Pub Date : 2024-10-01Epub Date: 2023-05-20DOI: 10.1007/s11764-023-01405-1
Dana Barnea, Emily S Tonorezos, Amber Khan, Joanne F Chou, Chaya S Moskowitz, Rana Kaplan, Suzanne L Wolden, Yolanda Bryce, Kevin C Oeffinger
Purpose: Childhood and young adult cancer survivors exposed to chest radiotherapy are at increased risk of lung cancer. In other high-risk populations, lung cancer screening has been recommended. Data is lacking on prevalence of benign and malignant pulmonary parenchymal abnormalities in this population.
Methods: We conducted a retrospective review of pulmonary parenchymal abnormalities in chest CTs performed more than 5 years post-cancer diagnosis in survivors of childhood, adolescent, and young adult cancer. We included survivors exposed to radiotherapy involving the lung field and followed at a high-risk survivorship clinic between November 2005 and May 2016. Treatment exposures and clinical outcomes were abstracted from medical records. Risk factors for chest CT-detected pulmonary nodule were assessed.
Results: Five hundred and ninety survivors were included in this analysis: median age at diagnosis, 17.1 years (range, 0.4-39.8); and median time since diagnosis, 22.3 years (range, 1-58.6). At least one chest CT more than 5 years post-diagnosis was performed in 338 survivors (57%). Among these, 193 (57.1%) survivors had at least one pulmonary nodule detected on a total of 1057 chest CTs, resulting in 305 CTs with 448 unique nodules. Follow-up was available for 435 of these nodules; 19 (4.3%) were malignant. Risk factors for first pulmonary nodule were older age at time of CT, CT performed more recently, and splenectomy.
Conclusions: Benign pulmonary nodules are very common among long-term survivors of childhood and young adult cancer.
Implications for cancer survivors: High prevalence of benign pulmonary nodules in cancer survivors exposed to radiotherapy could inform future guidelines on lung cancer screening in this population.
{"title":"Benign and malignant pulmonary parenchymal findings on chest CT among adult survivors of childhood and young adult cancer with a history of chest radiotherapy.","authors":"Dana Barnea, Emily S Tonorezos, Amber Khan, Joanne F Chou, Chaya S Moskowitz, Rana Kaplan, Suzanne L Wolden, Yolanda Bryce, Kevin C Oeffinger","doi":"10.1007/s11764-023-01405-1","DOIUrl":"10.1007/s11764-023-01405-1","url":null,"abstract":"<p><strong>Purpose: </strong>Childhood and young adult cancer survivors exposed to chest radiotherapy are at increased risk of lung cancer. In other high-risk populations, lung cancer screening has been recommended. Data is lacking on prevalence of benign and malignant pulmonary parenchymal abnormalities in this population.</p><p><strong>Methods: </strong>We conducted a retrospective review of pulmonary parenchymal abnormalities in chest CTs performed more than 5 years post-cancer diagnosis in survivors of childhood, adolescent, and young adult cancer. We included survivors exposed to radiotherapy involving the lung field and followed at a high-risk survivorship clinic between November 2005 and May 2016. Treatment exposures and clinical outcomes were abstracted from medical records. Risk factors for chest CT-detected pulmonary nodule were assessed.</p><p><strong>Results: </strong>Five hundred and ninety survivors were included in this analysis: median age at diagnosis, 17.1 years (range, 0.4-39.8); and median time since diagnosis, 22.3 years (range, 1-58.6). At least one chest CT more than 5 years post-diagnosis was performed in 338 survivors (57%). Among these, 193 (57.1%) survivors had at least one pulmonary nodule detected on a total of 1057 chest CTs, resulting in 305 CTs with 448 unique nodules. Follow-up was available for 435 of these nodules; 19 (4.3%) were malignant. Risk factors for first pulmonary nodule were older age at time of CT, CT performed more recently, and splenectomy.</p><p><strong>Conclusions: </strong>Benign pulmonary nodules are very common among long-term survivors of childhood and young adult cancer.</p><p><strong>Implications for cancer survivors: </strong>High prevalence of benign pulmonary nodules in cancer survivors exposed to radiotherapy could inform future guidelines on lung cancer screening in this population.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9520889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2023-06-22DOI: 10.1007/s11764-023-01404-2
Adaora Ezeani, Justin B E Tcheugui, Tanya Agurs-Collins
Background: The purpose of this study was to assess the association of metabolic syndrome (MetS) and its individual components in cancer survivors (CS) by gender, in comparison to participants without a history of cancer who have at least one chronic disease (CD) and those without a chronic disease diagnosis (NCD).
Methods: Data from participants 40 years and older (n = 12,734) were collected from the 2011 to 2018 National Health and Nutrition Examination Survey dataset. MetS was defined based on the National Cholesterol Education Program's Adult Treatment Panel III. Chi-square test and multivariate-adjusted logistic regression was used to assess group comparisons and associations respectively.
Results: Compared to NCD, CS and CD men had increased odds of meeting MetS, OR 2.60 (CI 1.75-3.87) and OR 2.18 (CI 1.59-2.98) respectively. For women, CS and CD participants also had higher odds of meeting MetS criteria compared to their healthy counterparts, OR 2.05 (CI 1.44-2.93) and OR 2.14 (CI 1.63-2.81) respectively. In subgroup analysis by cancer site, CS men with a history of hematologic malignancies (OR 4.88, CI 1.30-18.37) and CS women with cervical cancer (OR 4.25, CI 1.70-10.59) had highest odds of developing MetS, compared to NCD. CS men also showed a strong association with elevated waist circumference, low high density lipoprotein-c, and elevated triglycerides, even by cancer site, but there were no consistent findings among women.
Conclusion: This study indicates that CS men have a strong association with MetS, especially among those with blood-related cancers.
