Self-identity, lived experiences, and challenges of breast, cervical, and prostate cancer survivorship in Mexico: a qualitative study

Development and Validation of a Predictive Model of Prostate Screening Compliance: A Nationwide Population-Based Study

INTRODUCTION

Prostate cancer (PCa) is the second most common cancer in men worldwide, with significant incidence and mortality, particularly in Mexico, where diagnosis at advanced stages is common. Early detection through screening methods such as digital rectal examination and prostate-specific antigen testing is essential to improve outcomes. Despite current efforts, compliance with prostate screening (PS) remains low due to several barriers. This study aims to develop and validate a predictive model for PCa screening compliance in Mexican men.

MATERIALS AND METHODS

Retrospective observational design with data from the Mexican Health and Aging Study (MHAS). Participants were men aged 50-69 from three cohorts: development/internal validation, temporal validation, and external validation. Key predictors were identified using relaxed Least Absolute Shrinkage and Selection Operator (LASSO) regression, and model performance was assessed using the area under the curve (AUC) from receiver operating characteristic (ROC) analyses, along with calibration and decision curve analysis (DCA). A web nomogram was also developed.

RESULTS

The final model included seven key predictors. AUC values indicated good predictive performance: 0.783 for the training subgroup, 0.722 for the test subgroup, 0.748 for the time cohort, and 0.756 for the external cohort, with sensitivities of 73.5%. The DCA demonstrated the superior clinical utility of the model compared to the reference strategies.

CONCLUSIONS

The predictive model developed for performance to PCa screening is robust across different cohorts and highlights critical factors influencing performance. The accompanying web-based nomogram enhances clinical applicability and supports interventions aimed at improving PCa screening rates among Mexican men.

"Living With and Beyond" the Terms "Patient" and "Survivor": A Lived Experience Discussion of Terms Used by Young Adults With Cancer

OBJECTIVES

This paper explores the contexts and acceptability of common and emerging terms used to refer to oneself when facing cancer, including "patient," "survivor," and the newer terms "living with and beyond" and "lived experience."

METHODS

The discussion is informed by social identity theory, literature review, advocacy work, and lived cancer experience from the authors.

RESULTS

The term "patient" is recognized for its semantic relevance and widespread usage, but also its limitations for those with chronic or metastatic cancers, and people post-treatment. "Survivor" has similar prevalence and is noted for its community-driven emergence, however it lacks consensus on its qualifying definition and invokes "struggle language" which is not readily accepted by all. These two terms are contrasted with the more recent "lived experience" and "living with and beyond" phrasing seen in America and Western Europe. These terms map onto a larger variety of individual cancer experiences and recognize the agency of the individual. However, these terms are limited by their lack of clear translation into other languages and their comparatively complex phrasing.

CONCLUSION

It is recognized that heterogeneity in patient preference for social identity-based terms in cancer will persist, but as professionals, there is a duty to acknowledge and support the development of new terms for self-identification within the cancer community, especially when it presents a potential for improved autonomy, agency, and individuality.

IMPLICATIONS FOR NURSING PRACTICE

Nurses play an important role in supporting psychological wellbeing of people with a lived cancer experience which can be facilitated through individualized approaches to cancer-specific social identity terms.

Perceptions of lifestyle-related risk communication in patients with breast and colorectal cancer: a qualitative interview study in Sweden

BACKGROUND

Informing individuals about their risk of cancer can sometimes have negative consequences, such as inflicting unnecessary worry and fostering stigma. This study aims to explore how patients diagnosed with breast or colorectal cancer perceive and experience risk communication, particularly concerning the increased focus on lifestyle behaviors as the cause of cancer.

METHODS

Semi-structured interviews were conducted during autumn 2023, with 23 Swedish individuals, aged 34 to 79 years, diagnosed with breast or colorectal cancer. The collected data were analyzed using inductive thematic analysis described by Braun & Clark. The study adopted an experiential orientation grounded in critical realism.

