The journal of supportive oncology最新文献

Background: There is little research on the quality of life (QOL) and spiritual well-being (SWB) of women diagnosed with ovarian cancer and their spouses.

Objective: We compared the SWB and QOL of these women and their spouses over a 3-year period.

Methods: This is a descriptive, longitudinal study involving 70 women with ovarian cancer and 26 spouses. Questionnaires were completed postoperatively and by mail 3, 7, 12, 18, 24, and 36 months later. All participants completed the Functional Assessment of Chronic Illness Therapy (FACIT)-Spiritual Well-Being-Expanded Version, Symptom Distress Scale, and open-ended questions about changes in their lives. Diagnosed women completed the FACIT-Ovarian and spouses the Caregiver Burden Interview and Linear Analog Self-Assessment scales.

Results: Women reported a high level of SWB over time. Spouses' SWB was significantly worse than the women's at 1 and 3 years (P ≤ .05). Insomnia, fatigue, and outlook/worry were problematic across time, with no significant differences between women and spouses except that women experienced more insomnia through 3 months (P = .02). Emotional well-being was compromised over time for the women but not their spouses until year 3. Physical and social well-being were compromised in spouses across time, while women's social well-being remained high and physical well-being was problematic only for the first year.

Limitations: Limitations include a small spouse sample and, due to the disease process, attrition over time.

Conclusions: Ovarian cancer has significant, but different, effects on women and spouses. Some effects are static, while others are not, which underscores the need for continual monitoring.

When a patient is diagnosed with cancer, family members often assume responsibility for providing care. They are typically involved not only with the diagnostic and treatment phases of care but also across the care trajectory and into survivorship. These caregivers are a primary source of support to individuals with cancer. The purpose of this article is to present an overview of the challenges, needs, and roles of family caregivers over the course of the cancer treatment trajectory and to discuss what support the professionals can provide. Caregivers require support, coordination, and communication with health care providers if they are to be successful in carrying out tasks of care. Concern for caregivers as partners in patient care and caregiver outcomes deserves attention from health care professionals. Considering the caregivers' value to the health care team, this role should not be underestimated.

Patients with advanced lung cancer experience a high symptom burden with great impact upon functional status and quality of life and poor long-term survival. Respiratory symptoms, like dyspnea, cough, and hemoptysis, are highly prevalent and cause profound distress at the time of diagnosis and as disease progresses. This review discusses common reversible causes of dyspnea and examines pharmacologic and nonpharmacologic approaches to symptom management of dyspnea, cough, and hemoptysis.

In the last decade, the development of imatinib, a tyrosine kinase inhibitor, has brought about unprecedented change in the way newly diagnosed, chronic-phase chronic myeloid leukemia patients are treated. Two next-generation tyrosine kinase inhibitors, nilotinib and dasatinib, were initially indicated for imatinib-resistant or imatinib-intolerant chronic myeloid leukemia patients and recently received approval from the Food and Drug Administration for treatment of newly diagnosed, chronic-phase chronic myeloid leukemia patients. In comparison with the previous standards of care, benefits with these three tyrosine kinase inhibitors have included more rapid response rates, increased survival, and fewer side effects. The improved long-term outcomes have altered the approach to management of chronic myeloid leukemia from a progressive fatal disease with a poor prognosis to a chronic condition similar to diabetes or hypertension. Prolonged survival increases the need for patient education, support, monitoring, and assistance with adverse event management. Even low-grade side effects can adversely affect patients' quality of life and, therefore, require prompt attention to prevent long-term complications or suboptimal outcomes. New evidence has indicated that patient adherence to tyrosine kinase inhibitor therapy is essential to successful treatment. Midlevel practitioners can help to optimize outcomes by educating patients regarding the importance of adherence, performing regular monitoring, helping patients to understand their test results, and aggressively managing treatment-related side effects.

Background: Increasing evidence points to the theory of planned behavior as a useful framework to understand physical activity behavior in cancer patients.

Objective: Our primary aim was to examine the demographic, medical, and social-cognitive correlates of physical activity in palliative cancer patients.

Methods: A cross-sectional survey was administered to advanced cancer patients aged 18 years or older with a clinician-estimated life expectancy of less than 12 months and Palliative Performance Scale >30%, from outpatient palliative care, oncology clinics, and palliative home care.

Results: Fifty participants were recruited. Correlates of total physical activity levels were affective attitude (r = 0.36, P = .011), self-efficacy (r = 0.36, P = .010), and intention (r = 0.30, P = .034). Participants who reported 60 minutes or more of total physical activity daily reported significantly higher affective attitude (M = 0.9, 95% confidence interval [CI] 0.26-1.6, P = .008) and self-efficacy (M = 0.8, 95% CI 0.0-1.5, P = .046). Participants <60 years of age (M = 343, 95% CI -7 to 693, P = .054) and who were normal or underweight (M = 333, 95% CI -14 to 680, P = .059) reported higher weekly minutes of total physical activity.

Limitations: Our small sample may not be representative of the total palliative cancer population.

Conclusions: Affective attitude, self-efficacy, and intention were the strongest correlates of total physical activity levels, and younger and normal/underweight participants did more physical activity.