{"title":"Sex/gender differences in metabolic syndrome among cancer survivors in the US: an NHANES analysis.","authors":"Adaora Ezeani, Justin B E Tcheugui, Tanya Agurs-Collins","doi":"10.1007/s11764-023-01404-2","DOIUrl":"10.1007/s11764-023-01404-2","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to assess the association of metabolic syndrome (MetS) and its individual components in cancer survivors (CS) by gender, in comparison to participants without a history of cancer who have at least one chronic disease (CD) and those without a chronic disease diagnosis (NCD).</p><p><strong>Methods: </strong>Data from participants 40 years and older (n = 12,734) were collected from the 2011 to 2018 National Health and Nutrition Examination Survey dataset. MetS was defined based on the National Cholesterol Education Program's Adult Treatment Panel III. Chi-square test and multivariate-adjusted logistic regression was used to assess group comparisons and associations respectively.</p><p><strong>Results: </strong>Compared to NCD, CS and CD men had increased odds of meeting MetS, OR 2.60 (CI 1.75-3.87) and OR 2.18 (CI 1.59-2.98) respectively. For women, CS and CD participants also had higher odds of meeting MetS criteria compared to their healthy counterparts, OR 2.05 (CI 1.44-2.93) and OR 2.14 (CI 1.63-2.81) respectively. In subgroup analysis by cancer site, CS men with a history of hematologic malignancies (OR 4.88, CI 1.30-18.37) and CS women with cervical cancer (OR 4.25, CI 1.70-10.59) had highest odds of developing MetS, compared to NCD. CS men also showed a strong association with elevated waist circumference, low high density lipoprotein-c, and elevated triglycerides, even by cancer site, but there were no consistent findings among women.</p><p><strong>Conclusion: </strong>This study indicates that CS men have a strong association with MetS, especially among those with blood-related cancers.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10029845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2023-05-18DOI: 10.1007/s11764-023-01395-0
Eliza R Macdonald, Nadia M L Amorim, Amanda D Hagstrom, Katarina Markovic, David Simar, Rachel E Ward, Briana K Clifford
Purpose: Improvements in breast cancer management continue to increase survival and life expectancy after treatment. Yet the adverse effects of treatment may persist long term, threatening physical, psychological, and social wellbeing, leading to impaired quality of life (QOL). Upper-body morbidity (UBM) such as pain, lymphoedema, restricted shoulder range of motion (ROM), and impaired function are widely reported after breast cancer treatment, but evidence demonstrating its impact on QOL is inconsistent. Therefore, the aim of the study was to conduct a systematic review and meta-analysis evaluating the effect of UBM on QOL following primary breast cancer treatment.
Methods: The study was prospectively registered on PROSPERO (CRD42020203445). CINAHL, Embase, Emcare, PsycInfo, PubMed/Medline, and SPORTDiscus databases were searched for studies reporting QOL in individuals with and without UBM following primary breast cancer treatment. Primary analysis determined the standardised mean difference (SMD) in physical, psychological, and social wellbeing scores between UBM + /UBM - groups. Secondary analyses identified differences in QOL scores between groups, according to questionnaire.
Results: Fifty-eight studies were included, with 39 conducive to meta-analysis. Types of UBM included pain, lymphoedema, restricted shoulder ROM, impaired upper-body function, and upper-body symptoms. UBM + groups reported poorer physical (SMD = - 0.99; 95%CI = - 1.26, - 0.71; p < 0.00001), psychological (SMD = - 0.43; 95%CI = - 0.60, - 0.27; p < 0.00001), and social wellbeing (SMD = - 0.62; 95%CI = - 0.83, - 0.40; p < 0.00001) than UBM - groups. Secondary analyses according to questionnaire showed that UBM + groups rated their QOL poorer or at equal to, UBM - groups across all domains.
Conclusions: Findings demonstrate the significant, negative impact of UBM on QOL, pervading physical, psychological, and social domains.
Implications for cancer survivors: Efforts to assess and minimise the multidimensional impact of UBM are warranted to mitigate impaired QOL after breast cancer.
目的:乳腺癌治疗方法的改进不断提高了患者的生存率和预期寿命。然而,治疗的不良影响可能会长期存在,威胁患者的身体、心理和社会福祉,导致生活质量(QOL)下降。乳腺癌治疗后,疼痛、淋巴水肿、肩部活动范围(ROM)受限和功能受损等上半身发病率(UBM)被广泛报道,但证明其对 QOL 影响的证据并不一致。因此,本研究旨在对 UBM 对原发性乳腺癌治疗后 QOL 的影响进行系统回顾和荟萃分析:该研究在 PROSPERO(CRD42020203445)上进行了前瞻性注册。在 CINAHL、Embase、Emcare、PsycInfo、PubMed/Medline 和 SPORTDiscus 数据库中检索了报告原发性乳腺癌治疗后 UBM 患者和未 UBM 患者 QOL 的研究。主要分析确定了 UBM + /UBM - 组间身体、心理和社会福利评分的标准化平均差 (SMD)。二次分析根据调查问卷确定各组间 QOL 评分的差异:结果:共纳入 58 项研究,其中 39 项有助于进行荟萃分析。UBM 的类型包括疼痛、淋巴水肿、肩关节活动受限、上半身功能受损和上半身症状。UBM + 组的身体状况较差(SMD = - 0.99; 95%CI = - 1.26, - 0.71; p 结论:研究结果表明,UBM 对患者的 QOL 有着重大的负面影响,影响范围涉及身体、心理和社会领域:对癌症幸存者的启示:有必要努力评估并尽量减少UBM的多方面影响,以减轻乳腺癌后QOL受损的情况。
{"title":"Evaluating the effect of upper-body morbidity on quality of life following primary breast cancer treatment: a systematic review and meta-analysis.","authors":"Eliza R Macdonald, Nadia M L Amorim, Amanda D Hagstrom, Katarina Markovic, David Simar, Rachel E Ward, Briana K Clifford","doi":"10.1007/s11764-023-01395-0","DOIUrl":"10.1007/s11764-023-01395-0","url":null,"abstract":"<p><strong>Purpose: </strong>Improvements in breast cancer management continue to increase survival and life expectancy after treatment. Yet the adverse effects of treatment may persist long term, threatening physical, psychological, and social wellbeing, leading to impaired quality of life (QOL). Upper-body morbidity (UBM) such as pain, lymphoedema, restricted shoulder range of motion (ROM), and impaired function are widely reported after breast cancer treatment, but evidence demonstrating its impact on QOL is inconsistent. Therefore, the aim of the study was to conduct a systematic review and meta-analysis evaluating the effect of UBM on QOL following primary breast cancer treatment.</p><p><strong>Methods: </strong>The study was prospectively registered on PROSPERO (CRD42020203445). CINAHL, Embase, Emcare, PsycInfo, PubMed/Medline, and SPORTDiscus databases were searched for studies reporting QOL in individuals with and without UBM following primary breast cancer treatment. Primary analysis determined the standardised mean difference (SMD) in physical, psychological, and social wellbeing scores between UBM + /UBM - groups. Secondary analyses identified differences in QOL scores between groups, according to questionnaire.