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Swartjes H, Qaderi SM, Teerenstra S, Custers JAE, Elferink MAG, van Wely BJ, Burger JWA, van Grevenstein WMU, van Duijvendijk P, Verdaasdonk EGG, de Roos MAJ, Coupé VMH, Vink GR, Verhoef C, de Wilt JHW. Towards patient-led follow-up after curative surgical resection of stage I, II and III colorectal cancer (DISTANCE-trial): a study protocol for a stepped-wedge cluster-randomised trial. BMC Cancer 2023; 23:838. [PMID: 37679735 PMCID: PMC10483744 DOI: 10.1186/s12885-023-11297-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/13/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is among the most frequently diagnosed cancers. Approximately 20-30% of stage I-III CRC patients develop a recurrent tumour or metastases after curative surgical resection. Post-operative follow-up is indicated for the first five years after curative surgical resection. As intensified follow-up after curative surgical resection has shown no effect on survival, patient organisations and policy makers have advocated for a more patient-centred approach to follow-up. The objective of this study is to successfully implement patient-led, home-based follow-up (PHFU) in six hospitals in The Netherlands, with as ultimate aim to come to a recommendation for a patient-centred follow-up schedule for stage I-III CRC patients treated with surgical resection with curative intent. METHODS This study is designed as a stepped-wedge cluster-randomised trial (SW-CRT) in six participating centres. During the trial, three centres will implement PHFU after six months; the other three centres will implement PHFU after 12 months of inclusion in the control group. Eligible patients are those with pT2-4N0M0 or pT1-4N1-2M0 CRC, who are 18 years or older and have been free of disease for 12 months after curative surgical resection. The studied intervention is PHFU, starting 12 months after curative resection. The in-hospital, standard-of-care follow-up currently implemented in the participating centres functions as the comparator. The proportion of patients who had contact with the hospital regarding CRC follow-up between 12-24 months after curative surgical resection is the primary endpoint of this study. Quality of life, fear of cancer recurrence, patient satisfaction, cost-effectiveness and survival are the secondary endpoints. DISCUSSION The results of this study will provide evidence on whether nationwide implementation of PHFU for CRC in The Netherlands will be successful in reducing contact between patient and health care provider. Comparison of PROMs between in-hospital follow-up and PHFU will be provided. Moreover, the cost-effectiveness of PHFU will be assessed. TRIAL REGISTRATION Dutch Trail Register (NTR): NL9266 (Registered on January 1st, 2021).
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Affiliation(s)
- Hidde Swartjes
- Department of Surgery, Radboud university medical center, 6500, Nijmegen, The Netherlands
| | - Seyed M Qaderi
- Department of Surgery, Radboud university medical center, 6500, Nijmegen, The Netherlands
| | - Steven Teerenstra
- Department for Health Evidence, Radboud university medical center, Nijmegen, The Netherlands
| | - Jose A E Custers
- Department of Medical Psychology, Radboud university medical center, Nijmegen, The Netherlands
| | - Marloes A G Elferink
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands
| | - Bob J van Wely
- Department of Surgery, Ziekenhuis Bernhoven, Uden, The Netherlands
| | | | | | | | | | - Marnix A J de Roos
- Department of Gastrointestinal Surgery and Surgical Oncology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Veerle M H Coupé
- Department of Epidemiology and Data Science Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Geraldine R Vink
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Cornelis Verhoef
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Johannes H W de Wilt
- Department of Surgery, Radboud university medical center, 6500, Nijmegen, The Netherlands.
