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Dong Y, Lu J, Wang D, Zhu M, Teng L. The Association Between Vulnerability and Taste Changes in Older Cancer Patients Undergoing Chemotherapy. Cancer Invest 2025:1-10. [PMID: 40325851 DOI: 10.1080/07357907.2025.2500495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2025] [Accepted: 04/27/2025] [Indexed: 05/07/2025]
Abstract
This study aimed to examine the association between taste changes and vulnerability in elderly cancer patients undergoing chemotherapy. A cross-sectional study was conducted among older cancer patients undergoing chemotherapy in Wuxi, China. The Chemotherapy-induced Taste Alteration Scale (CiTAS) was used to measure taste alteration. The Vulnerable Elders Survey (VES) was used to measure vulnerability status. The univariate, correlation, and hierarchical regression analyses were applied to assess the association between taste changes and vulnerability. Of 200 older cancer patients, 123 (61.5%) participants were non-vulnerable. The univariate analysis revealed significant distribution differences of vulnerability in education level, smell abnormalities, drinking history, chemotherapy cycle, and taste changes. The level of taste changes was positively correlated with vulnerability (r = 0.401, p < 0.01). Results of the regression analysis indicated that vulnerability in older cancer patients was significantly associated with higher odds of "phantogeusia and parageusia" (OR = 4.505, p < 0.001). Taste changes may be an important influencing factor of vulnerability in older cancer patients.
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Affiliation(s)
- Yajun Dong
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Jiajia Lu
- Affiliated Wuxi Fifth Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Danhui Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Min Zhu
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Liping Teng
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
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Osaki K, Morishita S, Nakano J, Inoue J, Okayama T, Suzuki K, Tanaka T, Fukushima T. Relationship between quality of life before treatment and survival in patients with hematological malignancies: A meta-analysis. Fukushima J Med Sci 2025; 71:73-84. [PMID: 39909447 PMCID: PMC12079048 DOI: 10.5387/fms.24-00042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 10/09/2024] [Indexed: 02/07/2025] Open
Abstract
This meta-analysis aimed to investigate the impact of pretreatment quality of life (QoL) on overall survival (OS) in patients with hematological malignancies. The observational studies with relationship between QoL and OS in patients undergoing either hematopoietic stem cell transplantation (HSCT) or chemotherapy were collected. Stratification by treatment was performed to examine the association between QoL and OS. Six articles were included in the analysis. Overall, significant associations with OS were observed for global QoL (hazard ratio [HR] = 1.04, 95% confidence interval [CI] = 1.01-1.08), physical QoL (HR = 1.06, 95% CI:1.02-1.10), and social QoL (HR = 1.02, 95% CI: 1.00-1.03). When stratified by treatment, HSCT showed significant associations between OS and both global QoL (HR = 1.05, 95% CI:1.00-1.11) and physical QoL (HR = 1.03, 95% CI:1.00-1.06). For chemotherapy, significant associations were also observed between OS and global QoL (HR = 1.04, 95% CI:1.00-1.09), physical QoL (HR = 1.08, 95% CI:1.00-1.17), role QoL (HR = 1.02, 95% CI:1.00-1.04), and social QoL (HR = 1.02, 95% CI:1.00-1.04). No significant associations were observed regarding emotional QoL, which was only analyzed in HSCT. The factors influencing OS may vary depending on the treatment, emphasizing the importance of recognizing QoL from the pretreatment stage.
