Journal of Cancer Survivorship最新文献

Purpose: Protective lifestyle behaviors could potentially mitigate the risk of depression in breast cancer survivors. This study examined the association between changes in key health behaviors and depression risk after breast cancer diagnosis and treatment.

Methods: This nationwide cohort study assessed 30,523 breast cancer survivors without a prior history of depression, focusing on changes in weight, smoking habits, alcohol consumption, and physical activity from pre- to post-cancer diagnosis. The primary outcome was incident depression, with adjusted hazard ratios and confidence intervals calculated to consider potential confounders.

Results: During an average follow-up of 5.3 years (160,755 person-years), lifestyle changes post-diagnosis included decreases in smoking (2.8% to 0.9%) and alcohol consumption (24.9% to 7.5%) and an increase in physical activity (18.9% to 32.1%). Substantial weight gain (> 10%) was associated with a 27% elevated risk of depression compared to those who maintained weight. Both continuation and cessation of smoking were associated with increased depression risk compared to sustained non-smokers. Changes in alcohol consumption, either initiation or cessation, were associated with increased depression risk compared to sustained non-drinkers. Conversely, breast cancer survivors who became inactive post-diagnosis had a reduced risk of depression compared to those who remained inactive. Our exploratory analysis showed that regular physical activity prior to diagnosis was associated with a 7% lower risk of depression compared to inactivity.

Conclusion: We observed that post-diagnosis weight gain exceeding 10%, sustaining or quitting smoking, starting or stopping alcohol consumption, and pre-diagnosis physical inactivity were all associated with an increased risk of depression in breast cancer survivors. Healthcare providers should support healthy behaviors to mitigate depression risk after breast cancer diagnosis and treatment.

Purpose: Meditation is well known for its positive effects on recovery and quality of life enhancement among cancer patients. Meditation as an adjuvant therapy has received extensive attention from international scholars in relieving pain, reducing psychological pressure and improving the quality of life of cancer patients. In this study, we examine the current status of meditation in cancer research and its potential application value and future development.

Methods: We collected 825 articles published in the Web of science Core Collection between January 1, 1976, and July 1, 2024, covering 11 cancer types. Bibliometric tools such as VOSviewer, Citespace, and Biblioshiny were used to analyze publication trends, international collaborations, author contributions, keywords, co-citations, and journal impact.

Results: First, the steadily rising number of publications indicates an increasing scholarly focus on meditation's benefits for patients. Second, the USA, Australia, and China are the countries with the highest number of publications in each of the three clusters. Additionally, Carlson Linda E and eight other scholars are influential scholars in this field. Finally, through keyword co-occurrence and co-citation analysis, we identified "breast cancer," "quality of life," and "psychological intervention" as the hot topics of current research.

Conclusions: The study provides a valuable reference for scientific researchers to further explore meditation in cancer treatment.

Implications for cancer survivors: This study highlights the growing interest in meditation as an adjuvant therapy for cancer patients, underscoring its potential to improve survivors' quality of life. Current research primarily focuses on quality of life, mindfulness-based stress reduction therapy, and clinical trials. Additionally, online, virtual reality technology, cancer survivors, fear of cancer recurrence, and qualitative research may become cutting-edge research directions in the future.

Purpose: This cross-sectional study assessed the prevalence of unmet supportive care needs and financial burdens among South Korean adult cancer survivors.

Methods: A total of 1038 adult cancer survivors were recruited through convenience sampling from the 2022 Korean Population Census. Data were collected online from November 17 to December 15, 2022. Unmet supportive care needs were assessed across three domains: access and continuity of care, coping and emotional needs, and information needs. Ordinal logistic regression analyses were conducted, adjusting for relevant demographic and clinical characteristics.

Results: Among study participants, 65.7% of those with severe financial toxicity reported high unmet supportive care needs. The most frequently reported unmet need was related to coping and emotional support (44.7%). Cancer survivors diagnosed 6-10 years ago had significantly lower unmet supportive care needs compared with those diagnosed within the past three years (AOR = 0.69, 95% CI: 0.49-0.98). Survivors with stage III/IV cancer (AOR = 1.62, 95% CI: 1.13-2.32) were more likely to report high unmet needs. Additionally, those with severe financial toxicity were at significantly higher risk of reporting unmet needs (AOR = 3.26, 95% CI: 2.13-5.02).