RESULTS

Five themes with ten sub-themes were identified: Thoughts and feelings about the causes of cancer, Moralizing messages and negative encounters, The need to take action, Balancing uncertain risks and a fulfilling life, and Societal benefits of risk communication. The participants expressed that knowledge of the the cause of cancer is closely related to the possibility of taking preventive action against relapses. Ability to take action was also perceived important for their well-being. Therefore, risk information entails both feelings of self-blame and hope for the future. Participants asked for both information and lifestyle support from healthcare professionals. Lifestyle interventions and patient support groups were solicited and perceived as an important aspect of cancer survivals' well-being, and may help to reduce the cancer-related stigma.

CONCLUSION

Individuals that have or have had breast or colorectal cancer, including those leading healthy lifestyles, found moralistic risk information offensive, leading to feelings of shame when thinking about other peoples thoughts. Balancing information involves providing transparent, evidence-based information while considering individual and social contexts, avoiding stigmatization and blame, and supplementing information with support.

Turning a Curve: How People Use Everyday Resources to Negotiate Recovery From Cancer Treatment With Curative Intent

Many more cancers are treated with intent to cure now than in previous decades, but for most, this involves significant effects from which people need to recover psychologically and socially, as well as physically. This longitudinal photo-elicitation interview study uses grounded theory to explain how people discharged from specialist care made use of everyday social and material resources to manage this process at home. Recovery is presented as a curve in life's pathway requiring gradual reorientation, drawing on social worlds and domestic resources to calibrate this process. Findings are described in three stages: (1) responding to diagnosis and treatment, (2) using social resources for meaning-making, and (3) developing assets for recovery. During treatment, participants drew on past identities to reinforce their sense of self, and personalized health care communication supported this process. In the weeks after treatment, new frameworks of understanding were constructed from perspectives on cancer encountered in the family, workplace, and outpatient clinics. Recovery processes included the negotiation of personal change, the renegotiation of close relationships, and the use of everyday resources to regain three sensations: control, comfort, and continuity. Supportive care would benefit from an individualized exploration of the assets that can help people to negotiate this challenging phase as treatment comes to a close. Possibilities for self-care (the maintenance of health and well-being in the context of everyday life) can be explored and assessed through personalized discussion around the identities, social worlds, and everyday resources available to each individual.

Women's experiences with breast cancer during diagnosis and therapy, Wolaita, Ethiopia: a qualitative study

BACKGROUND

Breast cancer is the most common cancer in women and the most frequent cancer worldwide. After being diagnosed with breast cancer, women experience unexpected and stressful events. In Ethiopia, specifically in the study area, the experiences of women with breast cancer, the challenges they face during treatment and follow-up have not been thoroughly investigated.

OBJECTIVE

This qualitative study explores the experiences of women diagnosed with breast cancer and undergoing therapy at a University-based hospital in Ethiopia.

METHODS

A qualitative research design was used, to explore the experiences of women diagnosed with breast cancer and undergoing therapy. A purposively selected sample of ten women who had been diagnosed with breast cancer and were receiving therapy was recruited. Recruitment was conducted from August 1 to September 30, 2022. Semi-structured face-to-face interviews were conducted to collect data on their experiences. The interviews were transcribed verbatim, and a thematic analysis approach was employed utilizing open coding. The coded data were then analysed to reveal important insights and understandings about the participants' experiences with breast cancer during the diagnosis and therapy journey.

RESULT

The thematic analysis of the data revealed four prominent themes: women's mixed emotions, characterized by a sense of high threat and hope upon receiving breast cancer diagnosis results; dealing with the changes, both physical and psychological, that the cancer and its treatment bring about in women's bodies and emotional well-being; dealing with the challenges associated with accessing therapy, including unfavourable hospital conditions and financial hardship; and experiencing care and supports from health care providers, family and friends, and faith-based communities.

CONCLUSION

These findings underscore the importance of providing comprehensive support and care for women with breast cancer. Enhancing the hospital environment, addressing resource shortages, and prioritising patient well-being are crucial steps towards improving the experiences of breast cancer patients in the study area.

