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OBJECTIVES: To identify symptom profiles (e.g., fatigue, sleep disturbance, depression, anxiety, cognitive impairment) among prostate cancer survivors, examine factors associated with the identified symptom profiles, and compare quality-of-life outcomes. SAMPLE & SETTING: 98 prostate cancer survivors who completed primary treatment were enrolled in a randomized parent trial. METHODS & VARIABLES: Established scales were used to measure symptoms and quality of life. Latent profile analysis was employed to classify patient groups based on symptom experiences. Logistic regression assessed factors associated with symptom profiles. RESULTS: The mean age of participants was 69 years (SD = 6.8). A high-symptom group (n = 29) and a low-symptom group (n = 69) were identified. Higher perceived stress (odds ratio [OR] = 1.28; p = 0.006), poorer spiritual well-being (OR = 0.84; p = 0.006), and lower household income (OR = 0.12; p = 0.089) were associated with being classified into the high-symptom group. Patients in the high-symptom group reported worse quality of life across all domains (p < 0.05). IMPLICATIONS FOR NURSING: Prostate cancer survivors experience varying degrees of symptom severity. Understanding the symptom profiles and associated factors can inform nurses about patients in need of symptom management and targeted interventions.
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Supervivientes de Cáncer , Neoplasias de la Próstata , Calidad de Vida , Trastornos del Sueño-Vigilia , Humanos , Masculino , Neoplasias de la Próstata/psicología , Anciano , Supervivientes de Cáncer/psicología , Supervivientes de Cáncer/estadística & datos numéricos , Persona de Mediana Edad , Calidad de Vida/psicología , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/psicología , Fatiga/etiología , Fatiga/psicología , Depresión/psicología , Depresión/etiología , Ansiedad/psicología , Ansiedad/etiología , Encuestas y Cuestionarios , Anciano de 80 o más AñosRESUMEN
OBJECTIVES: To investigate the need for return-to-work (RTW) support among young adult cancer survivors and identify influencing factors. SAMPLE & SETTING: This cross-sectional study included 134 Korean young adult cancer survivors, recruited in two days in April 2022 through an online survey. METHODS & VARIABLES: The study measured the need for RTW support, cancer stigma, cancer fatigue, and social support. Analyses included descriptive statistics, Pearson's correlation, and stepwise multiple linear regression. RESULTS: The factors significantly influencing the need for RTW support were cancer type (p < 0.001), occurrence of metastasis or recurrence (p = 0.004), number of cancer treatment types being received (p = 0.007), and cancer fatigue (p = 0.012). These variables explained about 26% of the variance. IMPLICATIONS FOR NURSING: This study offers important need-oriented information and highlights the need for proactive management of cancer-related fatigue to provide RTW support for young adult cancer survivors.
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Supervivientes de Cáncer , Reinserción al Trabajo , Apoyo Social , Humanos , Estudios Transversales , Masculino , Femenino , Supervivientes de Cáncer/psicología , Supervivientes de Cáncer/estadística & datos numéricos , Reinserción al Trabajo/estadística & datos numéricos , Reinserción al Trabajo/psicología , Adulto , República de Corea , Encuestas y Cuestionarios , Adulto Joven , Neoplasias/psicología , Fatiga/etiología , Fatiga/psicologíaRESUMEN
PURPOSE: Cancer is a leading cause of morbidity and mortality worldwide. Although people are living longer with cancer, cancer has the potential to impact survivors' quality of life (QOL) negatively. Spirituality encompasses the concepts of transcendence, meaningfulness, faith, connectedness, and integrative energy. Spirituality is a part of everyday existence across cultures and religions and part of the human experience. Yet little has been published on spirituality in cancer survivorship. We could not find any previous reviews that examined the literature on the potential relationship between QOL and spirituality in cancer survivorship. Thus, this systematic review and meta-analysis aim to examine the current literature to more fully understand the relationship between spirituality and QOL. METHODS: Using PRISMA guidelines, a systematic review and meta-analysis were conducted to examine the relationship between spirituality and QOL in cancer survivorship in studies sourced from PubMed, CINHAL, and PsycINFO databases. RESULTS: Twenty-six articles published between 2005 and 2024 were included for review. All studies demonstrated a significant, positive correlation between QOL and spirituality, with r values ranging from 0.15 to 0.817. CONCLUSION: Our findings suggest a positive correlation between higher spirituality and increased QOL among cancer survivors. Future research is needed to improve the understanding of this relationship and its mediators so that supportive oncologic interventions can be modified to address unmet needs and spiritual suffering. By better understanding the relationship between spirituality and QOL, we can move towards supporting the highest level of QOL possible for cancer survivors.
