Psycho‐Oncology最新文献

Objective: Breast cancer patients often face a significant financial burden, leading to financial toxicity due to the necessity for long-term care, costly treatment, and follow-up measures. The purpose of this study is to systematically review the available qualitative evidence on how breast cancer patients cope with financial toxicity and their unmet need to promote the implementation of effective intervention strategies.

Methods: PubMed, Web of Science, PsycINFO, CINAHL, EMBASE, Scopus, CNKI, Wan Fang Data, and VIP databases were systematically searched for literature related to the study topic. This study was conducted according to the PRIMSA guidelines. Thematic synthesis methods were used to analyze the data and construct themes. The review was pre-registered on PROSPERO (CRD42024502030).

Results: The search yielded 1164 results; 23 articles met the inclusion criteria and reported on a total of 1098 breast cancer patients. The thematic analysis identified three themes and 15 sub-themes: coping emotions (shrouded in negative emotions and adopting a positive attitude); coping behaviors (increasing income sources, adjusting personal or family finances, seeking and accepting support, coping independently, avoidance, constrained decision, financial planning, and proactive negotiation); and coping needs (health insurance policy support, medical institutional support, non-medical institutional resources support, financial information needs, financial management needs).

Conclusion: Breast cancer patients exhibit a variety of emotional reactions and coping behaviors with financial toxicity alongside several unmet needs. This indicates the necessity of maintaining focus on financial toxicity in breast cancer patients and the implementation of appropriate management strategies to address their needs while optimizing the detection and mitigation of expenditures that jeopardize their health and quality of life.

Background: Nearly 20% of US cancer survivors develop cardiovascular disease (CVD) from cardiotoxic cancer treatments. Patients and providers may consider alternative treatments to lower cardiotoxicity risk, but these may be less effective at preventing relapse/recurrence, presenting a difficult tradeoff.

Aims: This study explored survivors' cancer treatment decision-making when weighing this tradeoff.

Methods: Using adjusted multivariable logistic regression, we examined 443 US survivors' risk perceptions (deliberative, affective, and intuitive) about cancer and CVD and associations of these with their selection between two hypothetical cancer treatments: Treatment A: 5% chance of cancer recurrence and 10% chance of CVD; Treatment B: 10% chance of recurrence and 5% chance of CVD. We explored the effects of delay discounting by randomizing to a condition describing cancer recurrence/CVD as either immediate or delayed.

Results: More survivors (Mage = 48, range = 18-93; M = 10.8 years post-diagnosis) selected Treatment A than Treatment B (72% v. 28%). Timing of onset was not associated with treatment selection. Greater affective risk perception (worry) about cancer was associated with increased odds of choosing Treatment A, whereas greater CVD worry was associated with decreased odds (OR-cancer = 1.33, p = 0.006; OR-CVD = 0.72, p = 0.007). Neither deliberative nor experiential risk perceptions were associated with treatment choice.

Conclusions: Survivors were more likely to select the treatment that minimized recurrence rather than CVD-regardless of the timing of onset. Treatment decision was linked to both cancer- and CVD-related worry but not deliberative or experiential risk perceptions. During treatment discussions, clinicians should open conversations about the risks of treatment-associated cardiotoxicity, the probabilities, and patients' relative worries about cancer and cardiotoxicity.

Objective: People's beliefs about cancer can affect the actions they take to prevent and detect the disease. We investigated socio-economic inequalities in beliefs about cancer and its causes in the general population.

Methods: We analyzed data from the representative probabilistic Spanish Oncobarometer survey (N = 4769, 2020) and the non-probabilistic weight-corrected Spanish Cancer Awareness Survey (N = 1029, 2022). Beliefs about cancer, recognition of cancer symptoms, and recognition of risk factors were measured with the Awareness and Beliefs about Cancer questionnaire. Endorsement of mythical causes was measured with the CAM-Mythical Causes questionnaire. The effects of socio-economic status (SES) were investigated in multiple regression analyses adjusted for age, sex, and personal and family cancer history.

Results: Individuals with lower SES were more likely to endorse pessimistic beliefs (e.g., "cancer is a death sentence"), and less likely to endorse optimistic beliefs about cancer (e.g., "people with cancer continue with normal activities"). Individuals with lower SES also recognized fewer cancer symptoms and risk factors and endorsed more mythical causes of cancer. The gap in knowledge regarding cancer causes was wider among people with low SES, who were more likely to endorse several mythical causes than some established risk factors included in cancer prevention recommendations.

Conclusions: Socio-economic inequalities in beliefs about cancer are robust and multidimensional and indicate worse preparedness to act against the disease among lower socio-economic groups. Differences in beliefs about disease outcomes and causes are likely one of the multiple contributors to cancer disparities and should be targeted and monitored in prevention efforts.

