Ni Yang, Yuan Xu, Shuli Guo, Haiyan Hou, Ying Liu, Ge Liu, Xinyi Zhou, Yufen Ma
Background
Identifying patients’ decisional conflict and its predictors is essential since it is a critical step before developing a patient decision aid for gastric cancer patients to promote decision-making in perioperative oral nutritional supplementation.
Aims
To investigate the current status of decisional conflict and its relationship with decision preparation and decision participation regarding perioperative oral nutritional supplementation in gastric cancer patients and to explore the predictors of decisional conflict.
Methods
A convenience sampling method was employed to recruit inpatients undergoing radical gastrectomy for gastric cancer, and self-reported questionnaires were used to collect data. The Random Forest model, least absolute shrinkage and selection operator regression, and multivariate stepwise linear regression analysis were employed for data analysis.
Results
A total of 181 patients with gastric cancer were investigated. 42.5% of them had no decisional conflict, and 57.5% of them had decisional conflict. 71.3% of them expressed a desire to engage in shared decision-making, but only 29.3% of them actually participated in it. The actual type of decision-making and knowledge about oral nutritional supplementation were predictors of decisional conflict.
Conclusion
Over half of the gastric cancer patients experienced decisional conflict regarding oral nutritional supplementation during the perioperative period. The actual type of decision-making and knowledge about oral nutritional supplementation among gastric cancer patients are two predictors for decisional conflict. Healthcare professionals should consider the two predictors when developing a patient decision aid to provide decision support.
{"title":"Decisional Conflict Regarding Perioperative Oral Nutritional Supplementation in Gastric Cancer Patients Based on a Random Forest Model: A Cross-Sectional Study","authors":"Ni Yang, Yuan Xu, Shuli Guo, Haiyan Hou, Ying Liu, Ge Liu, Xinyi Zhou, Yufen Ma","doi":"10.1155/ecc/4179990","DOIUrl":"https://doi.org/10.1155/ecc/4179990","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Identifying patients’ decisional conflict and its predictors is essential since it is a critical step before developing a patient decision aid for gastric cancer patients to promote decision-making in perioperative oral nutritional supplementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To investigate the current status of decisional conflict and its relationship with decision preparation and decision participation regarding perioperative oral nutritional supplementation in gastric cancer patients and to explore the predictors of decisional conflict.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A convenience sampling method was employed to recruit inpatients undergoing radical gastrectomy for gastric cancer, and self-reported questionnaires were used to collect data. The Random Forest model, least absolute shrinkage and selection operator regression, and multivariate stepwise linear regression analysis were employed for data analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 181 patients with gastric cancer were investigated. 42.5% of them had no decisional conflict, and 57.5% of them had decisional conflict. 71.3% of them expressed a desire to engage in shared decision-making, but only 29.3% of them actually participated in it. The actual type of decision-making and knowledge about oral nutritional supplementation were predictors of decisional conflict.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Over half of the gastric cancer patients experienced decisional conflict regarding oral nutritional supplementation during the perioperative period. The actual type of decision-making and knowledge about oral nutritional supplementation among gastric cancer patients are two predictors for decisional conflict. Healthcare professionals should consider the two predictors when developing a patient decision aid to provide decision support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2025 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/4179990","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elise Martin, Antonio Di Meglio, Stefano Maccarone, Barbara Pistilli, Laurence Vanlemmens, Carine Segura-Djezzar, Carole Bouleuc, Olivier Tredan, Tracy E. Crane, Davide Soldato, Cécile Charles, Aude Barbier, Bruno Raynard, Anthony Mangin, Bernadette Coquet, Guillemette Jacob, Julia Bonastre, Stefan Michiels, Dan Chaltiel, Fabrice André, Jennifer Ligibel, Ines Vaz-Luis, Maria Alice Franzoi
<div> <section> <h3> Introduction</h3> <p>The MEDEA randomized clinical trial evaluated the impact of a telephone-based weight loss intervention focused on calorie restriction and lifestyle behavior change among overweight and obese breast cancer (BC) patients on cancer-related fatigue in France. The intervention was linguistically and culturally adapted from the North American BWEL-A011401. Since patient acceptability and engagement with weight loss interventions are influenced by cross-country cultural differences in dietary, social, and behavioral habits, we conducted a qualitative study to explore these factors and inform future implementation.</p> </section> <section> <h3> Methods</h3> <p>Among 220 patients with Stage I–III BC who participated in MEDEA, 110 were randomized to receive the weight loss intervention delivered by dietitians through 24 semistructured calls over 12 months. Twenty patients receiving the intervention accepted participation in four focus groups to explore barriers and facilitators for uptake and engagement, as well as acceptability, satisfaction, and improvement suggestions. A thematic content analysis was performed using Nvivo12 software.