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Affiliation(s)
- Keiichi Osaki
- Department of Rehabilitation, Panasonic Health Insurance Organization, Matsushita Memorial Hospital
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Sciences, Fukushima Medical University School of Health Science
| | - Jiro Nakano
- Faculty of Rehabilitation, Kansai Medical University
| | - Junichiro Inoue
- Division of Rehabilitation Medicine, Kobe University Hospital International Clinical Cancer Research Center
| | - Taro Okayama
- Division of Rehabilitation Medicine, Shizuoka Cancer Center
| | | | - Takashi Tanaka
- Department of Rehabilitation, Hyogo Medical University Hospital
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Liang W, Chen X, Zeng C, Zhang H, Qin H, Jiang M. The relationship between frailty and depression in Chinese elderly prostate cancer patients following radical surgery: the mediating effect of sleep disturbances. Support Care Cancer 2025; 33:315. [PMID: 40122931 DOI: 10.1007/s00520-025-09374-0] [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: 12/17/2024] [Accepted: 03/18/2025] [Indexed: 03/25/2025]
Abstract
OBJECTIVE Depression is an important factor affecting long-term outcomes in prostate cancer patients. Frailty and sleep quality are associated with depressive symptoms, but the pathways through which frailty and sleep quality affect depression remain unclear. The aim of this study was to investigate the relationship between frailty and depression in older Chinese patients after radical prostate cancer surgery and to explore whether sleep disturbances mediate the effect of frailty on depression. METHODS A cross-sectional study was conducted with 277 elderly prostate cancer patients who underwent radical prostatectomy at a tertiary oncology center in Southern China (January 2022-March 2024). Inclusion criteria required ≥ 3 months postoperative recovery. Standardized instruments were administered: FRAIL Scale for frailty assessment, Pittsburgh Sleep Quality Index (PSQI) for sleep evaluation, and PHQ-9 for depression screening, supplemented by demographic questionnaires. RESULTS Clinically relevant depressive symptoms (PHQ-9 ≥ 5) were identified in 18.4% (n = 51). Depression scores showed positive correlations with frailty (r = 0.521, p < 0.01) and negative correlations with sleep quality (r = -0.521, p < 0.01). Mediation analysis revealed frailty directly predicted depression (β = 0.349, p < 0.001) and indirectly through sleep impairment (β = 0.119, p < 0.001), with the indirect pathway accounting for 25.43% of the total effect (95% CI:0.059-0.191). CONCLUSION Elderly prostate cancer survivors exhibit heightened post-prostatectomy depression risks. Frailty acts as a dual-pathway predictor-directly exacerbating depressive symptoms and indirectly via sleep deterioration. These findings advocate for multidimensional interventions targeting frailty management and sleep optimization to improve mental health outcomes in this vulnerable cohort.
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Affiliation(s)
- Wenguang Liang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoping Chen
- Urology Department, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, People's Republic of China
- Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, People's Republic of China
| | - Cuicui Zeng
- Urology Department, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, People's Republic of China
- Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, People's Republic of China
| | - Huiting Zhang
- Nursing Department, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, People's Republic of China.
- Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, People's Republic of China.
| | - Huiying Qin
- Nursing Department, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, People's Republic of China.
- Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, People's Republic of China.
| | - Mengxiao Jiang
- Urology Department, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- State Key Laboratory of Oncology in South China, Guangzhou, 510060, People's Republic of China.
- Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, People's Republic of China.
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Lin W, Chen S, Chen J, Wang C, Lu F. Global research and emerging trends in depression in lung cancer: a bibliometric and visualized study from 2014 to 2024. Front Oncol 2025; 15:1490108. [PMID: 40110200 PMCID: PMC11919658 DOI: 10.3389/fonc.2025.1490108] [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: 09/02/2024] [Accepted: 02/18/2025] [Indexed: 03/22/2025] Open
Abstract
Background The impact of depression on the physical and psychological well-being of lung cancer patients has raised significant concerns. This study explored lung cancer-related depression research from a bibliometric perspective. Methods Articles and reviews on depression in lung cancer published from 2014 to 2024 in the Web of Science Core Collection were retrieved and identified. The information extracted included "Full Record and Cited References". Bibliometric analysis was conducted using CiteSpace and Excel to examine relevant publications in terms of country, institution, authorship, journal, citations, and keywords. Results A total of 761 publications on depression in lung cancer were identified for analysis, contributed by 4,667 authors from 305 institutions and 58 countries. The annual publication count has steadily increased, culminating in a peak in 2024. China (275 papers), Harvard University (58 publications), and Joseph A. Greer (25 publications) were the most productive and influential country, institution, and author, respectively. Jennifer S. Temel emerges as a highly influential author, securing the second position in terms of both publication count and citation impact. The journal with the highest number of publications is Supportive care in cancer, while the Journal of Clinical Oncology has garnered the most citations. Reference and keyword analysis indicated that the research hotspots mainly included 1) Epidemiology of lung cancer-related depression; 2) The deleterious impact of depression on lung cancer patients, particularly with regards to their quality of life; 3) Association between inflammation and depression in lung cancer; 4) Treatment. Conclusions Our study employed bibliometric analysis to identify prevalent focal areas and emerging trends in the field of research on lung cancer-related depression. Our study found that numerous unanswered questions persist, including the intricate relationship between lung cancer and depression, the profound impact of depression on lung cancer patients, and the interplay between inflammation and depression in this specific population. Furthermore, a current challenge in clinical practice involves the development of secure and more efficacious treatment strategies for individuals with lung cancer-related depression. These findings provide valuable guidance for scholars seeking to explore new avenues of investigation.
