European Journal of Cancer Care最新文献

Objective: Cancer has an impact on psychosocial well-being as well as on mental health. Coaching increasingly appears as a source of psychosocial support to cancer patients. However, we currently lack a clear framework for coaching in that context. The present review aims to better define the concept of coaching in interventions for patients in cancer care research, as well as to synthesize frameworks, techniques, and providers.

Methods: A conceptual scoping review based on PRISMA was performed on studies focusing on coaching and cancer published in peer-reviewed journals until November 2024. Studies on coaching and cancer were systematically extracted from five online databases and then screened.

Results: A total of 237 studies were included after screening. Less than 15% of the studies provided an explicit definition of coaching. Six coaching categories were identified based on their goal, in addition to a general form of coaching. Coaching in cancer care occurs during the acute treatment phase as well as during the posttreatment phase. Most providers were healthcare professionals, despite an important heterogeneity. Techniques were sorted into 9 sets of techniques implemented in coaching interventions, including goal setting, providing support, and self-regulation.

Conclusions: This review provided structure to the field of coaching in cancer. It also showed that defining a field only on the word “coaching” does not appear sufficient to reflect the current heterogeneity. Consequently, there is a necessity for the field to clarify its theoretical frameworks, targets, and intervention components to increase the necessary reproducibility and cumulative knowledge.

Peritoneal mesothelioma (PM) is a rare and aggressive cancer with a significant impact on the patient quality of life. This study aimed to explore variability in the care pathway of people with PM and to explore the patient experience of the care pathway. A mixed-methods, longitudinal approach was employed. The three stages of the study were (1) cross-sectional survey of PM patients and family members exploring demographic characteristics, patient pathway, experiences of treatment and care; (2) qualitative, case study series of individual patients, their family member/carer/friend and professionals; and (3) case note review of case study patients living with PM. Forty-seven patients (30 women and 17 men) responded to the survey. We recruited seven case studies comprising seven patient participants, eight carers and six professionals. Findings revealed a significant delay in diagnosis due to nonspecific symptoms and challenges in differential diagnosis. The study highlights the need for improved timely diagnosis, enhanced communication between healthcare providers and patients, and referral to specialist mesothelioma multidisciplinary teams. Recommendations include the need to implement smoother treatment and management pathways, to increase referrals to specialist multi-disciplinary teams and to engage patients in decision-making throughout the treatment pathway.

This retrospective study aimed to determine the risk factors for venous thromboembolism (VTE) in patients undergoing radical hysterectomy for cervical cancer. Data from 366 patients who underwent radical surgery between June 2020 and December 2021 were collected from medical records. The patients were divided into a thrombosis group and a nonthrombotic group based on the presence or absence of VTE. Multivariate analyses revealed that age greater than 45 years, open radical hysterectomy surgery, an operation time exceeding 4 hours, intraoperative blood transfusion, and postoperative plasma D-dimer levels greater than 2.0 mg/L were significant independent risk factors for postoperative VTE, which could be used to help identify patients at an increased risk of VTE.

Background: Allogeneic stem cell transplantation (allo-SCT) represents a firmly established therapeutic option for patients facing (non-)malignant haematological diseases. Despite its curative potential, however, this treatment is associated with substantial morbidity and mortality rates as well as a decreased quality of life. Given this context, a scientific void needs to be addressed: How do patients deal with the existential situation of being exposed to a life threat despite the curative potential of their treatment? This study aims to explore the patients’ experiences considering their life threat in the context of the allo-SCT.

Methods: Qualitative semistructured, in-depth interviews were conducted with patients treated by allo-SCT over the course of transplantation (before, during or after hospitalization). Interview data were interpreted using category-based qualitative content analysis.

Results: Seventeen interviews were conducted. Results revealed a strong focus on hope and avoidance of dealing with the life threat. At the same time, challenges due to the lack of alternative treatments and the uncertain course were highlighted. The data revealed that patients wished to receive support by healthcare professionals, their carers and their social environment in general. Beyond that, patients desired to obtain honest information within an open discussion about a realistic prognosis and risk of treatment and course of disease.

Conclusion: The findings emphasize an interplay between hope, avoidance and psychological distress in the face of the patients’ life threat. To assist allo-SCT recipients in navigating their life threat during treatment, it is desirable to establish avenues that provide adequate support.

Trial Registration: German Registry of Clinical Trials: DRKS00027290

Background: Serum tumor markers are beneficial to patients with advanced cancer because they help in early diagnosis, determining prognosis, predicting response to certain medications, and monitoring therapy. The prognostic value of cancer antigen 15-3 (CA15-3) serum-level changes in breast cancer is very well established. The main cause behind the elevation of CA 15-3 is metastatic breast carcinoma. In this study, we will run a record review to study comprehensively the clinical association between chronic myeloid disorders and CA15-3 elevation.