</p> </section> <section> <h3> Results</h3> <p>Four focus groups were conducted. Overall, patients generally expressed positive perceptions of the intervention, highlighting several key themes: (1) satisfaction with the intervention, reporting objective benefits, including measurable weight loss and reduced symptom burden; (2) recognition of intervention as a catalyst for sustainable behavioral change; and (3) appreciation for the convenience of a telephone-based format. However, participants also identified several barriers to uptake and engagement, along with suggestions for improvement: (1) The need for tools to sustain engagement such as postintervention follow-up calls, psychological support, and resources for self-monitoring; (2) for the importance of further cultural adaptation; and (3) a call for a more patient-centered research ecosystem, encompassing the selection of relevant patient-reported outcomes, improved communication, and enhanced community-building efforts).</p> </section> <section> <h3> Conclusions</h3> <p>The MEDEA intervention was found to be acceptable and positively experienced, suggesting that a North American weight loss program seems adaptable to a different language and cultural context. This qualitative analysis also informed refinements to optimize weight loss interventions in a European context.</p> </section> <section>
{"title":"Experience and Perceptions With a Phone-Based Weight Loss Intervention Among Overweight and Obese Survivors of Breast Cancer Enduring Cancer-Related Fatigue in France: A Qualitative Study Within a Randomized Clinical Trial","authors":"Elise Martin, Antonio Di Meglio, Stefano Maccarone, Barbara Pistilli, Laurence Vanlemmens, Carine Segura-Djezzar, Carole Bouleuc, Olivier Tredan, Tracy E. Crane, Davide Soldato, Cécile Charles, Aude Barbier, Bruno Raynard, Anthony Mangin, Bernadette Coquet, Guillemette Jacob, Julia Bonastre, Stefan Michiels, Dan Chaltiel, Fabrice André, Jennifer Ligibel, Ines Vaz-Luis, Maria Alice Franzoi","doi":"10.1155/ecc/5589906","DOIUrl":"https://doi.org/10.1155/ecc/5589906","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The MEDEA randomized clinical trial evaluated the impact of a telephone-based weight loss intervention focused on calorie restriction and lifestyle behavior change among overweight and obese breast cancer (BC) patients on cancer-related fatigue in France. The intervention was linguistically and culturally adapted from the North American BWEL-A011401. Since patient acceptability and engagement with weight loss interventions are influenced by cross-country cultural differences in dietary, social, and behavioral habits, we conducted a qualitative study to explore these factors and inform future implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among 220 patients with Stage I–III BC who participated in MEDEA, 110 were randomized to receive the weight loss intervention delivered by dietitians through 24 semistructured calls over 12 months. Twenty patients receiving the intervention accepted participation in four focus groups to explore barriers and facilitators for uptake and engagement, as well as acceptability, satisfaction, and improvement suggestions. A thematic content analysis was performed using Nvivo12 software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four focus groups were conducted. Overall, patients generally expressed positive perceptions of the intervention, highlighting several key themes: (1) satisfaction with the intervention, reporting objective benefits, including measurable weight loss and reduced symptom burden; (2) recognition of intervention as a catalyst for sustainable behavioral change; and (3) appreciation for the convenience of a telephone-based format. However, participants also identified several barriers to uptake and engagement, along with suggestions for improvement: (1) The need for tools to sustain engagement such as postintervention follow-up calls, psychological support, and resources for self-monitoring; (2) for the importance of further cultural adaptation; and (3) a call for a more patient-centered research ecosystem, encompassing the selection of relevant patient-reported outcomes, improved communication, and enhanced community-building efforts).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The MEDEA intervention was found to be acceptable and positively experienced, suggesting that a North American weight loss program seems adaptable to a different language and cultural context. This qualitative analysis also informed refinements to optimize weight loss interventions in a European context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 ","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2025 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/5589906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145845776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is a lack of comprehensive analysis on the associations between malnutrition, body composition, and clinical, anthropometric, biochemical, nutrition-inflammation markers, mineral and trace element levels, cytokine concentrations, and antioxidant activity in patients with cancer. Differences regarding sex at birth, ethnicity, and cancer types and stages further contribute to variations in body composition and mineral and trace element levels. This study examines factors associated with malnutrition and body composition, adjusting for relevant clinical, biochemical, nutritional data, and lifestyle confounders.
Methods
In total, 78 male patients with recurrent or metastatic head and neck cancer (HNC) or nasopharyngeal carcinoma (NPC) were recruited. Clinical characteristics (e.g., age, tumor status, and performance status), lifestyle factors, anthropometric data, nutrition-inflammation markers, plasma levels of minerals, trace elements, and cytokines as well as antioxidant activity were determined and analyzed using multivariable logistic regression and analysis of covariance models.
Results
Half of the patients (50.3%) exhibited advanced grades of BMI-adjusted body weight loss (BWL), and nearly 90% had C-reactive protein levels exceeding 5 mg/L, reflecting poor nutritional status and elevated inflammation, despite being medically fit for chemotherapy. Plasma copper levels were independently associated with BMI-adjusted BWL as well as with lean body mass and total fat mass. Similarly, plasma zinc levels showed an independent association with total fat mass.
Conclusions
Plasma levels of trace elements, including copper and zinc, are strongly correlated with malnutrition and body composition in male patients with recurrent or metastatic HNC or NPC.