Conclusions: Unmet supportive care needs were significantly associated with severe financial toxicity, time since diagnosis, and cancer stage. Survivors with severe financial toxicity or advanced-stage cancer are at an increased risk of experiencing unmet needs.

Implications for cancer survivors: These findings highlight the need for targeted interventions to address the unmet supportive care needs of cancer survivors, particularly those experiencing severe financial burdens or diagnosed with advanced-stage cancer. Interventions should be tailored to different survivorship stages to improve long-term health outcomes and quality of life for cancer survivors in South Korea.

Objective: Fatigue is the most common side effect in cancer and cancer treatment. This study aimed to investigate the effect of different amounts of exercise on fatigue in patients with digestive tumors.

Methods: We searched articles published to March 2024 in the PubMed, Embase, Web of Science, and Cochrane databases. The amount of exercise was evaluated according to the American College of Sports Medicine (ACSM) and divided into high compliance and low compliance. The effect of compliance on fatigue in patients with digestive tumors was compared using standardized mean difference and 95% confidence intervals (95% CI).

Results: A total of 18 articles were included, and we found that exercise had beneficial effects on cancer-related fatigue (CRF) in patients with digestive tumors. Fifteen studies that met the ACSM recommendations were grouped eventually. Eight studies were classified as high compliance and 7 studies as low compliance. The CRF was improved significantly in the high compliance (- 1.89; 95% [CI], - 2.93 to - 0.86) compared with the low compliance (- 1.43; 95% [CI], - 2.25 to - 0.61).

Conclusion: Exercise intervention with high compliance showed a more significant improvement in fatigue in patients with digestive tumors compared with low compliance. However, these studies have not yet been fully uniform for the scoring tool for CRF, and further studies are needed to validate these findings.

Implications for cancer survivors: Compared with low compliance, exercise intervention with high compliance has shown a more significant improvement in fatigue among patients with digestive tumors. In addition, the beneficial effects of high compliance with exercise intervention on fatigue in patients with digestive tumors also provide important implications for cancer survivors. Regular exercise that conforms to the American College of Sports Medicine (ACSM) recommendations, especially maintaining high compliance, can serve as an effective strategy to alleviate cancer-related fatigue and improve the quality of life of survivors. However, these studies have not yet been fully unified in the scoring tools for cancer-related fatigue (CRF), and further research is needed to validate these findings.

Purpose: To compare the efficacy of the different mind-body exercises (MBEs) for quality of life (QOL) and cancer-related fatigue (CRF) in women breast cancer (BC) survivors.

Methods: This review searched published randomized controlled trials (RCTs) in eight electronic databases: PubMed, Web of Science, Embase, Cochrane CENTRAL, EBSCO, CNKI, VIP, and WanFang from inception to October 30, 2023. NMA and comparative effects ranking were performed using STATA 17.0 software.

Results: This study included 121 studies with 11,072 women BC patients and eight different MBEs. Baduanjin showed the largest effect size in significantly improving subjective QOL (SMD = 3.03, 95% CI (2.04, 4.01)) compared with the control group, followed by relaxation training (SMD = 1.44, 95% CI (1.04, 1.85)), yoga (SMD = 0.89, 95% CI (0.36, 1.42)), mindfulness (SMD = 0.83, 95% CI (0.54, 1.12)), and Tai chi (SMD = 0.76, 95% CI (0.04, 1.48)). Furthermore, Tai chi (SMD =  - 1.42, 95% CI (- 2.21, - 0.63)) ranked first in significantly reducing CRF in BC patients compared with the control group, followed by mindfulness (SMD =  - 0.81, 95% CI (- 1.11, - 0.50)), relaxation training (SMD =  - 0.70, 95% CI (- 1.12, - 0.28)), and yoga (SMD =  - 0.53, 95% CI (- 0.88, - 0.18)).