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Affiliation(s)
- Weilan Lin
- Respiratory Department, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- First Clinical College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Clinical Research Center for Integrative Medicine on Early Lung Cancer Diagnosis and Treatment of Fujian Province, Fuzhou, China
| | - Shun Chen
- Respiratory Department, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- First Clinical College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Clinical Research Center for Integrative Medicine on Early Lung Cancer Diagnosis and Treatment of Fujian Province, Fuzhou, China
| | - Jiawei Chen
- Respiratory Department, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Clinical Research Center for Integrative Medicine on Early Lung Cancer Diagnosis and Treatment of Fujian Province, Fuzhou, China
| | - Chune Wang
- Respiratory Department, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Clinical Research Center for Integrative Medicine on Early Lung Cancer Diagnosis and Treatment of Fujian Province, Fuzhou, China
| | - Feng Lu
- Respiratory Department, The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Clinical Research Center for Integrative Medicine on Early Lung Cancer Diagnosis and Treatment of Fujian Province, Fuzhou, China
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Woradet S, Chaimay B, Putthanachote N, Sarakarn P, Kaewmafai J. Quality of Life and Factors Associated with Quality of Life among Patients with Lung Cancer in Northeastern Thailand. Asian Pac J Cancer Prev 2025; 26:565-572. [PMID: 40022702 PMCID: PMC12118042 DOI: 10.31557/apjcp.2025.26.2.565] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2024] [Accepted: 02/09/2025] [Indexed: 03/03/2025] Open
Abstract
BACKGROUND Lung cancer is a leading cause of global morbidity and mortality, severely affecting patients' quality of life (QoL). Understanding the factors associated with QoL in these patients is crucial for improving treatment and care. This study aimed to assess QoL among lung cancer patients and identify the factors influencing it. METHODS This cross-sectional analytic study included 130 patients diagnosed with lung cancer at a tertiary facility in Northeastern Thailand. QoL was evaluated using the FACT-L interview, covering subscales such as physical, social/family, emotional, and functional well-being, as well as a lung cancer subscale, and the FACT-L Trial Outcome Index (TOI) and FACT-G. Descriptive statistics and multiple logistic regression were used for data analysis. RESULTS The majority of subjects had low overall QoL (52.31%; Mean ± SD: 45.24 ± 11.33), low FACT-L TOI (83.08%; 21.05 ± 9.21), and low FACT-G (57.69%; 35.72 ± 8.70). Subscale analysis revealed low levels of physical well-being (85.38%; 6.56 ± 3.54), emotional well-being (85.38%; 6.15 ± 3.67), and functional well-being (96.15%; 4.97 ± 3.82). However, about half of the subjects reported moderate social/family well-being (50.77%; 18.04 ± 4.17) and lung cancer subscale scores (56.15%; 9.51 ± 4.31). Multivariate analysis identified factors significantly associated with higher QoL, including age (AOR = 1.05, 95% CI: 1.01-1.10), absence of comorbidities (AOR = 3.95, 95% CI: 1.60-9.74), and absence of lymph node invasion (AOR = 4.42, 95% CI: 1.26-15.56). Conversely, sleep problems (AOR = 0.26, 95% CI: 0.08-0.81), local metastasis (AOR = 0.25, 95% CI: 0.09-0.72), and undergoing radiotherapy (AOR = 0.25, 95% CI: 0.07-0.98) were associated with lower QoL. CONCLUSIONS These findings suggest that lung cancer patients with sleep problems, local metastasis, or undergoing radiotherapy should receive intensive palliative care to improve their QoL during the end of life stage.
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Affiliation(s)
- Somkiattiyos Woradet
- Faculty of Health and Sports Science, Thaksin University, Thailand.
- ASEAN Cancer Epidemiology and Preventive Research Group (ACEP), Faculty of Public Health, Khon Kaen University, Thailand.
| | - Bhunyabhadh Chaimay
- Faculty of Health and Sports Science, Thaksin University, Thailand.
- ASEAN Cancer Epidemiology and Preventive Research Group (ACEP), Faculty of Public Health, Khon Kaen University, Thailand.
| | | | - Pongdech Sarakarn
- ASEAN Cancer Epidemiology and Preventive Research Group (ACEP), Faculty of Public Health, Khon Kaen University, Thailand.
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Thailand.