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Supervivientes de Cáncer , Calidad de Vida , Espiritualidad , Humanos , Supervivientes de Cáncer/psicología , Neoplasias/psicologíaRESUMEN
BACKGROUND: Childhood cancer remains a significant psychological burden for parents. Even after end of treatment, parents of childhood cancer survivors remain at high risk of developing anxiety and depression. However, knowledge about the prevalence and changes of these conditions post-treatment is limited. AIMS: This study aimed to assess the proportion of parents exhibiting clinically relevant symptoms of anxiety and/or depression, explore gender differences, examine factors associated with these conditions and their longitudinal data. METHODS: Five hundred and sixteen parents of childhood cancer survivors (aged 0-17 years at diagnosis of leukemia or central nervous system tumors) were evaluated after treatment and again 12-18 months later. Anxiety (GAD-7) and depression (PHQ-9) symptoms were assessed. Generalized linear mixed models were used to analyze factors influencing these conditions and their changes. RESULTS: At baseline, 30% of parents reported clinically relevant depression, and 34% reported anxiety, both decreasing to 16% at follow-up. Mothers reported higher anxiety and depression scores, with more meeting clinically relevant thresholds. Low family functioning, psychotherapy, physical illness, and a recent diagnosis were significant predictors of both conditions. Additional predictors for depression included unemployment, single-parent status, and fear of progression, while female gender was a predictor for anxiety in the final model. Greater symptom improvements were associated with higher baseline symptoms, whereas longer time since diagnosis was linked to less improvement. CONCLUSION: Anxiety and depression represent significant burdens for parents of childhood cancer survivors, with several modifiable risk factors identified. Targeted psychosocial support, early screening, and tailored interventions may reduce distress and improve family well-being.
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Ansiedad , Supervivientes de Cáncer , Depresión , Padres , Humanos , Femenino , Masculino , Supervivientes de Cáncer/psicología , Supervivientes de Cáncer/estadística & datos numéricos , Ansiedad/epidemiología , Ansiedad/psicología , Padres/psicología , Adulto , Niño , Adolescente , Prevalencia , Depresión/epidemiología , Depresión/psicología , Preescolar , Lactante , Persona de Mediana Edad , Neoplasias/psicología , Neoplasias/terapia , Recién Nacido , Factores de Riesgo , Factores SexualesRESUMEN
OBJECTIVE: This scoping review explores the multifaceted experience of cancer survivorship in Sub-Saharan Africa (SSA), with a focus on the post-treatment phase. The primary objective is to examine the psychosocial, cultural, and economic factors that influence post-treatment survivorship care and outcomes. METHODS: A comprehensive literature review was conducted using databases such as Web of Science Core Collection to identify studies published between 2000 and 2023. Eligible studies focused on post-treatment cancer survivorship in SSA. Data were extracted, analyzed, and synthesized to identify key themes and research gaps. RESULTS: The review identified substantial psychological distress among survivors, including depression, anxiety, and insomnia, often exacerbated by financial toxicity and limited access to psychosocial support services. Cultural factors, such as spiritual beliefs, reliance on traditional healers, and cancer-related stigma, influenced healthcare-seeking behaviors and overall well-being. Despite these challenges, social support networks, religiosity, and targeted psychosocial interventions improved emotional resilience and quality of life. However, major gaps remain, including insufficient integration of cultural beliefs into survivorship care, inadequate long-term follow-up (LTFU) programs, limited oncofertility support, and a lack of regionally diverse and longitudinal data. CONCLUSIONS: Cancer survivorship in SSA is shaped by intricate psychosocial, cultural, and economic dynamics that extend beyond clinical care. Addressing these challenges requires culturally sensitive, evidence-based interventions, including financial counseling, spiritual care integration, and the establishment of structured LTFU programs. Additionally, expanding access to oncofertility support and integrating culturally relevant psychosocial services can further enhance survivorship outcomes. Strengthening collaboration between policymakers, healthcare providers, and researchers-through interdisciplinary task forces, psycho-oncology workforce development, and community-driven initiatives-is essential for improving post-treatment outcomes and advancing cancer survivorship care in SSA.
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Supervivientes de Cáncer , Neoplasias , Calidad de Vida , Humanos , Supervivientes de Cáncer/psicología , Supervivientes de Cáncer/estadística & datos numéricos , África del Sur del Sahara , Neoplasias/psicología , Neoplasias/terapia , Apoyo Social , Estigma Social , Depresión/terapia , Depresión/psicología , Aceptación de la Atención de Salud/psicología , Ansiedad/psicología , Ansiedad/terapia , SupervivenciaRESUMEN
PURPOSE: This study aimed to understand the reasons for the high risk of job loss previously identified among foreign-born Chinese breast cancer survivors in the United States Qualitative interviews were conducted to explore challenges leading to job loss during/after treatment and to help identify potential interventions to promote job retention and re-employment. PATIENTS AND METHODS: The research team conducted semi-structured interviews with foreign-born Chinese breast cancer survivors in New York City. A total of 12 participants, previously enrolled in the Breast Cancer and the Workforce study, were interviewed between February and November 2018. Purposive sampling was used to identify participants diverse across job type and work history. Thematic content analysis was conducted on translated interview transcripts. RESULTS: Since diagnosis, 8/12 participants had experienced job loss (6/6 in service/production, 1/5 retail/administrative, and 1/1 professional/managerial). Many described being unable to work due to treatment side-effects, inflexible schedules, and a perception that work accommodations were unavailable. Only one participant who had lost her job went on to secure stable re-employment. CONCLUSIONS: Job type, language barriers, and cultural attitudes towards work accommodations contributed to a high job-loss rate in this population. Those who remained employed had received work accommodations. Lack of awareness or belief in obtaining accommodations was a critical factor in job loss. IMPLICATIONS FOR CANCER SURVIVORS: These findings highlight the necessity of advocacy for work accommodations for cancer patients and culturally competent care. Addressing these issues could improve job retention and financial stability for breast cancer survivors, particularly among immigrant and minority groups.