Psychosocial experiences of breast cancer survivors: a meta-review

PURPOSE

Advances in breast cancer care have led to a high rate of survivorship. This meta-review (systematic review of reviews) assesses and synthesises the voluminous qualitative survivorship evidence-base, providing a comprehensive overview of the main themes regarding breast cancer survivorship experiences, and areas requiring further investigation.

METHODS

Sixteen breast cancer reviews identified by a previous mixed cancer survivorship meta-review were included, with additional reviews published between 1998 and 2020, and primary papers published after the last comprehensive systematic review between 2018 and 2020, identified via database searches (MEDLINE, Embase, CINAHL, PsycINFO). Quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and the CASP (Critical Appraisal Skills Programme Qualitative) checklist for primary studies. A meta-ethnographic approach was used to synthesise data.

RESULTS

Of 1673 review titles retrieved, 9 additional reviews were eligible (25 reviews included in total). Additionally, 76 individual papers were eligible from 2273 unique papers. Reviews and studies commonly focused on specific survivorship groups (including those from ethnic minorities, younger/older, or with metastatic/advanced disease), and topics (including return to work). Eight themes emerged: (1) Ongoing impact and search for normalcy, (2) Uncertainty, (3) Identity: Loss and change, (4) Isolation and being misunderstood, (5) Posttraumatic growth, (6) Return to work, (7) Quality of care, and (8) Support needs and coping strategies.

CONCLUSIONS

Breast cancer survivors continue to face challenges and require interventions to address these.

IMPLICATIONS FOR CANCER SURVIVORS

Breast cancer survivors may need to prepare for ongoing psychosocial challenges in survivorship and proactively seek support to overcome these.

How should the healthcare system support cancer survivors? Survivors' and health professionals' expectations and perception on comprehensive cancer survivorship care in Korea: a qualitative study

BACKGROUND

Qualitative research on cancer survivors' need for comprehensive cancer survivorship care within the health care system is limited. Our study aimed to understand cancer survivors' and health professionals' expectations and perceptions for developing a comprehensive cancer survivorship care system in South Korea.

METHODS

An exploratory qualitative study was conducted. A total of 16 subjects (11 cancer survivors and 5 health professionals) were purposively sampled from Regional Cancer Survivorship Centers or Cancer Survivor Clinics in Korea. In-depth semi-structured online or face-to-face interviews were conducted. Six steps of thematic analysis were used to analyze data.

RESULTS

The following four primary themes emerged from the interviews: 1) introducing a customized follow-up care system to improve continuity of survivorship care, 2) implementing educational strategies for both survivors and health professionals to manage changed health, and 3) accepting cancer survivors as companions. These three themes included a total of nine subthemes. As a result, the comprehensive survivorship model identified needs in terms of 1) changes in the medical healthcare system and core services that can accommodate the cancer survivors' condition and 2) necessary care services and social support for cancer survivors.

CONCLUSIONS

This study identified the existing gaps in Korea's current healthcare system regarding comprehensive cancer survivorship care for cancer survivors. Further research on eHealth-based counseling and educational support, the payment models of cancer survivorship care within universal health coverage, and changing social perceptions to strengthen the biopsychosocial needs of cancer survivors is needed.

The lived experiences and caring needs of women diagnosed with cervical cancer: A qualitative study in Dar es Salaam, Tanzania

BACKGROUND

Cervical cancer continues to be a major global public health concern affecting the lives of many women and resulting in financial burdens. In 2020, cervical cancer was the seventh most commonly diagnosed cancer among all cancers worldwide and Tanzania was ranked fourth among the countries with the highest incidence rates (59.1 new cases per 100,000 women) of cervical cancer. The lived experience and caring needs of patients and their families provide insights into the psychosocial aspects of healthcare among the affected population. However, there is inadequate information concerning the lived experiences of cervical cancer patients in Tanzania and Sub-Saharan Africa in general. This study aimed to explore the lived experiences and caring needs of cervical cancer patients at Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania.

