Validation of the FACT-G7 in patients with hematologic malignancies

The Evaluation of the Adjunctive Therapeutic Value of Mindfulness-Based Stress Reduction Therapy for Patients With Nasopharyngeal Carcinoma Induced Moderate Depression

BACKGROUND

Nasopharyngeal carcinoma (NPC) presents a substantial challenge for patients, impacting their physical and psychological well-being. Patients may experience moderate depression, anxiety, and reduced quality of life due to the disease and its treatments. Therefore, we retrospectively analyzed the adjunctive therapeutic potential of mindfulness-based stress reduction (MBSR) therapy for NPC patients with moderate depression.

METHODS

Psychological parameters were assessed using standardized scales, including the Hamilton Depression Scale-17 (HAMD-17), Self-Rating Depression Scale (SDS), Perceived Social Support Scale (PSSS), the Short-From-12 Health Survey (SF-12), and Mindfulness Attention Awareness Scale (MAAS). Statistical analyses were performed to compare the two groups.

RESULTS

A total of 131 patients including 67 patients with control group and 64 patients with Mindfulness-Based Stress Reduction therapy group were included. After 8 weeks of treatment, the MBSR therapy group showed significant improvements in psychological parameters, including depression, anxiety, perceived stress, quality of life, and mindfulness attention awareness (p < 0.05), compared to the control group. Additionally, the MBSR therapy group reported significantly higher overall satisfaction with treatment, willingness to recommend treatment, and perceived benefit from treatment (p < 0.05).

CONCLUSION

The study findings support the adjunctive therapeutic value of MBSR therapy in improving psychological outcomes and patient satisfaction among individuals with NPC-induced moderate depression.

Impact of an Asian Community-Based Cancer Rehabilitation Program on Health-Related Quality of Life

BACKGROUND/OBJECTIVES

Inpatient exercise-based rehabilitation has been shown to improve health-related quality of life (HRQOL) in cancer survivors. However, there is a lack of studies on the impact of community-based cancer rehabilitation programs on health-related quality of life, especially in Asian countries.

METHODS

This was a retrospective cohort study involving patients with cancer at an outpatient community-based rehabilitation center. There were 197 patients who were recruited and enrolled in a physician-led rehabilitation program which included physiotherapists, occupational therapists, nutritionists and exercise physiologists.

RESULTS

Most of the patients had a diagnosis of breast cancer (61.4%), while 76 (38.6%) had a diagnosis of other cancers. On initial assessment, we found a mean Distress Thermometer (DT) level of 3.37 (SD = 2.41) and a mean Functional Assessment of Cancer Therapy-General-7 Item Version (FACT-G7) score of 11.83 (SD = 4.01). On follow-up assessment after 3-6 months of rehabilitation, there was a significant reduction in mean DT level to 2.42 (SD = 2.25) and an improvement in mean FACT-G7 score to 13.09 (SD = 4.77). Multivariate regression analysis revealed that significant factors for improvement in FACT-G7 scores were age (p = 0.046) and number of exercise therapy sessions (p < 0.001).

CONCLUSIONS

This study demonstrates the positive impact of a community-based cancer rehabilitation program on HRQOL among cancer patients.

Patient-Reported Sexual Function, Bladder Function and Quality of Life for Patients with Low Rectal Cancers with or without a Permanent Ostomy

BACKGROUND

Despite the increasing utilization of sphincter and/or organ-preservation treatment strategies, many patients with low-lying rectal cancers require abdominoperineal resection (APR), leading to permanent ostomy. Here, we aimed to characterize overall, sexual-, and bladder-related patient-reported quality of life (QOL) for individuals with low rectal cancers. We additionally aimed to explore potential differences in patient-reported outcomes between patients with and without a permanent ostomy.

METHODS

We distributed a comprehensive survey consisting of various patient-reported outcome measures, including the FACT-G7 survey, ICIQ MLUTS/FLUTS, IIEF-5/FSFI, and a specific questionnaire for ostomy patients. Descriptive statistics and univariate comparisons were used to compared demographics, treatments, and QOL scores between patients with and without a permanent ostomy.

RESULTS

Of the 204 patients contacted, 124 (60.8%) returned completed surveys; 22 (18%) of these had a permanent ostomy at the time of survey completion. There were 25 patients with low rectal tumors (≤5 cm from the anal verge) who did not have an ostomy at the time of survey completion, of whom 13 (52%) were managed with a non-operative approach. FACTG7 scores were numerically lower (median 20.5 vs. 22, p = 0.12) for individuals with an ostomy. Sexual function measures IIEF and FSFI were also lower (worse) for individuals with ostomies, but the results were not significantly different. MLUTS and FLUTS scores were both higher in individuals with ostomies (median 11 vs. 5, p = 0.06 and median 17 vs. 5.5, p = 0.01, respectively), suggesting worse urinary function. Patient-reported ostomy-specific challenges included gastrointestinal concerns (e.g., gas, odor, diarrhea) that may affect social activities and personal relationships.

CONCLUSIONS

Despite a limited sample size, this study provides patient-centered, patient-derived data regarding long-term QOL in validated measures following treatment of low rectal cancers. Ostomies may have multidimensional negative impacts on QOL, and these findings warrant continued investigation in a prospective setting. These results may be used to inform shared decision making for individuals with low rectal cancers in both the settings of organ preservation and permanent ostomy.