</p><p><strong>Results: </strong>Fifty-eight studies were included, with 39 conducive to meta-analysis. Types of UBM included pain, lymphoedema, restricted shoulder ROM, impaired upper-body function, and upper-body symptoms. UBM + groups reported poorer physical (SMD = - 0.99; 95%CI = - 1.26, - 0.71; p < 0.00001), psychological (SMD = - 0.43; 95%CI = - 0.60, - 0.27; p < 0.00001), and social wellbeing (SMD = - 0.62; 95%CI = - 0.83, - 0.40; p < 0.00001) than UBM - groups. Secondary analyses according to questionnaire showed that UBM + groups rated their QOL poorer or at equal to, UBM - groups across all domains.</p><p><strong>Conclusions: </strong>Findings demonstrate the significant, negative impact of UBM on QOL, pervading physical, psychological, and social domains.</p><p><strong>Implications for cancer survivors: </strong>Efforts to assess and minimise the multidimensional impact of UBM are warranted to mitigate impaired QOL after breast cancer.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9473322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2023-05-30DOI: 10.1007/s11764-023-01406-0
Casey R Cai, Shelby Cornelius, Jenna Demedis, Anna M Hagen, Mark Abbey-Lambertz, Gregory T Armstrong, Kevin C Oeffinger, Karen L Syrjala, Sarah L Taylor, Jean C Yi, Eric J Chow
Purpose: To better understand preferences and attitudes that adult-aged survivors of childhood cancer have toward survivorship care plans (SCP) and related SCP-based counseling.
Methods: Semi-structured qualitative interviews were conducted with 20 survivors participating in the Childhood Cancer Survivor Study who were at increased risk for cardiovascular disease secondary to their original cancer treatment. All participants were part of a larger randomized clinical trial (NCT03104543) testing the efficacy of an SCP-based counseling intervention with goal-setting designed to improve control of cardiovascular risk factors (i.e., hypertension, dyslipidemia, diabetes). A primarily deductive thematic analysis methodology guided interpretation; coded interview segments were grouped into primary themes of facilitators, barriers, suggestions, and positive sentiments.
Results: Participants described benefits of the intervention including facilitation of accountability, goal-setting, and increased knowledge of their health. Many participants also noted improved knowledge of their cancer treatment and subsequent risks, and they were interested in sharing this information with their primary care provider. However, several participants were disappointed when they did not achieve their goals or felt that they had low motivation. Participants generally wanted increased flexibility in the intervention, whether in the duration, frequency, or method of delivery.
Conclusions: The SCP-based intervention was generally well-received by those interviewed and appears promising for promoting goal-setting and accountability as part of an SCP-based intervention to improve control of cardiovascular risk factors.
Implications for cancer survivors: Many survivors are at risk for cardiovascular disease or other potentially modifiable effects of their treatment. SCP-based interventions may facilitate improved control of these late effects.
{"title":"Experiences of adult survivors of childhood cancer in a randomized cardiovascular health promotion trial: a qualitative report from the Childhood Cancer Survivor Study.","authors":"Casey R Cai, Shelby Cornelius, Jenna Demedis, Anna M Hagen, Mark Abbey-Lambertz, Gregory T Armstrong, Kevin C Oeffinger, Karen L Syrjala, Sarah L Taylor, Jean C Yi, Eric J Chow","doi":"10.1007/s11764-023-01406-0","DOIUrl":"10.1007/s11764-023-01406-0","url":null,"abstract":"<p><strong>Purpose: </strong>To better understand preferences and attitudes that adult-aged survivors of childhood cancer have toward survivorship care plans (SCP) and related SCP-based counseling.</p><p><strong>Methods: </strong>Semi-structured qualitative interviews were conducted with 20 survivors participating in the Childhood Cancer Survivor Study who were at increased risk for cardiovascular disease secondary to their original cancer treatment. All participants were part of a larger randomized clinical trial (NCT03104543) testing the efficacy of an SCP-based counseling intervention with goal-setting designed to improve control of cardiovascular risk factors (i.e., hypertension, dyslipidemia, diabetes). A primarily deductive thematic analysis methodology guided interpretation; coded interview segments were grouped into primary themes of facilitators, barriers, suggestions, and positive sentiments.</p><p><strong>Results: </strong>Participants described benefits of the intervention including facilitation of accountability, goal-setting, and increased knowledge of their health. Many participants also noted improved knowledge of their cancer treatment and subsequent risks, and they were interested in sharing this information with their primary care provider. However, several participants were disappointed when they did not achieve their goals or felt that they had low motivation. Participants generally wanted increased flexibility in the intervention, whether in the duration, frequency, or method of delivery.</p><p><strong>Conclusions: </strong>The SCP-based intervention was generally well-received by those interviewed and appears promising for promoting goal-setting and accountability as part of an SCP-based intervention to improve control of cardiovascular risk factors.</p><p><strong>Implications for cancer survivors: </strong>Many survivors are at risk for cardiovascular disease or other potentially modifiable effects of their treatment. SCP-based interventions may facilitate improved control of these late effects.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9552852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2023-06-10DOI: 10.1007/s11764-023-01414-0
Michelle A Mollica, Gina Tesauro, Lisa Gallicchio, Jennifer Guida, Molly E Maher, Emily Tonorezos
Purpose: To describe the characteristics of National Institutes of Health (NIH) cancer survivorship grants funded over the past 5 years and identify gap areas for future efforts and initiatives.