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Wang F, Nie A, Liao S, Zhang Z, Su X. Therapy-Related Symptoms and Sense of Coherence: The Mediating Role of Social Support and Hope in Lung Cancer Patients Undergoing Chemotherapy. Patient Prefer Adherence 2024; 18:2559-2568. [PMID: 39691782 PMCID: PMC11651130 DOI: 10.2147/ppa.s480306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 11/30/2024] [Indexed: 12/19/2024] Open
Abstract
Aim To investigate the current status of the sense of coherence in lung cancer patients undergoing chemotherapy and explore the mediating role of social support and hope in the relationship between therapy-related symptoms and sense of coherence. Methods We conducted a cross-sectional study to investigate lung cancer chemotherapy patients aged 18 years or older who completed at least two cycles of chemotherapy. Patients were recruited from the First Affiliated Hospital of Guangzhou Medical University's chemotherapy day ward from May to December 2023. Patients were required to complete a questionnaire that included the Sense of Coherence Scale, the Perceived Social Support Scale, the Herth Hope Index, and the Therapy-related Symptoms Checklist. The structural equation model was used to test the mediating role of social support and hope between therapy-related symptoms and the sense of coherence. Results A total of 241 patients were included. The scores of the sense of coherence, hope level, therapy-related symptoms, and social support were 68.79 ± 11.24, 38.94 ± 4.25, 11.53 ± 8.15, and 69.49 ± 8.15, respectively. Sense of coherence, social support, hope, and therapy-related symptoms were significantly related (P<0.01). Therapy-related symptoms had a direct negative influence on the sense of coherence [B=-0.144, 95% CI (-0.209, -0.070)]. Meanwhile, therapy-related symptoms influenced the sense of coherence via three pathways: independent mediation of social support [B=-0.021, 95% CI (-0.065, -0.002)], independent mediation of hope [B=-0.022, 95% CI (-0.057, -0.000)], and chain mediation of social support and hope [B=-0.012, 95% CI (-0.035, -0.002)]. Conclusion Lung cancer patients undergoing chemotherapy experience a medium sense of coherence. This study's findings indicate that the relationship between therapy-related symptoms and sense of coherence is affected by the independent mediating effect of social support and hope and the chain mediating effect of social support and hope. Therefore, reducing the burden of their therapy-related symptoms, providing them with social support, and fostering their hope can enhance patients' sense of coherence and improve their quality of life.
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Affiliation(s)
- Fang Wang
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Anliu Nie
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Shaona Liao
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Zhisheng Zhang
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
| | - Xiangfen Su
- The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People’s Republic of China
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Zhou Z, Yang Y, Sun J, Dong Y, Zhu M, Wang T, Teng L. Heterogeneity of pain-fatigue-sleep disturbance symptom clusters in lung cancer patients after chemotherapy: a latent profile analysis. Support Care Cancer 2024; 32:821. [PMID: 39589548 DOI: 10.1007/s00520-024-09032-x] [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: 09/19/2023] [Accepted: 11/18/2024] [Indexed: 11/27/2024]
Abstract
PURPOSE Pain-fatigue-sleep disturbance symptom cluster (PFS) was common in patients with lung cancer and seriously affected the life quality of patients. However, the heterogeneity and subgroups of PFS were unclear in lung cancer patients after chemotherapy. This study was conducted to identify distinct subgroups of PFS in patients with lung cancer after chemotherapy, and explore the differences and risk factors of PFS subgroups. METHODS Lung cancer patients after chemotherapy were recruited. Data were collected using the Chinese version of the Brief Pain Inventory, the Cancer Fatigue Scale, and the Pittsburgh Sleep Quality Index. The latent profile analysis (LPA) was used to identify the subgroups of PFS. Univariate analysis was used to identify the differences among all subgroups. Logistic regression and restricted cubic splines were used to investigate predictors of the PFS subgroups. RESULTS Based on LPA, 512 participants were divided into four subgroups (Class 1: low pain-fatigue-sleep disturbance; Class 2: moderate pain-moderate fatigue-low sleep disturbance, Class 3: low pain-high fatigue-high sleep disturbance, and Class 4: high pain-fatigue-sleep disturbance). The univariate analysis showed that gender, body mass index (BMI), Eastern Cooperative Oncology Group (ECOG) performance status, leukocyte, neutrophils, platelet, C-reactive protein, stress, anxiety, depression, and social support were associated with PFS. The logistic regression analysis revealed that patients in Class 2 and Class 3 were more likely to experience great stress than those in Class 1. Additionally, compared to Class 1, females, lower BMI, stress, anxiety, and depression were independent predictors of Class 4. CONCLUSION This study successfully identified subgroups of PFS in patients with lung cancer after chemotherapy. Based on the results of this study, medical workers can identify patients with high risks for PFS and conduct more targeted interventions to improve symptom management.
