Supportive Care in Cancer最新文献

Background: Persistent anxiety and depression can adversely affect the long-term quality of life in patients undergoing thyroid cancer surgery. However, the trajectories, influencing factors, and effects of coping styles on these psychological states are not well understood. This study aims to identify the trajectories and latent classes of anxiety and depression among thyroid cancer surgery patients and to explore the impact of demographic, clinical factors, and coping styles, focusing on the predictive role of coping.

Methods: A longitudinal study was conducted from November 2022 to January 2024 at two hospitals in Suzhou. Data were collected at four time points: preoperative (T₀), 1 month (T₁), 3 months (T₂), and 6 months (T₃) post-surgery using a demographic questionnaire, the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI). Repeated measures ANOVA described overall trends, Growth Mixture Model identified latent classes, and logistic regression assessed the predictive effect of coping styles.

Results: A total of 139 patients completed all follow-ups. Anxiety and depression levels significantly varied over time (P < 0.001). Anxiety decreased then increased, with the lowest score at T₂ (3.01 ± 3.84), while depression steadily decreased, reaching its lowest at T₃ (4.71 ± 6.38). Two latent classes were found for both anxiety and depression, with the majority in the remission groups (80.58% for anxiety; 89.93% for depression). High preoperative depression scores, postoperative superior laryngeal nerve injury, and negative coping were linked to exacerbation of anxiety, whereas negative coping was associated with exacerbation of depression. After adjusting, negative coping significantly predicted both anxiety (OR = 4.51, 95% CI: 1.51-13.26, P = 0.006) and depression exacerbation (OR = 8.91, 95% CI: 2.71-29.29, P < 0.001).

Conclusion: Thyroid cancer surgery patients exhibit diverse anxiety and depression trajectories. Patients with high preoperative depression scores, postoperative superior laryngeal nerve injury, or negative coping styles need extra attention. Notably, negative coping significantly predicts worsening anxiety and depression.

Background & aims: Post-treatment anxiety and depression are prevalent but often underrecognized among bladder cancer patients. This systematic review and meta-analysis aimed to estimate the pooled prevalence of these symptoms and to evaluate the effectiveness of intensive nursing interventions.

Methods: A comprehensive search of PubMed, EMBASE, the Cochrane Library, and Web of Science was conducted through October 18, 2025. Eligible studies included those reporting the prevalence or severity of anxiety and/or depression in bladder cancer patients, as well as studies comparing intensive nursing interventions with routine care. Data were synthesized using Stata/MP version 14.0. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the I² statistic, and subgroup analyses were performed to explore potential sources of variability.

Results: Sixteen studies involving 1,791 patients were included. The pooled prevalence of anxiety was 25.3% (95% CI: 22.2-28.6%) and that of depression was 29.4% (95% CI: 23.3-35.9%). Higher prevalence rates were observed in non-Western populations and among patients receiving multimodal treatment. Compared with routine care, intensive nursing interventions were associated with significant reductions in anxiety (SMD = -4.52; 95% CI: -6.07 to -2.96) and depression (SMD = -4.51; 95% CI: -5.96 to -3.07) (both P < 0.001). These findings remained robust in sensitivity analyses despite substantial heterogeneity.

Conclusion: Anxiety and depression are common among bladder cancer survivors. Intensive nursing interventions are associated with meaningful improvements in psychological outcomes and may be considered for integration into post-treatment supportive care.

Trial registration: PROSPERO registration number: CRD42024590858.

Purpose: Taste dysfunction is a common but underrecognized complication in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). Taste dysfunction can adversely affect oral intake, nutritional status, and overall quality of life. This study aimed to comprehensively evaluate taste function in allo-HCT recipients using both objective and subjective measures and to identify clinical factors associated with taste disturbances.

