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Franzoi IG, Granieri A, Sauta MD, Agnesone M, Gonella M, Grimaldi C, Vallauri I, Boglione A, Vana F, Bergnolo P, Comandone A. The psychological impact of sarcoma on affected patients. Psychooncology 2023; 32:1787-1797. [PMID: 37930090 DOI: 10.1002/pon.6240] [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: 07/10/2023] [Revised: 10/09/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE Sarcoma diagnosis and its treatment trajectory may deeply affect the somatopsychic balance of patients and their caregivers. This systematic review aimed at deepening the understanding of sarcoma's impact on the entire family unit involved in the illness experience on a physical (e.g. fatigue), psychological (e.g. mental health, affective regulation, defense mechanisms), and interpersonal (e.g. social isolation, loneliness) level. METHODS The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification and subsequent inclusion of 44 articles focused on sarcoma patients. Results were classified into seven categories: Quality of Life, worries and distress, anxiety and depression, suicide ideation, financial and occupational consequences, unmet needs, and coping strategies. Our search identified only one study focusing on informal caregivers, thus we could not perform a systematic review on these results. RESULTS Our findings underlined the traumatic impact of the sarcoma diagnosis. Patients can experience an impoverished emotional life, somatization, social withdrawal, difficulty in decision-making, increased feelings of discouragement and demoralization, and profound experiences of helplessness and vulnerability. Moreover, they seemed to display anxiety and depression and might present a higher suicide incidence than the general population. CONCLUSION Our review highlighted that the psychosocial aftermath of sarcoma patients should guide institutions and healthcare professionals toward the design of assessment and intervention models that could contemplate the different dimensions of their suffering. Furthermore, it points out that there is still a lack of evidence regarding the psychosocial impact affecting sarcoma patients' caregivers.
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Affiliation(s)
| | | | | | - Monica Agnesone
- S.S Psychology, Local Health Authority "Città di Torino", Turin, Italy
| | - Marco Gonella
- Department of Psychology, University of Turin, Turin, Italy
- S.S Psychology, Local Health Authority "Città di Torino", Turin, Italy
| | | | - Irene Vallauri
- Department of Psychology, University of Turin, Turin, Italy
| | | | - Federica Vana
- Department of Oncology, San Giovanni Bosco Hospital, Turin, Italy
| | - Paola Bergnolo
- Department of Oncology, San Giovanni Bosco Hospital, Turin, Italy
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Piątek S, Szczęsny N, Szymusik I, Karoń K, Piątkowski K, Bornio E, Bidziński M, Gujski M. Fertility-Sparing Treatment in Gestational Choriocarcinoma: Evaluating Oncological and Obstetrical Outcomes in Young Patients. Med Sci Monit 2023; 29:e942078. [PMID: 37957930 PMCID: PMC10656781 DOI: 10.12659/msm.942078] [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: 08/07/2023] [Accepted: 09/05/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Gestational choriocarcinoma (GC) is an uncommon neoplasia that occurs in women who may not have completed a procreation plan. The aim of this study was to evaluate oncological and obstetrical outcomes in young patients with GC after fertility-sparing treatment. MATERIAL AND METHODS The eligibility criteria for the study were histopathological diagnosis of GC, age ≤40 years, and treatment with systemic chemotherapy. Patients who underwent upfront hysterectomy were excluded. The response to treatment was assessed according to beta-human chorionic gonadotropin (beta-hCG) serum measurement. Complete response and progression were considered if the beta-hCG dropped to a normal range and increased (or reached a plateau), respectively. The birth rate was calculated as the number of women who gave birth after treatment divided by the total number of patients. RESULTS A total of 18 patients fulfilled the study's eligibility criteria. A complete response and progression to first-line chemotherapy were found in 13 (72.22%) and 5 (27.78%) patients, respectively. Salvage treatment was administered to patients with progression. Overall, 16 (88.88%) patients achieved complete response after treatment and 2 (11.12%) died. GC relapse was diagnosed in 1 patient 62 months after treatment. The birth rate was 22.22%, and a total of 6 children were born. All pregnancies ended in term delivery. No congenital abnormalities were detected in the newborns. CONCLUSIONS GC is a life-threatening form of gestational trophoblastic neoplasia, mainly due to its rapid course and resistance to chemotherapy. Most patients with GC will not be able to bear children after treatment.