Conclusions: Baduanjin and Tai chi are the most effective MBEs for improving QOL and CRF in female BC survivors, respectively. We recommend that healthcare providers prioritize Baduanjin and Tai chi as complementary therapies for BC survivors.

Implications for cancer survivors: Baduanjin and Tai chi have significant effects on improving the QOL of breast cancer patients and alleviating CRF, which is worthy of promotion and application.

Purpose: This study aimed to characterize associations between male childhood cancer survivors' perception of infertility risk and objective fertility status and to identify factors contributing to risk perception.

Methods: Participants were from SJLIFE, exposed to alkylating agents but not radiation, and completed a Men's Health Questionnaire (MHQ) and semen analysis. Samples were obtained following the 2010 World Health Organization Guidelines, and classified as azoospermic (0 sperm), oligospermic (> 0 and < 15 million sperm/ml), or normospermic (≥ 15 million sperm/ml). Participants were classified as at minimally or high/significantly increased risk for infertility according to the Pediatric Initiative Network (PIN) criteria. Perception of infertility risk was assessed via self-report where survivors indicated the following: (1) more risk than peers without cancer history, (2) less risk, or (3) equal risk, as well as factors contextualizing perceived risk. Chi-squared tests or Fishers' exact tests assessed differences in variables of interest.

Results: Among 238 participants (age 27 ± 6 years, 85% NH White, 47% survivors of leukemia), 58% perceived increased infertility risk than peers without cancer history, 29% equal risk, and 13% less risk. A larger proportion of survivors with azoospermia perceived higher risk than other groups (74%) (p = 0.01). No differences were observed in risk perception by PIN criteria. No differences were observed by sperm concentration category or PIN criteria in factors contextualizing perceived risk.

Conclusions: Male survivors not exposed to radiation in the SJLIFE cohort are generally aware of their infertility risk.

Implications for cancer survivors: Male survivors should seek continued follow-up care regarding fertility and information on risk from reputable sources.

Purpose: Ejaculatory dysfunction secondary to retrograde ejaculation or anejaculation is a complication of retroperitoneal lymph node dissection (RPLND) for survivors of testicular cancer. We explored survivors' experiences of ejaculatory dysfunction following RPLND.

Methods: In a sub-study of a single-arm phase 2 clinical trial (ACTRN12622000537752/12622000542796), participants reporting ejaculatory dysfunction ≥ 6 months following RPLND were invited to complete semi-structured interviews. Purposive sampling was used. Interviews continued until thematic saturation occurred, and codebook thematic analysis of interviews was performed.

Results: Of 58 individuals recruited to the trial, 33 (57%) reported ejaculatory dysfunction. Of these, 32 (97%) agreed to interview and 15 participated. Participants interviewed had median age 34 years (range 24-66), 12 (80%) in a long-term relationship with median time from surgery 36 months (range 11-112). Three overarching themes were identified. The first reflected the value of RPLND despite ejaculatory dysfunction. The second illuminated the impact(s) of ejaculatory dysfunction closely mapped to life stage, with flow-on impacts to fertility, sex, psychological wellbeing and communication. The third reflected information needs. Fertility was a substantial source of concern for some participants. Ejaculatory dysfunction had no effect on sex for some, whilst for others, sex was less pleasurable. Some reported benefits. Few reported ejaculatory dysfunction challenged masculinity, confidence, or self-esteem.

Conclusions: Future research should examine interventions to reduce distress related to fertility, challenged masculinity and body image.

Implications for cancer survivors: Whilst most participants considered ejaculatory dysfunction to have little impact on their sexual function and relationships, some reported significant difficulties varying by life stage and relationship status.

Purpose: This study investigates the association between socioeconomic position (SEP) and health-related quality of life (HRQoL) in a cross-sectional cohort among cancer survivors and compares with cancer-free people.

Methods: Survivors of colorectal, hematological, gynecological, prostate, thyroid cancer, and melanoma diagnosed 2000-2014 were identified in the PROFILES registry, and an age- and sex-matched cancer-free population were identified in the CentER panel. HRQoL, education, and comorbidity were self-reported. Street-level income and clinical factors were obtained from Statistics Netherlands and the Netherlands Cancer Registry. Multivariable logistic regression was used to examine associations of SEP (measured by education and income) and impaired HRQoL among cancer survivors and the cancer-free population, adjusting for age, sex, and time since diagnosis.

