Supportive Care in Cancer最新文献

Purpose: Onco-nephrology is an emerging subspecialty aiming to better understand and prevent renal events in cancer patients. We assessed patients' knowledge about (1) oncological/hematological treatments induced renal toxicity and (2) kidney protective measures.

Methods: Adult patients receiving systemic anti-tumor treatments in multiple day hospital units in France answered a self-administered questionnaire about their knowledge and expectations related to treatment-associated renal toxicity.

Results: In total, 621 questionnaires were collected in 8 units from November 2021 to January 2022. Among respondents, 84.5% were treated for a solid tumor. Overall, 34.3% (n = 208) patients reported they had some knowledge about potential renal adverse events related to their anticancer treatment, and 38.5% (n = 234) about kidney protection measures. Their referring oncologist or hematologist represented the commonest source of knowledge (67.8%). Sufficient hydration was cited as a kidney protection measure by 93.2% (n = 218) of patients declaring some knowledge about renal toxicity; prevention of nausea/vomiting by 52.6% (n = 123). Consumption of still and alkaline water was chosen by respectively 64.4% (n = 400) and 16.8% (n = 104) of participants to correct dehydration. A majority of patients expressed strong interest for receiving more information about renal toxicity and prevention: median Likert scale score was 10/10 (Q1-Q3, 5-10), with online resources mentioned as the most desired source of information.

Conclusion: One-third of patients declared they had some knowledge about potential renal toxicity of their oncologic treatment and the ways to prevent them, especially regarding hydration. However, a majority expressed interest for dedicated information, which conducted to the elaboration of free online educational sheets for patients.

Purpose: Scalp cooling therapy (SCT) improves chemotherapy-induced alopecia (CIA), but there are few published data about its efficacy in an Asian-predominant population. We report our tertiary institution experience of SCT in patients with breast or gynaecological cancers undergoing chemotherapy.

Methods: The Paxman scalp cooling system was employed for eligible women with breast or gynaecological cancers receiving anthracycline or taxane-based chemotherapy. Only patients with Grade (G) 0-1 alopecia by common terminology criteria for adverse events (CTCAE) version 4.0 were eligible initially, but patients with G2 alopecia were later included in the study. SCT was performed at each chemotherapy cycle, commencing 30 min prior to and continuing up to 90 min after completion of the drug infusion. Patients were assessed at the start and end of each session for hair preservation (defined as G0-2 alopecia) and comfort level of SCT (rated on a 5-point visual scale). The primary end point was success of hair preservation or hair regrowth after completion of all cycles of chemotherapy.

Results: Eighty-three patients were enrolled over a period of 18 months from December 2017 to October 2019, with a total of 510 scalp cooling cycles performed. 94.0% (n = 78) of patients reported a comfort score of 3 and above, indicating that the procedure was comfortable, upon a 5-point visual scale. Patients receiving weekly paclitaxel had highest success in hair preservation at 76.7% (23/30 patients), with a lower rate of hair preservation observed for the 3 weekly paclitaxel regimen (50%, 2/4 patients). In contrast, only 1 patient (5.3%, 1/19 patients) who underwent chemotherapy with anthracycline and cyclophosphamide achieved hair preservation.

Conclusion: SCT is well tolerated in an Asian-predominant population. Among women with breast or gynaecological cancers receiving taxane and/or anthracycline based chemotherapy, those who underwent SCT were about 50% more likely to achieve hair preservation or hair regrowth, as compared to historical controls.

Purpose: Caregivers provide vital support to people with cancer but often report feeling unsupported themselves. This study investigated rural caregivers' experiences seeking support for their health and wellbeing while caring for someone with cancer.

Methods: Through semi-structured interviews, 20 rural caregivers described their experiences seeking and accessing support for their own health and wellbeing while caring for someone with cancer, including what support was, or would have been, helpful. Interview transcripts were analysed using content analysis to identify the type and source of support sought and what aspects of the support were helpful or unhelpful.

Results: Health and wellbeing support was sought across medical and psychosocial domains. Caregivers' responses reflected both facilitators and barriers to support-seeking and benefits and challenges of accessing support. Facilitators to support-seeking included telehealth options and being involved in patient care discussions, as this helped caregivers know what to expect in their role. Barriers included social isolation while travelling for treatment and caregivers' needs for support not being acknowledged or understood by medical staff or social networks. Benefits of accessing support included help with managing daily responsibilities and being linked with additional services. Challenges included delays in receiving support, inadequate duration of support, and lack of lived experience among care providers.