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Affiliation(s)
- Szymon Piątek
- Department of Gynecologic Oncology, The Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Natalia Szczęsny
- Faculty of Medical Sciences and Health Sciences, Kazimierz Pułaski University of Technology and Humanities, Radom, Poland
| | - Iwona Szymusik
- Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Karolina Karoń
- Faculty of Medical Sciences and Health Sciences, Kazimierz Pułaski University of Technology and Humanities, Radom, Poland
| | - Krzysztof Piątkowski
- Faculty of Medical Sciences and Health Sciences, Kazimierz Pułaski University of Technology and Humanities, Radom, Poland
| | - Ewelina Bornio
- Faculty of Medical Sciences and Health Sciences, Kazimierz Pułaski University of Technology and Humanities, Radom, Poland
| | - Mariusz Bidziński
- Department of Gynecologic Oncology, The Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Mariusz Gujski
- Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
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Francis-Levin N, Ghazal LV, Francis-Levin J, Zebrack B, Chen M, Zhang A. Exploring the Relationship between Self-Rated Health and Unmet Cancer Needs among Sexual and Gender Minority Adolescents and Young Adults with Cancer. Curr Oncol 2023; 30:9291-9303. [PMID: 37887571 PMCID: PMC10605547 DOI: 10.3390/curroncol30100671] [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: 08/30/2023] [Revised: 10/14/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023] Open
Abstract
This study evaluates the unmet needs of sexual and gender minority (SGM) adolescent and young adult (AYA) cancer survivors by comparing SGM AYA self-rated health (SRH) scores to their non-SGM (i.e., cisgender/heterosexual) counterparts. The Cancer Needs Questionnaire-Young People (CNQ-YP) and self-rated health measures were used to assess unmet needs in AYAs aged 15-39 who had been diagnosed with cancer in the previous ten years (n = 342). Participants were recruited from a National Cancer Institute (NCI) Comprehensive Cancer Center registry using the modified Dillman's method. Self-reported sexual orientation and gender identity (SO/GI) data were collected. Independent t-tests were used to test between-group differences in unmet needs and Pearson's chi-square test was used to determine the difference in SRH scores between SGM and non-SGM AYA cancer survivors. SGM AYA cancer survivors reported greater mean needs than their non-SGM counterparts across all six domains and reported significantly greater needs in the domains of Feelings and Relationships, t(314) = -2.111, p = 0.036, Information and Activities, t(314) = -2.594, p = 0.009, and Education, t(207) = -3.289, p < 0.001. SGM versus non-SGM SRH scores were significantly different, indicating that a higher percentage of SGM AYAs reported poor/fair health compared to those who were non-SGM. Unmet life and activities needs were negatively associated with AYA cancer survivors' SRH, whereas unmet work needs were positively associated with AYA cancer survivors' SRH. An AYA's gender identity (SGM versus non-SGM) was not a moderator. SGM AYAs are an understudied group within an already vulnerable patient population. Unmet psychosocial needs related to one's feelings and relationships, and information and activity needs merit further research to develop tailored interventions that reflect the experiences of SGM AYAs.
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Affiliation(s)
- Nina Francis-Levin
- Division of Endocrinology, Metabolism & Diabetes, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Lauren V. Ghazal
- School of Nursing, University of Rochester, Rochester, NY 14642, USA;
| | - Jess Francis-Levin
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA;
| | - Bradley Zebrack
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA; (B.Z.); (M.C.)
| | - Meiyan Chen
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA; (B.Z.); (M.C.)
| | - Anao Zhang
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA; (B.Z.); (M.C.)
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Wei X, Law YW. Quality of life of services users in psychotropic drug treatment and rehabilitation services: a qualitative study from service user and provider perspectives. SOCIAL WORK IN HEALTH CARE 2023; 62:321-344. [PMID: 37555388 DOI: 10.1080/00981389.2023.2238008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 07/11/2023] [Indexed: 08/10/2023]
Abstract
Quality of life (QoL) is a widely recognized and valuable social outcome measure in drug treatment and rehabilitation services, but the discrepancies in QoL perceptions between service users and providers remain under-explored. In this study, semi-structured interviews were conducted with service users (n = 22) and providers (n = 29) to capture their perceptions of QoL and explore the similarities and discrepancies between their views. A thematic analysis and contrast exploration revealed a shared understanding of QoL that extends beyond health to six dimensions and prioritizes empowerment and connection. However, divergent views emerged regarding the priorities of material conditions, emotional well-being, and physical health. Findings underscore the importance of using shared decision-making as a strategy to effectively address these discrepancies and promote a more patient-centered approach in treatment and rehabilitation services.
