Mindfulness Stress Management for Female Cancer Survivors Facing the Uncertainty of Disease Progression: A Randomized Controlled Study

Cognitive-behavioural therapy effectiveness for fear of cancer recurrence: systematic review and meta-analysis

OBJECTIVE

Fear of cancer recurrence is one of the psychological distresses for patients with cancer and cancer survivors, which poses a physical and psychological threat. There is scant evidence on the effectiveness of cognitive-behavioural therapy in reducing fear of cancer recurrence. Therefore, we conducted a systematic review and meta-analysis to assess the effectiveness of cognitive-behavioural therapy for fear of cancer recurrence.

METHOD

The review was reported according to Preferred Reporting Items for Systematic Review and Meta-analyses statement. Seven databases were systematically searched from inception to 31 March 2023. Randomised controlled trials implementing cognitive-behavioural therapy interventions and studies reporting fear of cancer recurrence were included. The methodological quality of included studies was assessed using the Cochrane Risk of Bias Tool 2.

RESULTS

A total of 32 randomised controlled trials involving 1515 cancer survivors and 1845 patients with cancer undergoing treatment were included. The meta-analysis indicated a significant effect of cognitive-behavioural therapy on fear of cancer recurrence in patients with cancer and cancer survivors compared with controls (g=-0.65; 95% CI=-0.86, -0.44; p<0.001). The results of the overall risk of bias indicated some concerns in 4 studies and a high risk in 28 studies.

CONCLUSION

The study indicated the effectiveness of cognitive-behavioural therapy intervention for fear of cancer recurrence in patients with cancer and cancer survivors, which should inform future clinical practice of interventions for the treatment of fear of cancer recurrence.

PROSPERO REGISTRATION NUMBER

CRD42023404948.

Preoperative prediction of cervical cancer survival using a high-resolution MRI-based radiomics nomogram

BACKGROUND

Cervical cancer patients receiving radiotherapy and chemotherapy require accurate survival prediction methods. The objective of this study was to develop a prognostic analysis model based on a radiomics score to predict overall survival (OS) in cervical cancer patients.

METHODS

Predictive models were developed using data from 62 cervical cancer patients who underwent radical hysterectomy between June 2020 and June 2021. Radiological features were extracted from T2-weighted (T2W), T1-weighted (T1W), and diffusion-weighted (DW) magnetic resonance images prior to treatment. We obtained the radiomics score (rad-score) using least absolute shrinkage and selection operator (LASSO) regression and Cox's proportional hazard model. We divided the patients into low- and high-risk groups according to the critical rad-score value, and generated a nomogram incorporating radiological features. We evaluated the model's prediction performance using area under the receiver operating characteristic (ROC) curve (AUC) and classified the participants into high- and low-risk groups based on radiological characteristics.

RESULTS

The 62 patients were divided into high-risk (n = 43) and low-risk (n = 19) groups based on the rad-score. Four feature parameters were selected via dimensionality reduction, and the scores were calculated after modeling. The AUC values of ROC curves for prediction of 3- and 5-year OS using the model were 0.84 and 0.93, respectively.

CONCLUSION

Our nomogram incorporating a combination of radiological features demonstrated good performance in predicting cervical cancer OS. This study highlights the potential of radiomics analysis in improving survival prediction for cervical cancer patients. However, further studies on a larger scale and external validation cohorts are necessary to validate its potential clinical utility.

Effects of Comprehensive Noise Reduction Management Combined with Reality Therapy on Anxiety and Depression in Hospitalised Patients with Breast Cancer

Objective

This study was conducted to explore the effects of comprehensive noise reduction management combined with reality therapy on anxiety and depression in hospitalised patients with breast cancer.

Methods

The medical records of 166 inpatients with breast cancer in Tongji Hospital affiliated with Tongji Medical College of Huazhong University of Science and Technology from March 2020 to March 2022 were retrospectively analysed. According to different intervention methods, these patients were divided into group A (n = 58, receiving conventional intervention), group B (n = 55, receiving conventional intervention combined with reality therapy) and group C (n = 53, receiving conventional intervention combined with comprehensive noise reduction management and reality therapy intervention). Patients' anxiety and depression, quality of life and satisfaction degree in the three groups were compared.

Results

Before the intervention, the scores of the Hospital Anxiety and Depression Scale (HADS) and Short-From-36 Health Survey (SF-36) scale did not significantly differ amongst the three groups (P > 0.05). After the intervention, we observed a difference in the pairwise comparison of HADS scores amongst the three groups, in which group C had the lowest score and group A had the highest HADS score (P < 0.001). We also noted a difference in the pairwise comparison of SF-36 scores amongst the three groups, in which group C had the highest SF-36 score and group A had the lowest SF-36 score (P < 0.001). The pairwise comparison of satisfaction revealed a difference amongst the three groups, in which group C had the highest satisfaction (92.45%, 94.34% and 94.34%), and group A had the lowest satisfaction (74.14%, 74.14% and 75.86%; P < 0.05).

Conclusion

Comprehensive noise reduction management combined with reality therapy can effectively relieve the negative emotions of inpatients with breast cancer, as well as improve their survival state of patients. It is suggested that it be included in the clinical intervention system for breast cancer.

The Comparative Effect of Reduced Mindfulness-Based Stress on Heart Rate Variability among Patients with Breast Cancer

Heart rate variability (HRV) is a powerful tool for observing interactions between the sympathetic and parasympathetic nervous systems. This study evaluated HRV during a mindfulness-based stress reduction (MBSR) program among women with breast cancer after receiving treatment. A quasi-experimental, nonrandomized design was used. Patients were allocated to usual care (n = 25) and MBSR (n = 25) groups. HRV was measured using recognized methods to assess the autonomic nervous system. Two-way ANOVA and t-tests were used to examine HRV changes between and within groups, respectively. A significant interaction effect of time with group was observed on heart rate (F (1, 96) = 4.92, p = 0.029, η2 = 0.049). A significant difference was also observed within the MBSR group preintervention and postintervention with regard to heart rate (t (24) = −3.80, p = 0.001), standard deviation of the RR interval (t (24) = 5.40, p < 0.001), root-mean-square difference in the RR interval (t (24) = 2.23, p = 0.035), and high-frequency power (t (24) = 7.73, p < 0.001). Large effect sizes for heart rate and SDNN of 0.94 and 0.85, respectively, were observed between the MBSR and usual care groups. This study provides preliminary evidence that an MBSR program may be clinically useful for facilitating parasympathetic activity associated with feelings of relaxation in treated breast cancer survivors.