Results: We included 6693 cancer survivors and 565 cancer-free people. Cancer survivors with low versus medium SEP more frequently reported impaired HRQoL (odds ratio (OR) range for all HRQoL outcomes, 1.06-1.78 for short education and 0.94-1.56 for low income). Survivors with high compared to medium SEP reported impaired HRQoL less frequently (OR range for all HRQoL outcomes, 0.46-0.81 for short education and 0.60-0.84 for low income). The association between SEP and HRQoL was similar in the matched cancer-free population.

Conclusion: Low SEP was associated with impaired HRQoL in both cancer survivors and cancer-free people.

Implications for cancer survivors: Targeted care is warranted for cancer survivors with impaired HRQoL, especially among those with low SEP.

Purpose: Current early-stage breast and gynecological cancer care models often begin with a referral from a primary care provider (PCP) or gynecologist (OB/Gyn) and end with a patient being transitioned back to the referring provider at the completion of treatment. There is frequently little communication between oncologists and the referring provider during treatment, and this pattern continues after the patient completes their treatment.

Methods: We convened a diverse Patient Advisory Board (PAB) to identify areas where breast or gynecological cancer patients felt they could benefit from additional support during and after their cancer care. PAB members attended five Zoom meetings and completed four online surveys. Semi-structured interviews were conducted with primary care or OB/Gyn physicians to collect information on current practices.

Results: Patients identified multiple areas in which they needed additional support from their PCP. Providers also identified topics on which they could use additional training. However, there was little overlap between patient and provider priority topics. Both patients and providers agreed that there was inadequate communication between the cancer center and PCPs before, during, and after cancer treatment.

Conclusions: A shared-care model that emphasizes communication between primary care providers, the oncology care team, and patients is urgently needed. Patients indicated the need for additional support from their PCP on specific topics, and PCPs were interested in continuing their education to better serve their patients with cancer.

Implications for cancer survivors: The importance of consistent communication among all parties during the entire cancer journey was emphasized as a key area for improvement.

Purpose: We aimed to determine the effects of a classmate-supported, supervised, in-hospital physical activity program during treatment primarily on cardiorespiratory fitness and secondarily on physical function.

Methods: A multicenter non-randomized controlled intervention study including children diagnosed with cancer, 6-18 years at diagnosis treated with chemo-/radiotherapy. The intervention comprised (i) an educational session on cancer in the child's school class; (ii) selection of two "ambassadors"-classmates who were co-admitted, supporting the child's everyday hospital life; and (iii) supervised in-hospital physical activity from diagnosis and throughout intensive treatment. One-year post-treatment, physical testing included cardiorespiratory fitness (primary outcome), Sit-to-Stand test, Timed-Up-and-Go, and Handgrip Strength.

Results: The intervention group included 75 of 120 children (61% boys, 13.4 ± 3.1 years); the control groups included 33 of 58 children with cancer (58% boys, 13.5 ± 2.5 years), and 94 age- and sex-matched children without a cancer history. One-year post-treatment, cardiorespiratory fitness tended to be higher in the intervention group (37.0 ± 6.0 mL/kg/min) than in the patient control group with cancer (32.3 ± 9.7 mL/kg/min) (mean difference 4.7 [0.4 to 9.1], p = 0.034). The intervention group performed better in the secondary outcomes. Compared with community controls, both patient groups had lower cardiorespiratory fitness. The patient control group had lower Sit-to-Stand, Timed Up and Go, and Handgrip Strength, while the intervention group had strength comparable to that of the community controls.

Conclusions: Peer-supported, supervised, in-hospital physical activity during treatment may improve cardiorespiratory fitness and muscle strength 1-year post-treatment in children with cancer; however, survivors continue to have lower cardiorespiratory fitness than community controls.

Implications for cancer survivors: Children with cancer may benefit from in-hospital physical activity in improving long-term cardiorespiratory fitness and muscle strength.