 62 percent for alcohol dependence; 26.1 % of patients met criteria for major depression. Testing in multiple subsets of cognitive function demonstrated measurable deficits in both alcohol dependents and abusers. All deficits were significant when compared with population norms. CONCLUSIONS: Findings suggest that prevalence of alcohol abuse, major depression, and cognitive impairment is common in head and neck cancer patients preoperatively. Early diagnosis and management of these disorders should be considered in care of the head and neck cancer patient. © 2007 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved.
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Affiliation(s)
- Judith Czaja McCaffrey
- Department of Interdisciplinary Oncology-Head and Neck Program, H Lee Moffitt Cancer Center at University of South Florida College of Medicine, Tampa, FL 33612, USA.
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Reducing Trismus After Surgery and Radiotherapy in Oral Cancer Patients: Results of Alternative Operation Versus Traditional Operation. J Oral Maxillofac Surg 2016; 74:1072-83. [DOI: 10.1016/j.joms.2015.11.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 11/20/2015] [Accepted: 11/28/2015] [Indexed: 11/18/2022]
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Britton B, Baker A, Clover K, McElduff P, Wratten C, Carter G. Heads Up: a pilot trial of a psychological intervention to improve nutrition in head and neck cancer patients undergoing radiotherapy. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12502] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2016] [Indexed: 11/30/2022]
Affiliation(s)
- B. Britton
- Psycho-Oncology Service; Calvary Mater Newcastle; Waratah NSW Australia
- Priority Research Centre for Translational Neuroscience and Mental Health; University of Newcastle; Callaghan NSW Australia
| | - A. Baker
- School of Medicine and Public Health; University of Newcastle; Callaghan NSW Australia
| | - K. Clover
- Psycho-Oncology Service; Calvary Mater Newcastle; Waratah NSW Australia
| | - P. McElduff
- School of Medicine and Public Health; University of Newcastle; Callaghan NSW Australia
| | - C. Wratten
- Radiation Oncology Department; Calvary Mater Newcastle; Waratah NSW Australia
| | - G. Carter
- Psycho-Oncology Service; Calvary Mater Newcastle; Waratah NSW Australia
- Priority Research Centre for Translational Neuroscience and Mental Health; University of Newcastle; Callaghan NSW Australia
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