Taste disturbances are prominent side effects of antineoplastic medications and contribute to morbidity and quality-of-life impairment. Few treatment options are available for antineoplastic-related taste disorders. Hypnosis has been found to be effective for a variety of symptoms in the cancer setting, including insomnia, pain, mood disorders and anxiety. Numerous somatosensory perceptual changes have been observed with hypnosis, including perception of tactile stimuli and color. Here, we report a case of a 74-year-old woman with recurrent metastatic breast cancer presenting with an 18-month history of antineoplastic-related hypogeusia. She was treated with hypnosis and reported resolution of taste symptoms after 10 days of daily practice. Her improvement seems to be related to hypnotic changes in somatosensory perception, which may be associated with functional alterations in salience, executive control and default mode networks during hypnosis. Further investigation of hypnosis for antineoplastic-related taste disturbances is indicated.

Purpose: This study examined the feasibility and acceptability of a three-session, psychological-based intervention to improve intimacy and sexuality outcomes among women with breast and gynaecologic cancer in Singapore.

Method: Patients from outpatient oncology clinics completed screeners for marital and sexual distress. Those who endorsed either marital or sexual distress were invited into the study, and were randomized to receive the intervention immediately or be waitlisted. Intervention feasibility (i.e., reach, adherence) and acceptability (i.e., satisfaction, cultural sensitivity, willingness to pay) and marital, sexual, and body image outcome changes were examined.

Results: 1101 patients completed the screener; 24% of patients with breast or gynaecologic cancer reported marital or sexual distress. Forty-six patients who were eligible participated in the study. The majority (88%) of participants who started the intervention completed all 3 sessions. All (100%) participants who completed the intervention reported satisfaction and the majority (97%) reported they would recommend the intervention to a friend. The majority of participants found the intervention to be culturally sensitive (93%) and reported being willing to pay either out of pocket or through their national medical MediSave account (76%). Outcome changes were in expected directions with small effect sizes (0.24-0.42). Several themes emerged from open-ended feedback on what participants found useful and how the intervention can be improved.

Conclusions: Approximately one quarter of breast or gynaecologic cancer patient who are partnered in Singapore reported marital or sexual distress. Despite the low reach, we found good adherence and high acceptability of the psychological-based intervention. Our findings suggest there is room to improve awareness and delivery of sexuality-related care in an oncology setting.

Trial registration: Number and date: NCT03420547, April 10, 2018.

Objective: The Worries About Recurrence or Progression Scale (WARPS) was recently validated in four common chronic illnesses other than cancer, after a rigorous development process based on the COSMIN criteria. Available measures of fear of progression or fear of cancer recurrence (FCR) have been criticised for not meeting all COSMIN criteria. Therefore, this study aimed to explore the psychometric properties of the WARPS in a cancer sample to assess its applicability to measure FCR.

Methods: We recruited 346 participants living with or beyond cancer for an online survey. The psychometric properties of the WARPS were examined using a confirmatory factor analysis. Convergent validity was assessed against the current gold standard questionnaires and constructs related to FCR. Some participants completed a follow-up survey 2 weeks later, to assess the test-retest reliability. Finally, a Receiver Operating Characteristics analysis was conducted to determine clinical cut-offs for the WARPS.

Results: Confirmatory factor analysis confirmed that the WARPS has one underlying factor, fear of recurrence or progression (FRP), with adequate model fit. The WARPS demonstrated excellent internal consistency, test-retest reliability and showed convergent validity. ROC analysis revealed a cut-off of 54 for moderate, and 65 for severe FCR on the WARPS.

Conclusions: The WARPS demonstrated good psychometric properties in a cancer sample. It has the capacity to be used as a screening tool to identify clinical levels of FCR. The WARPS was developed consistent with the COSMIN criteria and overcomes some of the limitations of existing measures.

Objective: A recent randomized trial of a group psychosocial telehealth intervention (STRIDE) improved anxiety, depression, quality of life (QOL), symptom distress, coping, and self-efficacy to manage symptoms related to taking adjuvant endocrine therapy (AET) in women with non-metastatic hormone receptor-positive breast cancer. This study examined whether changes in coping and self-efficacy mediated intervention effects on anxiety, depression, QOL, and symptom distress.

Method: Women (N = 100) were recruited between 10/2019-06/2021 from Massachusetts General Hospital and were randomized to STRIDE or to the medication monitoring control group. Participants completed self-report measures of anxiety and depression (Hospital Anxiety and Depression Scale), QOL (Functional Assessment of Cancer Therapy-Breast Cancer scale), symptom distress (Breast Cancer Prevention Trial Symptom Scale), coping (Measure of Current Status-Part A), and self-efficacy (Self Efficacy for Managing AET Symptoms) at baseline and 24-week follow-up. Mediated regression models tested whether changes in coping ability and self-efficacy mediated the intervention effects on anxiety, depression, QOL, and symptom distress, controlling for key variables.

Results: Improvements in coping across the 24-week study period mediated the effect of STRIDE on anxiety symptoms (indirect effect, B = -0.61, SE = 0.28, 95% CI: -1.28, -0.17), depressive symptoms (indirect effect, B = -0.50, SE = 0.21, 95% CI: -0.97, -0.15), and QOL (indirect effect, B = 3.80, SE = 1.25, 95% CI: 1.54, 6.49), but not symptom distress. Changes in self-efficacy did not mediate improvements in any of the proposed outcomes.