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Asiático , Neoplasias de la Mama , Supervivientes de Cáncer , Investigación Cualitativa , Humanos , Femenino , Neoplasias de la Mama/psicología , Neoplasias de la Mama/etnología , Supervivientes de Cáncer/psicología , Persona de Mediana Edad , Adulto , Asiático/psicología , Asiático/estadística & datos numéricos , Ciudad de Nueva York , Desempleo/psicología , Desempleo/estadística & datos numéricos , Barreras de Comunicación , Empleo/psicología , Anciano , Entrevistas como Asunto , China/etnología , Pueblos del Este de AsiaRESUMEN
Follow-up care in adult childhood cancer survivors (ACCS) aims to screen for, prevent, and treat potential late effects. The trajectory of ACCS' health-related quality of life (HRQoL) attending follow-up care is unclear. We investigated changes in HRQoL of ACCS attending a follow-up care program. The primary outcome was the minimal clinically important decrease (MCID) in HRQoL of ≥ 5 points in the mental (MCS) and/or physical component score (PCS) of the 36-item Short Form (SF-36) between baseline and follow-up (3-months after the first visit). We compared baseline characteristics, psychological factors, satisfaction, and distress (measured using the Brief Symptom Inventory). In 47 ACCS (100%), no significant change in the overall median MCS and PCS was observed. In 14 ACCS (29.8%) a MCID in HRQoL was observed. Compared to ACCS without a MCID, they reported lower PCS (median 45.2 [31.7; 51.4] vs. 55.6 [46.1; 57.6], p = 0.007), a higher proportion of low physical health (PCS < 48; 71.4% vs. 27.3%, p = 0.009) and distress (50% vs. 18.8%, p = 0.030) at baseline. Satisfaction was high (94.9%). One in three ACCS experienced a clinically important decrease in HRQoL after follow-up care, with higher rates in those with lower physical health and higher psychological distress at baseline.
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Supervivientes de Cáncer , Calidad de Vida , Humanos , Supervivientes de Cáncer/psicología , Femenino , Masculino , Adulto , Estudios Prospectivos , Estudios de Seguimiento , Neoplasias/psicología , Neoplasias/terapia , Adulto Joven , Adolescente , Cuidados Posteriores/métodos , NiñoRESUMEN
Background: Though telehealth has been a promising avenue for engaging cancer survivors with health care and lifestyle programming, older and rural-dwelling cancer survivors may have additional challenges in accessing digital devices and tools that have not yet been described. This study aimed to use a robust, nationally representative sample collected in 2022 to provide an updated view of digital technology use and the use of technology for health in this population. Objective: This study aimed to examine the prevalence of digital technology use for health-related activities among older cancer survivors in both rural and urban settings. The primary outcomes of interest included (1) internet access and use for health-related activities, (2) digital device ownership and use as a tool for health behaviors, (3) use of social media for health, and (4) use of telehealth. Methods: A cross-sectional analysis of the National Cancer Institute's Health Information National Trends Survey Cycle 6 (HINTS 6) was completed to examine the prevalence of digital technology use among older cancer survivors. For analysis, the sample was restricted to cancer survivors over the age of 60 years (n=710). Unadjusted and adjusted logistic regression models were used to test the association between rurality and digital health tool use. Results: Overall, 17% (125/710) of the sample lived in a rural area of the United States and the mean sample age was 73 (SD 8.2) years. Older cancer survivors, regardless of rural-urban status, reported a high prevalence of internet usage (n=553, 79.9%), digital device ownership (n=676, 94.9%), and social media use (n=448, 66.6%). In unadjusted models, rural survivors were less likely than urban survivors to report that they had used a health or wellness application in the previous year (odds ratio [OR] 0.56, 95% CI 0.32-0.97; P=.04). In adjusted models, rural survivors were more likely to report that they had shared personal health information on social media (OR 2.64, 95% CI 1.13-6.19; P=.03). There were no differences in the proportion of rural and urban respondents who reported receiving health services through telehealth in the previous year. Conclusions: Regardless of the residential status, older cancer survivors report high internet and technology use for health-related activities. These results show promise for the feasibility of using digital technologies to implement supportive care and wellness programming with older cancer survivors.