Methods: We conducted a prospective observational study of 21 adult allo-HCT recipients. Taste function was assessed at two time points (pre-conditioning and pre-discharge) using the whole-mouth taste testing method for the five basic tastes and the Chemotherapy-induced Taste Alteration Scale (CiTAS). All 21 patients completed the CiTAS, and 19 patients underwent whole-mouth taste testing.

Results: Most patients exhibited objective taste dysfunction before transplantation, particularly for sweet, salty, sour, and bitter taste qualities. The objective taste thresholds remained stable post-transplantation, but the subjective CiTAS scores worsened for basic taste, general alterations, and discomfort. There was a trend (p = 0.057) for objective umami taste to be better preserved in patients with gastrointestinal graft-versus-host disease (GI-GVHD). Oral mucositis was associated with higher phantogeusia/parageusia scores, while high malnutrition risk or weight loss correlated with lower subjective symptom scores.

Conclusion: The discrepancy between subjective and objective assessments of taste dysfunction highlights that taste perception is regulated by multifactorial and complex mechanisms. Intensive supportive care, which is often provided to severely ill patients, may offer psychological reassurance that indirectly improves self-reported taste symptoms. Whether umami sensitivity is influenced by systemic factors such as GI-GVHD requires further study.

Objective: To evaluate the short-term (16 weeks post-intervention) and long-term effects (six- and 12-month follow-up) of two physical exercise interventions-Mat Pilates or belly dance-compared with a control group on lymphedema, range of motion, isometric strength, proprioception, and upper-limb symmetry in women who have undergone unilateral breast cancer surgery and are receiving hormone therapy.

Methods: Sixty-nine women who underwent unilateral breast cancer surgery were randomized into three groups: Mat Pilates, belly dance, and control. The Mat Pilates and belly dance groups participated in supervised exercise sessions three times per week, lasting 60 min each, for 16 weeks. The control group continued their usual daily activities and attended three educational lectures. The outcomes assessed included upper-limb functionality (DASH), lymphedema (arm volume), range of motion (digital goniometer), isometric strength (dynamometer), and limb symmetry (difference between the contralateral and homolateral limbs).

Results: In the Mat Pilates group, post-intervention effects were observed in increased range of motion (p = 0.026), improved isometric strength (p = 0.001), and enhanced strength symmetry between limbs (p = 0.034). In the belly dance group, post-intervention improvements were identified in upper-limb functionality (p = 0.001), lymphedema (p = 0.017), isometric strength (p = 0.001), and symmetry of both range of motion (p = 0.041) and strength between limbs (p = 0.009). However, none of these gains were sustained at follow-up assessments. No significant intragroup changes were observed in the control group.

Conclusion: Mat Pilates and belly dance were effective in improving upper-limb functionality, range of motion, lymphedema, isometric strength, and limb symmetry in breast cancer women undergoing hormone therapy. Both forms of physical exercise may be recommended by professionals involved in oncological rehabilitation.

Registry: ClinicalTrials.gov (NCT03194997) Registration June 20, 2017.

Objective: Ovarian function suppression (OFS) treatment causes a sudden drop in patients' estrogen to postmenopausal levels, accompanied by associated side effects that are often abrupt and intense. This study aimed to provide an evidence base for clinical practice by systematically searching for the best current evidence on managing symptom burden in OFS-treated breast cancer patients.

Method: We systematically searched relevant evidence from the creation date to 21 November 2023 in computerized decision systems, guideline networks, professional society networks, and databases. The literature type included guidelines, expert consensus, systematic review, meta-analysis, recommended practice, best practice, clinical decision-making, and evidence summary. After three researchers independently screened and evaluated the literature, two researchers integrated the evidence and checked it by a third person.

Results: A total of 15 articles were selected, including six guidelines and nine expert consensus articles, and the overall literature quality was high. Thirty-eight pieces of evidence were summarized into eight areas: supportive elements of symptom burden management, health education, regular assessment and monitoring, diet and nutrition, exercise training, lifestyle, prevention and control of comorbidities, and complementary and alternative therapies.

