Unmet psycho-social needs, coping strategies and psychological distress among people with cancer: Evidence from Pakistan.

OBJECTIVE: To explore the unmet psychosocial needs, coping styles and psychological distress among people with cancer. METHODS: The cross-sectional correlational study was conducted from May to July 2017 at Shifa International Hospital, Islamabad and Hayatabad Medical Complex, Peshawar, Pakistan which comprised of 182 patients diagnosed with cancer. Data was collected using the Supportive Care Needs Survey-Short Form-34, Mini-Mental Adjustment to Cancer Scale and the Hospital Anxiety Depression Scale. Data was analysed using SPSS 23v. RESULTS: It was found that all psychosocial needs were unmet among all participants (100%) who were suffering from cancer. However, health care information needs and psychological needs emerged to be strikingly unmet with 35.61% and 30.7% respectively. Moreover, maladaptive coping styles were highly endorsed than adaptive coping styles. CONCLUSION: This study pointed towards gaps in delivering quality care services in health care settings, inadequate attention and serious psychological health care neglect of people fighting with life threatening disease, indicating a dire need for proper psychological interventions for effective and holistic treatment planning to improve the whole process of illness and recovery.

T cell immunity to lymphoma following treatment with anti-CD40 monoclonal antibody.

In this study we demonstrate that treatment with anti-CD40 mAb eradicates a range of mouse lymphomas (BCL(1), A31, A20, and EL4), but only when used against i.v. tumor doses in excess of 10(7) cells. Only partial protection was seen against smaller tumor loads. We saw no evidence that anti-CD40 mAb changed the phenotype of the lymphomas or inhibited their growth in the initial period following treatment, but it did result in a rapid expansion of cytotoxic CD8(+) cells that was able to clear the neoplastic disease and provide long-term protection against tumor rechallenge. The CTL responses were blocked by mAb against a range of coreceptors and cytokines, including CD8, B7-1, B7-2, LFA-1, and IFN-gamma, but not CD4 or CTLA-4, indicating the presence of a conventional cellular Th1 response. Furthermore, we found evidence of cross-recognition between lymphomas (BCL(1) and A20) as measured by cytotoxicity and IFN-gamma responses in vitro and using tumor rechallenge experiments, suggesting common target Ags. Finally, although anti-CD40 was shown to stimulate NK cell killing, we could find no role for these cells in controlling tumor growth. These data underline the ability of anti-CD40 mAb to potentiate CTL responses and the potency of cellular immunity in eradicating large quantities of syngeneic tumor.