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Affiliation(s)
- Xinyi Wei
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Yik Wa Law
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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Zhang A, Delly J, Meister D, Jackson Levin N, Blumenstein K, Stuchell B, Walling E. The relationship between unmet cancer care needs and self-rated health among adolescents and young adults with cancer. Support Care Cancer 2023; 31:332. [PMID: 37166532 PMCID: PMC10172720 DOI: 10.1007/s00520-023-07792-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/01/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Adolescents and young adults (AYA) with cancer face unique psychosocial challenges that often impact their outcomes, including self-rated health. To date, few studies have focused on AYA cancer survivors' multidimensional unmet needs of cancer care in relation to their health status. METHODS/PROCEDURE This study surveyed 324 AYA cancer survivors in a cross-sectional design using the Cancer Needs Questionnaire - Young People (CNQ-YP). In addition to descriptive statistics and bivariate correlations, multinomial logistic regressions were used for analysis. RESULTS AYA cancer survivors' daily life needs were found to be significantly and negatively associated with self-rated health, OR = 0.910, 95% CI 0.843, 0.983, p < 0.01, and OR = 0.888, 95% CI 0.818, 0.966, p < 0.01. In addition, the unmet work needs were significantly and positively associated with participants' self-rated health, OR = 1.207, 95% CI 1.003, 1.452, p < 0.05. CONCLUSIONS Moving beyond simply describing the unique psychosocial needs confronting AYA cancer survivors, this study empirically identified two specific dimensions of unmet needs of AYA cancer survivors that were significantly correlated to their SRH, both of which should be considered in future service and intervention research to support AYAs with cancer.
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Affiliation(s)
- Anao Zhang
- University of Michigan School of Social Work, Ann Arbor, MI, USA.
- University of Michigan Health Adolescent and Young Adult Oncology Program, Ann Arbor, MI, USA.
| | - Joseph Delly
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Dalton Meister
- University of Michigan School of Social Work, Ann Arbor, MI, USA
| | - Nina Jackson Levin
- University of Michigan School of Social Work, Ann Arbor, MI, USA
- University of Michigan Department of Anthropology, Ann Arbor, MI, USA
| | - Kate Blumenstein
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Beth Stuchell
- University of Michigan Health Adolescent and Young Adult Oncology Program, Ann Arbor, MI, USA
| | - Emily Walling
- University of Michigan Health Adolescent and Young Adult Oncology Program, Ann Arbor, MI, USA
- University of Michigan Medical School Department of Pediatrics, Ann Arbor, MI, USA
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Longpré SM, Rader NC, Dougherty KJ, Motai Y, Leinhauser KC. Factors That Influence Occupational Engagement of Young Adults Who Are Cancer Survivors: A Pilot Study. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:218-227. [PMID: 36245400 DOI: 10.1177/15394492221128779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cancer and its treatment can impact occupational engagement. However, occupational therapy-specific research studying young adult cancer survivors remains limited. The objective of this study to identify the type of occupations that young adult cancer survivors choose to engage in and to understand their decision-making process when choosing these occupations. A mixed-methods explanatory sequential design was used. Eleven participants, nine females and two males, between the ages of 18 and 35, were included. Several occupations were identified for engagement such as activities of daily living, leisure, work, sleep and rest, and health management. The predominant factor that influenced why occupations were chosen was that individuals purposefully selected occupations that allowed them to choose a path toward a more meaningful life. Information gained from this pilot study can be used to inform occupational therapy practitioners regarding services and interventions that promote occupational engagement for young adult cancer survivors.