Methods: Research project grants (RPG) funded during Fiscal Year (FY) 2017 to 2021 focused on cancer survivorship were identified using a text mining algorithm of words from the NIH Research, Condition, and Disease Categorization (RCDC) thesaurus with survivorship-relevant terms. The title, abstract, specific aims, and public health relevance section of each grant were reviewed for eligibility. Grants meeting the eligibility criteria were double coded to extract study characteristics (e.g., grant mechanism, study design, study population).
Results: A total of 586 grants were funded by 14 NIH Institutes from FY2017 to FY2021, and the number of newly funded grants increased each FY, from 68 in 2017 to 105 in 2021. Approximately 60% of all grants included an intervention study, and interventions most often focused on psychosocial or supportive care (32.0%). The most common primary focus of the grants was late- and long-term effects of cancer treatment (46.6%), and least often financial hardship.
Conclusions: The results of this portfolio analysis indicate overall growth in the number and breadth of grants over the last five years, although notable gaps persist.
Implications for cancer survivors: This review of current NIH grants suggests a need for expanded research to understand and address survivor needs to ensure that the over 18 million cancer survivors in the United States have optimal quality of life and health outcomes.
{"title":"Survivorship science at the National Institutes of Health 2017-2021.","authors":"Michelle A Mollica, Gina Tesauro, Lisa Gallicchio, Jennifer Guida, Molly E Maher, Emily Tonorezos","doi":"10.1007/s11764-023-01414-0","DOIUrl":"10.1007/s11764-023-01414-0","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the characteristics of National Institutes of Health (NIH) cancer survivorship grants funded over the past 5 years and identify gap areas for future efforts and initiatives.</p><p><strong>Methods: </strong>Research project grants (RPG) funded during Fiscal Year (FY) 2017 to 2021 focused on cancer survivorship were identified using a text mining algorithm of words from the NIH Research, Condition, and Disease Categorization (RCDC) thesaurus with survivorship-relevant terms. The title, abstract, specific aims, and public health relevance section of each grant were reviewed for eligibility. Grants meeting the eligibility criteria were double coded to extract study characteristics (e.g., grant mechanism, study design, study population).</p><p><strong>Results: </strong>A total of 586 grants were funded by 14 NIH Institutes from FY2017 to FY2021, and the number of newly funded grants increased each FY, from 68 in 2017 to 105 in 2021. Approximately 60% of all grants included an intervention study, and interventions most often focused on psychosocial or supportive care (32.0%). The most common primary focus of the grants was late- and long-term effects of cancer treatment (46.6%), and least often financial hardship.</p><p><strong>Conclusions: </strong>The results of this portfolio analysis indicate overall growth in the number and breadth of grants over the last five years, although notable gaps persist.</p><p><strong>Implications for cancer survivors: </strong>This review of current NIH grants suggests a need for expanded research to understand and address survivor needs to ensure that the over 18 million cancer survivors in the United States have optimal quality of life and health outcomes.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9599406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2023-05-09DOI: 10.1007/s11764-023-01392-3
Anouk E Hiensch, Julia Beckhaus, Lenja Witlox, Evelyn M Monninkhof, Sanne B Schagen, Jonna K van Vulpen, Maike G Sweegers, Robert U Newton, Neil K Aaronson, Daniel A Galvão, Karen Steindorf, Martijn M Stuiver, Ilse Mesters, Hans Knoop, Martine M Goedendorp, Martin Bohus, Lene Thorsen, Karl-Heinz Schulz, Martina E Schmidt, Cornelia M Ulrich, Gabe S Sonke, Wim H van Harten, Kerri M Winters-Stone, Miranda J Velthuis, Dennis R Taaffe, Willem van Mechelen, Marie José Kersten, Frans Nollet, Joachim Wiskemann, Laurien M Buffart, Anne M May
Purpose: This individual participant data meta-analysis (IPD-MA) assesses exercise effects on self-reported cognitive functioning (CF) and investigates whether effects differ by patient-, intervention-, and exercise-related characteristics.
Methods: IPD from 16 exercise RCTs, including 1987 patients across multiple types of non-metastatic cancer, was pooled. A one-stage IPD-MA using linear mixed-effect models was performed to assess exercise effects on self-reported CF (z-score) and to identify whether the effect was moderated by sociodemographic, clinical, intervention- and exercise-related characteristics, or fatigue, depression, anxiety, and self-reported CF levels at start of the intervention (i.e., baseline). Models were adjusted for baseline CF and included a random intercept at study level to account for clustering of patients within studies. A sensitivity analysis was performed in patients who reported cognitive problems at baseline.