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Affiliation(s)
- Zhou Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Yiting Yang
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Jun Sun
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Yajun Dong
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Min Zhu
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Teng Wang
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Liping Teng
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China.
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Streck BP, Sass D, Brick R, Fisk L, Livinski AA, Guida JL. Systematic review of associations between anxiety, depression, and functional/biological aging among cancer survivors. JNCI Cancer Spectr 2024; 8:pkae100. [PMID: 39441826 PMCID: PMC11631420 DOI: 10.1093/jncics/pkae100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 08/06/2024] [Accepted: 09/06/2024] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND Evidence suggests a mind-body component to aging through which psychological distress from anxiety and depression drives molecular changes that promote early decline (ie, accelerated aging). Cancer survivors experience particularly high rates of anxiety and depression. Some survivors also have accelerated aging, though the relationships between anxiety and depression and aging are not clear. A synthesis of evidence is needed to understand the state of the science and impending priorities. METHODS PubMed, Embase, CINAHL, Web of Science, and PsycNet databases were searched for studies that measured associations between depression, anxiety, and nonchronological aging in cancer survivors (2012-2022). Data were methodologically evaluated. RESULTS Survivorship studies were included if they were peer reviewed, published in English from 2012 to 2022, and measured associations between anxiety and depression and aging. In total, 51 studies were included. Just over half were cross-sectional (53%). Foci included functional (n = 35 [69%]) and biological (n = 16 [31%]). Functional aging measures included frailty, sarcopenia, geriatric assessment, and cognition. Biological aging measures included telomere length, telomerase, age-related inflammatory blood-based biomarkers, renal insufficiency, anemia, and DNA methylation. We tested 223 associations. Associations between anxiety, depression, and aging were generally positive, though with varying strengths. Most compelling were associations between functional aging and depression. There were concerns for selection and measurement biases. CONCLUSIONS Findings suggest positive associations between anxiety, depression, and aging among cancer survivors. Future work is needed to clarify temporality, develop a consensus on the measurement of aging, and diversify cohorts.
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Affiliation(s)
- Brennan Parmelee Streck
- Basic Biobehavioral and Psychological Sciences Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD 20850, United States
| | - Dilorom Sass
- Neurooncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20814, United States
| | - Rachelle Brick
- Basic Biobehavioral and Psychological Sciences Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD 20850, United States
| | - Leah Fisk
- School of Health and Rehabilitation Sciences, Department of Occupational Therapy, The University of Pittsburgh, Pittsburgh, PA 15219, United States
| | - Alicia A Livinski
- National Institutes of Health Library, Office of Research Services, Office of the Director, National Institutes of Health, Bethesda, MD 20892, United States
| | - Jennifer L Guida
- Basic Biobehavioral and Psychological Sciences Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD 20850, United States
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Rahnea-Nita RA, Rebegea LF, Dumitru M, Mitrica RI, Nechifor A, Firescu D, Maier AC, Constantin GB, Grigorean VT, Rahnea-Nita G. Anxiety and Depression in Advanced and Metastatic Lung Cancer Patients-Correlations with Performance Status and Type of Treatment. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1472. [PMID: 39336513 PMCID: PMC11434171 DOI: 10.3390/medicina60091472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/25/2024] [Accepted: 09/04/2024] [Indexed: 09/30/2024]
Abstract
Background and Objectives: The treatment of advanced and metastatic lung cancer is multimodal, and it is coordinated by a multidisciplinary team. Anxiety and depression occur frequently in patients with lung cancer, creating considerable discomfort in therapeutic management. At the same time, these psychoemotional symptoms affect the patients' quality of life. Objective: This research seeks to identify correlations both between anxiety and depression and the patients' performance statuses, as well as between anxiety and depression and the type of treatment: radiotherapy, chemotherapy, tyrosine kinase inhibitors (TKI), immunotherapy and palliative care. Materials and Methods: The study evaluated 105 patients with lung cancer from two oncologic centers. Patients were assessed for anxiety and depression using the questionnaire Hospital Anxiety and Depression Scale (HADS). The HADS is a self-report rating scale of 14 items. It measures anxiety and depression, and has two subscales. There are seven items for each subscale. There are 4-point Likert scale ranging from 0 to 3. For each subscale, the score is the sum of the seven items, ranging from 0 to 21. Results: The most powerful correlation with statistical significance was observed between the IT type of treatment (immunotherapy) and the normal level of anxiety, PC = 0.82 (p < 0.001) as well as the normal level of depression. Palliative treatment was correlated with anxiety and depression, both borderline and abnormal. For ECOG 3-4 performance status and abnormal anxiety, respectively, abnormal depression was significantly associated. Also, continuous hospitalization was associated with abnormal anxiety and depression. Conclusions: Early assessments of anxiety and depression are necessary in patients with advanced and metastatic lung cancer, with unfavorable performance status, who have been admitted to continuous hospitalization, and who require palliative care.