Conclusion: Coping is an essential component of a brief group psychosocial intervention that drives improvements in mood and QOL for women with non-metastatic hormone receptor-positive breast cancer taking AET.

Clinical trial registration: NCT03837496.

Background: Advancements in precision oncology have led to a growing community of adults with advanced cancer who live longer but face prognostic uncertainty, with corresponding fears of the future. Their worst future fears related to cancer remain understudied, hindering support efforts.

Aims: This study aimed to characterize the presence, content, and predictors of imagined future worst-case scenarios related to cancer (WCS) among distressed adults with advanced cancer.

Methods: Two hundred fifteen distressed adults with advanced solid tumor cancer (mixed type) responded to survey questions regarding the presence (Yes/No) of a WCS related to cancer and if yes, to briefly describe it. Mixed methods were used to assess WCS prevalence, thematic content, and sociodemographic, psychological, and medical predictors.

Results: Two thirds (66.5%) of advanced cancer survivors endorsed having a WCS. Content reflected four major themes of Death (52.2%), Suffering and Deterioration (47.1%), Cancer Progression and Future Uncertainty (28.7%), and Concern about Family (18.4%). WCS often contained more than one major theme, further distinguished by additional themes and sub-themes that revealed distinct fears. Higher anxiety and lower life meaning/peace predicted the presence of a WCS whereas sociodemographic characteristics, depression, time since diagnosis, and physical symptom burden did not. Younger age and living with children predicted a WCS focused on loved ones.

Conclusions: WCS are prevalent and diverse in content among distressed adults with advanced cancer. Assessing WCS offers a quick and straightforward way to solicit advanced cancer survivors' most intense fears about the future with cancer, thereby facilitating patient-provider communication and support efforts.

Study objective: To assess the impact of a personalized integrative medicine (IM) intervention on healthcare providers (HCPs) expressing war-related emotional/spiritual and physical concerns.

Methods: Physicians, nurses, para-medical and other HCPs from 5 hospital departments in northern Israel underwent IM treatments provided by IM-trained practitioners working in integrative oncology (IO) care settings. The two main HCP-reported concerns were scored (from 0 to 6) before and following the intervention using the Measure Yourself Concerns and Wellbeing questionnaire. Post-intervention narratives were examined for emotional/spiritual keywords (ESKs).

Results: Of 190 participating HCPs, 121 (63.7%) expressed ESKs in post-treatment narratives (ESK group), with 69 not expressing ESKs (nESK group). Both groups had similar demographic and professional backgrounds, and reported improved measure yourself concerns and well-being (MYCAW) QoL-related concerns immediately post-intervention. However, between-group analysis found significantly greater improvement in the ESK group for the first (p < 0.001) and second (p = 0.01) MYCAW concerns, as well as emotional/spiritual concerns (p < 0.001). Pain-related concerns improved similarly in both groups, with improved scores continuing to 24-h post-treatment.

Conclusions: HCPs with war-related emotional/spiritual and physical QoL-related concerns showed significant improvement following the IM intervention. This was more significant among those reporting ESKs for their two major and emotional/spiritual concerns, with pain scores improving similarly in both groups. Future research needs to explore specific and non-specific effects of IM intervention provided by IO practitioners working outside their "comfort zone", fostering collaboration between IM and mental health providers to address HCP wellbeing and resilience during a time of national crisis.

Objective: The diagnosis of a mood-related psychiatric disorder (MRPD) among patients with cancer has been associated with decreased quality of life and lower cancer survival. This study aimed to understand the risk of a new MRPD after cancer diagnosis by individual risk behaviors, with a specific focus on tobacco use and the presence of a human papillomavirus (HPV)-associated cancer.

Methods: Single-center retrospective cohort study of 11,712 patients diagnosed with cancer between 2009 and 2020. We identified predictors of a new MRPD after cancer diagnosis using a time-to-event analysis and Cox proportional hazards model including demographics, disease characteristics, and tobacco use and HPV-associated tumors.

Results: Univariate analyses revealed lower hazard ratios (HRs) of a new MRPD among individuals that identified as Asian/Pacific Islanders and among the older age groups (> 51 years). Univariate analyses additionally demonstrated higher HRs of MRPD among females; sexual minorities; former and current smokers; individuals with HPV-associated cancers; and individuals diagnosed at later stages. These relationships were observed in the multivariate model when adjusting for covariates. Shorter time-to-MRPD was observed when stratifying by individual behavioral risk factors, with active smokers and individuals with an HPV-associated cancer being at the highest risk.

Conclusions: Individual behavioral risk factors increase risk of new MRPD after being diagnosed with cancer. These findings build on past studies by linking tobacco use and HPV-associated cancers with MRPD risk in oncology and can be used to identify patients at risk of developing new MRPDs post-cancer diagnosis and engaging them in treatment.