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Supervivientes de Cáncer , Población Rural , Telemedicina , Población Urbana , Humanos , Supervivientes de Cáncer/estadística & datos numéricos , Estudios Transversales , Masculino , Femenino , Población Rural/estadística & datos numéricos , Anciano , Población Urbana/estadística & datos numéricos , Persona de Mediana Edad , Estados Unidos/epidemiología , Tecnología Digital , Anciano de 80 o más Años , Medios de Comunicación Sociales/estadística & datos numéricos , Neoplasias/epidemiología , Neoplasias/terapia , Salud DigitalRESUMEN
Parents influence the physical activity (PA) of the childhood cancer survivors (CCS). This mixed-methods study, aiming to obtain an understanding of Chinese parents' perceptions of PA in CCS and how the cancer experience changes their views, which may affect these children's PA engagement. A mixed methods study was conducted at two hospitals in Hangzhou. A qualitative investigation using the thematic descriptive phenomenological approach analyzed data concerning the parents of 9-18-year-old childhood cancer survivors who had completed hospitalized treatment for at least three months. A cross-sectional investigation examined the association between parents' attitudes and children's PA levels using unconditioned binary logistic regression analysis. The qualitative investigation included 35 parents (74.3% female). More than half of the parents understood the benefits of regular PA. Most parents supported children's participation in low-intensity PA, but opposed high-intensity activities. Many parents changed their parenting style after cancer diagnosis, which might affect the development and persistence of children's PA. In the cross-sectional investigation, CCS were more likely to engage in low-level moderate-to-vigorous physical activity (MVPA) or less MVPA when receiving less paternal support (adjusted OR = 0.92, 95%CI:0.88-0.96) and maternal support (adjusted OR = 0.91, 95%CI:0.87-0.95). Insufficient paternal MVPA engagement (adjusted OR = 3.83, 95%CI: 2.57-5.70) and maternal MVPA engagement (adjusted OR = 5.65, 95%CI: 3.74-8.54) were associated with lower MVPA engagement in CCS. This study identified the understanding of parents of childhood cancer survivors concerning PA engagement and related life changes brought about by cancer experiences from the parental perspectives. These changes affect parental attitude towards children's participation in PA, and parental attitude and behavior affect children's participation in PA. Based on the above findings, some tentative practical implications for physical activity participation among childhood cancer survivors are drawn: (1) childhood cancer survivors should be encouraged to participate in more MVPA and consult a rehabilitation physician if necessary; (2) parents and children engage in exercise together is an important way to promote the levels of physical activity among childhood cancer survivors; (3) Chinese parents have insufficient awareness of the benefits of childhood cancer survivors participation in physical activity. We should strengthen health education for parents, promote parents to support childhood cancer survivors participate in physical activity.
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Supervivientes de Cáncer , Ejercicio Físico , Padres , Humanos , Femenino , Masculino , Niño , Supervivientes de Cáncer/psicología , Padres/psicología , Estudios Transversales , Adolescente , Adulto , China , Neoplasias , Relaciones Padres-Hijo , Pueblos del Este de AsiaRESUMEN
BACKGROUND AND PURPOSE: Sexual dysfunction is a common late effect of cancer reducing quality of life. This study investigated sexual health in cancer survivors shortly after diagnosis and at long-term follow-up compared to the general population. METHODS: A nationwide survey stratified by sex and age was distributed to a representative sample of the Norwegian population. Of the 5,135 respondents (33% response rate), 453 were cancer survivors, and 4,682 were cancer-free controls. Time since cancer diagnosis was divided into two categories: 2 years or less (short-term) and over 2 years (long-term). Sexual health was evaluated using the EORTC questionnaires SHQ-22 and the sexual domains of the QLQ-BR23/QLQ-BR45. Multivariable linear regression analyses compared sexual health between cancer survivors and cancer-free controls, and between short- and long-term cancer survivors. RESULTS: Cancer survivors reported significantly poorer sexual health outcomes than cancer-free controls, except for the importance of maintaining a sexually active life, rated equally important. There were minimal differences in sexual health between short-term and long-term cancer survivors. Interestingly, male cancer survivors appeared to be more affected by sexual health challenges than females, when compared to their cancer-free controls. INTERPRETATION: This study is the first to utilize the EORTC SHQ-22 questionnaire to assess sexual health in cancer survivors and controls. Sexual health was found to be significantly worse in cancer survivors compared to age-matched controls. It is imperative to address this overlooked health issue in the follow-up programs for cancer survivors.
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Supervivientes de Cáncer , Calidad de Vida , Salud Sexual , Humanos , Supervivientes de Cáncer/estadística & datos numéricos , Supervivientes de Cáncer/psicología , Masculino , Noruega/epidemiología , Femenino , Persona de Mediana Edad , Adulto , Anciano , Estudios de Casos y Controles , Disfunciones Sexuales Fisiológicas/etiología , Disfunciones Sexuales Fisiológicas/epidemiología , Neoplasias/psicología , Neoplasias/epidemiología , Encuestas y Cuestionarios , Adulto Joven , Estudios de SeguimientoRESUMEN
INTRODUCTION: The fatigue-sleep disturbance-depression symptom cluster (FSDSC) is commonly experienced by breast cancer (BC) survivors, leading to a deteriorated quality of life (QoL). Somatic acupressure (SA) has been recommended as a promising non-pharmacological intervention for cancer-related fatigue (the core symptom of the FSDSC) in the guidelines, showing its encouraging role in relieving cancer-related sleep disorders, fatigue and depression. This phase III randomised controlled trial (RCT) is designed to evaluate the effects, safety and cost-effectiveness of SA for managing the FSDSC in BC survivors. METHODS: This phase III RCT will be a partial-blinded, sham-controlled, three-arm, parallel clinical trial, involving a 7-week SA intervention period and a 12-week follow-up period. 108 BC survivors will be randomly allocated in a ratio of 1:1:1 to either a true SA group (self-administered acupressure plus usual care), a sham SA group (self-administered light acupressure at non-acupoints plus usual care) or a usual care group. The primary outcomes will be the effectiveness of SA on the FSDSC at both the individual symptom level and cluster symptom level. Each individual symptom will be specifically measured by the Brief Fatigue Inventory (fatigue), the Pittsburgh Sleep Quality Index (sleep disturbance) and the Hospital Anxiety and Depression Scale-Depression (depression). The cluster symptom level will be measured by using an FSDSC composite score, an averaging score of three separated 0-10 numeric rating scales for fatigue, depression and sleep disturbance. The secondary outcomes will include QoL (measured by the Functional Assessment of Cancer Therapy-Breast), adverse events and cost-effectiveness. Outcomes will be assessed at baseline (week 0), immediately after intervention (week 7) and follow-up (week 19). All outcomes will be analysed based on the intention-to-treat principle using the Statistical Package for Social Science (SPSS 25) software. ETHICS AND DISSEMINATION: Ethical approvals of this study have been granted by the Human Research Ethics Committee at Charles Darwin University (H22110) and the Clinical Trial Ethics Committee at the Affiliated Hospital of Zunyi Medical University (KLL-2023-594), and the Second Affiliated Hospital of Zunyi Medical University (KYLL-2023-058). Findings from this trial will be published in peer-reviewed journals and presented at professional conferences. TRIAL REGISTRATION NUMBER: NCT06412107.