{"title":"Plasma Copper Level Correlates With Body Mass Index–Adjusted Body Weight Loss Grades and Total Fat Mass in Male Patients With Recurrent or Metastatic Head and Neck and Nasopharyngeal Cancers","authors":"Chun-Feng Wu, Pei-Hung Chang, Hang Huong Ling, Yi-Ping Pan, Yu-Ching Lin, Wen-Chi Chou, Chia-Lin Peng, Zih-Syuan Chen, Simon Hsia, Kun-Yun Yeh","doi":"10.1155/ecc/5986221","DOIUrl":"https://doi.org/10.1155/ecc/5986221","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>There is a lack of comprehensive analysis on the associations between malnutrition, body composition, and clinical, anthropometric, biochemical, nutrition-inflammation markers, mineral and trace element levels, cytokine concentrations, and antioxidant activity in patients with cancer. Differences regarding sex at birth, ethnicity, and cancer types and stages further contribute to variations in body composition and mineral and trace element levels. This study examines factors associated with malnutrition and body composition, adjusting for relevant clinical, biochemical, nutritional data, and lifestyle confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 78 male patients with recurrent or metastatic head and neck cancer (HNC) or nasopharyngeal carcinoma (NPC) were recruited. Clinical characteristics (e.g., age, tumor status, and performance status), lifestyle factors, anthropometric data, nutrition-inflammation markers, plasma levels of minerals, trace elements, and cytokines as well as antioxidant activity were determined and analyzed using multivariable logistic regression and analysis of covariance models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Half of the patients (50.3%) exhibited advanced grades of BMI-adjusted body weight loss (BWL), and nearly 90% had C-reactive protein levels exceeding 5 mg/L, reflecting poor nutritional status and elevated inflammation, despite being medically fit for chemotherapy. Plasma copper levels were independently associated with BMI-adjusted BWL as well as with lean body mass and total fat mass. Similarly, plasma zinc levels showed an independent association with total fat mass.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Plasma levels of trace elements, including copper and zinc, are strongly correlated with malnutrition and body composition in male patients with recurrent or metastatic HNC or NPC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2025 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/5986221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca Philipp, Charlotte Walbaum, Carsten Bokemeyer, Martin Härter, Karin Oechsle, Sigrun Vehling
Objective
Prevalence rates of depression and anxiety in patients with a serious physical illness are high. Psychodynamic psychotherapies show potential in mitigating such psychological distress because they address hindering relational experiences and unconscious conflicts that may impair patients’ capacity to cope with illness-related distress. We investigated the efficacy of psychodynamic psychotherapy for symptoms of depression and anxiety in patients with serious physical illness.
Methods
We conducted a systematic literature search to identify randomized controlled trials and quasi-experiments of psychodynamic psychotherapies in adults with serious physical illness. We conducted random-effects meta-analyses and narrative summaries.
Results
We identified 15,112 records and included 5 RCTs (n = 648, mean age: 52.4 years, 69% female). Meta-analyses showed no significant differences between psychodynamic and standard treatment for the reduction of depressive symptoms in serious physical illness (SMD = −0.24, 95% CI: −0.87 to 0.39). No meta-analysis was calculated for anxiety symptoms due to the small number of studies investigating this outcome.
Conclusion
Quantitative evidence for the efficacy of psychodynamic psychotherapy in this population is inconclusive. More research is needed with regard to effective intervention length and adequate outcome measures, especially in patients with incurable illness.
{"title":"Efficacy of Psychodynamic Psychotherapy in Serious Physical Illness: Systematic Review and Meta-Analysis","authors":"Rebecca Philipp, Charlotte Walbaum, Carsten Bokemeyer, Martin Härter, Karin Oechsle, Sigrun Vehling","doi":"10.1155/ecc/4791709","DOIUrl":"https://doi.org/10.1155/ecc/4791709","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Prevalence rates of depression and anxiety in patients with a serious physical illness are high. Psychodynamic psychotherapies show potential in mitigating such psychological distress because they address hindering relational experiences and unconscious conflicts that may impair patients’ capacity to cope with illness-related distress. We investigated the efficacy of psychodynamic psychotherapy for symptoms of depression and anxiety in patients with serious physical illness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic literature search to identify randomized controlled trials and quasi-experiments of psychodynamic psychotherapies in adults with serious physical illness. We conducted random-effects meta-analyses and narrative summaries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 15,112 records and included 5 RCTs (<i>n</i> = 648, mean age: 52.4 years, 69% female). Meta-analyses showed no significant differences between psychodynamic and standard treatment for the reduction of depressive symptoms in serious physical illness (SMD = −0.24, 95% CI: −0.87 to 0.39). No meta-analysis was calculated for anxiety symptoms due to the small number of studies investigating this outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Quantitative evidence for the efficacy of psychodynamic psychotherapy in this population is inconclusive. More research is needed with regard to effective intervention length and adequate outcome measures, especially in patients with incurable illness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2025 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/4791709","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study demonstrates the potential benefits of large language models (LLMs) such as ChatGPT-4o and DeepSeek-R1 in supporting multidisciplinary uro-oncologic tumor boards (MUTBs) discussing complex urological-oncological cases. In particular, DeepSeek-R1 has demonstrated better performance than ChatGPT-4o in specific types of urological malignancies and specific treatment protocols.
Objective
This study examined the agreement between the AI-based systems ChatGPT-4o and DeepSeek-R1 and the decision making of a MUTB, which is a team of experts who assess uro-oncological cases.