METHODS

A qualitative descriptive study was carried out among cervical cancer patients at ORCI in Dar es Salaam, Tanzania. Using a purposeful sampling technique, 12 cervical cancer patients were interviewed with the principles of saturation guiding sample size determination. A semi-structured face-to-face interview guide was employed to collect the information. A conventional content analysis approach was used to analyze data after translation with the aid of NVivo 12.0 computer software.

RESULTS

Five themes emerged after data analysis: knowledge and attitude about cervical cancer, sufferings from a disease process, socio-economic disruptions, psychological problems, and sexual and reproductive concerns.

CONCLUSION

The findings of this study provide insights into the life experiences and caring needs of cervical cancer patients and call for response from healthcare stakeholders to develop and implement comprehensive and culturally consonant approaches in providing care to the affected population. More qualitative studies are required to ascertain the lived experiences of advanced cervical cancer patients and those of long-term cervical cancer survivors.

Construction of a cutoff and fusion model of breast cancer patients in family: a grounded theory study

PURPOSE

To construct a coping model for interactions between breast cancer patients and their families across the disease trajectory using the patients' voice, and to establish a mechanism for restoring family balance when faced with stresses related to breast cancer.

METHODS

This study employed a longitudinal qualitative study design using constructivist grounded theory. We divided breast cancer trajectory into four periods: suspicion, diagnosis, treatment, and rehabilitation. We then interviewed patients during each of these periods.

RESULTS

Twenty patients with breast cancer were interviewed. A cutoff and fusion model of the breast cancer patient's interactions with her family contained three coping themes: independence, coexistence, and interconversion. The coping trajectory of breast cancer patients in their families has specific themes in each period, such as anxiety, information, emotion, and experience.

CONCLUSION

We constructed a cutoff and fusion model of breast cancer patients' coping trajectory in their families. This model not only explains the opposite, coexistent, and interconvertible relationship between cutoff and fusion but also the specific challenges requiring cutoff and fusion during the four periods. Our findings highlight the dynamic balance of cutoff and fusion for patients' coping in their families.

IMPLICATIONS FOR PRACTICE

This model helps clinical staff understand the coping of breast cancer patients in their families. When providing family education, clinical staff should suggest that they not only provide support to the patient but give each other space as well.

The social and economic impacts of cervical cancer on women and children in low- and middle-income countries: A systematic review

BACKGROUND

There is limited knowledge on the social and economic impacts of a diagnosis of cervical cancer on women and children in low- and middle-income countries (LMICs).

OBJECTIVES

To determine the social and economic impacts associated with cervical cancer among women and children living in LMICs.

SEARCH STRATEGY

The MEDLINE, PsychInfo, CINAHL, Pais International, and CAB Global Health databases were systematically searched to retrieve studies up to June 2021.

SELECTION CRITERIA

Studies were included if they reported on either the social or economic impacts of women or children in a LMIC.

DATA COLLECTION AND ANALYSIS

Data was independently extracted by two co-authors. The authors performed a quality assessment on all included articles.

MAIN RESULTS

In all, 53 studies were included in the final review. Social impacts identified included social support, education, and independence. Economic impacts included employment and financial security. No study reported the economic impact on children. Studies that utilized quantitative methods typically reported more positive results than those that utilized qualitative methods.

CONCLUSIONS

Additional mixed-methods research is needed to further understand the social support needs of women with cervical cancer. Furthermore, research is needed on the impact of a mother's diagnosis of cervical cancer on her children.