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Acupresión , Neoplasias de la Mama , Supervivientes de Cáncer , Depresión , Fatiga , Calidad de Vida , Trastornos del Sueño-Vigilia , Humanos , Acupresión/métodos , Neoplasias de la Mama/complicaciones , Femenino , Fatiga/terapia , Fatiga/etiología , Supervivientes de Cáncer/psicología , Trastornos del Sueño-Vigilia/terapia , Trastornos del Sueño-Vigilia/etiología , Depresión/terapia , Depresión/etiología , Ensayos Clínicos Fase III como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Adulto , Persona de Mediana EdadRESUMEN
PURPOSE: This study explored perceived changes in health behaviours and body weight following a cancer diagnosis and investigated related sociodemographic and clinical characteristics. METHODS: Individuals living with and beyond breast, prostate, or colorectal cancer (N = 5835) completed the 'Health and Lifestyle After Cancer Survey' which explored their perceptions of health behaviour change following a cancer diagnosis. Multinomial logistic regressions were conducted with perceived changes as dependent variables, and sociodemographic and clinical characteristics as independent variables. RESULTS: Approximately half of the participants did not perceive changes in their physical activity, alcohol intake and body weight, and most did not perceive dietary changes. Less than a third of individuals perceived positive health behaviour changes (11.7% increased physical activity, 24.3% healthier diet, and 31.3% decreased alcohol intake), 35.9% perceived decreases in physical activity, and 27.0% perceived increases in body weight, whereas 19.2% perceived decreases in body weight. Individuals with no education, who were unmarried, and with anxiety/depression and pain/discomfort, were more likely to perceive changes in physical activity, body weight, and diet, but in different directions. Participants of younger age were more likely to perceive increases in their physical activity, a healthier diet, and increases in body weight. CONCLUSION: Following a diagnosis of cancer, a large proportion of individuals perceived that their health behaviours were unchanged. However, some groups of individuals were more likely to perceive positive changes, whereas others were more likely to perceive negative changes, with differences also observed according to the type of health behaviour. IMPLICATIONS FOR CANCER SURVIVORS: Participants with no education, who were unmarried, with anxiety/depression and pain/discomfort, may be more at risk of experiencing negative health behaviour changes post-diagnosis. Clinicians should consider targeting health behaviour support to prevent worse outcomes in the long term.
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Peso Corporal , Neoplasias de la Mama , Neoplasias Colorrectales , Ejercicio Físico , Conductas Relacionadas con la Salud , Neoplasias de la Próstata , Humanos , Masculino , Femenino , Estudios Transversales , Persona de Mediana Edad , Neoplasias Colorrectales/psicología , Neoplasias Colorrectales/diagnóstico , Anciano , Neoplasias de la Mama/psicología , Neoplasias de la Mama/diagnóstico , Reino Unido , Neoplasias de la Próstata/psicología , Neoplasias de la Próstata/diagnóstico , Ejercicio Físico/fisiología , Ejercicio Físico/psicología , Adulto , Supervivientes de Cáncer/psicología , Supervivientes de Cáncer/estadística & datos numéricos , Encuestas y Cuestionarios , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Estilo de VidaRESUMEN
Acute lymphoblastic leukemia (ALL) and other hematological malignancies are the most common cancers in children, with chemotherapy and/or radiotherapy as the primary treatment options. These treatments, however, may have long-term effects on ovarian function and fertility in female survivors. This study aims to evaluate ovarian function and reserve in female survivors of childhood hematological malignancies by assessing hormonal markers and ovarian follicle count. This cross-sectional study included 30 female survivors of acute leukemia, non-Hodgkin lymphoma (NHL), and Hodgkin lymphoma (HL) who completed chemotherapy between 2013 and 2023. Hormonal markers including anti-Müllerian hormone (AMH), inhibin B, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and ovarian follicle counts were measured. Statistical analysis was performed using SPSS, with a significance level of p < 0.05. Out of 263 patients diagnosed with hematological malignancies during the study period, 30 female patients were included. The median age at diagnosis was 14 years (range: 7-24 years). The malignancy breakdown was as follows: 7 patients (23.3%) with ALL, 2 patients (6.7%) with acute myeloid leukemia (AML), 9 patients (30%) with HL, and 12 patients (40%) with NHL. The median number of right ovarian follicles was 6 (range: 0-13), and the median number of left ovarian follicles was 7 (range: 2-12), with a total median follicle count of 12.5 (range: 5-25). AMH levels were normal in 26 patients (86.7%) and low in 3 patients (10%), with 3 patients (10%) diagnosed with decreased ovarian reserve (DOR), defined by AMH levels < 0.96 ng/mL. Inhibin-B levels were normal in 25 patients (83.3%), elevated in 1 patient (3.3%), and low in 4 patients (13.3%). Significant correlations were found between AMH and inhibin-B (p = 0.005, r = 0.508), FSH and inhibin-B (p = 0.041, r = 0.375), and inhibin-B and total follicle count (p = 0.014, r = 0.444). Additionally, a significant modarate correlation between AMH levels and total follicle count was observed (p = 0.033, r = 0.396). The evaluation of ovarian reserve using AMH, inhibin B, and ovarian follicle counts provides critical insights for fertility planning in survivors of childhood cancer. Early and comprehensive assessments may improve reproductive outcomes and quality of life for these patients.