Methods
A total of 97 uro-oncological cases covering a period of one year were retrospectively evaluated. The treatment plans for the cases were determined using traditional tumor board methods and separately presented to ChatGPT-4o and DeepSeek-R1. Comprehensive medical records were created for each case, and the planned treatments were classified as surgical intervention, radiotherapy/chemotherapy (RT-CT), advanced imaging, or follow-up. Agreement between the board and AI decisions was analyzed using Cohen’s kappa and with precision, recall, and F1 scores.
Results
In prostate cancer cases, DeepSeek-R1 showed substantial agreement (κ = 0.787, p < 0.001) with the board decisions, while ChatGPT-4o showed moderate agreement (κ = 0.593, p < 0.001). For renal malignancies, DeepSeek-R1 showed moderate agreement (κ = 0.603,p < 0.001), while ChatGPT-4o showed slight agreement (κ = 0.172, p < 0.001). In bladder cancer cases, DeepSeek-R1 showed moderate agreement (κ = 0.604, p < 0.05), but ChatGPT-4o did not show statistically significant agreement (κ = 0.217, p > 0.05). When all cases were considered together, DeepSeek-R1 showed high agreement, while ChatGPT-4o showed moderate agreement (DeepSeek-R1: κ = 0.773, p < 0.001; ChatGPT-4o: κ = 0.608, p < 0.001).
Conclusion
Our findings suggest that DeepSeek-R1’s decision support performance is better than that of ChatGPT-4o in various oncological scenarios. The results highlight the potential for publicly available AI models to be used in complex clinical fields, such as oncology.
本研究证明了chatgpt - 40和DeepSeek-R1等大型语言模型（llm）在支持多学科泌尿肿瘤委员会（MUTBs）讨论复杂泌尿肿瘤病例方面的潜在益处。特别是，DeepSeek-R1在特定类型的泌尿系统恶性肿瘤和特定治疗方案中表现出比chatgpt - 40更好的性能。本研究检验了基于人工智能的chatgpt - 40和DeepSeek-R1系统与mub（一个评估泌尿肿瘤病例的专家团队）决策之间的一致性。方法对97例1年泌尿外科肿瘤患者进行回顾性分析。病例的治疗方案采用传统的肿瘤板方法确定，并分别提交给chatgpt - 40和DeepSeek-R1。为每个病例创建全面的医疗记录，并将计划的治疗分为手术干预、放疗/化疗（RT-CT）、高级成像或随访。董事会和人工智能决策之间的一致性使用科恩的kappa以及精度、召回率和F1分数进行分析。结果在前列腺癌病例中，DeepSeek-R1与董事会的决定基本一致（κ = 0.787, p < 0.001），而chatgpt - 40则表现出中度一致（κ = 0.593, p < 0.001）。对于肾脏恶性肿瘤，DeepSeek-R1表现出中度一致性（κ = 0.603,p < 0.001），而chatgpt - 40表现出轻微一致性（κ = 0.172, p < 0.001）。在膀胱癌病例中，DeepSeek-R1表现出中度一致性（κ = 0.604, p < 0.05），而chatgpt - 40表现出无统计学意义的一致性（κ = 0.217, p < 0.05）。当所有病例一起考虑时，DeepSeek-R1显示高一致性，而chatgpt - 40显示中等一致性（DeepSeek-R1: κ = 0.773, p < 0.001; chatgpt - 40: κ = 0.608, p < 0.001）。结论在多种肿瘤情况下，DeepSeek-R1的决策支持性能优于chatgpt - 40。这一结果突显了公开可用的人工智能模型在复杂临床领域（如肿瘤学）应用的潜力。
{"title":"Exploring the Utility of ChatGPT-4o and DeepSeek-R1 for Multidisciplinary Uro-Oncology Tumor Boards: A Tumor Type–Specific Analysis","authors":"Ertugrul Cakir, Tumay Bekci, Serdar Aslan, Ural Oguz, Ercan Ogreden, Erhan Demirelli, Dogan Sabri Tok, Birgul Tok, Sendag Yaslikaya, Sevket Zorlu, Yahya Han Memis","doi":"10.1155/ecc/9029196","DOIUrl":"https://doi.org/10.1155/ecc/9029196","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study demonstrates the potential benefits of large language models (LLMs) such as ChatGPT-4o and DeepSeek-R1 in supporting multidisciplinary uro-oncologic tumor boards (MUTBs) discussing complex urological-oncological cases. In particular, DeepSeek-R1 has demonstrated better performance than ChatGPT-4o in specific types of urological malignancies and specific treatment protocols.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study examined the agreement between the AI-based systems ChatGPT-4o and DeepSeek-R1 and the decision making of a MUTB, which is a team of experts who assess uro-oncological cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 97 uro-oncological cases covering a period of one year were retrospectively evaluated. The treatment plans for the cases were determined using traditional tumor board methods and separately presented to ChatGPT-4o and DeepSeek-R1. Comprehensive medical records were created for each case, and the planned treatments were classified as surgical intervention, radiotherapy/chemotherapy (RT-CT), advanced imaging, or follow-up. Agreement between the board and AI decisions was analyzed using Cohen’s kappa and with precision, recall, and F1 scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In prostate cancer cases, DeepSeek-R1 showed substantial agreement (<i>κ</i> = 0.787, <i>p</i> < 0.001) with the board decisions, while ChatGPT-4o showed moderate agreement (<i>κ</i> = 0.593, <i>p</i> < 0.001). For renal malignancies, DeepSeek-R1 showed moderate agreement (<i>κ</i> = 0.603,<i>p</i> < 0.001), while ChatGPT-4o showed slight agreement (<i>κ</i> = 0.172, <i>p</i> < 0.001). In bladder cancer cases, DeepSeek-R1 showed moderate agreement (<i>κ</i> = 0.604, <i>p</i> < 0.05), but ChatGPT-4o did not show statistically significant agreement (<i>κ</i> = 0.217, <i>p</i> > 0.05). When all cases were considered together, DeepSeek-R1 showed high agreement, while ChatGPT-4o showed moderate agreement (DeepSeek-R1: <i>κ</i> = 0.773, <i>p</i> < 0.001; ChatGPT-4o: <i>κ</i> = 0.608, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that DeepSeek-R1’s decision support performance is better than that of ChatGPT-4o in various oncological scenarios. The results highlight the potential for publicly available AI models to be used in complex clinical fields, such as oncology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2025 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/9029196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