Conclusions: To optimise rural caregivers' access to support for their health and wellbeing, support services should be prompt and flexible in delivery, simple to navigate, integrated with patient care, improve caregivers' coping ability, provide access to additional supports, and reduce caregiver burden.

Objective: To evaluate the quality of oral health care through indicators in patients undergoing hematopoietic stem cell transplantation for the management of oral mucositis.

Methods: Thirty-five patients were evaluated. Photobiomodulation was performed during the conditioning regimen, 1 day, 5 days, and 10 days after transplantation. Four process indicators and 13 outcome indicators were used to evaluate the effectiveness of the intervention, according to SQUIRE 2.0.

Results: All process indicators demonstrated a compliance rate of 100% to the desired standard. Outcome indicators revealed that 66.6% of patients experienced mucositis during at least one follow-up period. A statistically significant increase was observed between periods of 1 and 5 days post-transplant, as well as between 1 and 10 days post-transplant (p < 0.05), with a predominance of grade I mucositis (p = 0.014). Four patients (16.7%) reported feeling pain, occurring between 5 and 10 days after transplantation, with moderate pain being the most prevalent. Oral mucositis did not show a statistically significant association with pain, associated treatments, leukopenia, comorbidities, or type of transplant.

Conclusions: The indicators demonstrated their suitability for evaluating oral health in both the prevention and treatment of oral mucositis in these patients. Furthermore, the effectiveness of photobiomodulation in improving the quality of oral health in the patients studied was confirmed.

Purpose: Clinical guidelines recommend cancer survivors (i.e., people with a cancer diagnosis) engage in regular physical activity (PA) during and post treatment, yet most do not. Additionally, PA promotion for cancer survivors has primarily focused on post treatment, calling for an understanding of PA promotion during treatment. This study explores the PA experiences and preferences of both in-treatment and post-treatment breast and gynecologic cancer survivors (BGCS) to inform the design of a PA intervention.

Methods: Semi-structured interviews were conducted with postmenopausal women aged ≥ 50 years, diagnosed with breast or gynecological cancer (stages 1-3), who were undergoing, or recently completed (12 to 24 months) chemotherapy and/or primary treatment. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to explore themes.

Results: Participants (N = 26; M_age: 63.9 years) had a breast (92.3%) and gynecologic (7.7%) cancer diagnosis and 46.2% (n = 12) were in treatment whereas 53.8% (n = 14) were post treatment. BGCS experienced several side effects of cancer treatment and both groups felt PA was an important goal. In-treatment BGCS focused on managing side effects (e.g., fatigue) and recognized energy fluctuated around treatments, making those periods less ideal for PA. In-treatment BGCS strongly endorsed a flexible, at-home intervention. Post-treatment BGCS emphasized recovery and relapse prevention, also favoring at-home, flexible interventions but showing greater interest towards support groups to aid with their recovery journey. Preferred activities included walking, dancing, and muscle-strengthening.

Conclusion: Findings highlight the unique challenges postmenopausal BGCS face in participating in PA, especially in-treatment, emphasizing the importance of a tailored PA intervention.

Purpose: Significant disparities exist in cancer detection, treatment, and outcomes for racial/ethnic minoritized groups in the US. The objective of this study was to explore racial/ethnic disparities in healthcare utilization, cancer care experiences, and beliefs about cancer in patients diagnosed with cancer among diverse racial/ethnic groups in the US.

Methods: Data from the Health Information National Trends Survey -Surveillance, Epidemiology, and End Results (HINTS-SEER 2021) were analyzed for 1,108 cancer survivors. Bivariate analysis of the study variables with race/ethnicity were conducted with weighted analysis from STATA version 17. Sampling weights using svy was conducted.

Results: Racial/ethnic differences in healthcare utilization remained significant when controlling for the confounding factors. Asians and Hispanics were less likely to have a regular healthcare provider compared to non-Hispanic whites (NHW) (aOR = 3.31, p = .003; aOR = 2.17, p = .014; respectively). Asians were less likely than NHW to have had healthcare provider visits in the past 12 months (aOR = 4.89, p = .011). There were no statistically significant differences between racial/ethnic groups in the cancer care experiences. Racial/ethnic differences in fatalistic beliefs about cancer were not significant in the final multivariate model; however, being older (β = -.41, p = .033), and having a higher education level (β = -1.23, p < .001), were associated with lower level of fatalistic beliefs about cancer.