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Hormona Antimülleriana , Neoplasias Hematológicas , Ovario , Humanos , Femenino , Adolescente , Niño , Neoplasias Hematológicas/sangre , Neoplasias Hematológicas/terapia , Adulto Joven , Estudios Transversales , Ovario/fisiopatología , Hormona Antimülleriana/sangre , Hormona Folículo Estimulante/sangre , Folículo Ovárico , Reserva Ovárica/fisiología , Supervivientes de Cáncer , Adulto , Inhibinas/sangre , Hormona Luteinizante/sangre , Estradiol/sangreRESUMEN
Cancer-related cognitive impairment (CRCI) has emerged as a significant long-term complication in cancer survivors, particularly those undergoing chemotherapy, radiotherapy, or targeted therapies. Despite advances in treatment, CRCI affects patients' quality of life, impacting their daily functioning, work capacity, and psychological well-being. In recent years, research has focused on identifying predictive factors for CRCI and developing risk prediction models to facilitate early intervention. This review summarizes the latest progress in CRCI risk prediction models, including traditional statistical approaches such as logistic regression and advanced machine learning techniques. While machine learning models demonstrate superior predictive performance, limitations such as data availability and model interpretability remain. Additionally, the review highlights key risk factors-such as age, cancer type, and treatment modalities-and evaluates the strengths and weaknesses of various predictive models in terms of accuracy, generalizability, and clinical applicability. Finally, this paper discusses the challenges in validating these models across diverse populations and the need for further research to enhance model reliability and personalization of interventions.
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Disfunción Cognitiva , Neoplasias , Humanos , Disfunción Cognitiva/etiología , Neoplasias/complicaciones , Medición de Riesgo , Aprendizaje Automático , Factores de Riesgo , Calidad de Vida , Supervivientes de Cáncer/psicologíaRESUMEN
PURPOSE: Sedentary behavior (SB) contributes to the heightened risk of cardiovascular disease (CVD) in endometrial cancer survivors (ECS). This feasibility study aimed to evaluate key outcomes to assess the practicality of SB reduction interventions for ECS. Secondary aims included SB domain assessment and preliminary efficacy testing of the relationship between SB and arterial stiffness. METHODS: Forty stage-1 ECS (BMI ≥ 25.0 kg/m², aged 50-80, <12 months post-treatment) participated in the study, which measured total and domain-specific SB using accelerometry and ecological momentary assessment (EMA). Aortic pulse wave velocity (PWV) was estimated via Mobil-O-Graph, and linear regression models examined the association between SB and PWV. RESULTS: The study achieved 4 of 5 assessed outcomes, with a 63% consent rate in 10 months. Retention was high, with 90% of participants completing all aspects. Fidelity was strong, though EMA compliance was 69%, slightly below the 70% target. Self-reported SB was 71.4% lower than accelerometer-measured SB [MD: -5.00 hours/day (95% CI: -6.57 to -3.43), P < .001]. ECS exhibited a PWV of 9.04 ± 1.80 m/s, 13.4% higher than normative values, with occupational SB significantly associated with PWV. CONCLUSIONS: This study highlights high SB and PWV levels in ECS, indicating the need for interventions, particularly for occupational SB. The high retention and consent rates suggest ECS are willing to engage in behavior change, pointing to future research focusing on strategies to reduce SB and improve cardiovascular health.
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Acelerometría , Supervivientes de Cáncer , Neoplasias Endometriales , Estudios de Factibilidad , Análisis de la Onda del Pulso , Conducta Sedentaria , Rigidez Vascular , Humanos , Femenino , Análisis de la Onda del Pulso/métodos , Persona de Mediana Edad , Anciano , Neoplasias Endometriales/psicología , Neoplasias Endometriales/fisiopatología , Supervivientes de Cáncer/psicología , Acelerometría/métodos , Rigidez Vascular/fisiología , Anciano de 80 o más Años , Enfermedades Cardiovasculares/fisiopatología , Ejercicio Físico/fisiologíaRESUMEN
BACKGROUND: Although social withdrawal is common among colorectal cancer (CRC) survivors with permanent stomas, it has been poorly addressed due to a lack of valid assessment tools. The social withdrawal subscale (SWS) from the Internalized Stigma of Mental Illness (ISMI) scale shows promise for assessing social withdrawal. However, there was no available data on its validity for this purpose. This study aimed to investigate the reliability and validity of the SWS as a screening tool for identifying survivors at risk of social withdrawal. METHODS: Two separate convenience samples of 127 and 245 CRC survivors with permanent stomas were selected. Item analysis and exploratory factor analysis (EFA) were conducted with the first sample of 127 survivors. Confirmatory factor analysis (CFA), reliability analysis, and tests for convergent and discriminant validity were performed with the second sample of 245 survivors. Additionally, the screening cut-off score and accuracy of the SWS scores were determined using receiver operating characteristic (ROC) curves. RESULTS: The item-total correlation coefficients of the SWS ranged from 0.530 to 0.787. The EFA demonstrated a single-factor structure for the SWS. The CFA confirmed appropriate construct validity (χ²/df = 103.115/52 = 1.983, goodness-of-fit index (GFI) = 0.925, comparative fit index (CFI) = 0.959, and root mean square error of approximation (RMSEA) = 0.068). The test-retest reliability was 0.849. Pearson correlation analysis showed significant and moderate to large relationships between the SWS and the chosen criterion measures, supporting its good convergent validity. ROC analysis identified SWS scores of ≥ 15 as the optimal screening cut-off, with a sensitivity of 86.5%, specificity of 50.5%, and an area under the curve (AUC) of 0.748 (95% CI: 0.673-0.823, P < 0.001). CONCLUSION: The SWS demonstrates acceptable reliability and validity for measuring social withdrawal among CRC survivors with permanent stomas. Future studies should further evaluate its utility in clinical settings.