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Affiliation(s)
- Roxana-Andreea Rahnea-Nita
- Clinical Department, Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
- Oncology-Palliative Care Department, "Sf. Luca" Chronic Diseases Hospital, 041915 Bucharest, Romania
| | - Laura-Florentina Rebegea
- Clinical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, 800008 Galati, Romania
- Radiotherapy Department, "Sf. Ap. Andrei" County Emergency Clinical Hospital, 800579 Galati, Romania
| | - Mihaela Dumitru
- Radiotherapy Department, "Sf. Ap. Andrei" County Emergency Clinical Hospital, 800579 Galati, Romania
| | - Radu-Iulian Mitrica
- Clinical Department, Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
- Radiotherapy Department, The Oncological Institute "Prof. Dr. Alexandru Trestioreanu", 022328 Bucharest, Romania
| | - Alexandru Nechifor
- Clinical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, 800008 Galati, Romania
| | - Dorel Firescu
- Clinical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, 800008 Galati, Romania
| | - Adrian-Cornel Maier
- Clinical Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, 800008 Galati, Romania
| | - Georgiana Bianca Constantin
- Morphological and Functional Sciences Department, Faculty of Medicine and Pharmacy, "Dunarea de Jos" University, 800008 Galati, Romania
| | - Valentin-Titus Grigorean
- Clinical Department, Faculty of Medicine, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
- Department of General Surgery, "Bagdasar-Arseni" Clinical Emergency Hospital, 041915 Bucharest, Romania
| | - Gabriela Rahnea-Nita
- Oncology-Palliative Care Department, "Sf. Luca" Chronic Diseases Hospital, 041915 Bucharest, Romania
- Clinical Department, Faculty of Midwifery and Nursing, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
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Huang J, Shi Y, Chen Y, Tang L, Zhang Z. How social support influences learned helplessness in lung cancer patients: the chain mediation role of individual resilience and self-efficacy. Front Psychol 2024; 15:1436495. [PMID: 39300997 PMCID: PMC11410703 DOI: 10.3389/fpsyg.2024.1436495] [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: 05/22/2024] [Accepted: 08/27/2024] [Indexed: 09/22/2024] Open
Abstract
Background Social support, which is a crucial external resource for cancer patients, was demonstrated to be a positive predictor of learned helplessness (LH). But it is far from clear whether and how social support decreases the LH in cancer patients. The purpose of present study is to detect the association between social support and LH and the role of individual resilience and self-efficacy in mediating this relationship. Methods The convenience sampling method was utilized. From August 2022 to February 2024, a total of 537 lung cancer patients (M age = 60.25 years, SDage = 9.85 years) from five tertiary hospitals in one municipalities (Chongqing), and two provinces (Sichuan and Yunnan) were recruited, among which 389 were males and 148 were females. LH, social support, individual resilience, and self-efficacy were assessed by using standard scales. A structural equation model was constructed employing AMOS 23.0 to examine the interrelationships among social support, individual resilience, self-efficacy, and LH of lung cancer patients. Results A total of 537 lung cancer patients were finally included. Social support, individual resilience, and self-efficacy were positively related to LH (r = -0.299 to -0.451, p < 0.01). The mediation model revealed that the direct effect of social support on LH was significant (β = -0.407, p < 0.001). Besides, social support could also affect LH through three pathways: (1) the mediating effect of individual resilience (β = -0.075, p < 0.001); (2) the mediating effect of self-efficacy (β = -0.060, p < 0.05); (3) the chain mediating effect of individual resilience and self-efficacy (β = -0.011, p < 0.05). Conclusion The results indicate that social support alleviates lung cancer patients' LH, and that individual resilience and self-efficacy mediate the correlation between social support and LH. Besides providing adequate social support, intervention strategies built on individual resilience and self-efficacy should be applied to reduce LH in lung cancer patients.