Method: In this retrospective study, we run CA15-3 on 106 patients with different myeloid disorders diagnosed between 2008 and 2021 from several tertiary care centers in Saudi Arabia, Jeddah, majority of which (38 cases) were diagnosed with chronic myeloid leukemia (35.8%). Others had essential thrombocytosis (22.6%), chronic myeloproliferative neoplasm (20.8%), myelofibrosis (7.5%), acute myeloid leukemia (4.7%), myelodysplastic syndrome (4.7%), and polycythemia vera (3.8%).

Result: An increase in CA15-3 was seen in 50% of all cases. In particular, polycythemia vera showed an elevation in 100% of the cases (4 out of 4). Second in expressivity is myelodysplastic syndrome (80%, 4 out of 5 cases). Close in value is myelofibrosis (75%, 6 out of 8 cases). The least association is noted between CA15-3 and essential thrombocytosis (16.7%, 4 out of 24 cases).

Conclusion: When CA15-3 levels are considered during the time of myeloid disorder diagnosis, it shows an independent predictive value. More research is needed to determine the utility of these serum biomarkers in myeloid disorders decision-making. This is a thorough case series of chronic myeloid disorders inclusive of all myeloproliferative neoplasms besides myelodysplastic syndrome describing the association with CA15-3.

Introduction: Chronic cancer-related fatigue (CCRF) is a common symptom among patients. Current therapies target the patient alone, while evidence suggests that targeting the dyad might be more beneficial.

Method: Using a mixed methods design, we conducted two studies that together aimed to provide more insight into the needs, benefits, barriers and preferences regarding a couples therapy for CCRF. In a qualitative study, we conducted focus groups and semi-structured interviews with a purposive sample of 10 patients and 10 partners with experience of CCRF care, followed by thematic analysis. In a subsequent quantitative study, a convenience sample of patients (n = 172) and partners (n = 55) completed an online survey developed based on the qualitative findings.

Results: In the qualitative study, both patients and partners expressed that a couples therapy could help them. Perceived benefits included empowerment of partners to support patients and improved couples communication. In the online survey, the need for a dyadic approach to CCRF therapy was confirmed by both patients (39%) and partners (91%). The benefits reported by most patients and partners were that partners could get attention for their own problems related to the patients’ cancer and fatigue (patients: 72%, partners: 86%) and receive advice on coping with fatigue (66% and 90%, respectively). Participants in both studies identified barriers, such as a fear of burdening partners with a couples therapy (50%). Partner involvement was considered desirable for most therapy elements (e.g., psychoeducation, contact with the therapist, exercises and relapse prevention). Yet, individual preferences varied widely.

Conclusion: Results of both studies support the potential acceptability of a couples therapy for CCRF among patients and partners. Based on divergent preferences, we determined that a couples therapy must provide flexibility regarding the degree, intensity and type of partner involvement. Dyadic psychoeducation can be used as a solid starting point to manage expectations and get relief from perceived barriers.

Chemotherapy plays a crucial role in cancer treatment, targeting rapidly dividing abnormal and normal cells, which often leads to significant side effects. This study aimed to assess the awareness of chemotherapy among cancer patients at Suresh Wagle Memorial Cancer Centre, Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. A descriptive cross-sectional design was employed, involving 103 cancer patients selected through nonprobability, purposive sampling. Data were collected via in-person interviews using a semistructured questionnaire. Statistical analysis, including chi-square tests, was conducted to explore associations between patients’ knowledge of chemotherapy and biodemographic variables. The results indicated that nearly half of the respondents, 50 (48.5%), had moderate knowledge of chemotherapy, while a significant association was found between the cycle of chemotherapy and access to health information, with a p value of less than 0.05. The study highlights the need for regular patient education and counseling to enhance awareness and understanding of chemotherapy. The use of educational materials such as brochures, videos, and online resources is recommended to reinforce patients’ knowledge and improve their overall quality of life during treatment.

Purpose: The provision of evidenced-based sexual well-being support is considered a key metric of quality prostate cancer care. However, patients continually report high rates of unmet sexual health needs. To provide insight into the challenges healthcare professionals (HCPs) face in delivering sexual well-being support, we conducted a qualitative study.

Methods: HCPs were recruited via professional organisations/networks and snowballing. Interviews were semistructured, conducted via telephone/video and transcribed verbatim. Interviews explored work experience, sexual support provided, challenges faced and areas of prioritisation to improve care delivery. Data were analysed using reflexive thematic analysis. The lack of representation from urologists and radiation oncologists was a limitation.