He Liu, Tianyi Xia, Song Xiang, Zhenzhou Chen, Yang Pan, Xiaolong Liang, Zhengqiang Wei
Background
Tumor progression and recurrence are major contributors to the poor prognosis of colorectal cancer (CRC), with angiogenesis playing a critical role in these processes. Although tumor-derived exosomes are hypothesized to significantly promote angiogenesis, the underlying mechanisms in CRC remain poorly understood.
Methods
Serum exosomal samples from five paired CRC and non-CRC patients were sequenced to identify differentially expressed miRNAs. The biological function of miR-146a and its downstream targets in angiogenesis were investigated using in vitro and in vivo models.
Results
Our findings demonstrate that miR-146a is highly enriched in CRC-derived exosomes, and its expression in serum exosomes is significantly elevated in CRC patients compared to healthy controls. MiR-146a can be transferred from CRC cells to human umbilical vein endothelial cells (HUVECs) via exosomes, enhancing their proliferation, migration, and tube formation. Mechanistically, exosomal miR-146a promotes these proangiogenic effects by downregulating the tissue inhibitor of metalloproteinase 3 (TIMP3) in HUVECs. Furthermore, in vivo experiments confirmed that exosomal miR-146a from CRC cells drives tumor growth and angiogenesis.
Conclusions
This study highlights exosomal miR-146a as a key driver of angiogenesis in CRC, suggesting its potential as a therapeutic target for antiangiogenic strategies in CRC treatment.
{"title":"Cancer-Derived Exosomal miR-146a Promotes Angiogenesis by Suppressing TIMP3 in Colorectal Cancer","authors":"He Liu, Tianyi Xia, Song Xiang, Zhenzhou Chen, Yang Pan, Xiaolong Liang, Zhengqiang Wei","doi":"10.1155/ecc/8427059","DOIUrl":"https://doi.org/10.1155/ecc/8427059","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tumor progression and recurrence are major contributors to the poor prognosis of colorectal cancer (CRC), with angiogenesis playing a critical role in these processes. Although tumor-derived exosomes are hypothesized to significantly promote angiogenesis, the underlying mechanisms in CRC remain poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Serum exosomal samples from five paired CRC and non-CRC patients were sequenced to identify differentially expressed miRNAs. The biological function of miR-146a and its downstream targets in angiogenesis were investigated using in vitro and in vivo models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our findings demonstrate that miR-146a is highly enriched in CRC-derived exosomes, and its expression in serum exosomes is significantly elevated in CRC patients compared to healthy controls. MiR-146a can be transferred from CRC cells to human umbilical vein endothelial cells (HUVECs) via exosomes, enhancing their proliferation, migration, and tube formation. Mechanistically, exosomal miR-146a promotes these proangiogenic effects by downregulating the tissue inhibitor of metalloproteinase 3 (TIMP3) in HUVECs. Furthermore, in vivo experiments confirmed that exosomal miR-146a from CRC cells drives tumor growth and angiogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights exosomal miR-146a as a key driver of angiogenesis in CRC, suggesting its potential as a therapeutic target for antiangiogenic strategies in CRC treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2025 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/8427059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hosna Ghorbani, Akram Ghahramanian, Arefeh Davoodi, Tonia C. Onyeka, Leila Valizadeh, Farzaneh Bagheriyeh, Sana Mojtahedy
Background
This study aimed to identify the information needs of mothers of children diagnosed with leukemia and to examine the relationship between these needs and the care burden.
Methods
This longitudinal descriptive study, conducted in 2022, involved 110 mothers of children and adolescents aged 6 to 18 with leukemia. Data were collected at two points: upon admission and before discharge. The study utilized a 13-item information needs scale and a 22-item Caregiver Burden Scale (CBS) to gather data. The multivariable linear regression analyses were employed to identify predictors of caregiver burden, including variables that were significant in the bivariate analyses (p values < 0.05) as independent variables in the multivariate model.