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Affiliation(s)
- Jingui Huang
- Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Yumei Shi
- Department of Medical Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Yuemei Chen
- Department of Nursing, Chongqing University Cancer Hospital, Chongqing, China
| | - Ling Tang
- Department of Nursing, Chongqing University Cancer Hospital, Chongqing, China
| | - Zhaoli Zhang
- Department of Nursing, Chongqing University Cancer Hospital, Chongqing, China
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11
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Han CJ, Rosko AE, Spakowicz DJ, Hammer MJ, Von Ah D. Associations of frailty with symptoms, and HRQOL in older cancer survivors after cancer treatments: a systematic review and meta-analyses. Qual Life Res 2024; 33:583-598. [PMID: 37897643 DOI: 10.1007/s11136-023-03537-4] [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] [Accepted: 10/03/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Frailty in older adult cancer survivors after cancer treatments is associated with various health outcomes. However, there is less agreement on how frailty affects symptoms and health-related quality of life (HRQOL). This systematic review and meta-analysis aimed to evaluate the current literature on frailty, symptoms, and HRQOL, as well as the associations of frailty with these factors in older adult cancer survivors with chemotherapy. METHODS A review was conducted on peer-reviewed publications from 2008 to 2023, using seven electronic databases. Meta-analyses were performed using random effects models to determine pooled effect estimates for frailty prevalence, symptom severity, and HRQOL scores. RESULTS A total of 26 studies involving older cancer survivors were included in the analysis. Most of these studies were conducted in Western countries and focused on White survivors, particularly those with breast cancer. The mean pooled prevalence of frailty was 43.5%. Among frail survivors, the most common symptoms reported after cancer treatments were pain (36.4%), neuropathy (34.1%), and fatigue (21.3%). Frailty was associated with higher pooled mean symptom severity (B = 1.23, p = 0.046) and lower functional HRQOL (B = - 0.31, p = 0.051, with marginal significance) after cancer treatments. CONCLUSION Frail older cancer survivors are at high risk of adverse symptoms and poor HRQOL after cancer treatment. Further research on screening for frailty is needed to prevent older adults from developing worse symptoms burden and maintain HRQOL. It is also essential to understand the mechanisms of the associations between frailty, symptoms and HRQOL in this population.
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Affiliation(s)
- Claire J Han
- Center for Healthy Aging, Self-Management and Complex Care, College of Nursing Columbus, The Ohio State University, Office 377, Newton Hall, 1585 Neil Avenue, Columbus, OH, 43210, USA.
- Cancer Survivorship and Control Survivorship, Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA.
| | - Ashley E Rosko
- Division of Hematology, The Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA
| | - Daniel J Spakowicz
- Division of Medical Oncology, Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Marilyn J Hammer
- Dana-Farber Cancer Institute, and Member of the Faculty, Medical Oncology Harvard Medical School, Boston, MA, USA
| | - Diane Von Ah
- Center for Healthy Aging, Self-Management and Complex Care, College of Nursing Columbus, The Ohio State University, Office 377, Newton Hall, 1585 Neil Avenue, Columbus, OH, 43210, USA
- Cancer Survivorship and Control Survivorship, Ohio State University-James: Cancer Treatment and Research Center, Columbus, OH, USA
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12
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Joensen MB, Lindahl-Jacobsen L, Lindahl M, Maersk JL. Making meaning of everyday life in the context of lung cancer treatment-a qualitative study of outpatients' perspectives. Scand J Occup Ther 2023; 30:1541-1551. [PMID: 37625436 DOI: 10.1080/11038128.2023.2249043] [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: 03/14/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND The increasing survival after a lung cancer diagnosis implies that patients live longer with the disease, which means that symptoms and side effects of the treatment become part of everyday life. AIM The study explored how older adults make meaning of everyday life when undergoing treatment for their lung cancer. MATERIAL AND METHODS A qualitative study using semi-structured interviews was conducted with 12 older adults with lung cancer undergoing various treatments. The analysis followed Giorgi's phenomenologic five-step method. RESULTS The analysis revealed three partly overlapping themes: meeting the health care system, losing identity, and struggling for meaning in everyday life. The patients appreciate clear and coherent communication at the oncology clinic. They had different needs for support from organised support groups, friends, communities, or relatives to make meaning of everyday life. CONCLUSION Creating meaning in everyday life is essential despite the disease and the treatments' side effects. Interpersonal relationships create meaningfulness in everyday life through a salutogenic perspective that makes everyday life comprehensible and manageable. SIGNIFICANCE The patients need an everyday life perspective on the disease and the side effects, which a salutogenic approach in the encounter with the health care system could support.