Results: Minimal significant beneficial exercise effects on self-reported CF (β=-0.09 [-0.16; -0.02]) were observed, with slightly larger effects when the intervention was delivered post-treatment (n=745, β=-0.13 [-0.24; -0.02]), and no significant effect during cancer treatment (n=1,162, β=-0.08 [-0.18; 0.02]). Larger effects were observed in interventions of 12 weeks or shorter (β=-0.14 [-0.25; -0.04]) or 24 weeks or longer (β=-0.18 [-0.32; -0.02]), whereas no effects were observed in interventions of 12-24 weeks (β=0.01 [-0.13; 0.15]). Exercise interventions were most beneficial when provided to patients without anxiety symptoms (β=-0.10 [-0.19; -0.02]) or after completion of treatment in patients with cognitive problems (β=-0.19 [-0.31; -0.06]). No other significant moderators were identified.
Conclusions: This cross-cancer IPD meta-analysis observed small beneficial exercise effects on self-reported CF when the intervention was delivered post-treatment, especially in patients who reported cognitive problems at baseline.
Implications for cancer survivors: This study provides some evidence to support the prescription of exercise to improve cognitive functioning. Sufficiently powered trials are warranted to make more definitive recommendations and include these in the exercise guidelines for cancer survivors.
{"title":"Moderators of exercise effects on self-reported cognitive functioning in cancer survivors: an individual participant data meta-analysis.","authors":"Anouk E Hiensch, Julia Beckhaus, Lenja Witlox, Evelyn M Monninkhof, Sanne B Schagen, Jonna K van Vulpen, Maike G Sweegers, Robert U Newton, Neil K Aaronson, Daniel A Galvão, Karen Steindorf, Martijn M Stuiver, Ilse Mesters, Hans Knoop, Martine M Goedendorp, Martin Bohus, Lene Thorsen, Karl-Heinz Schulz, Martina E Schmidt, Cornelia M Ulrich, Gabe S Sonke, Wim H van Harten, Kerri M Winters-Stone, Miranda J Velthuis, Dennis R Taaffe, Willem van Mechelen, Marie José Kersten, Frans Nollet, Joachim Wiskemann, Laurien M Buffart, Anne M May","doi":"10.1007/s11764-023-01392-3","DOIUrl":"10.1007/s11764-023-01392-3","url":null,"abstract":"<p><strong>Purpose: </strong>This individual participant data meta-analysis (IPD-MA) assesses exercise effects on self-reported cognitive functioning (CF) and investigates whether effects differ by patient-, intervention-, and exercise-related characteristics.</p><p><strong>Methods: </strong>IPD from 16 exercise RCTs, including 1987 patients across multiple types of non-metastatic cancer, was pooled. A one-stage IPD-MA using linear mixed-effect models was performed to assess exercise effects on self-reported CF (z-score) and to identify whether the effect was moderated by sociodemographic, clinical, intervention- and exercise-related characteristics, or fatigue, depression, anxiety, and self-reported CF levels at start of the intervention (i.e., baseline). Models were adjusted for baseline CF and included a random intercept at study level to account for clustering of patients within studies. A sensitivity analysis was performed in patients who reported cognitive problems at baseline.</p><p><strong>Results: </strong>Minimal significant beneficial exercise effects on self-reported CF (β=-0.09 [-0.16; -0.02]) were observed, with slightly larger effects when the intervention was delivered post-treatment (n=745, β=-0.13 [-0.24; -0.02]), and no significant effect during cancer treatment (n=1,162, β=-0.08 [-0.18; 0.02]). Larger effects were observed in interventions of 12 weeks or shorter (β=-0.14 [-0.25; -0.04]) or 24 weeks or longer (β=-0.18 [-0.32; -0.02]), whereas no effects were observed in interventions of 12-24 weeks (β=0.01 [-0.13; 0.15]). Exercise interventions were most beneficial when provided to patients without anxiety symptoms (β=-0.10 [-0.19; -0.02]) or after completion of treatment in patients with cognitive problems (β=-0.19 [-0.31; -0.06]). No other significant moderators were identified.</p><p><strong>Conclusions: </strong>This cross-cancer IPD meta-analysis observed small beneficial exercise effects on self-reported CF when the intervention was delivered post-treatment, especially in patients who reported cognitive problems at baseline.</p><p><strong>Implications for cancer survivors: </strong>This study provides some evidence to support the prescription of exercise to improve cognitive functioning. Sufficiently powered trials are warranted to make more definitive recommendations and include these in the exercise guidelines for cancer survivors.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9493532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2023-05-10DOI: 10.1007/s11764-023-01400-6
Henning Bahlburg, Tabea Hellmann, Karl Tully, Marius Cristian Butea-Bocu, Moritz Reike, Florian Roghmann, Joachim Noldus, Guido Müller
Purpose: This study aims to report on psychosocial distress and QoL in bladder cancer patients after radical cystectomy (RC) and urinary diversion to obtain a better basis for patient counseling and postoperative care.
Methods: The study relied on prospectively collected data for 842 patients, who underwent three weeks of inpatient rehabilitation after RC and creation of an ileal conduit (IC) or ileal neobladder (INB). Data on QoL and psychosocial distress were collected by validated questionnaires. Multivariate logistic regression was performed to identify predictors for high psychosocial distress.
Results: Four-hundred and forty-seven patients (326 male, 121 female) received an IC, while 395 patients (357 male, 38 female) received an INB. Health-related QoL improved steadily in the whole cohort during follow-up. Patients with an INB reported better physical function but suffered more from diarrhea and financial worries. Patients with an IC reported reduced satisfaction with their body image, increased worries about the future, and suffered more from constipation. Psychosocial distress increased significantly during follow-up. One year after surgery, 43.1% of patients suffered from high psychosocial distress. Multivariate regression analysis identified age ≤ 59 years (OR 1.731; CI 1.056-2.838; p = 0.030) and lymph node metastases (OR 2.073; CI 1.133-3.793; p = 0.018) as independent predictors for high psychosocial distress.
Conclusion: QoL improves significantly in all patients one year after RC. However, psychosocial distress remains high in a substantial number of patients.