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Affiliation(s)
| | - Nadeya C Rader
- Blanchfield Army Community Hospital, Fort Campbell, KY, USA
| | | | - Yael Motai
- Wellness Beyond Rehab, LLC, Oldsmar, FL, USA
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Day JR, Miller B, Loeffler BT, Mott SL, Tanas M, Curry M, Davick J, Milhem M, Monga V. Patient reported quality of life in young adults with sarcoma receiving care at a sarcoma center. Front Psychol 2022; 13:871254. [PMID: 36248560 PMCID: PMC9559373 DOI: 10.3389/fpsyg.2022.871254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 08/25/2022] [Indexed: 01/01/2023] Open
Abstract
Background Sarcomas are a diverse group of neoplasms that vary greatly in clinical presentation and responsiveness to treatment. Given the differences in the sites of involvement, rarity, and treatment modality, a multidisciplinary approach is required. Previous literature suggests patients with sarcoma suffer from poorer quality of life (QoL) especially physical and functional wellbeing. Adolescent and young adult (AYA) patients are an underrepresented population in cancer research and have differing factors influencing QoL. Methods Retrospective analysis of Young Adult patients (age 18-39) enrolled in the Sarcoma Tissue Repository at University of Iowa. QoL was assessed using the self-report FACT-G questionnaire at enrollment and 12 months post-diagnosis; overall scores and the 4 wellbeing subscales (Physical, Emotional, Social, Functional) were calculated. Linear mixed effects models were used to measure the association between the rate of change in FACT-G subscale scores and baseline clinical, comorbidity, and treatment characteristics. Results 49 patients were identified. 57.1% of patients had a malignancy involving an extremity. Mean FACT-G scores of overall wellbeing improved from baseline to 12 months (76.4 vs. 85.4, p < 0.01). Social and emotional wellbeing did not differ significantly between baseline and 12 months. Physical wellbeing (18.8 vs. 23.9, p < 0.01) and functional wellbeing (16.8 vs. 20.0, p< 0.01) scores improved from baseline to 12 months. No difference was seen for FACT-G overall scores for age, sex, laterality, marital status, performance status, having children, clinical stage, limb surgery, chemotherapy, or tumor size. A difference was demonstrated in physical wellbeing scores for patients with baseline limitation (ECOG 1-3) compared to those with no baseline limitation (ECOG 0) (p = 0.03). A difference was demonstrated in social wellbeing based on anatomical site (p = 0.02). Conclusion Young adults with sarcoma treated at a tertiary center had improvements in overall reported QoL at 12 months from diagnosis. Overall baseline QoL scores on FACT-G were lower than the general adult population for YA patients with sarcoma but at 12 months became in line with general population norms. The improvements seen merit further investigation to evaluate how these change over the continuum of care. Quality of life changes may be useful outcomes of interest in sarcoma trials.
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Affiliation(s)
- Jonathan R. Day
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Benjamin Miller
- Department of Orthopedics, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | | | - Sarah L. Mott
- Holden Comprehensive Cancer Center, Iowa City, IA, United States
| | - Munir Tanas
- Department of Pathology, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Melissa Curry
- Holden Comprehensive Cancer Center, Iowa City, IA, United States
| | - Jonathan Davick
- Department of Pathology, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Mohammed Milhem
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, United States
| | - Varun Monga
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, United States,*Correspondence: Varun Monga,
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Pettit T, Proffit E, Reid J, Dobinson H, Waugh V, Sue L, Vincent T, McMillan S, Hemmaway C, Kilpatrick K, Wilding E, Watson H, Ballantine K. "I Don't Have to be Sick to Still Be Worthy": The Barriers Experienced by Adolescent and Young Adult Cancer Survivors in New Zealand. J Adolesc Young Adult Oncol 2022. [PMID: 35917507 DOI: 10.1089/jayao.2022.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: To identify the spectrum and nature of survivorship barriers experienced by New Zealand's adolescent and young adult (AYA) cancer survivor population. In addition, we explore associations between survivorship barriers and sociodemographic characteristics, cancer type, and day-to-day happiness following the end of treatment. Methodology: Participants were recruited for the online survey from AYA cancer service patient databases. Eligibility criteria included: aged 12-24 years at diagnosis, diagnosed between 2010 and 2019, and completed treatment at least one year prior. The analysis focused on 11 barriers (domains, issues, or concerns) which respondents may have faced during survivorship. Results: Two hundred and eighteen AYA survivors participated in the study. The mean number of impactful survivorship barriers was 2.5 (standard deviation 1.7), with 13 respondents (6.0%) reporting no barriers of concern and 31 (14.2%) reporting 5 or more. A higher number of impactful barriers was associated with lower day-to-day happiness (r = -0.34, p ≤ 0.001). The most commonly identified impactful survivorship barriers were mental health (50.0% of respondents), physical health (43.1%), thinking and memory (33.0%), education and work (27.1%), social life (26.1%), and fertility (22.5%). Subgroup analysis identified significant differences according to gender, age at diagnosis, tumor group, ethnicity, and time since diagnosis. Poor access to health care and unmet needs were common themes. Positive impacts, particularly with regards to family relationships, were also identified. Conclusion: These results will inform initiatives to improve AYA survivorship care in New Zealand. Gaps in service delivery and funding will need to be overcome by utilizing innovative strategies and broad sector engagement.