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Affiliation(s)
- Maria Bensen Joensen
- Centre for Health and Rehabilitation, University College Absalon, Slagelse, Denmark
| | | | - Marianne Lindahl
- Centre for Health and Rehabilitation, University College Absalon, Slagelse, Denmark
| | - Jesper Larsen Maersk
- Centre for Health and Rehabilitation, University College Absalon, Slagelse, Denmark
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Li Z, Qian L, Chu J, Liu Y, Maitiniyazi G, Chen Y, Cheng X, He J, Cheng L, Ou M, Wang J, Xia S. Diet Is Associated with Frailty in Lung Cancer: A Possible Role of Gut Microbiota. Nutrients 2023; 15:4298. [PMID: 37836582 PMCID: PMC10574134 DOI: 10.3390/nu15194298] [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: 09/06/2023] [Revised: 10/02/2023] [Accepted: 10/07/2023] [Indexed: 10/15/2023] Open
Abstract
This study investigated the associations between diet and frailty in lung cancer patients and the potential role of the gut microbiota involved. We assessed dietary intake and frailty status in 231 lung cancer patients by 3-day, 24-h dietary recalls and Fried frailty criteria, respectively, and collected 50 fecal samples for next-generation sequencing. A total of 75 (32.5%) patients were frail, which might be related to significantly lower intake of energy, protein, carbohydrate, dietary fiber, niacin, leucine, some minerals, and a poorer dietary quality as indicated by the Chinese Healthy Eating Index (p < 0.05). Among these, carbohydrate (OR = 0.98; 95% CI 0.96-0.99; p = 0.010), calcium (OR = 0.99; 95% CI 0.99-1.00; p = 0.025), and selenium (OR = 1.03; 95% CI 1.00-1.06; p = 0.022) were all significantly associated with frailty. A multivariate logistic regression analysis showed that the mean risk of frailty was 0.94 times lower (95% CI 0.90-0.99; p = 0.009) among participants with higher CHEI scores. Additionally, the frail patients demonstrated significantly lower gut microbiota β diversity (p = 0.001) and higher relative abundance of Actinobacteriota (p = 0.033). Frailty in lung cancer patients might be associated with insufficient nutrients intake and a poor dietary quality through gut microbiota regulation.
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Affiliation(s)
- Ziyuan Li
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Lei Qian
- Department of Rehabilitation, Wuxi Ninth People’s Hospital Affiliated to Soochow University, Wuxi 214063, China;
| | - Jianghui Chu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Jiangnan University, Wuxi 214125, China;
| | - Yuan Liu
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | | | - Yue Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Xinxin Cheng
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Jianyun He
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Lan Cheng
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Minmin Ou
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
| | - Jun Wang
- Department of Rehabilitation, Wuxi Ninth People’s Hospital Affiliated to Soochow University, Wuxi 214063, China;
| | - Shufang Xia
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (Z.L.); (Y.L.); (Y.C.); (X.C.); (J.H.); (L.C.); (M.O.)
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14
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Zhu M, Wang T, Sun J, Zhou Z, Wang D, Teng L. Heterogeneity of vulnerability and taste changes in older cancer patients undergoing chemotherapy: a latent class analysis. Support Care Cancer 2023; 31:392. [PMID: 37310497 DOI: 10.1007/s00520-023-07862-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/04/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE Taste changes and vulnerability are commonly co-occurring in oncology patients undergoing chemotherapy. However, few studies explored the association and the inter-individual variability of these two conditions. This study aimed to identify heterogeneous subtypes of vulnerability and taste changes in older cancer patients undergoing chemotherapy, and explore individuals' characteristics and risk factors. METHODS In this cross-sectional study, the latent class analysis (LCA) was conducted to identify the heterogeneous subgroups of patients with distinct vulnerability and taste change profiles. Differences in sociodemographic and clinical characteristics among the subpopulation were evaluated using parametric and nonparametric tests. Multinomial logistic regression was performed to investigate predictors of taste change-vulnerability subgroup classification. RESULTS Three subgroups of those older cancer survivors were identified from the LCA: Class 1 (27.5%)-"Moderate taste change and low vulnerability", Class 2 (29.0%)-"Low taste change and moderate vulnerability", Class 3 (43.5%)-"High taste change and high vulnerability". 98.9% of Class 3 reported taste changes and 54.0% reported vulnerability. Results from multinomial logistic regression indicated that patients in Class 3 were more likely to report experiencing mouth dryness and high blood pressure, and have received more than 3 cycles of chemotherapy. CONCLUSION The findings could provide new insights into the association between taste changes and vulnerability in older cancer adults receiving chemotherapy. Identifying different latent classes of taste changes and vulnerability would be helpful for developing interventions tailored to the heterogeneous survivors.
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Affiliation(s)
- Min Zhu
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Teng Wang
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Jun Sun
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Zhou Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Danhui Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - Liping Teng
- Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu, China.
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