Conclusion: This study summarizes the best evidence on non-pharmacological interventions for symptom burden management in OFS-treated breast cancer patients, guiding clinical practice. As non-pharmacological interventions for symptom burden management in OFS-treated breast cancer patients are still in their infancy, the best evidence for OFS-treated breast cancer patients should be selected for clinical application in the future in a site-specific and individualized manner, and the best evidence should be continuously updated.

Purpose: Social determinants of health (SDOH) are associated with disparities not only in risk factors, screening, diagnosis, and treatment outcomes for cancer but also in access to immunotherapy treatment, particularly with immune checkpoint inhibitors (ICIs). The purpose of this systematic review was to describe the extent of inclusion of indicators of SDOH in studies using PROMs to assess toxicities associated with ICI treatment.

Methods: PubMed, EMBASE, MEDLINE, PsycINFO, CINAHL, Web of Knowledge, and the Cochrane Library were searched for papers using patient-reported outcomes measures (PROMs) to assess toxicities in ICI treatment until October 2024.

Results: A total of 43 studies were included after applying the inclusion criteria, with the majority being RCTs (n = 20). SDOH features were extracted using the PROGRESS-Plus framework. The most frequently reported PROGRESS-Plus factors were residence (100%; 43/43), age (100%; 43/43), and gender (97.7%; 42/43). Race/ethnicity was included in 16 studies (37.2%) and education in 11 (25.6%). Very few studies reported socioeconomic status (11.6%; 5/43), social capital (9.3%; 4/43), and occupation (9.3%; 4/43). None of the studies included information on religion, disability, and sexual orientation.

Conclusion: Collection and consideration of SDOH in studies using PROMs to assess toxicities in ICI treatment in cancer care are limited. Reported SDOH are not sufficient as they overlook important characteristics such as religion, disability, and sexual orientation. Improved accuracy and details are essential in understanding the needs of various populations. Availability of these data will facilitate understanding of health inequalities and prompt action to address avoidable disparities in health, improving outcomes for all.

Purpose: Cancer-related cognitive impairment (CRCI) can impact cancer survivors' return to work and occupational functioning for many years following the completion of cancer treatment. Understanding the characteristics of CRCI-related occupational difficulties and unmet supportive care needs is critical for the development of effective interventions. Within occupational roles, a higher level of education is typically associated with greater cognitive load and different demands. The objective of this study was to examine whether the level of education accounted for CRCI-related (a) occupational difficulties and (b) occupational unmet supportive care needs, beyond the contributions of perceived cognitive functioning and employment level.

Methods: A cross-sectional design was utilised using a sub-section of an existing self-reported dataset involving 358 employed cancer survivors, comprising demographic and clinical data, as well as data from MASCC COG-IMPACT and PROMIS Cog tools. Hierarchical multiple linear regression models were used for hypothesis testing.

Results: After accounting for perceived cognitive functioning and employment level, highest level of education did not account for a significant amount of unique variance in CRCI-related occupational difficulties (R² Change = 0.004, F Change _{(1, 354)} = 3.26, p = .147). However, after accounting for perceived cognitive functioning and employment level, highest level of education did account for a significant amount of unique variance in CRCI-related occupational unmet needs (R² Change = 0.011, F Change _{(1, 354)} = 4.75, p = .030).

Conclusion: Theoretical explanations of findings, including compensatory accommodations such as role adjustment and differences in the availability of occupational support, are provided. It is proposed that those with higher levels of education may not have access to appropriate levels of supportive care as it relates to CRCI in occupational settings, thus potentially informing future interventions. It is proposed that individuals with higher levels of education may experience gaps in supportive care for CRCI, particularly in relation to maintaining work performance and meeting occupational expectations. This suggests that future interventions should consider strategies to better support cognitive functioning in workplace contexts for cancer survivors.