Implications for cancer survivors: To prevent chronic psychological disorders, easily accessible opportunities for psycho-oncological counseling are needed for patients following RC.
目的:本研究旨在报告根治性膀胱切除术(RC)和尿路改道术后膀胱癌患者的社会心理压力和生活质量,为患者咨询和术后护理提供更好的依据:该研究依赖于前瞻性收集的 842 名患者的数据,这些患者在接受根治性膀胱切除术和建立回肠导尿管(IC)或回肠新膀胱(INB)后接受了为期三周的住院康复治疗。通过有效问卷收集了有关QoL和社会心理压力的数据。采用多变量逻辑回归法确定高社会心理压力的预测因素:447名患者(326名男性,121名女性)接受了IC治疗,395名患者(357名男性,38名女性)接受了INB治疗。在随访期间,整个组群的健康相关生活质量稳步提高。接受 INB 治疗的患者表示身体机能有所改善,但腹泻和经济问题更为严重。接受 IC 治疗的患者对自己身体形象的满意度降低,对未来的担忧增加,便秘症状加重。在随访期间,心理社会困扰明显增加。术后一年,43.1%的患者遭受了严重的心理社会困扰。多变量回归分析发现,年龄≤59岁(OR 1.731;CI 1.056-2.838;P = 0.030)和淋巴结转移(OR 2.073;CI 1.133-3.793;P = 0.018)是高社会心理压力的独立预测因素:结论:所有患者的 QoL 在 RC 一年后都有明显改善。结论:所有患者在 RC 一年后的 QoL 都有明显改善,但仍有相当多的患者面临严重的心理社会问题:对癌症幸存者的启示:为了预防慢性心理障碍,需要为 RC 患者提供方便的肿瘤心理咨询机会。
{"title":"Psychosocial distress and quality of life in patients after radical cystectomy - one year follow-up in 842 German patients.","authors":"Henning Bahlburg, Tabea Hellmann, Karl Tully, Marius Cristian Butea-Bocu, Moritz Reike, Florian Roghmann, Joachim Noldus, Guido Müller","doi":"10.1007/s11764-023-01400-6","DOIUrl":"10.1007/s11764-023-01400-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to report on psychosocial distress and QoL in bladder cancer patients after radical cystectomy (RC) and urinary diversion to obtain a better basis for patient counseling and postoperative care.</p><p><strong>Methods: </strong>The study relied on prospectively collected data for 842 patients, who underwent three weeks of inpatient rehabilitation after RC and creation of an ileal conduit (IC) or ileal neobladder (INB). Data on QoL and psychosocial distress were collected by validated questionnaires. Multivariate logistic regression was performed to identify predictors for high psychosocial distress.</p><p><strong>Results: </strong>Four-hundred and forty-seven patients (326 male, 121 female) received an IC, while 395 patients (357 male, 38 female) received an INB. Health-related QoL improved steadily in the whole cohort during follow-up. Patients with an INB reported better physical function but suffered more from diarrhea and financial worries. Patients with an IC reported reduced satisfaction with their body image, increased worries about the future, and suffered more from constipation. Psychosocial distress increased significantly during follow-up. One year after surgery, 43.1% of patients suffered from high psychosocial distress. Multivariate regression analysis identified age ≤ 59 years (OR 1.731; CI 1.056-2.838; p = 0.030) and lymph node metastases (OR 2.073; CI 1.133-3.793; p = 0.018) as independent predictors for high psychosocial distress.</p><p><strong>Conclusion: </strong>QoL improves significantly in all patients one year after RC. However, psychosocial distress remains high in a substantial number of patients.</p><p><strong>Implications for cancer survivors: </strong>To prevent chronic psychological disorders, easily accessible opportunities for psycho-oncological counseling are needed for patients following RC.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9792000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01Epub Date: 2023-06-06DOI: 10.1007/s11764-023-01407-z
Manon Mangiardi-Veltin, Jimmy Mullaert, Mireille Coeuret-Pellicer, Marcel Goldberg, Marie Zins, Roman Rouzier, Delphine Hequet, Claire Bonneau
Purpose: Sexuality, a substantial factor in quality of life, may be altered after breast cancer (BC) treatments as they intimately afflict femininity. This study aimed to assess the prevalence of sexual dysfunction in women with a history of BC and to compare it with women without a BC history.
Methods: The French general epidemiological cohort CONSTANCES includes more than 200,000 adults. All inclusion questionnaires from CONSTANCES non-virgin adult female participants were analyzed. Women reporting a history of BC were compared to controls in univariate analysis. Multivariate analysis was performed to highlight any demographic risk factor for sexual dysfunction.
Results: Among the 2,680 participants who had a history of BC, 34% did not engage in sexual intercourse (SI) in the month preceding the completion of the questionnaire (n = 911), 34% had pain during SI (n = 901) and 30% were not satisfied with their sex life (n = 803). Sexual dysfunction was significantly more frequent in women who had a history of BC: they had less sexual interest (OR 1.79 [1.65;1.94], p < 0.001), experienced more pain during SI (OR 1.10 [1.02;1.19], p < 0.001) and were more dissatisfied with their sex life (OR 1.58 [1.47;1.71], p < 0.001). This stayed true after adjustment on multiple demographic factors such as age, menopausal status, body mass index and depression.
Conclusions: Overall, in this real-life study in a large national cohort, history of BC appeared to be a risk factor for sexual disorders.
Implications for cancer survivors: Efforts to detect sexual disorders in BC survivors and offer quality support must be pursued.