Results
In the first week, the mean score for the overall information needs scale was 2.19 ± 0.54, which significantly increased to 2.99 ± 0.34 by the fourth week. The mean score for the overall CBS was 2.97 ± 0.41 (out of 4) in the first week, rising significantly to 3.34 ± 0.34 by the fourth week (p < 0.001). There was a significant inverse correlation between overall information needs and overall CBS both in the first week (r = −0.415, p < 0.01) and in the fourth week (r = −0.224, p < 0.05).
Conclusions
This study highlights the evolving information needs and increasing caregiver burden among mothers of children and adolescents with leukemia during their initial round of chemotherapy. Although increasing information helps alleviate the caregiver burden, the upward trend in perceived caregiver burden from the first suggests the need for additional supportive interventions.
本研究旨在了解白血病患儿母亲的信息需求，并探讨这些需求与护理负担之间的关系。这项纵向描述性研究于2022年进行，涉及110名6至18岁白血病儿童和青少年的母亲。数据收集于两点：入院时和出院前。本研究采用13项信息需求量表和22项照顾者负担量表（CBS）收集数据。采用多变量线性回归分析来确定照顾者负担的预测因子，包括在双变量分析中显著的变量（p值<； 0.05）作为多变量模型中的自变量。结果第1周患者总体信息需求量表平均得分为2.19±0.54分，第4周显著提高至2.99±0.34分。第一周CBS总分平均为2.97±0.41分（总分4分），第四周显著上升至3.34±0.34分（p < 0.001）。总体信息需求与总体CBS在第一周（r = - 0.415, p < 0.01）和第四周（r = - 0.224, p < 0.05）呈显著负相关。结论：本研究突出了白血病儿童和青少年的母亲在第一轮化疗期间不断变化的信息需求和不断增加的照顾者负担。虽然越来越多的信息有助于减轻照顾者的负担，但从一开始感知到的照顾者负担的上升趋势表明需要额外的支持性干预。
{"title":"Examining Caregiving Burden in Mothers of Children With Newly Diagnosed Leukemia: The Role of Information Needs","authors":"Hosna Ghorbani, Akram Ghahramanian, Arefeh Davoodi, Tonia C. Onyeka, Leila Valizadeh, Farzaneh Bagheriyeh, Sana Mojtahedy","doi":"10.1155/ecc/5535983","DOIUrl":"https://doi.org/10.1155/ecc/5535983","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to identify the information needs of mothers of children diagnosed with leukemia and to examine the relationship between these needs and the care burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This longitudinal descriptive study, conducted in 2022, involved 110 mothers of children and adolescents aged 6 to 18 with leukemia. Data were collected at two points: upon admission and before discharge. The study utilized a 13-item information needs scale and a 22-item Caregiver Burden Scale (CBS) to gather data. The multivariable linear regression analyses were employed to identify predictors of caregiver burden, including variables that were significant in the bivariate analyses (<i>p</i> values < 0.05) as independent variables in the multivariate model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the first week, the mean score for the overall information needs scale was 2.19 ± 0.54, which significantly increased to 2.99 ± 0.34 by the fourth week. The mean score for the overall CBS was 2.97 ± 0.41 (out of 4) in the first week, rising significantly to 3.34 ± 0.34 by the fourth week (<i>p</i> < 0.001). There was a significant inverse correlation between overall information needs and overall CBS both in the first week (<i>r</i> = −0.415, <i>p</i> < 0.01) and in the fourth week (<i>r</i> = −0.224, <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the evolving information needs and increasing caregiver burden among mothers of children and adolescents with leukemia during their initial round of chemotherapy. Although increasing information helps alleviate the caregiver burden, the upward trend in perceived caregiver burden from the first suggests the need for additional supportive interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2025 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/5535983","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manon Gouez, Mayeul Tabutin, Jean Dubrez, Coralie D’Inca, Charlotte Bruneau, Lidia Delrieu, Houssein El Hajj, Baptiste Fournier, Béatrice Fervers, Olivia Pérol
Purpose
Despite its demonstrated benefits, prehabilitation before lung cancer surgery remains poorly implemented. This study investigated the preferences, interests, and barriers to exercise-based prehabilitation among patients eligible for thoracic surgery.
Method
This cross-sectional study conducted from January 2022 to July 2023 used self-administered questionnaires to collect data on preferences and barriers to exercise-based prehabilitation in cancer patients scheduled for lung resection at a French comprehensive cancer center.
Results
Most of the 23 participants (n = 20, 90.9%) were unaware of prehabilitation but expressed a strong interest in participating in an exercise program prior to lung surgery (n = 16, 72.7%). Walking (n = 16, 80.0%) and home-based exercise (n = 14, 70.0%) were the most preferred activities. Programs of short to moderate duration (1–4 weeks) and located within 30 min travel from home were preferred. Participants preferred exercising alone or with family members and showed limited interest in the group or facility-based sessions. While 81.8% (n = 18) felt capable of engaging in an exercise-based prehabilitation program, common barriers included distance from the care center, breathlessness, and fatigue. Physical and medical limitations were more frequently reported than psychological ones.