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Arron MNN, Custers JAE, van Goor H, van Duijnhoven FJB, Kampman E, Kouwenhoven EA, de Wilt JHW, Kok DE. The association between anastomotic leakage and health-related quality of life after colorectal cancer surgery. Colorectal Dis 2023. [PMID: 36999516 DOI: 10.1111/codi.16543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 04/01/2023]
Abstract
AIM Colorectal anastomotic leakage (AL) is a serious complication. Studies on the impact of AL on health-related quality of life (HRQoL) are scarce. We aimed to investigate the association between AL and HRQoL in colorectal cancer patients up to 2 years after diagnosis, and to evaluate whether AL is associated with a clinically relevant decrease in HRQoL over time. METHODS Patients diagnosed with Stage I-III colorectal cancer undergoing elective surgical resection with primary anastomosis between 2010 and 2017 were included. HRQoL was evaluated using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, represented by the summary score, and analysed at diagnosis and at 6 months and 2 years post-diagnosis. Multivariable linear regression was performed to assess the association between AL and HRQoL, while multivariable logistic regression was used to investigate the association between AL and a clinically relevant HRQoL decrease (≥10 points) during follow-up compared to the time of diagnosis. RESULTS In total, 1197 patients were included of whom 63 (5%) developed AL. AL was not associated with HRQoL at 6 months post-diagnosis nor at 2 years post-diagnosis. However, having AL was associated with an increased risk of a clinically relevant decrease in HRQoL at 6 months post-diagnosis (OR 3.65, 95% CI 1.62-8.21) but not at 2 years after diagnosis (OR 1.91, 95% CI 0.62-5.93). CONCLUSION Although AL was not associated with HRQoL at 6 months or 2 years post-diagnosis, AL was a determinant of a clinically relevant decrease in HRQoL at 6 months after diagnosis. Future work should identify feasible and effective strategies to prevent declines in QoL in this patient population.
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Affiliation(s)
- Melissa N N Arron
- Department of Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Jose A E Custers
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Harry van Goor
- Department of Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | | | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | | | - Johannes H W de Wilt
- Department of Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
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Qaderi SM, van der Heijden JAG, Verhoeven RHA, de Wilt JHW, Custers JAE. Trajectories of health-related quality of life and psychological distress in patients with colorectal cancer: A population-based study. Eur J Cancer 2021; 158:144-155. [PMID: 34666216 DOI: 10.1016/j.ejca.2021.08.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/16/2021] [Accepted: 08/29/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND The aim of this nationwide cohort study was to examine the course of symptoms and trajectories of health-related quality of life (HR-QoL) and psychological distress during follow-up and to identify vulnerable patients. METHODS Patients with pathological stage I-III colorectal cancer (CRC) between 2013 and 2018 were included. Baseline characteristics were collected from the Netherlands Cancer Registry, and patients completed the European Organisation for Research and Treatment of Cancer QLQ-C30/CR29, Hospital Anxiety and Depression Scale and low anterior resection syndrome (LARS) questionnaires at the baseline and subsequently at 3, 6, 12, 18 and 24 months. Latent class growth and multinomial logistic regression analyses were performed to outline 24-month trajectories in HR-QoL and distress and to identify predictive factors. RESULTS A total of 1535 patients with colon cancer or rectal cancer were included. Trajectory analysis of HR-QoL identified three patient classes: high HR-QoL (62.7%), improving HR-QoL (29.0%) and low HR-QoL (8.3%). The following patient groups were identified with having low distress (64.0%), moderate distress (26.9%) and high distress (9.1%). Around 13% of the total cohort had either persistent low HR-QoL or high psychological distress throughout follow-up. Patients belonging to this vulnerable group were significantly more likely to be female, to be younger aged, to have lower education, to have disease stage II-III or to have major LARS. CONCLUSIONS Although most patients treated for stage I-III CRC fared well, a small but significant proportion of around 13% did not recover during follow-up and reported low HR-QoL and/or high psychological distress levels throughout. This study's findings should be taken into account when organising and selecting patients for tailored follow-up.