目的:性生活是影响生活质量的一个重要因素,在乳腺癌(BC)治疗后,性生活可能会发生改变,因为这些治疗密切影响着女性的魅力。本研究旨在评估有乳腺癌病史的女性中性功能障碍的发生率,并与无乳腺癌病史的女性进行比较:法国一般流行病学队列 CONSTANCES 包括 20 多万成年人。我们对 CONSTANCES 非处女成年女性参与者的所有纳入问卷进行了分析。在单变量分析中,将报告有 BC 病史的女性与对照组进行了比较。进行了多变量分析,以突出性功能障碍的人口风险因素:在 2,680 名有 BC 病史的参与者中,34% 的人在填写问卷前的一个月内没有进行过性交(SI)(n = 911),34% 的人在进行 SI 时感到疼痛(n = 901),30% 的人对自己的性生活不满意(n = 803)。总体而言,在这项大型全国性队列的现实生活研究中,BC 病史似乎是导致性功能障碍的一个危险因素:对癌症幸存者的启示:必须努力检测BC幸存者的性障碍并提供高质量的支持。
{"title":"Prevalence of sexual dysfunction after breast cancer compared to controls, a study from CONSTANCES cohort.","authors":"Manon Mangiardi-Veltin, Jimmy Mullaert, Mireille Coeuret-Pellicer, Marcel Goldberg, Marie Zins, Roman Rouzier, Delphine Hequet, Claire Bonneau","doi":"10.1007/s11764-023-01407-z","DOIUrl":"10.1007/s11764-023-01407-z","url":null,"abstract":"<p><strong>Purpose: </strong>Sexuality, a substantial factor in quality of life, may be altered after breast cancer (BC) treatments as they intimately afflict femininity. This study aimed to assess the prevalence of sexual dysfunction in women with a history of BC and to compare it with women without a BC history.</p><p><strong>Methods: </strong>The French general epidemiological cohort CONSTANCES includes more than 200,000 adults. All inclusion questionnaires from CONSTANCES non-virgin adult female participants were analyzed. Women reporting a history of BC were compared to controls in univariate analysis. Multivariate analysis was performed to highlight any demographic risk factor for sexual dysfunction.</p><p><strong>Results: </strong>Among the 2,680 participants who had a history of BC, 34% did not engage in sexual intercourse (SI) in the month preceding the completion of the questionnaire (n = 911), 34% had pain during SI (n = 901) and 30% were not satisfied with their sex life (n = 803). Sexual dysfunction was significantly more frequent in women who had a history of BC: they had less sexual interest (OR 1.79 [1.65;1.94], p < 0.001), experienced more pain during SI (OR 1.10 [1.02;1.19], p < 0.001) and were more dissatisfied with their sex life (OR 1.58 [1.47;1.71], p < 0.001). This stayed true after adjustment on multiple demographic factors such as age, menopausal status, body mass index and depression.</p><p><strong>Conclusions: </strong>Overall, in this real-life study in a large national cohort, history of BC appeared to be a risk factor for sexual disorders.</p><p><strong>Implications for cancer survivors: </strong>Efforts to detect sexual disorders in BC survivors and offer quality support must be pursued.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9633134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-28DOI: 10.1007/s11764-024-01682-4
Adam Daly, Johannes Karl, Simon Dunne
Purpose: Many cancer treatments can lead to a disrupted body image and identity. One intervention to address these outcomes is therapeutic tattooing. However, despite the wide dissemination of this practice for cancer survivors (CSs), current research on it is lacking. This study aimed to identify tattoo artists' (TAs') perspectives on the types, impacts, barriers, and facilitators of therapeutic tattooing for CSs and the impact of doing this work on themselves.
Methods: Twenty-two international TAs who tattoo CSs were interviewed and resultant transcripts were analyzed thematically.
Results: The following themes emerged: Emotional Management of Artists, Emotional Transformation of CSs, Stigma and its effects on CSs, Artist Barriers, CS Barriers, Artist Facilitators, and CS Facilitators. The findings also identify a typology of cancer survivorship therapeutic tattoos.
Conclusion: This is the first study to identify barriers/facilitators of therapeutic tattooing, a typology of cancer survivorship therapeutic tattoos, TAs' perspectives on therapeutic tattooing, and potential negative outcomes from this practice. The findings indicate that therapeutic tattooing can be both beneficial and harmful for CSs and TAs, that there is a need for better therapeutic tattooing training for TAs and healthcare providers (HPs), increased awareness of therapeutic tattoos, and a reduction in barriers to the practice and greater collaboration between HPs and TAs.
Implications for cancer survivors: Findings from this study have major policy implications for healthcare systems, non-profit organizations, and regulatory bodies, which could serve to empower cancer survivors to make more informed decisions about their bodies and support enhanced training and accreditation of this practice.