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Affiliation(s)
- Tristan Pettit
- Children's Haematology Oncology Centre, Waipapa Hospital, Christchurch, New Zealand
| | - Ellyn Proffit
- Midland AYA Cancer Services, Waikato Hospital, Hamilton, New Zealand
| | - Julia Reid
- Department of Paediatrics and Child Health, Wellington Regional Hospital, Wellington, New Zealand
| | - Hazel Dobinson
- Department of Paediatrics and Child Health, Wellington Regional Hospital, Wellington, New Zealand
| | - Val Waugh
- Southern Blood & Cancer Service, Dunedin Hospital, Dunedin, New Zealand
| | - Louise Sue
- Canterbury AYA Cancer Services, Waipapa Hospital, Christchurch, New Zealand
| | - Tracey Vincent
- Auckland & Northland AYA Cancer Services, Auckland City Hospital, Auckland, New Zealand
| | - Simone McMillan
- Auckland & Northland AYA Cancer Services, Auckland City Hospital, Auckland, New Zealand
| | - Claire Hemmaway
- Department of Haematology, Auckland City Hospital, Auckland, New Zealand
| | - Kate Kilpatrick
- Department of Haematology, Auckland City Hospital, Auckland, New Zealand
| | - Eleanor Wilding
- Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Heidi Watson
- AYA Cancer Network Aotearoa, Auckland, New Zealand
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Recruiting Adolescent and Young Adult Cancer Survivors for Patient-Reported Outcome Research: Experiences and Sample Characteristics of the SURVAYA Study. Curr Oncol 2022; 29:5407-5425. [PMID: 36005166 PMCID: PMC9406992 DOI: 10.3390/curroncol29080428] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/13/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Participation of Adolescents and Young Adults with cancer (AYAs: 18–39 years at time of diagnosis) in patient-reported outcome studies is warranted given the limited knowledge of (long-term) physical and psychosocial health outcomes. We examined the representativeness of AYAs participating in the study, to observe the impact of various invitation methods on response rates and reasons for non-participation. Methods: A population-based, cross-sectional cohort study was performed among long-term (5–20 years) AYA cancer survivors. All participants were invited using various methods to fill in a questionnaire on their health outcomes, including enclosing a paper version of the questionnaire, and sending a reminder. Those who did not respond received a postcard in which they were asked to provide a reason for non-participation. Results: In total, 4.010 AYAs (response 36%) participated. Females, AYAs with a higher socio-economic status (SES), diagnosed more than 10 years ago, diagnosed with a central nervous system tumor, sarcoma, a lymphoid malignancy, stage III, or treated with systemic chemotherapy were more likely to participate. Including a paper questionnaire increased the response rate by 5% and sending a reminder by 13%. AYAs who did not participate were either not interested (47%) or did want to be reminded of their cancer (31%). Conclusions: Study participation was significantly lower among specific subgroups of AYA cancer survivors. Higher response rates were achieved when a paper questionnaire was included, and reminders were sent. To increase representativeness of future AYA study samples, recruitment strategies could focus on integrating patient-reported outcomes in clinical practice and involving AYA patients to promote participation in research.