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Affiliation(s)
- Seyed M Qaderi
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands.
| | - Joost A G van der Heijden
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands
| | - Rob H A Verhoeven
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands; Department of Research & Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands; Amsterdam UMC, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Johannes H W de Wilt
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Surgical Oncology, Nijmegen, the Netherlands
| | - Jose A E Custers
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, Nijmegen, the Netherlands
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Van Beek FE, Wijnhoven LMA, Custers JAE, Holtmaat K, De Rooij BH, Horevoorts NJE, Aukema EJ, Verheul S, Eerenstein SEJ, Strobbe L, Van Oort IM, Vergeer MR, Prins JB, Verdonck-de Leeuw IM, Jansen F. Adjustment disorder in cancer patients after treatment: prevalence and acceptance of psychological treatment. Support Care Cancer 2021; 30:1797-1806. [PMID: 34599663 PMCID: PMC8486632 DOI: 10.1007/s00520-021-06530-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/28/2021] [Indexed: 11/03/2022]
Abstract
Purpose To investigate the prevalence of adjustment disorder (AD) among cancer patients and the acceptance of psychological treatment, in relation to sociodemographic, clinical, and psychological factors. Methods Breast, prostate, and head and neck cancer patients of all stages and treatment modalities (N = 200) participated in this observational study. Patients completed the Hospital Anxiety and Depression Scale, Checklist Individual Strength, Distress Thermometer and problem list. Patients with increased risk on AD based on these questionnaires were scheduled for a diagnostic interview. Patients diagnosed with AD were invited to participate in a randomized controlled trial on the cost-effectiveness of psychological treatment. Participation in this trial was used as a proxy of acceptance of psychological treatment. Logistic regression analyses were used to investigate associated factors. Results The overall prevalence of AD was estimated at 13.1%. Sensitivity analyses showed prevalence rates of AD of 11.5%, 15.0%, and 23.5%. Acceptance of psychological treatment was estimated at 65%. AD was associated both with being employed (OR = 3.3, CI = 1.3–8.4) and having a shorter time since diagnosis (OR = 0.3, CI = 0.1–0.8). Conclusion Taking sensitivity analysis into account, the prevalence of AD among cancer patients is estimated at 13 to 15%, and is related to being employed and having a shorter time since diagnosis. The majority of cancer patients with AD accept psychological treatment.
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Affiliation(s)
- F E Van Beek
- Department of Clinical, Neuro & Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - L M A Wijnhoven
- Department of Medical Psychology, Radboud Institute of Health Sciences, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - J A E Custers
- Department of Medical Psychology, Radboud Institute of Health Sciences, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - K Holtmaat
- Department of Clinical, Neuro & Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - B H De Rooij
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - N J E Horevoorts
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,CoRPS - Center of Research On Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - E J Aukema
- Ingeborg Douwes Centrum, Center for Psycho-Oncology, Amsterdam, The Netherlands
| | - S Verheul
- Department of Medical Psychology, CWZ Nijmegen, Nijmegen, The Netherlands
| | - S E J Eerenstein
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - L Strobbe
- Department of Oncological Surgery, CWZ Nijmegen, Amsterdam, The Netherlands
| | - I M Van Oort
- Department Urology, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - M R Vergeer
- Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC, VUmc, Amsterdam, The Netherlands
| | - J B Prins
- Department of Medical Psychology, Radboud Institute of Health Sciences, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - I M Verdonck-de Leeuw
- Department of Clinical, Neuro & Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - F Jansen
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam UMC, VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
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van der Heijden JAG, Qaderi SM, Verhoeven R, Custers JAE, Klarenbeek BR, Maaskant-Braat AJG, de Wilt JHW. Transanal total mesorectal excision and low anterior resection syndrome. Br J Surg 2021; 108:991-997. [PMID: 33837383 DOI: 10.1093/bjs/znab056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Bowel dysfunction after rectal cancer surgery is common, with some experiencing low anterior resection syndrome (LARS) is common after rectal cancer surgery. This study examined if transanal total mesorectal excision (TaTME) has a similar risk of LARS and altered quality of life (QoL) as patients who undergo low anterior resection (LAR). METHODS Patients who underwent TaTME or traditionally approached total mesorectal excision in a prospective colorectal cancer cohort study (2014-2019) were propensity score matched in a 1 : 1 ratio. LARS and QoL scores were assessed before and after surgery with a primary endpoint of major LARS at 12 months analysed for possible association between factors by logistic regression. RESULTS Of 61 TaTME and 317 LAR patients eligible, 55 from each group were propensity score matched. Higher LARS scores (30.6 versus 25.4, P = 0.010) and more major LARS (65 versus 42 per cent, P = 0.013; OR 2.64, 95 per cent c.i. 1.22 to 5.71) were reported after TaTME. Additionally, QoL score differences (body image, bowel frequency, and embarrassment) were worse in the TaTME group. CONCLUSIONS TaTME may be associated with more severe bowel dysfunction than traditional approaches to rectal cancer.