Conclusion
Despite limited awareness, lung cancer patients show a strong interest in exercise-based prehabilitation. Home-based and flexible programs aligned with patient preferences may help overcome participation barriers. These findings support the development of personalized, accessible prehabilitation strategies to enhance engagement before lung surgery.
{"title":"Preferences, Interests, and Barriers to Physical Activity–Based Prehabilitation Prior to Lung Resection: A Survey Study","authors":"Manon Gouez, Mayeul Tabutin, Jean Dubrez, Coralie D’Inca, Charlotte Bruneau, Lidia Delrieu, Houssein El Hajj, Baptiste Fournier, Béatrice Fervers, Olivia Pérol","doi":"10.1155/ecc/5723896","DOIUrl":"https://doi.org/10.1155/ecc/5723896","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Despite its demonstrated benefits, prehabilitation before lung cancer surgery remains poorly implemented. This study investigated the preferences, interests, and barriers to exercise-based prehabilitation among patients eligible for thoracic surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This cross-sectional study conducted from January 2022 to July 2023 used self-administered questionnaires to collect data on preferences and barriers to exercise-based prehabilitation in cancer patients scheduled for lung resection at a French comprehensive cancer center.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most of the 23 participants (<i>n</i> = 20, 90.9%) were unaware of prehabilitation but expressed a strong interest in participating in an exercise program prior to lung surgery (<i>n</i> = 16, 72.7%). Walking (<i>n</i> = 16, 80.0%) and home-based exercise (<i>n</i> = 14, 70.0%) were the most preferred activities. Programs of short to moderate duration (1–4 weeks) and located within 30 min travel from home were preferred. Participants preferred exercising alone or with family members and showed limited interest in the group or facility-based sessions. While 81.8% (<i>n</i> = 18) felt capable of engaging in an exercise-based prehabilitation program, common barriers included distance from the care center, breathlessness, and fatigue. Physical and medical limitations were more frequently reported than psychological ones.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite limited awareness, lung cancer patients show a strong interest in exercise-based prehabilitation. Home-based and flexible programs aligned with patient preferences may help overcome participation barriers. These findings support the development of personalized, accessible prehabilitation strategies to enhance engagement before lung surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2025 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/5723896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sadio Righes, Pauline Waroquier, Marie Caillier, Oriane Verkaeren, Paulus Kristanto, Isabelle Merckaert
Background
Cancer-related fatigue (CRF) is one of the most frequently reported symptoms among breast cancer survivors. Recommendations regarding nonpharmacological treatments for CRF include physical activity, psychosocial, and mind–body interventions. Despite the close association of CRF with psychological symptoms, to our knowledge, no study has assessed the impact of a psychosocial intervention on CRF among patients meeting criteria for clinical levels of psychological symptoms.
Aim
This study presents findings on changes in CRF, sleep disturbances, energy levels, and physical activity from a randomized controlled trial (RCT) evaluating the efficacy of an eight-session emotion and self-regulation group intervention ecologically boosted through daily app-based prompts. The intervention, specifically designed for breast cancer survivors in the early survivorship period who exhibited clinical levels of psychological symptoms, showed its efficacy in targeting some psychological symptoms (i.e., worry, intrusive thoughts, and negative emotions).
Method
At the end of radiation therapy treatment, breast cancer survivors were screened for clinical levels of psychological symptoms and randomly assigned to either an immediate (n = 61) or a delayed intervention group (n = 59, intervention delayed by 5 months). CRF, sleep disturbances, energy levels, and physical activity were assessed using self-reported questionnaires, visual analog scales, and ecological momentary assessments. Assessments were performed at baseline (T1), 5 months (T2), and 10 months (T3). Mixed models were conducted to evaluate the intervention’s efficacy in treating CRF.
Results
Treated patients reported less general fatigue (p = 0.028), reduced motivation (p = 0.005), and mental fatigue (p = 0.024), as well as lower levels of habitual physical fatigue (p = 0.043) and momentary fatigue in daily life (p = 0.009).
Conclusions
Our study highlights the usefulness of targeting emotion and self-regulation in a brief group intervention to treat CRF among patients with clinical levels of psychological symptoms. Further research is needed to clarify the mechanisms driving the efficacy of the intervention.