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Schut ARW, Lidington E, Timbergen MJM, Younger E, van der Graaf WTA, van Houdt WJ, Bonenkamp JJ, Jones RL, Grünhagen DJ, Sleijfer S, Verhoef C, Gennatas S, Husson O. Unraveling Desmoid-Type Fibromatosis-Specific Health-Related Quality of Life: Who Is at Risk for Poor Outcomes. Cancers (Basel) 2022; 14:cancers14122979. [PMID: 35740642 PMCID: PMC9221474 DOI: 10.3390/cancers14122979] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/10/2022] [Accepted: 06/12/2022] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Desmoid-type fibromatosis (DTF) is an uncommon, non-metastasising soft-tissue tumour. Patients can experience a wide variety of disease-specific issues related to the unpredictable clinical course and aggressiveness of DTF, negatively impacting their health-related quality of life (HRQoL). Little is known about which DTF patients are particularly affected by an impaired HRQoL. In the current study, HRQoL was evaluated among different groups of DTF patients, using the EORTC QLQ-C30 and the DTF-QoL, a DTF-specific HRQoL questionnaire. Age, sex, presence of comorbidities, and type of treatment were found to be most strongly associated with DTF-specific HRQoL outcomes. In general, socio-demographic factors had the greatest impact on generic HRQoL, whereas the influence of clinical factors was mainly seen on the DTF-QoL, underlining the importance of a disease-specific questionnaire. Knowledge of the differences in DTF-specific HRQoL between subgroups can be used to individualize the HRQoL-measurement strategy for research and clinical practice. Abstract Desmoid-type fibromatosis (DTF) is a rare, soft-tissue tumour. These tumours do not metastasize, but their local aggressive tumour growth and unpredictable behaviour can have a significant impact on health-related quality of life (HRQoL). Little is known about which DTF patients are particularly affected by an impaired HRQoL. The objectives of this study were to assess HRQoL among different groups of DTF patients and to investigate which socio-demographic and clinical characteristics were associated with DTF-specific HRQoL. A cross-sectional study was conducted among DTF patients from the United Kingdom and the Netherlands. HRQoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), accompanied by the DTF-QoL to assess DTF-specific HRQoL. The scores were compared amongst subgroups, based on the socio-demographic and clinical characteristics of DTF patients. Multiple linear regression analyses with a backward elimination were conducted to identify the factors associated with DTF-specific HRQoL. A total of 235 DTF patients completed the questionnaires. Female patients, patients with more than two comorbidities, or patients who received treatment other than only active surveillance (AS) or surgery scored significantly worse on the subscales of both the EORTC QLQ-C30 and DTF-QoL. Patients that were ≥ 40 years scored significantly worse on the physical functioning scale of the EORTC QLQ-C30, while younger patients (18–39 years) scored significantly worse on several DTF-QoL subscales. Differences in the DTF-QoL subscales were found for tumour location, time since diagnosis and the presence of recurrent disease. Furthermore, treatments other than AS or surgery only, female sex, younger age and the presence of comorbidities were most frequently associated with worse scores on the DTF-QoL subscales. This study showed that (DTF-specific) HRQoL differs between groups of DTF patients. Awareness of these HRQoL differences could help to provide better, personalised care that is tailored to the needs of a specific subgroup.
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Affiliation(s)
- Anne-Rose W. Schut
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (A.-R.W.S.); (M.J.M.T.); (W.T.A.v.d.G.); (S.S.)
- Department of Surgical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (D.J.G.); (C.V.)
| | - Emma Lidington
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.L.); (E.Y.); (R.L.J.); (S.G.)
| | - Milea J. M. Timbergen
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (A.-R.W.S.); (M.J.M.T.); (W.T.A.v.d.G.); (S.S.)
- Department of Surgical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (D.J.G.); (C.V.)
| | - Eugenie Younger
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.L.); (E.Y.); (R.L.J.); (S.G.)
| | - Winette T. A. van der Graaf
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (A.-R.W.S.); (M.J.M.T.); (W.T.A.v.d.G.); (S.S.)
- Department of Medical Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
| | - Winan J. van Houdt
- Department of Surgical Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands;
| | - Johannes J. Bonenkamp
- Department of Surgical Oncology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Robin L. Jones
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.L.); (E.Y.); (R.L.J.); (S.G.)
- Division of Clinical Studies, Institute of Cancer Research, Royal Marsden NHS Foundation Trust, London SM2 5NG, UK
| | - Dirk. J. Grünhagen
- Department of Surgical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (D.J.G.); (C.V.)
| | - Stefan Sleijfer
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (A.-R.W.S.); (M.J.M.T.); (W.T.A.v.d.G.); (S.S.)
| | - Cornelis Verhoef
- Department of Surgical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (D.J.G.); (C.V.)
| | - Spyridon Gennatas
- Sarcoma Unit, Royal Marsden NHS Foundation Trust, London SW3 6JJ, UK; (E.L.); (E.Y.); (R.L.J.); (S.G.)