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Affiliation(s)
- J A G van der Heijden
- Department of Surgical Oncology, Radboud Institute for Health Science (RIHS), Radboud University Medical Centre, Nijmegen, the Netherlands
| | - S M Qaderi
- Department of Surgical Oncology, Radboud Institute for Health Science (RIHS), Radboud University Medical Centre, Nijmegen, the Netherlands
| | - R Verhoeven
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands.,Amsterdam UMC, Department of Medical Oncology, Cancer Centre Amsterdam, Amsterdam, the Netherlands
| | - J A E Custers
- Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - B R Klarenbeek
- Department of Surgical Oncology, Radboud Institute for Health Science (RIHS), Radboud University Medical Centre, Nijmegen, the Netherlands
| | - A J G Maaskant-Braat
- Department of Surgical Oncology, Máxima Medical Centre, Veldhoven, the Netherlands
| | - J H W de Wilt
- Department of Surgical Oncology, Radboud Institute for Health Science (RIHS), Radboud University Medical Centre, Nijmegen, the Netherlands
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Klein IL, van de Loo KFE, Hoogeboom TJ, Janssen MCH, Smeitink JAM, van der Veer E, Verhaak CM, Custers JAE. Blended cognitive behaviour therapy for children and adolescents with mitochondrial disease targeting fatigue (PowerMe): study protocol for a multiple baseline single case experiment. Trials 2021; 22:177. [PMID: 33648576 PMCID: PMC7923335 DOI: 10.1186/s13063-021-05126-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 02/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background Mitochondrial disease is a rare, hereditary disease with a heterogeneous clinical presentation. However, fatigue is a common and burdensome complaint in children and adolescents with mitochondrial disease. No psychological intervention targeting fatigue exists for paediatric patients with a mitochondrial disease. We designed the PowerMe intervention, a blended cognitive behaviour therapy targeting fatigue in children and adolescents with mitochondrial disease. The aim of the intervention is to reduce perceived fatigue by targeting fatigue-related cognitions and behaviours. Methods A multiple baseline single case experiment will be conducted in five children (8–12 years old) and 5 adolescents (12–18 years old) with mitochondrial disease and severe fatigue. Patients will be included in the study for 33 weeks, answering weekly questions about the fatigue. Patients will be randomly assigned a baseline period of 5 to 9 weeks before starting the PowerMe intervention. The intervention consists of face-to-face and online sessions with a therapist and a website with information and assignments. The treatment will be tailored to the individual. Each patient will work on their personalized treatment plan focusing on personally relevant goals. The primary outcome is perceived fatigue. Secondary outcomes are quality of life, school presence and physical functioning. Discussion The results of the PowerMe study will provide information on the efficacy of a blended cognitive behaviour therapy on reducing perceived fatigue and its impact on daily life in children and adolescents with mitochondrial disease. Strengths and limitations of the study design are discussed. Trial registration Dutch Trial Register NTR 7675. Registered on 17 December 2018. Identifier https://www.trialregister.nl/trial/7433
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Affiliation(s)
- I L Klein
- Radboud university medical center, Radboud Institute for Health Sciences, Radboud Center for Mitochondrial Medicine, Department of Medical Psychology, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands.