Behavior change techniques in digital physical activity interventions for breast cancer survivors: a systematic review

Given the broad benefits of physical activity (PA) but low PA levels among breast cancer survivors (i.e., women who have received a breast cancer diagnosis), innovative and evidence-based techniques are needed to motivate and support exercise. This study systematically reviews the use of behavior change techniques (BCTs) in digital PA interventions for breast cancer survivors. Studies were retrieved from five electronic databases and were included if they (i) sampled exclusively female breast cancer survivors aged >18 years, (ii) involved a digital intervention with the primary purpose of increasing PA, (iii) included a BCT component, (iv) used a randomized or quasi-randomized design, and (v) were published from January 2000 to May 2022. Two coders independently extracted data. Twenty primary studies met the inclusion criteria and were included in this review. All interventions used at least one BCT (mean 4 ± 1, range 2-13); self-monitoring (85%) and goal setting (79%) were the most common BCTs. Twelve of 20 (60%) studies reported improvements in PA behavior in the intervention vs. control group, and self-monitoring and goal setting were the most commonly used BCTs in these studies. Of the 93 total BCTs, 66 were not used in any interventions in the review, including critical constructs for PA behavior change (e.g., biofeedback). BCTs, important facilitators of PA behavior change, are being underutilized in digital PA interventions for breast cancer survivors. Future research should incorporate more diverse BCTs to explore if they can add to the effectiveness of digital interventions for this population.

Vivencia de la espiritualidad en el paciente con cáncer en quimioterapia ambulatoria

Objetivo: Analizar la vivencia de la espiritualidad en el paciente con cáncer en tratamiento con quimioterapia ambulatoria. Materiales y métodos: Se realizó una investigación cualitativa con enfoque histórico hermenéutico. Participaron seis personas con diagnóstico de cáncer que se encontraban en tratamiento de quimioterapia ambulatoria en tres centros asistenciales de la ciudad de Medellín, Colombia entre julio de 2020 y julio de 2021.  La información se recolectó a través de entrevistas semiestructuradas. El proceso de análisis se realizó utilizando técnicas de la teoría fundamentada de Strauss y Corbin, tales como: microanálisis, codificación abierta, codificación axial y comparación constante. Resultado: La forma como los pacientes con cáncer en tratamiento de quimioterapia ambulatoria viven la espiritualidad se representa a través de las siguientes categorías: “Emociones vividas durante el tratamiento como impulso para seguir adelante”, “Las redes de apoyo, una fuente de fortaleza y esperanza”, “El cáncer, una prueba divina entre las limitaciones y el aprendizaje”, “La empatía del personal de salud, un mecanismo para afrontar la enfermedad y generar bienestar” y “La espiritualidad, una fuerza que cambia la perspectiva de la enfermedad”. Conclusiones: Pese a la connotación negativa del diagnóstico de cáncer, la dimensión espiritual en el paciente con cáncer en tratamiento de quimioterapia ambulatoria contribuye a que la persona vea la enfermedad desde una perspectiva positiva, aumente la fe y la esperanza para continuar luchando, le dé un sentido de que todo ha valido la pena, permite ver más allá y proporciona tranquilidad para enfrentar las adversidades ocasionadas por el cáncer.

Lived Experience of Breast Cancer Survivors: A Phenomenological Study

BACKGROUND

Breast cancer (BrCa) is the most common cancer worldwide. Five-year survival rates among individuals with BrCa are the highest of all types of cancer, yet there is a paucity of knowledge about the experiences of survivors regarding living through their diagnosis and treatment. In-depth interviews and the systematic analysis of self-reported experiences may provide in-depth information about the BrCa survivorship experience.

PURPOSE

This qualitative study was designed to identify and elucidate the lived experiences of Thai women with BrCa who successfully completed their treatment program for BrCa and/or treatment with chemotherapy for over 5 years and are currently cancer-free.

METHODS

A phenomenological method was employed. Survivors of BrCa who met the inclusion criteria were purposively selected and invited to take part in the study. Study data were collected between January and March 2019. An open-ended, in-depth interview guide was used to direct the conversation concerning the participants' experiences and perceptions. Thematic analysis was used for data analysis.

RESULTS

Data saturation was reached after 12 interviews. The five themes derived from the data include (a) being distressed, (b) accepting treatments and seeking alternative treatments, (c) going through difficult times, (d) becoming a stronger person, and (e) becoming thankful.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The experiences and themes identified enhance scholarly understanding regarding the experience of survivors of BrCa. A true understanding of this experience enables healthcare providers to craft and deliver appropriate interventions that provide quality care and improve women's health, thereby enhancing their quality of life. The results of this study may contribute to the development of new theories by using different qualitative approaches such as grounded theory.