Purpose: A conceptualisation of subjective financial distress as a consequence of a cancer diagnosis and treatment is still missing due to a lack of a comprehensive model accounting for all relevant dimensions of financial effects of cancer experienced by patients. Our goal was to derive a model for the German healthcare system to shed light on the complex process of financial effects of cancer.

Methods: The model was developed through systematic literature review and qualitative studies, including interviews with 18 cancer patients and a focus group with 4 social services representatives. The iterative process of model development was accompanied by an ongoing exchange in the interdisciplinary research team.

Results: The developed model of financial effects of cancer experienced by patients consists of three dimensions: (1) actual and anticipated financial disadvantages, (2) behavioural and cognitive coping strategies, and (3) subjective financial distress conceptualised as negative effects in different aspects of daily living: employment, living situation, family, social participation, health promoting lifestyle, additional personally preferred treatments, navigating the health system, and a further area so-called unspecific.

Conclusion: Subjective financial distress is driven by different financial effects of cancer experienced by patients and is perceived as negative in various aspects of daily living. While the identified categories of daily living can be observed in countries with universal healthcare coverage, the content and degree of each subcategory depend on country-specific characteristics. The introduced model can be used to inform the development of a new patient-reported outcome measure (PROM).

Trial registration number: NCT05319925 (registration date, 2022-06-01).

Purpose: Hematopoietic stem cell transplantation (HSCT) is a physically and psychosocially complex process for patients and their families, and nurses play a key role in coordinating patient care. This study aimed to explore nurses' perspectives on caregiver engagement in the care of patients undergoing hematopoietic stem cell transplantation.

Methods: A qualitative descriptive design with purposive sampling was used. Data were collected through semi-structured interviews with eleven nurses working in a bone marrow transplantation unit in Ankara. The data were analyzed using thematic analysis.

Results: Five main themes and ten sub-themes were identified. The main themes were 1) Nurses' expectations and caregiver involvement, 2) Impact of caregiver's engagement, 3) Caregiver strain and challenges, 4) Support needs of caregivers, and 5) Nurses' role in supporting caregivers.

Conclusions: Nurses perceived that caregiver engagement positively improves patient outcomes but also noted that this placed a significant burden on caregivers. Nurses play a pivotal role in addressing the challenges and supporting caregivers through emotional support, education, and advocacy. Targeted interventions, such as education, psychological support, and enhanced communication, are crucial for supporting caregivers effectively and improving the well-being of both caregivers and patients.

Purpose: Patient navigation programs have demonstrated intervention efficacy associated with barrier reduction and health outcome improvements in the context of cancer care. Greater characterization of barriers and barrier resolution likelihoods may support program optimization.

Methods: A 3-month longitudinal, non-comparative community-focused (i.e., lay navigator) patient navigation program was implemented at an NCI-designed cancer center between 2018 and 2021. Barriers to cancer care were reported by patients (n = 207) at pre-intervention and re-assessed at post-intervention. Descriptive analyses examined patient-level associations among pre-intervention barriers and post-intervention rates of barrier resolution. Logistic regressions were conducted at the barrier level and patient level to estimate the likelihood of barrier resolution associated with Health Access, Financial, and Psychosocial barrier domains.

Results: Participants reported an average of 3.54 distinct barriers to cancer care. Barriers associated with Health Access and Financial domains were most frequently endorsed. Post-navigation, barriers were found to differ in their resolution rates. At the barrier domain level, resolution rates differed significantly (X²(2) = 7.826, p = 0.02), with Financial barriers significantly less likely (OR = 0.61; 95% CI = 0.41, 0.89) to be resolved. For participants who reported barriers exclusively within the Financial domain, the odds of any of their barriers being "resolved" were approximately 77% lower compared to participants who reported barriers in other domains.

Conclusion: In this community-focused patient navigation program, barriers in the Financial domain proved to be the most difficult to resolve. The amenability of specific barriers to resolution via patient navigation can guide program tailoring and optimization.