| | - K F E van de Loo
- Radboud university medical center, Radboud Institute for Health Sciences, Radboud Center for Mitochondrial Medicine, Department of Medical Psychology, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
| | - T J Hoogeboom
- Radboud university medical center, Radboud Institute for Health Sciences, IQ Healthcare, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
| | - M C H Janssen
- Radboud university medical center, Radboud Institute for Molecular Life Sciences, Radboud Center for Mitochondrial Medicine, Department of Internal Medicine, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
| | - J A M Smeitink
- Radboud university medical center, Radboud Institute for Molecular Life Sciences, Radboud Center for Mitochondrial Medicine, Department of Pediatrics, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
| | - E van der Veer
- International Mito Patients Association, Bergambacht, The Netherlands
| | - C M Verhaak
- Radboud university medical center, Radboud Institute for Health Sciences, Radboud Center for Mitochondrial Medicine, Department of Medical Psychology, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
| | - J A E Custers
- Radboud university medical center, Radboud Institute for Health Sciences, Radboud Center for Mitochondrial Medicine, Department of Medical Psychology, PO Box 9101, Geert Grooteplein Zuid 10, 6500 HB, Nijmegen, The Netherlands
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Qaderi SM, Swartjes H, Custers JAE, de Wilt JHW. Health care provider and patient preparedness for alternative colorectal cancer follow-up; a review. Eur J Surg Oncol 2020; 46:1779-1788. [PMID: 32571636 DOI: 10.1016/j.ejso.2020.06.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/06/2020] [Accepted: 06/11/2020] [Indexed: 12/15/2022] Open
Abstract
Follow-up after curative treatment for colorectal cancer (CRC) puts pressure on outpatient services due to the growing number of CRC survivors. The aim of this state-of-the-art review was to evaluate setting, manner and provider of follow-up. Moreover, perceptions of CRC survivors and health care providers regarding standard and alternative follow-up were examined. After a comprehensive literature search of the PubMed database, 69 articles were included reporting on CRC follow-up in the hospital, primary care and home setting. Hospital-based follow-up is most common and has been provided by surgeons, medical oncologists, and gastroenterologists, as well as nurses. Primary care-based follow-up has been provided by general practitioners or nurses. Even though most hospital- or primary care-based follow-up care requires patients to visit the clinic, telephone-based care has proven to be a feasible alternative. Most patients perceived follow-up as positive; valuing screening and detection for disease recurrence and appreciating support for physical and psychosocial symptoms. Hospital-based follow-up performed by the medical specialist or nurse is highly preferred by patients and health care providers. However, willingness of both patients and health care providers for alternative, primary care or remote follow-up exists. Nurse-led and GP-led follow-up have proven to be cost-effective alternatives compared to specialist-led follow-up. If proven safe and acceptable, remote follow-up can become a cost-effective alternative. To decrease the personal and financial burden of follow-up for a growing number of colorectal cancer survivors, a more acceptable, flexible and dynamic care follow-up mode consisting of enhanced communication and role definitions among clinicians is warranted.
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Affiliation(s)
- S M Qaderi
- Department of Surgical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - H Swartjes
- Department of Surgical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - J A E Custers
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - J H W de Wilt
- Department of Surgical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
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van Ruitenbeek E, Custers JAE, Verhaak C, Snoeck M, Erasmus CE, Kamsteeg EJ, Schouten MI, Coleman C, Treves S, Van Engelen BG, Jungbluth H, Voermans NC. Functional impairments, fatigue and quality of life in RYR1-related myopathies: A questionnaire study. Neuromuscul Disord 2018; 29:30-38. [PMID: 30578099 DOI: 10.1016/j.nmd.2018.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/30/2018] [Accepted: 10/31/2018] [Indexed: 01/01/2023]
Abstract
Mutations in RYR1 are a common genetic cause of non-dystrophic neuromuscular disorders. To obtain baseline data concerning the prevalence of fatigue, the psychological disease burden and quality of life associated with these common conditions, we performed a questionnaire study. Seventy-two patients were included in this study, 33 with a congenital myopathy and 39 with malignant hyperthermia or exertional rhabdomyolysis. Our results showed that patients with RYR1-related myopathies have more functional impairments and significant chronic fatigue compared to healthy controls, with almost half of patients being severely fatigued. Whilst fatigue, pain and associated physical and social difficulties were more pronounced in those with permanent phenotypes, individuals with intermittent phenotypes also scored higher in all relevant categories compared to healthy controls. These findings indicate that RYR1-related myopathies, despite being often considered relatively mild conditions, are nevertheless associated with severe fatigue and functional limitations, resulting in substantial loss of quality of life. Moreover, milder but in essence similar findings in patients with RYR1-related malignant hyperthermia and rhabdomyolysis suggest that those phenotypes are not truly episodic but in fact associated with a substantial permanent disease burden. These preliminary data should help to design more comprehensive quality of life studies to inform standards of care.