Cancer treatment-related financial toxicity experienced by patients in low- and middle-income countries: a scoping review

PURPOSE

In the past decade, literature has called attention to financial toxicities experienced by cancer patients. Though studies have addressed research questions in high-income countries, there remains a paucity of in-depth reviews regarding low- and middle-income countries (LMICs). Our scoping review provides an overview of treatment-related financial toxicities experienced by cancer patients in LMICs.

METHODS

A systematic search was conducted in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. English peer-reviewed articles that (a) explored patients' experience with financial toxicity due to cancer treatment (b) were specific to LMICs as defined by the World Bank and (c) focused on qualitative data were included. Details regarding participants and main findings were extracted and synthesized.

RESULTS

The search yielded 6290 citations, and 42 studies across 3 low-income, 9 lower-middle-income and 8 upper-middle-income countries. Main themes identified included cancer patients encountered various material hardships, managed costs with different coping behaviours and experienced negative psychological responses to their financial burden. Higher levels of financial toxicities were associated with patient characteristics such as lower socio-economic status and lack of insurance, as well as patient outcomes such as lower quality of life.

CONCLUSION

Cancer patients in LMIC experience deleterious financial toxicities as a result of treatment. This comprehensive characterization of financial toxicities will better allow health systems to adopt evidence-based mitigation strategies to reduce the financial burden on patients.

Transitional self-disappear: the journey of cancer survivors to self re-coherence in a Middle East society

Purpose

People who experience cancer often face serious and unpleasant challenges in understanding their past, present, and future. They think they have lost their lifetime, agency, and interpersonal relationships, and no longer know their bodies. These experiences can change survivors’ perceptions of themselves. Therefore, the present study aimed to develop a deep theoretical understanding of the change of self in cancer survivors.

Methods

Semi-structured interviews were used to collect data. Interviews were conducted with 17 cancer survivors, 2 oncologists, and 2 family members of survivors. In this study, grounded theory methodology was used to explore the process of understanding and experiencing “self” in cancer survivors.

Results

The present study generated a model about the change of self, with the main concept called “transitional self-disappear,” which is understandable based on the concepts of self-disruption (temporal disruption, highlighted body, interference in the agency, individual-self disruption, over-differentiation, relational self-disruption, and painful emotional experiences), self-reconstruction strategy, and quality of self-coherence, and occurs in the context of the cancer-based socio-cultural experiences and individual-environmental preparedness.

Conclusion

This model illuminated the complex paths and roads of the survivors’ journey from self-disappear to self reconstruction/re-coherence. A healthier experience of this journey can be facilitated by the transcendence of the “self” conceptualized in the past, and the promotion of specific (cancer-based socio-cultural experiences) and general (individual-environmental preparedness) conditions.

A qualitative study on the experience of empowerment from the perspectives of breast cancer survivors

AIM

To describe the experience of empowerment for breast cancer survivors in order to increase quality of life after treatment.

DESIGN

We adopted a qualitative design in this study.

METHODS

A qualitative descriptive approach guided by interpretive description methodology as the theoretical framework was used in this study. Semi-structured group and individual interviews were conducted with eleven female Chinese breast cancer survivors (mean age 54.18 years, 100% female).

RESULTS

Many survivors reported that they continued to experience disease-related discomfort from the physiological aspect, but they use multiple ways to improve quality of life. Breast cancer survivors experienced empowerment after treatment. Empowerment mainly required three components: a belief in good health, capability of self-management and acquisition of a good social support system.

Stigma and its influencing factors among breast cancer survivors in China: A cross-sectional study

PURPOSE

Although stigma has attracted considerable scholarly attention, few studies have focused on its influencing factors among discharged breast cancer survivors, especially in a Chinese cultural context. The present study therefore explores stigma and its influencing factors among breast cancer survivors in China.