{"title":"Efficacy of a Brief Ecologically Boosted Emotion Regulation Group Intervention on Cancer-Related Fatigue in Breast Cancer Survivors: A Randomized Controlled Trial","authors":"Sadio Righes, Pauline Waroquier, Marie Caillier, Oriane Verkaeren, Paulus Kristanto, Isabelle Merckaert","doi":"10.1155/ecc/6659905","DOIUrl":"https://doi.org/10.1155/ecc/6659905","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cancer-related fatigue (CRF) is one of the most frequently reported symptoms among breast cancer survivors. Recommendations regarding nonpharmacological treatments for CRF include physical activity, psychosocial, and mind–body interventions. Despite the close association of CRF with psychological symptoms, to our knowledge, no study has assessed the impact of a psychosocial intervention on CRF among patients meeting criteria for clinical levels of psychological symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study presents findings on changes in CRF, sleep disturbances, energy levels, and physical activity from a randomized controlled trial (RCT) evaluating the efficacy of an eight-session emotion and self-regulation group intervention ecologically boosted through daily app-based prompts. The intervention, specifically designed for breast cancer survivors in the early survivorship period who exhibited clinical levels of psychological symptoms, showed its efficacy in targeting some psychological symptoms (i.e., worry, intrusive thoughts, and negative emotions).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>At the end of radiation therapy treatment, breast cancer survivors were screened for clinical levels of psychological symptoms and randomly assigned to either an immediate (<i>n</i> = 61) or a delayed intervention group (<i>n</i> = 59, intervention delayed by 5 months). CRF, sleep disturbances, energy levels, and physical activity were assessed using self-reported questionnaires, visual analog scales, and ecological momentary assessments. Assessments were performed at baseline (T1), 5 months (T2), and 10 months (T3). Mixed models were conducted to evaluate the intervention’s efficacy in treating CRF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Treated patients reported less general fatigue (<i>p</i> = 0.028), reduced motivation (<i>p</i> = 0.005), and mental fatigue (<i>p</i> = 0.024), as well as lower levels of habitual physical fatigue (<i>p</i> = 0.043) and momentary fatigue in daily life (<i>p</i> = 0.009).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study highlights the usefulness of targeting emotion and self-regulation in a brief group intervention to treat CRF among patients with clinical levels of psychological symptoms. Further research is needed to clarify the mechanisms driving the efficacy of the intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2025 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/6659905","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145619174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Living with prostate cancer presents considerable psychological challenges. Previous research has identified masculinity, intolerance of uncertainty, coping, and psychological flexibility as predictors of psychological adjustment, suggesting an integrative framework. However, the interplay between these factors remains underexplored. This study aims to address this gap by examining how these psychological factors collectively influence distress and well-being in prostate cancer, with a specific focus on the moderated mediation models involving coping and psychological flexibility. Findings will inform the development of tailored interventions and supportive care for men with prostate cancer.
Methods
A cross-sectional, correlational survey design was employed. A total of 162 men diagnosed with prostate cancer completed an online survey containing a battery of validated measures and demographic questions. Bivariate correlation, hierarchical regression, and conditional process analyses were conducted to test the proposed relationships.
Results
Psychological flexibility, masculine identity, masculine self-esteem, intolerance of uncertainty, and coping collectively explained 61.9% of the variance in distress and 52.7% in mental well-being. Masculine self-esteem emerged as the strongest predictor of both outcomes. Psychological flexibility explained significant additional variance beyond other psychological predictors and prostate cancer symptoms. Moreover, psychological flexibility moderated the indirect relationship between masculine self-esteem and distress through avoidant coping, as well as the direct effect of intolerance of uncertainty on distress.
Conclusions
Screening for difficulties related to masculine self-esteem and intolerance of uncertainty may help identify men at higher risk of poorer psychological adjustment following prostate cancer diagnosis. Interventions such as Acceptance and Commitment Therapy or mindfulness-based approaches may enhance psychological flexibility, improve tolerance of uncertainty, and foster adaptive engagement with masculine identity. Targeted interventions addressing the framing and enactment of masculinity may also prove beneficial.
{"title":"Psychological Flexibility Buffers the Effects of Intolerance of Uncertainty and Diminished Masculine Self-Esteem on Distress in Prostate Cancer","authors":"Yingna Li, Anne Finucane, David Gillanders","doi":"10.1155/ecc/7770664","DOIUrl":"https://doi.org/10.1155/ecc/7770664","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Living with prostate cancer presents considerable psychological challenges. Previous research has identified masculinity, intolerance of uncertainty, coping, and psychological flexibility as predictors of psychological adjustment, suggesting an integrative framework. However, the interplay between these factors remains underexplored. This study aims to address this gap by examining how these psychological factors collectively influence distress and well-being in prostate cancer, with a specific focus on the moderated mediation models involving coping and psychological flexibility. Findings will inform the development of tailored interventions and supportive care for men with prostate cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional, correlational survey design was employed. A total of 162 men diagnosed with prostate cancer completed an online survey containing a battery of validated measures and demographic questions. Bivariate correlation, hierarchical regression, and conditional process analyses were conducted to test the proposed relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Psychological flexibility, masculine identity, masculine self-esteem, intolerance of uncertainty, and coping collectively explained 61.9% of the variance in distress and 52.7% in mental well-being. Masculine self-esteem emerged as the strongest predictor of both outcomes. Psychological flexibility explained significant additional variance beyond other psychological predictors and prostate cancer symptoms. Moreover, psychological flexibility moderated the indirect relationship between masculine self-esteem and distress through avoidant coping, as well as the direct effect of intolerance of uncertainty on distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Screening for difficulties related to masculine self-esteem and intolerance of uncertainty may help identify men at higher risk of poorer psychological adjustment following prostate cancer diagnosis. Interventions such as Acceptance and Commitment Therapy or mindfulness-based approaches may enhance psychological flexibility, improve tolerance of uncertainty, and foster adaptive engagement with masculine identity. Targeted interventions addressing the framing and enactment of masculinity may also prove beneficial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2025 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/7770664","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145619122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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