Asunto(s)
Supervivientes de Cáncer , Neoplasias Colorrectales , Humanos , Neoplasias Colorrectales/psicología , Femenino , Masculino , Persona de Mediana Edad , Supervivientes de Cáncer/psicología , Reproducibilidad de los Resultados , Anciano , Psicometría , Aislamiento Social/psicología , Adulto , Escalas de Valoración Psiquiátrica/normas , Estomas Quirúrgicos , Análisis Factorial , Estigma SocialRESUMEN
BACKGROUND: The existing studies have pointed out that cancer survivorship experiences significantly contribute to a comprehensive understanding of cancer survivors and insights into oncological care development. However, little is known about the long-term survivorship experiences of osteosarcoma survivors within the Chinese context. OBJECTIVE: This study aims to explore osteosarcoma survivorship and coping strategies to enrich our understanding of the unique challenges and psychological needs of this population. METHODS: A qualitative narrative inquiry was used to provide a comprehensive understanding of survivors' illness narratives and coping strategies during osteosarcoma survivorship. Twelve osteosarcoma survivors were recruited using purposeful sampling. The data were collected through narrative inquiry interviews, which were audio-recorded and transcribed. A thematic narrative analysis is used to interpret the narrative inquiry data. RESULTS: Three themes of illness narratives were identified, including "No one knows: chaos," "Rethinking: restitution," and "Restarting and retelling: quest." Coping strategies encompassed in the subthemes indicated the importance of archive efforts of osteosarcoma survivors in questing post-traumatic identity, values, and reconnecting to the community. Alternative narratives that emerged beyond the illness narrative framework highlighted contextual-specific insights. CONCLUSION: This study demonstrates that a narrative approach provides an alternative perspective for exploring the cancer survivorship experience. The findings underscore the evolving nature of illness narratives, highlighting the long-term need for ongoing psychological support for osteosarcoma survivors. Moreover, the study highlighted a comprehensive understanding of osteosarcoma survivorship within the Chinese context. Specifically, it emphasizes (1) the rethinking of current medical discourse and psycho-oncology practice within the Chinese context and (2) the narrative empowerment of bone cancer survivors. These findings have significant implications for expanding exploration into the nuanced experiences and identification of barriers to the integration of medical and psychological support among Chinese cancer survivors.
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Adaptación Psicológica , Supervivientes de Cáncer , Narración , Osteosarcoma , Investigación Cualitativa , Humanos , Osteosarcoma/psicología , Osteosarcoma/mortalidad , Osteosarcoma/terapia , Masculino , Femenino , Supervivientes de Cáncer/psicología , China/epidemiología , Adulto , Adulto Joven , Persona de Mediana Edad , Adolescente , Neoplasias Óseas/psicología , Calidad de Vida , Habilidades de AfrontamientoRESUMEN
OBJECTIVE: Subependymal giant cell astrocytomas (SEGA) are present in patients with tuberous sclerosis complex (TSC), occasionally requiring surgical removal. The study aimed to analyze the results from our series of children undergoing surgery for SEGA. METHODS: We retrospectively identified children with TSC undergoing resection of SEGA at Oslo University Hospital between 1982 and 2016. Patient charts, radiological images, epilepsy, and neuropsychological reports were reviewed. RESULTS: Out of 208 patients with TSC, 18 (9%) underwent resection of SEGA. Due to missing data, we could only analyze results from 14 surgeries in 11 children (median age 6 years, range 0-19; male/female ratio 2.7:1). The tumours were bilateral in four (36%) patients. The tumour diameter was a median of 19 mm (10-104 mm). The surgical approach was transcortical in eight (57%) and transcallosal in six surgeries (43%). Gross total resection was achieved in 12 (86%) of surgeries. There was no mortality or major morbidity related to surgery except for one case of chronic subdural hematoma, but out of two patients with ventriculoperitoneal shunts, one developed shunt infection, and both experienced shunt failures during the follow-up. During the follow-up (median 11 years, range 1-21), three patients (27%) underwent repeated surgery. We could not document any significant impact of the surgery on patients' cognitive functioning or the grade of epilepsy. CONCLUSIONS: Resection of SEGA in children with TSC was associated with a low complication rate. We could not document any impact of surgery on patients' cognitive functioning or grade of epilepsy. However, the neuropsychological data were limited in most cases. Neuropsychological assessment should be performed before the surgery and be a part of follow-up after surgery.