- Department of Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
| | - Olga Husson
- Department of Surgical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands; (D.J.G.); (C.V.)
- Department of Medical Oncology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- Division of Clinical Studies, Institute of Cancer Research, Royal Marsden NHS Foundation Trust, London SM2 5NG, UK
- Correspondence: ; Tel.: +44-2034-376-342
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Psychosocial Distress Due to Interference of Normal Developmental Milestones in AYAs with Cancer. CHILDREN 2022; 9:children9030309. [PMID: 35327680 PMCID: PMC8947616 DOI: 10.3390/children9030309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 01/19/2023]
Abstract
Cancer in the adolescent and young adult phase poses additional challenges to this period of development that is crucial to the transition to independence. This report provides a brief review of normal developmental milestones in this age range while highlighting the disruptive effects of cancer. We focus on the psychological burden of cancer in patients aged 15–39 years and explore the application of the total pain model to highlight the psychological/emotional, social, and spiritual aspects of non-physical pain. We also briefly review posttraumatic growth and resilience. Lastly, we provide a review of areas for possible development and future research.
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Symptom Profiles of Adolescents and Young Adults in Active Cancer Treatment by Diagnostic Groups. Cancer Nurs 2022; 45:306-315. [PMID: 34966060 PMCID: PMC9207147 DOI: 10.1097/ncc.0000000000001047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The symptom experience of adolescents and young adults (AYAs) with cancer can differ based on the cancer and its treatments. A dearth of information exists on how symptoms differ by individual factors such as age and gender. OBJECTIVES The objectives were to describe symptoms in AYAs across 5 cancer diagnostic groups by the individual factors of age group, sex, race/ethnicity, and time since diagnosis; and then to describe symptoms based on these individual factors within diagnostic groups. METHODS This was a secondary analysis of baseline data pooled from 2 multisite studies on symptoms in AYAs with acute lymphoblastic leukemia, brain cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, and sarcoma. Symptoms were assessed using the Computerized Symptom Capture Tool. RESULTS Data from 118 AYAs with cancer, aged 13 to 29 years, were analyzed. Eight of the most commonly reported symptoms were reported in at least 4 diagnostic groups. Across diagnostic groups, symptoms varied little based on individual factors. Within groups, certain symptoms differed in frequency by individual factors. CONCLUSIONS The lack of major differences in symptom prevalence based on individual factors across diagnostic groups supports a heterogeneous approach to symptom research with AYAs. The study identified individual factors within diagnostic groups worthy of further exploration. IMPLICATIONS FOR PRACTICE Providers can facilitate discussions with AYAs about symptoms by being aware of common symptoms that may occur in certain cancer diagnostic groups and based on individual factors. The significance of the individual symptom experience should not be underestimated, emphasizing the importance of person-centered symptom assessment.
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Adolescent and Young Adult (AYA) Cancer Survivorship Practices: An Overview. Cancers (Basel) 2021; 13:cancers13194847. [PMID: 34638332 PMCID: PMC8508173 DOI: 10.3390/cancers13194847] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/25/2021] [Accepted: 09/25/2021] [Indexed: 12/24/2022] Open
Abstract
Worldwide, more than 1.2 million adolescents and young adults (AYAs; those aged 15-39 years) are diagnosed with cancer each year. Although considerable variability exists according to cancer site and stage of disease, the 5-year relative survival at the time of diagnosis has been estimated at >80% for all AYA patients with cancer combined. Extensive survivorship research in recent decades has focused on patients diagnosed with cancer as children (<15 years) and older adults (>39 years), yet few studies to date have reported outcomes specifically for patients diagnosed as AYAs. With increasing incidence and improving survival for many tumor types, leading to the majority of AYA patients with cancer becoming long-term survivors, there is a critical need for research efforts to inform the survivorship care of this growing population. This article describes the population of AYA cancer survivors according to their epidemiology and late and long-term effects, the challenges and models of AYA survivorship care, as well as future opportunities for research and healthcare.
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