METHOD

Between December 2017 and May 2018, 103 breast cancer survivors at the outpatient clinic of a tertiary cancer center in southern China were enrolled in a cross-sectional study. The research instruments comprised the Social Impact Scale (SIS), the General Self-Efficacy Scale (GSES), the Medical Coping Modes Questionnaire (MCMQ), and sociodemographic and disease-related questionnaires. Descriptive statistics, univariate analysis, and multivariable linear regression were used to explore the current status of stigma and to identify influencing factors.

RESULTS

Of the respondents, 76.7% and 8.7%, respectively, reported moderate and high levels of stigma. The mean SIS score was 55.20 ± 12.15 (moderate), and the SIS subscale with the highest average score was financial insecurity. The results of a multivariable linear regression showed that body image (β = 0.32, P＜0.001), spousal support (β = -0.47, P < 0.001), personal acceptance of the disease (β = -0.22, P＜0.001), coping modes (resignation) (β = 0.14, P < 0.001), support from medical staff (β = -0.23, P < 0.001) and self-efficacy (β = -0.10, P = 0.037) were the main factors influencing stigma among breast cancer survivors (R² = 0.83).

CONCLUSIONS

Stigma, among breast cancer survivors, which is influenced by various sociocultural factors, is a neglected issue requiring attention. Healthcare professionals should therefore formulate effective measures for alleviating stigma in this group by improving their self-efficacy and acceptance of the disease, reducing their poor body image and negative coping mode, and eliciting more support from their spouses and medical staff.

Factors Associated with "Survivor Identity" in Men with Breast Cancer

Cancer patients vary in their comfort with the label “survivor”. Here, we explore how comfortable males with breast cancer (BC) are about accepting the label cancer “survivor”. Separate univariate logistic regressions were performed to assess whether time since diagnosis, age, treatment status, and cancer stage were associated with comfort with the “survivor” label. Of the 70 males treated for BC who participated in the study, 58% moderately-to-strongly liked the term “survivor”, 26% were neutral, and 16% moderately-to-strongly disliked the term. Of the factors we explored, only a longer time since diagnosis was significantly associated with the men endorsing a survivor identity (OR = 1.02, p = 0.05). We discuss how our findings compare with literature reports on the comfort with the label “survivor” for women with BC and men with prostate cancer. Unlike males with prostate cancer, males with BC identify as “survivors” in line with women with BC. This suggests that survivor identity is more influenced by disease type and treatments received than with sex/gender identities.

Association of supportive care needs and quality of patient-centered cancer care with depression in women with breast and cervical cancer in Mexico

OBJECTIVE

To compare the prevalence of depression, supportive care needs (SC-needs), and quality of patient-centered cancer care (PCC-quality) between women with breast cancer and women with cervical cancer and to assess the association of SC-needs and PCC-quality with depression.

METHODS

We conducted a cross-sectional survey in a public oncology hospital in Mexico City with 247 breast cancer and 165 cervical cancer ambulatory patients aged ≥18 years with at least one hospitalization and ≤5 years since diagnosis. Participants completed the short-form Supportive Care Needs Survey, the Patient-Centered Quality of Cancer Care Questionnaire, and the Hospital Anxiety and Depression Scale. We performed multiple logistic regression analyses to evaluate the association between SC-needs, PCC-quality, and probable presence of depression.

RESULTS

Nearly all women reported SC-needs-mainly health system and information needs, followed by physical and psychological needs. PCC-quality was substandard in both groups. PCC-quality was lowest when addressing biopsychosocial needs, followed by information for treatment decision-making needs. Cervical cancer patients had probable depression more often (41.2%) than those with breast cancer (29.5%). Having unmet psychological and care needs was associated with increased odds of probable depression, while high-quality timely care was associated with reduced odds of probable depression.

CONCLUSION

In Mexico, women with cervical and breast cancer face unmet SC-needs, probable depression, and substandard PCC-quality, pointing to priority areas for improvements in cancer care.