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Affiliation(s)
- E van Ruitenbeek
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J A E Custers
- Department of Medical Psychology, Radboudumc, Nijmegen, The Netherlands
| | - C Verhaak
- Department of Medical Psychology, Radboudumc, Nijmegen, The Netherlands
| | - M Snoeck
- Department of Anesthesiology, Canisius Wilhelmina Hospital Nijmegen, The Netherlands
| | - C E Erasmus
- Department of Pediatric Neurology, Radboudumc, Nijmegen, The Netherlands
| | - E J Kamsteeg
- Department of Human Genetics, Radboudumc, Nijmegen, The Netherlands
| | - M I Schouten
- Department of Human Genetics, Radboudumc, Nijmegen, The Netherlands
| | - C Coleman
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK
| | - S Treves
- Basel University, Basel, Switzerland
| | - B G Van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - H Jungbluth
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK; Randall Division for Cell and Molecular Biophysics, Muscle Signaling Section, King's College, London, UK; Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK
| | - N C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
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Thewes B, Kaal SEJ, Custers JAE, Manten-Horst E, Jansen R, Servaes P, van der Graaf WTA, Prins JB, Husson O. Prevalence and correlates of high fear of cancer recurrence in late adolescents and young adults consulting a specialist adolescent and young adult (AYA) cancer service. Support Care Cancer 2017; 26:1479-1487. [PMID: 29168035 PMCID: PMC5876258 DOI: 10.1007/s00520-017-3975-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 11/13/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE High fear of cancer recurrence (FCR) is a frequently reported problem among cancer patients. Previous research has shown that younger age is associated with higher levels of FCR. However, little attention has been given to date about how FCR manifests itself among adolescent and young adult (AYA) cancer patients. This study explores the prevalence, correlates of high FCR, and its association with HRQoL in cancer patients in their late adolescence or young adulthood. METHODS Seventy-three AYA cancer patients, aged 18-35 years at diagnosis, consulted the AYA team of the Radboud University Medical Center completed questionnaires including the Cancer Worry Scale (CWS), Quality of Life-Cancer Survivors (QOL-CS), and Hospital Anxiety and Depression Scale (HADS). Sociodemographic and medical data was collected by self-reported questionnaire. RESULTS Forty-five participants experienced high FCR (62%), which was higher than the 31-52% reported in previous studies among mixed adult cancer patient samples. Sociodemographic and medical variables were not associated with levels of FCR. High FCR was significantly associated with lower levels of social and psychological functioning and overall HRQoL and higher levels of anxiety and psychological distress. CONCLUSION Results illustrate that FCR is a significant problem among AYA cancer patients consulting an AYA team, with participants reporting higher levels of FCR than cancer patients of mixed ages. Health care providers should pay specific attention to this problem by screening and the provision of appropriate psychosocial care when needed.
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Affiliation(s)
- Belinda Thewes
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands.
| | - Suzanne E J Kaal
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jose A E Custers
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Eveliene Manten-Horst
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Rosemarie Jansen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Petra Servaes
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
- Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, UK
| | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, The Netherlands
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Thewes B, Husson O, Poort H, Custers JAE, Butow PN, McLachlan SA, Prins JB. Fear of Cancer Recurrence in an Era of Personalized Medicine. J Clin Oncol 2017; 35:3275-3278. [PMID: 28723231 DOI: 10.1200/jco.2017.72.8212] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Belinda Thewes
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Olga Husson
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hanneke Poort
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jose A E Custers
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Phyllis N Butow
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sue-Anne McLachlan
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Judith B Prins
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
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