Cancer-Related Psychological Distress in Lymphoma Survivor: An Italian Cross-Sectional Study

Psychosocial interventions for post-treatment haematological cancer survivors: An integrative review

PURPOSE

To synthesize literature regarding the implementation and evaluation of psychosocial interventions designed to reduce distress in post-treatment haematological cancer survivors.

METHODS

An integrative review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases searched were Medline, Cinahl, PsychInfo, WoS, and EMBASE, during November 2022.

RESULTS

The total number of eligible studies was 14. The interventions comprised four main intervention categories: care planning, psychological therapy-based, supported self-care/self-management, and survivorship clinic visits. Overall psychosocial interventions were shown to improve outcomes for haematological cancer survivors.

CONCLUSIONS

Psychosocial interventions may play a role in reducing distress for post-treatment haematological cancer survivors and have shown improvements in both psychological and physical outcomes. However, the evidence base was limited and heterogeneous indicating the need for more research.

IMPLICATIONS FOR CANCER SURVIVORS

Psychosocial interventions for haematological cancer survivors have the potential to reduce psychosocial distress during the post-treatment period.

Survivorship preparedness and activation among survivors of lymphoma

OBJECTIVES

Taking an active role in managing post-treatment care has emerged as a key aspect of promoting a successful transition into survivorship and is associated with better patient outcomes. In this study, we focus on two key aspects of active self-management, activation and preparedness. Activation was defined as understanding one's role in the care process and having the knowledge, skill, and confidence to take on a role in managing self-care. Preparedness was defined as the extent to which individuals perceived they had sufficient information about what to expect after cancer treatments are completed. The study goal was to characterize survivorship preparedness and activation among lymphoma survivors within 5 years of treatment completion in New Jersey and examine the association of sociodemographic, medical, care transition experiences, practical concerns, and psychosocial factors with activation and preparedness.

METHODS

One hundred and one Hodgkin lymphoma or non-Hodgkin lymphoma survivors who had completed treatment within 5 years completed a survey of survivorship care experiences (response rate = 34.12%).

RESULTS

Approximately 60% of survivors reported high activation, with similar percentages for higher preparedness. Less activated survivors were significantly (p < .05) younger, married, resided in a more deprived geographic area, and reported more fatigue and information needs. Less activated survivors reported recalling that their providers were significantly (p < .05) less likely to discuss long-term side effects, psychosocial needs, risk-reducing lifestyle recommendations, and how to manage other medical concerns. Fewer care transition practices were most strongly associated with lower preparedness.

CONCLUSIONS

A significant proportion were not activated for survivorship, and both activation and preparedness were strongly associated with providers' survivorship transition practices.

IMPLICATIONS FOR CANCER SURVIVORS

Implementing programs to foster more activation and preparedness for lymphoma survivorship care would benefit from education about recommended follow-up care and healthy lifestyle practices. Providers should routinely ask about their patients' confidence and preparedness for survivorship and provide referrals for appropriate care as needed.

How I Follow Hodgkin Lymphoma in First Complete (Metabolic) Remission?

Hodgkin lymphoma is characterized by a high cure rate in the modern era of medicine regardless of stage, but patients suffer from a high risk of comorbidity associated with the administered therapy. The main aim of this review article is to assess and analyze the various comorbidities associated with Hodgkin lymphoma and address the survivorship of patients, including fertility, secondary cancers due to cardiovascular toxicity, and quality of life. Furthermore, this review explores the optimal strategy for detecting relapse. The treatment paradigm of Hodgkin lymphoma has shifted, with a paradigm shift toward achieving a high cure rate and low toxicity as a standard of care in this patient population. Checkpoint inhibitors, especially nivolumab, in combination with chemotherapy are increasingly being studied in the first line of therapy. However, their long-term toxicity remains to be assessed in longer follow-up. In conclusion, Hodgkin lymphoma survivors, regardless of their treatment, should be followed up individually by a multidisciplinary survivorship team in order to detect and properly treat the long-term side effects of therapy.

Mortality among patients with diffuse large B-cell lymphoma and mental disorders: a population-based study

BACKGROUND

Mental disorders have been reported in patients with diffuse large B-cell lymphoma (DLBCL), but studies examining their association with mortality are lacking.

METHODS

We conducted a population-based study using linked administrative health-care databases from Ontario, Canada. All patients with DLBCL 18 years of age or older treated with rituximab-based therapy between January 1, 2005, and December 31, 2017, were identified and followed until March 1, 2020. Mental disorders were defined as either preexisting or postdiagnosis (after lymphoma treatment initiation). Cox proportional hazards models were used to estimate the adjusted hazard ratio (HR) between mental disorders and 1-year and all-cause mortality while controlling for covariates.

RESULTS

We identified 10 299 patients with DLBCL. The median age of the cohort was 67 years; 46% of patients were female, and 28% had a preexisting mental disorder. At 1-year follow-up, 892 (9%) had a postdiagnosis mental disorder, and a total of 2008 (20%) patients died. Preexisting mental disorders were not associated with 1-year mortality (adjusted HR = 1.06, 95% confidence interval [CI] = 0.96 to 1.17, P = .25), but postdiagnosis disorders were (adjusted HR = 1.51, 95% CI = 1.26 to 1.82, P = .0001). During a median follow-up of 5.2 years, 2111 (22%) patients had a postdiagnosis mental disorder, and 4084 (40%) patients died. Both preexisting and postdiagnosis mental disorders were associated with worse all-cause mortality (preexisting adjusted HR = 1.12, 95% CI = 1.04 to 1.20, P = .0024; postdiagnosis adjusted HR = 1.63, 95% CI = 1.49 to 1.79, P < .0001).

CONCLUSIONS

Patients with DLBCL and mental disorders had worse short-term and long-term mortality, particularly those with postdiagnosis mental disorders. Further studies are needed to examine mental health service utilization and factors mediating the relationship between mental disorders and inferior mortality.

Trajectories of symptom severity predicts quality of life change in newly diagnosis lymphoma survivors: An initial study

OBJECTIVE

This study aimed to explore the subgroups of symptom severity and impact of their trajectories on quality of life in lymphoma survivors.

METHODS

Secondary data were analysed from a prospective study with four-time measures: before treatment (T1), during treatment (T2), treatment completion (T3) and 10 weeks after treatment (T4). Data were analysed using descriptive statistics, group-based trajectory model and generalised estimation equation.

RESULTS

Fifty nine of 61 participants completed three-time measure (mean age = 60.43 years, male-predominant). The changes in symptom severity over time were divided into two subgroups: slight-stable group (n = 54, 89%) and mild-fickle group (n = 7, 11%). Pain, tiredness and sleeping trouble were the predominant symptoms. The quality of life change in the slight-stable group was significantly better than that of the mild-fickle group (B = 13.35, SE = 3.53, p < 0.001). The overall quality of life at T2, T3 and T4 was better than it was at T1.

CONCLUSION

The different trajectories of symptom severity significantly influenced quality of life changes in lymphoma survivors. Healthcare providers must be aware that there is a group of lymphoma survivors with relatively severe symptoms when newly diagnosed, compared to the opposite. More attention must be paid to this group, in addition to providing in-time symptom management.