目的:许多癌症治疗方法都会导致身体形象和身份的破坏。治疗性纹身是解决这些问题的干预措施之一。然而,尽管这种做法在癌症幸存者(CSs)中得到广泛传播,但目前却缺乏相关研究。本研究旨在确定纹身艺术家(TAs)对治疗性纹身的类型、影响、障碍和促进因素的看法,以及从事这项工作对他们自身的影响:对 22 名为 CS 进行纹身的国际 TA 进行了访谈,并对访谈记录进行了专题分析:结果:出现了以下主题:艺术家的情感管理、CS 的情感转变、耻辱感及其对 CS 的影响、艺术家障碍、CS 障碍、艺术家促进者和 CS 促进者。研究结果还确定了癌症幸存者治疗性纹身的类型:这是首次研究确定治疗性纹身的障碍/促进因素、癌症幸存者治疗性纹身的类型、助产士对治疗性纹身的看法以及这种做法的潜在负面结果。研究结果表明,治疗性纹身对 CSs 和 TAs 既有利也有弊,需要对 TAs 和医疗服务提供者(HPs)进行更好的治疗性纹身培训,提高对治疗性纹身的认识,减少这种做法的障碍,加强 HPs 和 TAs 之间的合作:这项研究的结果对医疗保健系统、非营利性组织和监管机构具有重要的政策意义,可帮助癌症幸存者对自己的身体做出更明智的决定,并支持加强对这种做法的培训和认证。
{"title":"\"Art is just something that makes people heal\"-a qualitative investigation of tattoo artists' perspectives on cancer survivorship therapeutic tattoos.","authors":"Adam Daly, Johannes Karl, Simon Dunne","doi":"10.1007/s11764-024-01682-4","DOIUrl":"https://doi.org/10.1007/s11764-024-01682-4","url":null,"abstract":"<p><strong>Purpose: </strong>Many cancer treatments can lead to a disrupted body image and identity. One intervention to address these outcomes is therapeutic tattooing. However, despite the wide dissemination of this practice for cancer survivors (CSs), current research on it is lacking. This study aimed to identify tattoo artists' (TAs') perspectives on the types, impacts, barriers, and facilitators of therapeutic tattooing for CSs and the impact of doing this work on themselves.</p><p><strong>Methods: </strong>Twenty-two international TAs who tattoo CSs were interviewed and resultant transcripts were analyzed thematically.</p><p><strong>Results: </strong>The following themes emerged: Emotional Management of Artists, Emotional Transformation of CSs, Stigma and its effects on CSs, Artist Barriers, CS Barriers, Artist Facilitators, and CS Facilitators. The findings also identify a typology of cancer survivorship therapeutic tattoos.</p><p><strong>Conclusion: </strong>This is the first study to identify barriers/facilitators of therapeutic tattooing, a typology of cancer survivorship therapeutic tattoos, TAs' perspectives on therapeutic tattooing, and potential negative outcomes from this practice. The findings indicate that therapeutic tattooing can be both beneficial and harmful for CSs and TAs, that there is a need for better therapeutic tattooing training for TAs and healthcare providers (HPs), increased awareness of therapeutic tattoos, and a reduction in barriers to the practice and greater collaboration between HPs and TAs.</p><p><strong>Implications for cancer survivors: </strong>Findings from this study have major policy implications for healthcare systems, non-profit organizations, and regulatory bodies, which could serve to empower cancer survivors to make more informed decisions about their bodies and support enhanced training and accreditation of this practice.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-26DOI: 10.1007/s11764-024-01683-3
Katrina Gaitatzis, Belinda Thompson, Fiona Tisdall Blake, Louise Koelmeyer
Purpose: Head and neck cancer (HNC) treatments often lead to significant morbidity, including lymphedema. This systematic review aims to comprehensively explore the prevalence and impact of head and neck lymphedema (HNL) following treatment.
Methods: A systematic literature search was conducted up to September 2023. Studies evaluating HNL prevalence, associated factors, impact, patient-reported outcomes (PROMs), and physical assessments were included. Methodological quality assessment was performed, and data were synthesised narratively.
Results: Twelve studies met the inclusion criteria, with methodological quality ranging from moderate to high. Internal lymphedema prevalence was consistently higher than external lymphedema, with varying rates attributed to treatment modalities and assessment methods. PROMs such as the Lymphedema Symptom Intensity and Distress-Head and Neck and physical assessments including Patterson's Rating Scale were commonly utilised. HNL significantly impacted quality of life and physical function, with reported symptoms including discomfort, tightness, swallowing difficulties, and psychological distress.
Conclusion: HNL is a common sequela of HNC treatment with significant implications for individuals' QoL. Standardised assessment protocols and tailored interventions are needed to address the needs of individuals with HNL and improve overall outcomes.
Implications for cancer survivors: This systematic review highlights a significant prevalence of lymphedema, particularly internal lymphedema in the larynx and pharynx, following treatment. Swallowing difficulties, nutritional issues, anxiety, depression, and body image concerns were associated with both internal and external lymphedema. The impact on quality of life is substantial, with survivors experiencing physical symptoms and psychosocial challenges, emphasising the importance of integrated care approaches tailored to both aspects of well-being.
{"title":"Patient-reported outcome measures and physical function following head and neck lymphedema - a systematic review.","authors":"Katrina Gaitatzis, Belinda Thompson, Fiona Tisdall Blake, Louise Koelmeyer","doi":"10.1007/s11764-024-01683-3","DOIUrl":"https://doi.org/10.1007/s11764-024-01683-3","url":null,"abstract":"<p><strong>Purpose: </strong>Head and neck cancer (HNC) treatments often lead to significant morbidity, including lymphedema. This systematic review aims to comprehensively explore the prevalence and impact of head and neck lymphedema (HNL) following treatment.</p><p><strong>Methods: </strong>A systematic literature search was conducted up to September 2023. Studies evaluating HNL prevalence, associated factors, impact, patient-reported outcomes (PROMs), and physical assessments were included. Methodological quality assessment was performed, and data were synthesised narratively.</p><p><strong>Results: </strong>Twelve studies met the inclusion criteria, with methodological quality ranging from moderate to high. Internal lymphedema prevalence was consistently higher than external lymphedema, with varying rates attributed to treatment modalities and assessment methods. PROMs such as the Lymphedema Symptom Intensity and Distress-Head and Neck and physical assessments including Patterson's Rating Scale were commonly utilised. HNL significantly impacted quality of life and physical function, with reported symptoms including discomfort, tightness, swallowing difficulties, and psychological distress.</p><p><strong>Conclusion: </strong>HNL is a common sequela of HNC treatment with significant implications for individuals' QoL. Standardised assessment protocols and tailored interventions are needed to address the needs of individuals with HNL and improve overall outcomes.</p><p><strong>Implications for cancer survivors: </strong>This systematic review highlights a significant prevalence of lymphedema, particularly internal lymphedema in the larynx and pharynx, following treatment. Swallowing difficulties, nutritional issues, anxiety, depression, and body image concerns were associated with both internal and external lymphedema. The impact on quality of life is substantial, with survivors experiencing physical symptoms and psychosocial challenges, emphasising the importance of integrated care approaches tailored to both aspects of well-being.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}