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Astrocitoma , Neoplasias Encefálicas , Esclerosis Tuberosa , Humanos , Esclerosis Tuberosa/complicaciones , Esclerosis Tuberosa/cirugía , Masculino , Femenino , Astrocitoma/cirugía , Astrocitoma/complicaciones , Niño , Preescolar , Estudios Retrospectivos , Adolescente , Lactante , Neoplasias Encefálicas/cirugía , Neoplasias Encefálicas/complicaciones , Adulto Joven , Procedimientos Neuroquirúrgicos/métodos , Resultado del Tratamiento , Recién NacidoRESUMEN
BACKGROUND: Up to 75% of young adult cancer survivors (YACS) experience chronic insomnia, negatively affecting physical and emotional health and overall quality of life. Cognitive behavioral therapy for insomnia (CBT-I) is a gold-standard intervention to address insomnia. To improve CBT-I access and treatment adherence, screen-based digital CBT-I platforms have been developed. However, even with these digital products, widespread uptake of CBT-I remains limited, and new strategies for CBT-I delivery are warranted. OBJECTIVE: The objective of this study is to understand how YACS experience insomnia and how they might incorporate technology-delivered CBT-I into a daily routine and test the feasibility and acceptability of a novel screen-free voice-activated virtual assistant-delivered CBT-I prototype. METHODS: Eligible participants-ages 18-39, living with a history of cancer (any type, any stage), self-reporting on average less sleep than National Sleep Foundation recommendations, and English-speaking-were recruited from a major urban cancer center, 2 regional oncology clinics, and 2 cancer survivorship support groups. We conducted 4 focus groups to understand the YACS experience of insomnia, their routine use of technology at home, particularly voice-activated virtual assistants such as Amazon Alexa, and input on how CBT-I might be delivered at home through a smart speaker system. We developed a prototype device to deliver key elements of CBT-I at home along with circadian lighting and monitoring of post-bedtime device use, collected YACS user perspectives on this prototype, and then conducted a single-arm feasibility and acceptability study. RESULTS: In total, 26 YACS (6-7 participants per group) experiencing insomnia participated in focus groups to share experiences of insomnia during cancer survivorship and to provide input regarding a CBT-I prototype. Common triggers of insomnia included worry about disease management and progression, disease-related pain and other symptoms, choices regarding personal device use, and worry about the impact of poor sleep on daily functioning. In total, 12 participants completed device prototype testing, engaging with the prototype 94% of the assigned times (twice daily for 14 days; meeting predetermined feasibility cutoff of engagement ≥70% of assigned times) and rating the prototype with an overall mean score of 5.43 on the Satisfaction subscale of the Usability, Satisfaction, and Ease of Use scale (range 4.42-7; exceeding the predetermined cutoff score for acceptability of 5.0). All participants completing the study reported they would be interested in using the prototype again and would recommend it to someone else with insomnia. CONCLUSIONS: YACS were highly engaged with our voice-activated virtual assistant-delivered CBT-I prototype and found it acceptable to use. Following final device development, future studies should evaluate the efficacy of this intervention among YACS. TRIAL REGISTRATION: ClinicalTrials.gov NCT05875129; https://clinicaltrials.gov/study/NCT05875129.
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Supervivientes de Cáncer , Estudios de Factibilidad , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Supervivientes de Cáncer/psicología , Masculino , Femenino , Adulto , Adulto Joven , Adolescente , Terapia Cognitivo-Conductual/métodos , Terapia Cognitivo-Conductual/instrumentación , Grupos Focales , Voz , Aceptación de la Atención de Salud , Calidad de VidaRESUMEN
BACKGROUND: The COVID-19 pandemic exacerbated mental health challenges. This study aimed to investigate the mental health impact of the pandemic on cancer survivors from diverse backgrounds using the All of Us Research Program's COVID-19 Participant Experience (COPE) survey. METHODS: This analysis included respondents of the COPE survey with average depression, anxiety, and self-harm metrics computed for individuals completing multiple survey iterations. Multivariable logistic regression assessed the relationship between cancer survivorship, demographic factors, and mental health outcomes. Sensitivity analyses were conducted to investigate peak mental health challenges and time trend. RESULTS: Among 100,203 respondents, 20,561 (20.5%) were cancer survivors. Cancer survivors differed demographically from the general population, tending to be older and more likely to report higher socioeconomic status. Cancer survivors exhibited significantly higher odds of self-harm (aOR = 1.09, 95% CI 1.01-1.18). Sensitivity analyses focusing on peak mental health scores revealed that cancer survivors had significantly increased odds of experiencing anxiety (aOR = 1.11, 95% CI 1.06-1.17), depression (aOR = 1.11, 95% CI 1.06-1.17), and self-harm tendencies (aOR = 1.09, 95% CI 1.01-1.18) compared to non-cancer survivors. Within the cancer survivor subgroup, younger age, gender and sexual minority status, lower income, and widowed/separated/divorced status were associated with worse mental health outcomes. CONCLUSION: During the COVID-19 pandemic, cancer survivors exhibited significantly higher odds of depression, anxiety, and self-harm compared to non-survivors, with certain subgroups demonstrating heightened vulnerability. Our study highlights the critical need for integrated mental health services in cancer survivorship care programs, especially among those from underserved groups who are at high risk, as we continue to evolve with the pandemic.