Results: Twenty-one HCPs were interviewed, including nurses, pharmacists, sexologists, a physiotherapist and an oncologist. Eight key themes were identified. Themes 1–5 describe the challenges faced by HCPs in providing sexual well-being support, such as logistical issues and reliance on other HCPs. The remaining three themes describe areas of change recommended by HCPs to improve delivery of support, including standardisation of penile rehabilitation guidelines, training for specialists and GPs and prioritisation of multidisciplinary sexual well-being support as part of routine care.

Conclusions: HCPs face several challenges in providing sexual well-being support to prostate cancer patients, which could be ameliorated through greater awareness and education about the importance of sexual well-being support and through standardising pathways and guidelines. Addressing challenges faced by HCPs in the delivery of sexual well-being support may ultimately improve patient experiences and reduce unmet sexual health needs following prostate cancer treatment.

Natural chemicals have been considered as promising molecules in cancer treatment because of their broad spectrum of activities. Flavonoids show high affinity against key molecular targets associated with developing cancer, and tumor cells exhibit an inability to resist flavonoid treatment. Flavonoids are natural molecules synthesized during secondary plant metabolism that has protective activities against biotic and abiotic factors (animals, bacteria, and fungi) and are resistant to ultraviolet light, temperature, and solid minerals and contaminants. They have been purified from plants and synthetic molecules and have an antioxidant, antitumor, and cardioprotective activities in humans. The large flavonoid family includes polymethoxyflavones, which are extracted from the peels of citrus fruits such as Citrus nobilis, from which nobiletin (NOB) is obtained. The compounds derived from this promising anticancer chemical include 5-demethylnobiletin (5-DMN). These compounds inhibit a large number of targets that regulate the hallmarks of cancer by inducing apoptosis, cell cycle arrest, inhibition of proliferation, epithelial–mesenchymal transition, limiting migration, and angiogenesis. 5-DMN has exhibited potency in the regulation of anticancer activities. This review was conducted to summarize and compare the effects of NOB and 5-DMN on different types of cancer.

Background: Breast cancer survivors (BCSs) often face long-term complications, with upper-limb lymphedema and cancer-related fatigue (CRF) being challenging. This study aimed to investigate the relationship between upper-limb lymphedema and fatigue among BCSs.

Method: This cross-sectional study was performed on 102 BCSs, of which 31 (30.4%) had breast cancer–related lymphedema. Duration, stage, and excess volume were considered as indicators of breast cancer–related lymphedema severity. QoL was measured using the EORTC QLQ-C30. The score of the fatigue symptom scale was used based on EORTC QLQ-C30 for CRF assessment. Also, the brief fatigue inventory was used to measure the severity of fatigue among participants.

Results: The mean fatigue symptom scale and brief fatigue inventory scores were 37.90 ± 24.59 and 3.69 ± 1.25, respectively. The mean fatigue symptom scale was significantly different among BCSs with BMI ≤ 25 and BMI > 25 (29.59 ± 24.49 vs. 41.51 ± 23.88, p = 0.026). Also, the mean brief fatigue inventory was significantly different among BCSs with the number of dissected lymph nodes (LNs) ≤ 5 and > 5 (3.52 ± 1.18 vs. 4.08 ± 1.34, p = 0.042). Additionally, women with breast cancer–related lymphedema had significantly higher scores of fatigue symptom scale and brief fatigue inventory (46.59 ± 27.12 vs. 34.11 ± 22.56, p = 0.03, and 4.75 ± 1.21 vs. 3.22 ± 0.96, p = 0.001, respectively). Except for a weak correlation between BMI and fatigue symptom scale and brief fatigue inventory (r: 0.279, p = 0.004, and r: 0.313, p = 0.001, respectively), there was no other significant relationship between CRF and study variables such as breast cancer–related lymphedema duration, stage, and excess volume. Meanwhile, fatigue symptom scale and brief fatigue inventory were significantly correlated with global health and functional scale scores of EORTC QLQ-C30. The ROC curve which models the diagnostic efficacy for fatigue symptom scale showed an AUC of 0.634 (p = 0.034, 95% CI: 0.510–0.759), while the ROC curve which models the diagnostic efficacy for brief fatigue inventory showed an AUC of 0.821 (p < 0.001, 95% CI: 0.735–0.908).

Conclusion: This study highlighted that while breast cancer–related lymphedema was associated with increased CRF, the severity of lymphedema did not significantly correlate with CRF. Additionally, CRF might be an indicator of breast cancer–related lymphedema among BCSs.