Conclusion: The findings suggest tailored approaches to improve healthcare utilization rates among racial/ethnic minoritized groups and highlight the need for increased research and clinical practice efforts to address racial/ethnic disparities in the cancer care continuum.

Objective: To explore the potential profiles of the sense of coherence (SOC) among cancer radiotherapy patients using latent profile analysis (LPA) and to characterize each category. Additionally, we investigated the correlation between different profiles of the SOC and the coping strategies.

Methods: Convenience sampling method was used to select 241 cancer radiotherapy patients hospitalized in a specialized hospital in Shanghai from March 2023 to October 2023 as research subjects. The study utilized a general information questionnaire, the Sense of Coherence Scale-13 (SOC-13), and the Medical Coping Modes Questionnaire (MCMQ) for the survey.

Results: LPA identified three potential profiles based on varying levels of SOC: "Low level-High meaningfulness" group (n = 38, 15.8%), "Moderate level-High manageability" group (n = 104, 43.2%), and "High level-Balanced" group (n = 99, 41%). Age (OR = 6.544, P = 0.015), residence (OR = 0.217, P = 0.004), initial recurrence (OR = 2.869, P = 0.028), and side effects (OR = 2.862, P = 0.015) were significant predictors. A lower level of the SOC was significantly associated with higher scores in acceptance-resignation (P < 0.001).

Conclusion: The SOC among cancer radiotherapy patients can be divided into three potential profiles. Younger patients with side effect have lower levels of the SOC. Adopting a acceptance-resignation coping strategies is related to a lower SOC, suggesting that enhancing the level of the SOC plays a positive role in helping patients cope with stressful events.

Purpose: Young adult Latino testicular cancer survivors experience adverse impacts after treatment. We developed Goal-focused Emotion regulation Therapy (GET) to improve distress symptoms, goal navigation skills, and emotion regulation. This open pilot trial extended GET to Latino young adult survivors of testicular cancer and assessed feasibility and tolerability as well as changes in anxiety and depressive symptoms. Secondary outcomes included goal navigation, emotion regulation, and components of hope-related goal processes (i.e., agency and pathway mapping). To assess the extent to which GET is culturally congruent or in need of adaptation, the influence of simpatía and acculturative stress were also examined.

Methods: Thirty-five eligible young adult (age 18-39) survivors treated with chemotherapy were enrolled and assessed at baseline. Study acceptability, tolerability, and therapeutic alliance were examined. Preliminary efficacy was evaluated for changes in anxiety and depressive symptoms as well as psychological processes (goal navigation, agency, goal pathway skill, and emotion regulation) from baseline to immediate post- and 3-month post-intervention.

Results: Among the 35 men assessed at baseline, 54% initiated intervention sessions. Among these, 94.7% completed all study procedures. Helpfulness ratings of intervention components and therapeutic alliance scores were strong. Repeated measures ANOVA revealed significant reductions in anxiety and depressive symptoms from pre- to post-intervention with sustained change at the 3-month follow-up. Favorable patterns of change were also observed in GET-related psychological processes. Simpatía was associated with less depressive symptoms at post-intervention, but not change in anxiety. Acculturative stress was associated with increased anxiety and depressive symptoms over time.

Conclusion: GET is a feasible and acceptable intervention for reducing adverse outcomes after testicular cancer for young adult Latino men. Results should be considered preliminary but suggest meaningful changes in emotional and psychological outcomes.

The aim of this study is to verify the correlation between hemoglobin (Hb) and hematocrit (Ht) levels with phase angle (PhA) values in patients with cancer of the gastrointestinal tract and accessory digestive organs. A cross-sectional study was conducted with 82 patients (38 females/44 males) diagnosed with cancer of gastrointestinal tract and accessory organs of digestion. Hb (g/dL) and Ht (%) levels were assessed by the cyanomethemoglobin and microhematocrit methods, respectively. Body composition and PhA were evaluated by the bioelectrical impedance analysis (BIA). The cut-off point used to classify patients with low PhA was set < 4°. Fifty-five (67%) of patients had PhA ≥ 4° values. We observed that body weight, BMI, fat mass, % weight loss, Ht, and Hb were higher in the PhA ≥ 4° group than in the PhA < 4° group. In the regression analysis, we found a positive association between PhA, Ht, and Hb without and after adjustment for sex, age, BMI, and type of treatment. In mixed cancer patients, there was a positive correlation between blood-red cell markers and PhA. This may be evidence that we can use of hematological parameters to suggest changes in PhA values during oncological treatment.